ACC 346 METROPOLITAN BOROUGH OF FULHAM REPORT of the MEDICAL OFFICER OF HEALTH Including the Report of the Public Analyst for the year 1953 * M. I. ADAMS B.Sc., M.B., B.Ch., D.P.H. Medical Officer of Health CONTENTS Subject Page No: Public Health Committee and Staff of Department 1-3 Introduction 4-6 Vital Statistics and Infectious Disease 7-17 Report of Chest Clinic and Tuberculosis 18-19 Mass X-Ray Visit 20 Hospitals in the Borough 21 Old People's Welfare 22-24 Public Conveniences 25-26 L.C.C. Personal Health Services 27-29 Health Education 30-31 New Legislation 31-32 Sanitary Circumstances of the Area 33-39 Atmospheric Pollution and Factories Act 40-43 Rag Flock 44 Pharmacy & Poisons 45 Food Inspection 46-63 Report of Public Analyst 64-74 Detailed Index at end of Report. The Problem of Atmospheric Pollution An untouched aerial view of the bend in the River Thames which forms Fulham's southern boundary. Atmospheric pollution caused through the heavy industries situated on the riverside is clearly illustrated. The photograph is reproduced by courtesy of Aero Films, Ltd. ATMOSPHERIC POLLUTION SANDS END WARD Atmospheric Pollution Measurement Station The Deposit gauge assembly in the foreground is used for collecting samples of all the chief impurities in the air. The Lead Peroxide measuring apparatus on the left is used for measuring the amount of sulphur dioxide in the atmosphere. (1) MEMBERS OF THE PUBLIC HEALTH COMMITTEE (as at December, 1953) Ex-officio: Councillor William George Wallis, J.P., (Mayor) Chairman: Councillor John William Perotti Vice-Chairman: Councillor Percy Edward Fenne Councillors Miss Phyllis May Cooper Thomas Michael Cox, J.P. Mrs. Elizabeth Lydia Desborough Thomas Henry Wilfred Edwards Mrs. Marjorie Annie Gale Mrs. Rosemary Longstaff Mrs. Laura May Mills Herbert Henry Poulter Walter Rankin Henry James Rickards (2) STAFF OF THE PUBLIC HEALTH DEPARTMENT (December, 1953) Medical Officer of Health - Mary I. Adams, B.Sc., M.B., B.Ch., D.P.H. Deputy Medical Officer of Health - Caroline A, Meade, M.B., B.S. (Lond.), D.P.H. Public Analyst - Thomas McLachlan, A.C.G.F.C., F.R.I.C. Administrative and Clerical Section. Chief Clerk - J.E. Burton, D.F.M. Second Clerk - J.W. Chance, A.I. Hsg., Dip. R.I.P.H.H. Administrative Clerk - B.C. Bolton. Clerk - S.T. Ansell. Clerk - R.A. Green Clerk-Typist - Miss R. Reed Shorthand-Typist - Mrs. C.M. Phillips. Clerk - Miss P. Dopson. Clerk - Mr. J.R. McWhinnie. Secretary to M.O.H. - Miss R.P. Begg. Clerk-Typist - Vacant. Sanitary Inspectors' Section. Chief Sanitary Inspector - G.W. Herrick, D.P.A. (1) (2) Deputy to Chief Sanitary Inspector and Officer-in-charge Rodent Repression Service. - F.E. Walsh (1) (2) Senior Sanitary Inspector and Sampling Officer. - A,W. Gammack (1) (2) Factories and Smoke Abatement Officer - F.C. Payne (1) (2) (3) (4) Lady Sanitary Inspector - Miss E.H. Sexton, S.R.N., S.C.M., H.V. (1) District Sanitary Inspector - H. Hutchinson (1) (2) District Sanitary Inspector - C.J. Price (1) (2) District Sanitary Inspector - I. Jones (1) District Sanitary Inspector - W.G. Thurgood (1) (3) District Sanitary Inspector - A.H, Newport (1) (2) District Sanitary Inspector - G. Bailey (1) (2) District Sanitary Inspector - D. Brisk (1) District Sanitary Inspector - K.H. Popham (1) District Sanitary Inspector - R. Moore (1) District Sanitary Inspector - J. Healy (1) District Sanitary Inspector - F. Williams (1) (2) (1) Certificate Royal Sanitary Institute and Sanitary Inspectors' Examination Joint Board. (2) Meat & Other Foods Certificate, Royal Sanitary Institute. (3) Diploma of the Royal Institute of Public Health & Hygiene. (4) Smoke Certificate, Royal Sanitary Institute. (3) DISINFECTING STATION Superintendent: J.H. Hughes. Three Disinfectors: One Motor Driver: One Disinfector/ Motor Driver. W.H. Parsons. R.J. Osmond. A. Lamb. L. Howes. A. Wright. RODENT CONTROL One Foreman Operative: Three Operatives: R. Hawkins. K.L. Skinner. A.W. Hutchins. V.E.S. Wills. PUBLIC CONVENIENCES Fifteen Male Attendants: Fifteen Female Attendants: S. Brazil. R.W. Chapman. W. Covey. W.C. Cook. F.W. Davis. F.W. Hawkins. W.A. Howard. A.R. Light. S.G. Marshall. H.B. Mills. A.J. Munday. J.J.M. Ross. K.G. Tamblyn. F.J. Taylor. W.J. Wade. Mrs. D.E. Collis Mrs. K. Cook. Mrs. A. Brophy. Mrs. E. Crowle. Mrs. M. Cude. Mrs. E. Edwards. Mrs. F. Francis. Mrs. N. Johnson. Mrs. A. Larking. Miss V.M. Lewington. Mrs. F. May. Miss E. O'Hara. Mrs. E.A. Schabbon. Mrs. F.E.A. Spencer. Mrs. A.S. Thomas. MORTUARY KEEPER G. Churchill. (4) METROPOLITAN BOROUGH OF FULHAM Public Health Department, Town Hall, FULHAM, S .W. 6 To the Mayor, Aldermen and Councillors of the METROPOLITAN BOROUGH OF FULHAM. Your Worship, Ladies and Gentlemen, I have the honour to present my Annual Report on the health of the Borough of Fulham for the year 1953. The report follows again the form indicated by the Minister of Health. I am pleased to include the report of your Public Analyst, Mr. T. McLachlan, A.C.G.F.C., F.R.I.C., and also that of Dr. H.C. Price, Chest Physician, Fulham, on the work on tubercular disease carried out at the Fulham Chest Clinic. The mid-year population of the Borough estimated by the RegistrarGeneral, is given as 122,500 showing a slight decrease compared with 122,800 in 1952, but still slightly above the figure for 1951 (122,400). The Birth Rate for the year (13.65) is very little lower than for 1952, viz: 13.99; the Still Birth Rate 0.22 shows a desirable decline compared with 1952, viz: 0.33. The Infantile Mortality Rate 27.5 is an increase on the 1952 figure of 25.6. The Death Rate which includes deaths from all forms of tubercular disease continues the decline commenced in 1951. The total number of deaths which occurred in Fulham during the year was 1,411. I regret to report one maternal death in 1953, as in the previous year, giving a Maternal Mortality Rate of .58 per 1,000 births. The statistical records for the year indicate that the health of the people in Fulham continues its good record and maintains a satisfactory standard. Notifiable infectious diseases show an increase compared with the low figure recorded in 1952. Measles and whooping cough with their periodic incidence account almost entirely for this rise. Fulham's infectious diseases figures, per 1,000 of the population, compare favourably with those of London and the country as a whole. A welcome reduction occurred in the number of poliomyelitis notifications and in all forms of tubercular disease. (5) Interesting reports by Dr. Meade, Deputy Medical Officer, are included on an outbreak of Epidemic Vomiting-a comparatively new disease -and also on an outbreak of Sonne Dysentery in a private day nursery. There were no cases of small pox, typhoid fever or paratyphoid during the year. No case of diphtheria has occurred in Fulham since 1949. Hurlingham House, the former British Red Cross Convalescent Home has been opened during the year by the London County Council as a hostel for men with tubercular disease who are infected on discharge from hospital, ambulant tuberculous patients not requiring nursing, or are homeless. There is accommodation at present for 27 men who may be admitted from anywhere in the County of London. During the year the Sanitary Inspectorate has been regraded and reorganised, This followed on decisions made by the National Joint Council. Districts were made smaller and increased in number incorporating food inspection in each district. There is an acute shortage of Sanitary Inspectors and Fulham, in common with many Metropolitan and other Boroughs, has not been able to maintain its establishment. Recommendations to remedy this shortage are made in the Government's Working Party Report on the Recruitment, Training and Qualifications of Sanitary Inspectors. The high standard of food hygiene in food handlers and premises used for storage, preparation, cooking and serving of food has been maintained. The year has seen a considerable increase in the number of kitchens and preparation rooms redecorated. Other improvements include new shop fronts, fitted counter cases for food, and an increase in the number of counter and other refrigerators. The difficulties of maintaining reasonable standards of fitness in existing housing accommodation are still with us. To these have been added problems which arise from owners of short lease properties which may first be owned by bankrupt owners, and subsequently may be taken over by firms with equal disregard for the discharge of their obligations to their tenants. The resumption of Slum Clearance has continued. The London County Council represented and secured the Minister of Housing's approval of clearance proposals affecting Aintree Street and Welford Terrace. The work amongst the old people continues to increase. A wellinformed public opinion at all levels on the needs of the elderly and continued co-operation regarding services and facilities available to them, ensures that the fullest use is made of these services. (6) The laundry service for the bed-ridden (soiled garments and bedding) continues to serve a useful purpose. Dr. Wyman and the staff of the Fulham Hospital co-operate most helpfully and actively regarding admission of the aged sick, and patients are admitted as soon as possihle. Owing, however, to the small number of beds available and the usual long occupancy of each bed, there is a waiting list. As this report goes to press I regret to record the death of Mr. C.J. Price, a Sanitary Inspector with this Council for twenty-one years, a loyal and faithful officer of the Council who did valuable work with the Civil Defence Section during the 1939-1945 war. May I again express my indebtedness to the members of the Council for their continued help and consideration and especially to the past and present Chairman of the Public Health Committee and the past and present Chairman of the Staff Committee for the sympathetic and understanding manner in which they have always considered the special problems relating to the work of the Public Health Department. Cordial thanks are due to all my Chief Officer colleagues and the members of their departments for their kindly help, and also to the staff of the Public Health Department for the consistently loyal way each member has carried out the work which has made this report possible. I have the honour to be, Your Worship, Ladies and Gentlemen, Your obedient Servant, (7) EXTRACTS FROM VITAL STATISTICS FOR THE YEAR 1953. POPULATION (estimated) 122,500 AREA of Borough 1,706 acres SEPARATE DWELLINGS (estimated at 31.12.53) 32,995 A Penny Rate produces approx: £4,800 p.a. 936 Marriages were registered during the year. LIVE BIRTHS: Rate per 1,000 Population. Total Males Females 1952 1953 Legitimate 1,566 791 775 13.07 12,78 Illegitimate 107 66 41 0.92 0,87 Totals 1,673 857 816 13,99 13,65 STILLBIRTHS: Legitimate 23 13 10 0.26 0,19 Illegitimate 4 2 2 0.04 0,03 Totals 27 15 12 0.3 0.22 DEATHS: 1,411 751 660 11.9 11.5 Death Rate of Infants under one year of age: 1952 1953 All infants per 1,000 live births 25.6 27.5 Legitimate Infants per 1,000 legitimate births 25.5 26,2 Illegitimate Infants per 1,000 illegitimate births 26.5 46.7 CLASSIFICATION OF CAUSES OF DEATH 1411 Deaths as follows:- Tuberculosis Respiratory Under 1 Age Groups Over 45 Total 1-5 5 - 45 - — 5 18 23 Tuberculosis, other - - 1 - 1 Syphilitic Disease - - 1 9 10 Diphtheria - - - - - Whooping Cough 2 - - - 2 Meningococcal Infections - 1 - 1 2 Acute Poliomyelitis - - - - - Measles - — 1 - 1 Other infective and parasitic diseases - - 1 1 2 Cancer - 1 16 237 254 Diabetes - — — 12 12 Vascular lesions of nervous system - — 3 162 165 Coronary disease, angina - - 1 154 155 Hypertension with heart disease - - - 38 38 Other heart disease - - 4 162 166 Other circulatory disease - - - 59 59 Influenza 1 - 1 14 16 Pneumonia 4 - 1 104 109 Bronchitis 1 - 1 143 145 Other diseases of respiratory system - - 2 9 11 Ulcer of stomach and duodenum — — 2 25 27 Gastritis, enteritis, diarrhœa — - — 2 2 Nephritis and nephrosis - - 2 13 15 Hyperplasia of prostate - - - 10 10 Pregnancy, childbirth, abortion - - 1 - 1 Congenital malformations 5 1 2 2 10 Other defined aixl ill-defined diseases 30 1 10 82 123 Motor vehicle accidents — — 1 2 3 All other accidents 1 1 6 18 26 Suicide — - 5 16 21 Homicide and operations of war 2 — — — 2 46 5 67 1,293 1,411 (8) (9) INFANT DEATHS: There were 46 deaths of infants under the age of one year. A large number of deaths in the first month being, as is usual, due to prematurity, immaturity and congenital malformation. Cause of Death 1952. 1953. Whooping Cough — 2 Pneumonia 4 4 Gastritis, enteritis and diarrhoea 2 — Prematurity 18 13 Asphyxia 1 4 Atelectasis 1 5 Congenital malformations 6 5 Bronchitis — 1 Influenza — 1 Malnutrition — 1 All other causes 12 10 The Infant Mortality rate was 27.5 per 1,000 live births (25.6 in 1952). There was 1 maternal death giving a rate of .58 per 1,000 births (live and still) (.57 in 1952). (10) (11) TABLE OF NOTIFIABLE DISEASES Disease Authority for Notification Acute Encephalitis. Public Health Act, 1936, (Sec, 143). Regulation (No. 2259) made by the Minister of Health, 1949. (1.1.50). Acute Influenzal Pneumonia. Public Health Act, 1936. (Sec. 143). Regulation (No. 229) made by the Minister of Health, 1953. (1.4.53). Acute Primary Pneumonia . do. do. do. Acute Poliomyelitis Public Health Act, 1936. (Sec. 143). Regulation (No. 2259) made by the Minister of Health, 1949. (l.1.50). Anthrax, L.C.C. Order, 1909, Public Health (London) Act, 1936. (Secs. 192 and 305). Cholera. Public Health (London) Act, 1936. (Secs. 192 and 304). Continued Fever. do. do. do. Diphtheria. do. do. do. Dysentery. Public Health Act, 1936. (Sec. 143). Regulation (No. 229) made by the Minister of Health, 1953 (1.4.53). Epidemic Diarrhoea (under 5 years of age). Fulham Borough Council Order, 1919. Public Health (London) Act, 1936. (Secs. 192 and 305). Erysipelas. Public Health (London) Act, 1936. (Secs. 192 and 304). Food Poisoning. Food and Drugs Act, 1938. (Sec. 17). Glanders. L.C.C. Order, 1909. Public Health (London) Act, 1936. (Secs. 192 and 305). Hydrophobia in Man. L.C.C. Order, 1909. Public Health (London) Act, 1936. (Secs. 192 and 305). Leprosy. Public Health Act, 1936. (Sec. 143). Regulation (No .1036) made by the Minister of Health, 1951. (22.6.51). (Notification direct to Ministry of Health). (12) Disease Authority for Notification Malaria Public Health Act, 1936. (Sec. 143). Regulation (No. 229) made by the Minister of Health, 1953. (1.4.53). Measles. Public Health Act, 1936. (Sec. 143). Regulations made by the Minister of Health, 1938 to 1948. Membranous Croup. Public Health (London) Act, 1936. (Secs. 192 and 304). Meningococcal Infection. Public Health Act, 1936. (Sec. 143). Regulation (No. 2259) made by the Minister of Health, 1949. (1.1.50). Ophthalmia Neonatorum. L.C.C. Order, 1910. Public Health (London) Act, 1936. (Secs. 192 and 305). Regulations made by the Minister of Health 1926 to 1937. Plague. Public Health Act, 1936. (Sec. 143). Regulations of Local Government Board, 1900. Puerperal Pyrexia. Public Health Act, 1936. (Sec. 143). Regulation (No. 1081) made by the Minister of Health, 1951. (1.8.51). Relapsing Fever, Public Health (London) Act, 1936. (Secs. 192 and 304). Scabies. Public Health Act, 1936. (Sec. 143). County of London (Scabies) Regulations, 1943. Scarlatina or Scarlet Fever. Public Health (London) Act, 1936. (Secs. 192 and 304). Small-pox. Public Health (London) Act, 1936. (Secs. 192 and 304). Tuberculosis. Public Health Act, 1936. (Sec. 143). Regulation (No. 704) made by the Minister of Health, 1952 (1.5.52). Typhoid and Paratyphoid Fevers. Public Health Act, 1936. (Sec. 143). Regulation (No. 229) made by the Minister of Health, 1953. (1.4.53). Typhus Fever. Public Health (London) Act, 1936. (Secs. 192 and 304). Whooping Cough. Public Health Act, 1936. (Sec. 143). Regulations made by the Minister of Health, 1938 to 1948. NOTIFIABLE INFECTIOUS DISEASES The following table shows the number of cases of infectious disease notified during 1953 (corrected figures) with the comparative figires for the last five years. Infectious Disease 1949 1950 1951 1952 1953 Diphtheria 6 — — — — Scarlet Fever 327 126 77 134 70 Measles 1099 527 1948 720 908 Whooping Cough 192 428 450 50 531 Paralytic ) 32 6 4 12 7 Acute Poliomyelitis -Non-Paralytic) 4 5 2 2 2 Acute Encephalitis - - 1 - 2 Acute Pneumonia 32 32 70 26 45 Dysentery 10 10 71 32 48 Typhoid Fever 10 - 1 1 - Paratyphoid Fever - - 8 1 - Meningococcal Infection 4 3 7 2 3 Erysipelas 20 12 17 7 9 Puerperal Pyrexia 14 10 9 40 23 Ophthalmia Neonatorum 6 4 1 1 18 Epidemic Diarrhœa 45 12 12 12 17 Scabies 28 20 17 7 15 Malaria — — — 1 3 Food Poisoning 11 6 2 8 26 Pulmonary Tuberculosis 245 209 172 191 161 Non-pulmonary Tuberculosis 23 19 24 30 11 2108 1429 2893 1277 1899 (13) (14) The following are some of the infectious disease rates for Fulham as compared with London and England & Wales: Notifications Rates per 1,000 Population Fulham London England & Wales Scarlet Fever 0.57 1.02 1.39 Diphtheria — 0.00 0.01 Meningococcal Infection 0.02 0.03 0.03 Whooping Cough 4.33 3.30 3.58 Measles 7.41 8.09 12.36 Pneumonia 0.36 0.73 0.84 Acute Poliomyelitis: Paralytic 0.05 0.07 0.07 Non-paralytic 0.01 0.03 0.04 Food Poisoning 0.21 0.38 0.24 Puerperal Pyrexia Rates per 1,000 Total Live & Still Births Fulham London England & Wales 13.53 28.61 18.23 PREVALENCE OF AND CONTROL OVER INFECTIOUS AND OTHER DISEASES. Smallpox: There were 10 contacts of smallpox or persons from smallpox areas abroad requiring observations during the year. Poliomyelitis: 25 suspect cases were admitted to hospital for observation during the year. Of these 7 cases were confirmed as suffering from paralytic poliomyelitis and 2 cases confirmed as suffering from non-paralytic poliomyelitis. Of the total number of cases, 1 occurred in a child under 5 years, 6 occurred in children of school age and the remaining 2 cases were adult. Food Poisoning: There was one outbreak of food poisoning concerning 12 Fulham residents. This outbreak occurred in Hammersmith. 14 other isolated cases were notified. There is no doubt that a considerable amount of food poisoning exists which is not notified as those suffering from it do not consult their doctor unless they are seriously ill. It is then usually impossible to obtain and investigate suspected articles of food. Scabies and allied conditions: Treatment was arranged for 23 adults and 5 children at the Kensington Medicinal Baths. Dysentery: There were 60 cases of dysentery notified during the year, but in 12 instances diagnosis was not confirmed. Of the confirmed cases 35 notifications were in respect of Sonne dysentery. (15) (16) FOOD-BORNE SONNE DYSENTERY An interesting outbreak of food-borne Sonne dysentery occurred at the end of the year. A child attending a private nursery was notified as a case of suspected food poisoning and it was found, on investigation, that 10 other cases had occurred at the nursery within the same two days. All the children affected partook of dinners which were partly prepared by a neighbouring cafe but only children who eat meat were ill. Investigation showed that prior to the outbreak an infant at the cafe had been suffering from diarrhoea, which was subsequently proved to be Sonne dysentery, and both parents were found to be carrying the organism. All the 11 affected nursery children were proved to have the same organism. The nursery staff were free from infection, as were three "non meat-eaters" and a number of part-time children who did not eat dinners. Fortunately none of the affected children was seriously ill and, owing to excellent co-operation by all concerned, few secondary cases occurred. As soon as the nature of the infection was established, the nursery was closed pending satisfactory clearance certificates for a sufficient numher of children to warrant its re-opening. The outbreak is instructive as showing how easily dysentery infection can be transported, since the parents of the infant at the cafe, although using the kitchen, were not directly concerned in the preparation of the nursery children's meals. EPIDEMIC WINTER VOMITING. Considerable attention has been drawn lately to outbreaks of epidemic vomiting and an investigation was carried out in a school in mid-September, 1953, at the invitation of the Divisional Medical Officer, London County Council. The school concerned was temporarily housed in one wing of a modern L.C.C. School, The Sulivan. Some 60 cases occurred, reaching a maximum incidence on the 18th September. Sulivan School children were barely in contact with the visiting school but 14 cases occurred there, with a maximum incidence on the same date. The last recognised case at either of these schools was on the 25th September. Both these schools used the same dining room for dinners but the Sulivan School had the first sitting. A neighbouring school attended the dining room daily for a third sitting. This school had no recognised cases in September when the other two schools had cases but between the 28th September and 10th October, some 19 cases of vamiting occurred there. Also at the end of September an outbreak of vomiting was reported, affecting 15 out of a total of 31 inmates of a Borough Council Hostel (5 of these lived quite separately from the others and were all unaffected). 4 children from the Hostel attended the Sulivan School and one attended the third (17) school (Holy Cross). The Holy Cross child and 2 of the others were affected within the same short period of five days which covered the limits of the Hostel outbreak„ The characteristic attack appeared to consist of violent vomiting, sometimes accompanied by headache and abdominal pain but preceded by nausea and seldom followed by diarrhoea. Although there were a few cases of dysentery occurring in the schools at that time, the description of attacks was such that it was fairly easy to pick out the few dysentery cases from the big majority of others and, so far as stool investigations could be carried out, the results confirmed the histories given in a remarkable manner, no pathogens being found in the vomiting cases. All the Fulham Hostel inmates provided specimens for stool examination and all were negative. Stool investigations of all school catering staff showed that they were all free from pathogens. None of these had been ill and in any case a number of children affected were not eating school dinners; also an incidence spread over two weeks is against a form of food infection. Each family at the Hostel prepares independent meals so there was no question of food poisoning arising. Other investigations carried out at the Sulivan School and the Fulham Borough Council Hostel, included the water, milk, etc. Although the nature of the attacks of vomiting followed the usual pattern and the onset was frequently during school hours, many cases occurred "in the night" as usually described. The schools involved were Primary ones, so that the age range of those attacked was 5 - H years, both boys and girls affected, but adult school staff were also attacked, as were parents and infants at the Borough Hostel. There is, of course, no proof that the Holy Cross outbreak and the Hostel outbreak were connected with that occurring amongst the Sulivan School and their "guest" school, but the fact that there were contacts in each instance is strongly suggestive. EXCLUSION FROM WORK OF CONTACTS OF INFECTIOUS DISEASE By regulations made under the National Insurance Act of 1946. a certificate can be issued in any case where the Medical Officer of Health considers it advisable that a person should be excluded from work» This is usually done where a person is suspected of being a "carrier" of a disease, or has been in contact with a disease, and where the person, because of the nature of his/her occupation, is liable to transmit the diseases (e.g. a food handler). The granting of such a certificate enables the person affected to claim sickness benefit. One certificate was issued during the year. (18) ANNUAL REPORT OF THE FULHAM CHEST CLINIC The general improvement in the tuberculosis figures of recent years has continued in the year under review - the notifications being 172 (191) and the deaths 24. (27). The year was chiefly noteworthy for the opening of the new X-Ray Department at the Western Hospital and the appointment of a full-time Radiographer. This new department is satisfying a long felt want and already after only barely six months the number of X-rays have risen to over a 100 per week. This new department is capable of dealing with all types of chest investigation and it is to be hoped that this facility will be used increasingly by the local General Practitioners. Contact Investigations: Several schools in the Borough have been investigated during the year following the discovery of secondary cases amongst the school children and this type of work will tend to increase following the welcome decision of the London County Council to vaccinate with B.C.G vaccine all school leavers who require it. There has been a general increase in the work of investigating contacts of known cases and the number of children in receipt of B.C.G. vaccine has risen, from 90 - 160 this year. Treatment: The increase of treating patients in their homes and the seconding of more General Hospital beds to tuberculosis work, together with the slight fall in incidence in the disease, has greatly reduced the waiting list for the in-patient treatment of women and eased the situation as far as the men are concerned,, The fall in the female waiting list is enabling many more patients to be treated in hospital rather than in over-crovded and unsuitable homes. Chronic Tuberculosis and the Aged: The quicker turn over of hospital beds and the increase in speed of treatment of the acute case of pulmonary tuberculosis with, in general, a shortening of the time away from work is tending more and more to throw into relief the much greater and long term problem of the chronic tuberculous patient; many of whom are cases from the prestreptomycin era. In fact the problem of the tuberculous is now more and more becoming part of the general problem of the chronic sick and aged in Fulham. The opening of Hurlingham Lodge Hostel, where first-class (19) accommodation is provided for homeless or sputum positive cases is, of course, the ideal answer to this problem - though two dozen odd beds is but a drop in the ocean. This type and standard of accommodation should be freely available for those suffering in the same way with chronic bronchitis, asthma and emphysema. There has been some success in the treatment of the early case of pulmonary tuberculosis, and this should guide us in our approach to the larger problem of chronic respiratory disease in general and not lull us into complacency. The success in the treatment of the acute case is a step in the right direction but we need to know a lot more about the causation, treatment and after care of the "chesty" subject, from 40 years onwards. We must also not forget that the tuberculosis incidence and death rate goes up again for the men over 40. SUMMARY OF CLINIC STATISTICS No: of new patients attending 759 No: of attendances:- 1. Notified cases 2,418 2. Contacts 564 3. Observations 484 4. Refill Clinic 3,097 7,265 Attendances at Laboratory: (a) for investigation 4,319 (b) for medicines 2,041 6,360 No: of clinic notifications 161 Pul. 11 Non 172 No: of deaths 21 Pul, 3 Non 24 No: of home visits by Chest Physician 399 No: of home visits by Health Visitors 3,973 No: of x-rays taken 2,366 No: of patients undergoing home treatment 134 No: of B.C.G. vaccinations 160 No: of notified cases on register at 31.12.53 1,467 (20) VISIT OF THE MASS X-RAY SERVICE The Mass X-Ray Service of the South West Metropolitan Area made a successful visit to the Borough from 20th October to 15th December, 1953. They operated from two centres, one in Wandsworth Bridge Road and the other in West Kensington. The success of this visit was largely due to the publicity given to it and here once again the co-operation from the doctors, dentists and chemists in the Borough was a very great help. The results of the visit were as follows:- A total of 7,469 people were examined - 3,287 men and 4,182 women. 35 men and 22 women had radiologically significant lesions. 8 men and 8 women were to be followed up by the Mass X-Ray Service. 5 men had chest lesions, probably not tuberculous, of sufficient seriousness to merit investigation at a chest hospital. A further 386 films showed abnormalities of no clinical significance and these people received the usual 'satisfactory' notification, BACTERIOLOGICAL EXAMINATIONS. The following bacteriological examinations were carried out for the Council on specimens submitted by general practitioners and the Public Health Department during the year at the West London Hospitals:- Nose and Throat Swabs 70 Faeces 602 Miscellaneous 5 MEDICAL EXAMINATIONS The medical examination of both new entrants to the staff and persons referred for special examination or superannuation purposes were carried out during the year, 106 persons in all being examined. (21) HOSPITALS HI THE BOROUGH OF FULHAM Details supplied by courtesy of the Fulham & Kensington Hospital Management Committee. (1) Fulham Hospital; St. Dunstan's Road, W.6. An acute general hospital for medical and surgical cases; mental observation unitj chronic sick wards; out-patient department. Number of staffed beds - 384. (2) Fulham Maternity Hospital: 5-7, Parsons Green, S.W.6. Number of staffed beds - 30. (3) Western Hospital: Seagrave Road, SeW. 6. A hospital for the treatment of infectious diseases of all kinds; poliomyelitis unit; pulmonary tuberculosis wards. Number of staffed beds - 182. (4) Fulham Chest Clinic: 114, New King's Road, S.W. 6. Various types of clinic sessions held for the out-patient treatment of tuberculosis. There are 2 Registered Homes in the Borough: The Glazbury Nursing Home, 20, Glazbury Road, W.14, and 94, Sedlescombe Road, S.W.6, which is a home for blind men and women. (22) OLD PEOPLE'S WELFARE It ia a pleasure to record that the closest co-operation continues between voluntary and statutory bodies, thus making existing benefits and facilities available to all known old people in the Borough. The Old People's Welfare Committee - a very active Committee embodies all local action for the welfare of the aged and includes the establishment of twenty-seven social and luncheon clubs for the elderly. There are also services operating each year for a Christmas Dinner Party and Seaside Holidays and, generallyf for Chiropody, Meals-on-Wheels, and Invalid Meals. A visiting service to the housebound and lonely, loneliness being a general problem of the elderly, arranges for regular visits, and these are eagerly looked forward to and are much appreciated. Information about the needs of old people continues to reach the Public Health Department. These old people are visited to assess their need and suitability or necessity for action to be taken under the National Assistance Acts, 1948 and 1951. The number of visits paid by the Lady Sanitary Inspector are as follows:- 1953 1952. New cases (first visits) 332 232 Re-visits 984 743 Totals 1,316 975 Arrangements were made for the voluntary removal of 101 elderly people from their homes to:- Hospitals 68 Homes for the Aged 33 S.O.S. CARD SCHEME The S.O.S. Card Scheme was started in August with the object of getting help quickly to elderly people In emergency. This scheme has proved very successful, and two examples are appended:- (a) In November last neighbours living opposite an old lady observed an S.O.S. Card in a front window. A doctor was called and the old lady was removed to hospital /fi minutes after the first information on this case was received. (b) A telephone call was made to this department that an S.O.S. Card had been seen in a window in the Dawes Road. The old lady was visited and found to be suffering from shock, and her doctor was notified immediately. (23) NATIONAL ASSISTANCE ACT. 19A8. Section 47. NATIONAL ASSISTANCE (AMENDMENT) ACT, 1951. Compulsory removals under the above Acts were made in respect of two old people, brief particulars of which are as follows:- National Assistance Act. 19A8. Section 47: An old lady of seventy-three who had been in hospital for thirteen months for skin-graft treatment was, on discharge, found to be living in a small top floor back room in very unsatisfactory and unhygienic conditions. There was no proper lighting and the nearest sanitary accommodation was on the ground floor. Complaints were received that slops and excreta were being emptied from the window. Repeated visits were made by this department but all help was refused, and as her nearest known relatives, two daughters, were both living abroad, the old lady was removed to a home where she could receive proper care and attention. National Assistance (Amendment) Act. 1951. Notification was received by this Department of premises owned and occupied by a sick old man who was alleged to live on his own. Several attempts were made by this department to visit the old man in his home but, these having failed, a warrant to enter the premises was obtained from the Police Courts. When discovered, the man was found to be in a very neglected condition and was suffering from cancer of the eye. He refused all offers of help from this department and, in his own interests, an application was made and an order obtained for his detention and maintenance in hospital under this Act, SERVICE FOR INCONTINENT PERSONS Section 122 of the Public Health (London) Act, 1936, enables a sanitary authority, on a report from the Medical Officer of Health, to cleanse or destroy any filthy or verminous articles within its district. A scheme under the provisions of this Section to cleanse the linen and bedding of aged and incontinent persons was commenced in March, 1952, and is proving of real benefit to sufferers. The work is carried out at the Disinfecting Station and the replacement in November of the obsolete laundry machinery by modern equipment is enabling the staff to deal more quickly and efficiently with the increased volume of work. (24) The following articles were cleansed during the year:- Sheets 3,054 Towels 751 Pillow Cases 749 Underwear 1,782. Mattress Covers 109 Pieces 729 Total 7,174 NATIONAL ASSISTANCE ACT. 19a8. Section 50. Burial or Cremation of the Dead. Eight funerals were arranged under the provisions of this Section. The funerals were carried out by Mr0 Jo Goulbom of 61, Greyhound Road, the Council's official Contractor. Details of the cost of the burials are as follows * 8 Funerals as per contract £71. 3s. 3d. Less amount recovered from estate of deceased, or by gifts, or responsible relatives traced £29.19s.6d. Balance being cost to Council £4L. 3s. 9d. * The cost of the funerals varies slightly, the average cost of an adult being approximately £11. 10s. 0d. MORTUARY Following a busy period at the Mortuary when from the 1st December, 1952, to the 18th March, 1953, 250 cases were accommodated (158 post mortem cases and 92 convenience cases) the Mortuary arrangements were discussed with the visiting pathologists with a view to carrying out some modest improvements. A Vent Axia fan and fluorescent lights were installed in the post mortem room and a lever trolley was purchased, which, in an emergency can be used as a post mortem table. The lever trolley has greatly facilitated the work of the Mortuary Keeper in the moving of bodies. It is intended to increase the refrigeration accommodation as soon as possible by altering the arrangements of the body racks of the existing chamber. The following cases were dealt with during the year:- No. of post mortems carried out by order of the Coroner 299 No. of convenience cases _168 Total 467 (25) PUBLIC CONVENIENCES Proposed New Sites: Negotiations for the purchase of a site to build a Public Convenience in the West Kensington area are proceeding. This modern Convenience will replace the underground Convenience at Gibbs Green which is small, cramped, old and very expensive to maintain. A Convenience is also required in the Wandsworth Bridge area, but to date negotiations for several suitable sites have been unsuccessful. Washing Facilities: The Free Wash facilities provided by the Council to encourage personal hygiene, continue to be used and appreciated by members of the public. There is also a steady demand for the '3d. Wash and Brush Up1 despite the increased use of the. Free Wash facilities. Theft of Lead; At the beginning of the year two of the Public Conveniences were visited by thieves who removed lead fittings from two W.C. compartments. The thefts were reported to the police but so fair as is known, no one was apprehended. (26) (27) LONDON COUNTY COUNCIL - PERSONAL HEALTH SERVICES The Maternity and Child Welfare Services since July 1948 are the responsibility of the London County Council. Division I of the London County Council consists of the Metropolitan Boroughs of Chelsea, Fulham, Hammersmith and Kensington. The Divisional Medical Officer is assisted in each of the four Boroughs in the day to day administration of the Maternity and Child Welfare Services by the respective Borough Medical Officer. Dr, Violet I. Russell, the Divisional Medical Officer, has kindly supplied the following information regarding these services for the year 1953:- Ante-Natal Clinics Number of women who attended during the year 1,111 Maternal Deaths; There was 1 maternal death during the year 1 Infant Welfare Centres: Total number of children who attended centres during the year 3,367 Health Visitors: Number of infants under one year of age visited for first time 1,401 Total visits to infants under one year 7,075 Total visits to children - 1 to 5 years 12,634 Number of expectant mothers visited for first time 892 Total visits to expectant mothers 1,718 (28) Infant Life Protection; Number of Foster mothers at 31st December 1953 50 Number of Foster children " " " 63 Child Minders (Daily Guardians): Number of daily guardians minding children (voluntary) 57 Number of children minded 65 Care of Premature Infants: Number of premature births during the year 97 Number of deaths under one month 12 Dental Clinic: Number of expectant and nursing mothers treated 230 Number of cases in which general anaesthetic was administered 78 Number of teeth extracted 364 Number of children under five years treated 229 Number of cases in which general anaesthetic was administered 28 Number of teeth extracted 45 Immunisation and Vaccination: 862 children were immunised in London County Council clinics during the year, a further 723 being immunised at schools and by private doctors. 536 received boosting injections. The peroentage of the child population immunised against diphtheria at the end of the year was 83%, an increase of 12% over last year which is very satisfactory. 826 children were vaccinated in London County Council clinics during the year. (29) SERVICES Ante-Natal: Mornings: Afternoons 5/7 Parsons Green — Tuesday, Thursday 170 Wandsworth Bridge Road Wednesday - 90/92 Greyhound Road Friday Thursday 62/63 Burne Jones House Friday Wednesday Family Planning: 90/92 Greyhound Road — Tuesday 5/7 Parsons Green Thursday — Infant Consultation: 5/7 Parsons Green Wednesday, Friday Monday, Wednesday 170 Wandsworth Bridge Road Tuesday Tuesday 90/92 Greyhound Road Monday, Wednesday and Friday 62/63 Burne Jones House Thursday Monday, Thursday Toddlers' Clinic: 62/63 Burne Jones House Tuesday 90/92 Greyhound Road Thursday — 170 Wandsworth Bridge Road Tuesday — Vaccination: 90/92 Greyhound Road Wednesday — 170 Wandsworth Bridge Road Thursday — Immunisation: 90/92 Greyhound Road Tuesday — 170 Wandsworth Bridge Road — Thursday Day Nurseries: Eridge House, Fulham Park Road. Grove House, Bagley's Lane St. Jaines, Maxwell Road. Mulgrave, Mulgrave Road. Home Help Service; (Office where application may be made: 129, Fulham Palace Road, W.6.) Number of cases attended during the years- Maternity 27 Tuberculosis 66 Others (including aged and infirm persons) 832 (30) HEALTH EDUCATION The year was a busy one in this field, Several new ideas have been tried out with success. The purchase of a film strip projector and screen has proved of great assistance in giving lectures. At the beginning of September all the organisations in the Borough were circularised, made aware of the facilities available in the Department and invited to submit requests for talks on topics with health aspects. In addition to these lectures, discussion groups have been held with the aid of the Central Council of Health Education film strips and sound recordings. The usual leaflet and poster propaganda was carried out and other activities included Film Shows: These were held at the Central Library and 12 very successful shows to mixed audiences were given; 1,642 persons attended (average 137). In addition an Adults Only show at which 114. persons were present was also arranged. Although the attendance for this show was lower than the other shows it is intended to repeat this type of performance to enable talks and films unsuitable for children to be presented. There was also a special show arranged for the Food Trade at which the Principal Speaker was Mr. Morley Parry, Food Hygiene Advisory Officer to the Ministry of Food. Two films on food handling were shown and a panel formed to answer questions from the audience; it was a pity only 51 persons attended. Lectures and Discussion Groups: 9 of these were given to audiences ranging in numbers from 180 to 8, the average being 45 (total 406 persons). As the departmental facilities become better known it is hoped that more requests will be received from organisations. Fulham Health Guides This booklet, which was written and illustrated largely within the Department, was published - with the aid of advertisements - free of charge to the Council by a commercial firm. 3,000 copies of the Booklet were delivered in October and only some 200 remained by the end of the year, A competition to submit 12 rules for Safe Food Handling was advertised in the Booklet and the three winners presented with their prizes by the Mayor, Councillor W.G. Wallis, J.P. at one of the Film Shows. (31) Health Hints: These consisted of brief articles of some 100 - 120 words on a variety of topics, such as Immunization, Burns, etc., and were written by Dr. Meade, Deputy Medical Officer of Health. They were published weekly in two of the local papers urrier the title 'Health Hints - by a Doctor', and were very well received. Schoolboys' Essays: After a party of schoolboys had visited the Department and given an insight into its workings they were invited to write an essay on their visit. Four prizes were given for the best entries and the boys were presented with these at a meeting of the Public Health Committee. Altogether it has been a year in which progress has been made in Health Education. This would not have been possible without the willing help and co-operation of the Public Healtti Committee, whose members have taken the Chair at all the Film Shows, members of the Department and the Borough Librarian and his staff at the Central Library. In an endeavour to reach a wider audience it is hoped to take the film shows to suitable halls in the Borough in addition to showing them at the Library. ACTS OF PARLIAMENT. STATUTORY INSTRUMENTS AND CIRCULAR LETTERS ISSUED BY GOVERNMENT DEPARTMENTS WITH REGARD TO THE PUBLIC HEALTH SERVICES DURING THE YEAR 1953. Statutory Instruments: Offals in Meat Products Order, 1953. Public Health (Infectious Diseases) Regulations, 1953. Labelling of Food Order, 1953. Food Standards (Preserves) Order, 1953. Food Standards (Ice Cream) Order, 1953. The Flour Order, 1953. The Bread Order, 1953. Food Standards (Preserves) (Amendment) Order, 1953. Food Standards (Saccharin Tablets) Order, 1953. Artificial Sweetness in Food Order, 1953. The Salvaged Goods (Revocation) Order, 1953. Local Authorities (Charges for Dustbins) (Revocation) Order, 1953. Public Health (Condensed Milk) (Amendment) Regulations. 1953. Public Health (Preservatives etc, in Food) (Amendment) Regulations, 1953. (32) Public Health (Preservatives etc in Food) (Amendment No;2) Regulations, 1953. Milk (Special Designation) (Pasteurised and Sterilised Milk) (Amendment) Regulations, 1953. Food Standards (Soft Drinks) Order, 1953. Milk and Dairies (Amendment) Regulations, 1953. Labelling of Food (Amendment) Order, 1953. Ministry of Health Circulars: Annual Reports of Medical Officers of Health for 1952. Public Health (Infectious Diseases) Regulations, 1953. Ministry of Food Circulars: Meat Products (No. 3) Orier, 1952. Milk and Dairies Regulations, 1949 - Approved Oxidising and Preservative Agents. The Home-Canned Fruit and Vegetable Order, 1950 - Revocation of Offals in Meat Products Order, 19531 Meat Products (No. 3) Order, 1953. The Cream and. Use of Milk (Revocation) Older, 1953. Ice Cream Standard. Milk and Dairies Regulations, 194-9 - Approved Oxidising and Preservative Agents. Preventative of Nuisance from Blowflies. Clean Catering. Food Standards (Saccharin Tablets) Order, 1953. Artificial Sweeteners in Food Order, 1953. The Flour Order, 1953; The Bread Order, 1953. The Salvaged Goods (Revocation) Order, 1953. Public Health (Condensed Milk) (Amendment) Regulations, 1953. Public Health (Preservatives etc. in Food) (Amendment) Regulations, 1953. Disposal of Meat and Offal unfit for Human Consumption. Milk (Special Designation) (Pasteurised and Sterilised Milk) (Amendment) Regulations, 1953. Standard for Soft Drinks Order, 1953. Milk and Dairies (Amendment) Regulations, 1953. (33) SANITARY CIRCUMSTANCES OF THE AREA Much difficulty was again experienced in getting repairs carried out in many properties held on short leases which were first owned by a bankrupt, who had shown small regard beyond rent collecting, and subsequently taken over by a firm which evinced almost equal disregard to its obligations. Where public health nuisances were concerned, Court Orders were obtained and subsequently works were carried out by the Council's contractors in default. In other cases action was taken under Section 9, Housing Act, 1936, after deciding that the premises concerned could be made fit at a reasonable cost, works in default being undertaken where appropriate. Similar action resulted in the necessary repairs being carried out in a few premises apparently abandoned by absentee landlords. These cases apart, in general, it appears that statutory requests have been complied with slightly more readily than in previous post-war years, though it is still necessary to serve many more statutory notices and bring more cases to Court than in the pre-war days. Inspections after complaint 4,254 Re-inspections 11,344 Inspections after Infectious Disease 270 Re-inspections after Infectious Disease 87 Drains tested 275 Drains inspected 1,486 Intimation Notices served 2,470 Statutory Notices served 1,064 Intimation Notices complied with 1,797 Statutory Notices complied with 890 Housing enquiries 534 Overcrowd ing Inspections 72 Other visits 633 (34) SUMMARY OF WORKS CARRIED OUT UNDER SUPERVISION OF SANITARY INSPECTORS Fresh Air Inlets 17 Soil and Vent pipes repaired or renewed 30 Drains cleared 127 Drains repaired 138 Draing relaid 23 Rainwater gutters and pipes repaired or renewed 255 Drains sealed off 3 Traps cleansed, repaired etc. 58 Pans renewed 14.0 Seats repaired or renewed 91 Flushing cisterns repaired or renewed 157 Fastenings provided to doors, and doors repaired 139 Sinks provided, repaired or renewed 72 Sink and bath wastes repaired or renewed 103 New baths fitted 14 New lavatory basins fitted 21 Baths cleansed 10 Drinking water cisterns cleansed etc 39 Water supply pipes and fittings repaired 121 Rooms cleansed 1,052 Internal house repairs 2,276 Fireplaces repaired (nuisances from smoke etc.) 300 Kitchen ranges repaired or renewed (for cooking purposes) 97 Washing coppers repaired or renewed 24 Dampness remedied 1,481 Rooms provided with adequate light and ventilation 39 Staircases provided with light and ventilation and repaired 60 Ventilated food cupboards provided 1 Ventilation provided under floors and repairs 276 Roofs repaired 1,002 Other external repairs 289 Accumulations of refuse removed 87 Dustbins 186 lards, forecourts paved and drained 83 Other nuisances 20 Bombed sites 15 Additional W.C. accommodation 13 Rat runs traced 4 Total 13,263 (35) DISINFECTION. DISINFESTATIOH & LAUNDRY SERVICES The following details relate to the services provided by the Disinfecting Superintendent and his staff during 1953:- No: of rooms disinfected after Infectious Disease 184. No: of articles stoved 6,061 No: of rooms disinfested 639 No: of inspections made of prospective Council tenants 372 Laundry carried out for the Dust Destructor staff:- Roller Towels 2 Hand towels 71 Boiler suits 23 Bath towels 1,720 Dust coats 24 Duffle coats 7 The Disinfecting Superintendent has also dealt with many kinds of infestation such as cockroaches, beetles, ants, silver fish, moths etc. List of verminous and stained articles destroyed during 1953:- Bedsprings 8 Bedsteads 7 Mattresses 42 Beds 10 Divans 2 Pillows 22 Sheets 5 Blankets 7 Quilts 2 Clothing 120 Furniture 12 Miscellaneous pieces 253 Total 490 LEGAL PROCEEDINGS Public Health Nuisance Summonses: During the year ended 1953, 152 summonses were down for hearing at the West London Magistrates Court and the Kensington Divisional Petty Sessions with regard to cases where owners had failed to comply with Statutory Notices served under the Public Health (London) Act, 1936. The cases were dealt with as follows:- No: of Summonses served Not of Orders made No.of cases where daily penalties were awarded. No: of cases withdrawn, or adjourned sine die 152 14 3 135 (36) WORKS IN DEFAULT Public Health (London) Act, 1936: During 1953 the Council's contractors carried out works in default at 10 premises, the owners having failed to comply with Statutory Notices served under the Public Health (London) Act, 1936, The costs of the work varied in individual cases from 17s, 6d, to £85 15s. 6d., the total sum involved being £203. 12s. 4d. Housing Act. 1936; Section 9. - 2. Homestead Road. The owner of these premises failed to comply with the Section 9 notice served on 11th December, 1952, and work in default was carried out at a cost of £135. 9s. 9d. Section 11. - 4. May Street. The owner of the above premises failed to comply with the Demolition Order made on 22nd September, 1952, and owing to their dangerous condition, the premises were demolished in default at a cost of £51. 17s. 6d. DEMOLITION AND CLOSING ORDERS Housing Act, 1936, Section 11. Demolition Orderss Premises: 3, A, 5 & 6, St, Thomas' Way Date made: 21, 4, 1953. Housing Act. 1936. Section 12. Closing Orders: 2a, Halfold Road. (Front Basement room) 30. 9. 1953. 47, Britannia Road- (Two Basement rooms and Scullery). 13. 10.1953. (37) HOUSING ACTS. 1936 to 1952. The London County Council (Aintree Street. Fulham) Order. 1953: The London County Council declared 76 premises in Aintree Street and Welford Terrace to be a clearance area and made an Order for the compulsory acquisition of 46 further premises in these streets. Following a Public Inquiry, when objections were heard, the action of the County Council has been confirmed by the Minister of Housing and Local Government. RENT RESTRICTIONS ACTS During the year 10 applications for a Certificate of Disrepair were received. In 9 cases the premises were found not to be in a reasonable state of repair, and certificates were issued. In the remaining case the state of the premises did not warrant the issue of a certificate of disrepair. 3 Revocation Certificates were issued to owners during the same period on satisfactory completion of the necessary repairs. HABITATION CERTIFICATES UNDER SECTION 95(2) OF THE PUBLIC HEALTH (LONDON) ACT. 1936. During the year 204 certificates were issued in respect of newly erected and rebuilt premises in the Borough. REHOUSING OF FULHAM RESIDENTS ON L.C.C. HOUSING ESTATES During the year 431 families were visited by the Sanitary Inspectors at the request of the London County Council and the Borough Architect and Director of Housing, Fulham Borough Council, in connection with applications for alternative accommodation. Of this number 132 cases applied on the grounds of overcrowding and the remaining 299 on medical grounds and the insanitary condition of their living accommodation. 81 families were found to be living in overcrowded conditions, and reports were sent to the Director of Housing and Valuer, London County Council, recommending them for alternative accommodation on the L.C.C. Housing Estates. 236 families were known to have been rehoused during the year. There is close co-operation between the Housing and Public Health Departments on all matters relating to housing. (38) DWELLINGS COMPLETED BY THE COUNCIL between 1st January and 31st December. 1953. Information supplied by the courtesy of The Borough Architect and Director of Housing, Estates No. of Flats Number of Rooms per Flat Total Rooms (1) (2) (?) (4) (5) Sulivan Court 18 6 - 12 42 Lancaster Court 50 - 10 20 10 10 170 Gap Sites (Isolated Value Payment bombed sites). 14/18, Dancer Road 6 - - 4 2 - 20 19/23, Kinnoul Road 6 - 1 5 - - 17 52/58, Claxton Grove 6 - - - 6 - 24 12/22, Gledstanes Road 20 - 12 8 - 68 10/12, Byam Street 3 - - 3 - - 9 22/26, Beryl Road 4 - - 4 - - 12 24/28, Pursers Cross Road 4 - 4 - - - 8 94/98, St. Dunstans Road 4 - - 4 - - 12 18/24, Yeldham Road 4 - - - 4 - 16 25/29, Harbledown Road 4 - 4 - - - 8 4/5, Ackmar Road 2 - - 2 - - 6 12, Oxberry Avenue 2 1 - — 1 - 5 27/29, Rigault Road 3 - - 3 - 9 6/8, Crefeld Road 3 - - 3 - - 9 43/47, Crabtree Lane 7 1 3 3 - - 16 47/49, Brecon Road 4 2 - 2 - - 8 19, Beryl Road ) House ) 1 - - - 1 - 4 2, Colehill Lane ) House ) 1 - - - 1 - 4 1, Crefeld Road ) House ) 1 - - - 1 - 4 Totals 153 10 22 77 34. 10 471 (39) DRAINAGE OF NEW BUILDINGS and RECONSTRUCTION OF DRAINAGE Additions to existing buildings or additional sanitary accommodation 44 Reconstruction of drainage systems 7 Rebuilding of premises demolished by enemy action 12 New buildings 14 Total agreed applications for approval of plans 77 PREVENTION OF DAMAGE BY PESTS ACT. 194.9. The Council's Rodent Repression Service maintained its campaign against rodents during the year. The number of notifications received by the department, of the existence of rat or mice infestations during the year, totalled 896, an increase of 242 on the figure for last year. This fact is indicative that the public are fully aware of their responsibilities in reporting the presence of rodents. In addition to those premises from which notifications were received, 255 other premises were inspected by the Rodent Operators. Investigation of complaints and visits for subsequent treatment of premises found to be infested necessitated 7,175 visits by the staff. Mice infestations were rather more than rat infestations, the figures being 472 and 342 respectively. A total of 107 business premises were treated for infestations, 45 for rats and 62 for mice. As during the previous year a number of defective outlet drains were discovered as a direct result of investigations of rat infestations and these were repaired and the cost of so doing was met by the owners of the premises concerned. In accordance with the requirements of the Ministry of Agriculture and Fisheries, and with the co-operation of the Borough Surveyor, two treatments of the public sewers were carried out during the year. Comparison of the bait takes during these treatments with the treatments last year again indicate that the rat population of the sewers is apparently being held in check. (40) ATMOSPHERIC POLLUTION The disastrous consequences attributed to the 1952 Lord on "Smog" focussed public attention very definitely on the importance of atmospheric pollution in relation to health. This was referred to in my Annual Report for 1952. At the time of writing the Beaver Committee set up by the Government is engaged in interviewing interested public bodies, and the Committee's final report is eagerly awaited. An interim report has already been published making a number of practical suggestions with a view to bringing about a reduction in atmospheric pollution. In this Borough the presence of grit particles in the atmosphere - in various areas of the Borough - is a problem which has been recurring with regularity. It occurs during the early months of the year when the prevalent winds are N.N.E. and E. Thereafter, the wind direction changes to S.W. and S.S.W. During the prolonged spell of dry weather which occurred at the beginning of 1953, particularly in February and March, a serious nuisance from dust and grit was encountered. The nuisance was especially bad in the Sands End area which is situated in a loop of the River Thames and is also fringed by many heavy industries in Wandsworth, Battersea and Chelsea. Complaints were received from large numbers of residents and the phrase "black snow" was coined to describe the deposit which literally covered everything. Owing to its situation in the loop of the river this area is especially subject to wind currents and eddies. So far as I have been able to ascertain there are no records of the rate of velocity of these particular currents, but anemometer readings taken at various sites in this area, at a height of 8 feet, indicate that turbulence does occur in this loop of the river, in contrast to the more settled winds at higher levels as observed by the behaviour of smoke issuing from high chimney stacks. (See frontispiece). In common with other Metropolitan Boroughs this Council decided to 3et up an Atmospheric Pollution Station, as mentioned in my last report, which would give the position in Fulham with an overall picture of it in greater London and link it up with far-reaching outside areas and districts. Later the Council decided it would be valuable to have definite information about the position in the Borough itself, and a second station was established. The problem of atmospheric pollution generally is both vast and complicated. There are no easy solutions. In Fulham alone 1½ million tons of coal annually for industrial purposes and just under 60,000 tons annually for domestic fires are used. Whilst industrial and residential premises are in such close proximity, pollution of greater or lesser degree is inevitable. (41) By taking all possible precautionary steps in relation to plant, stocks of coal, siting of stocks and type of coal and other materials from which dust can blow, and in training those responsible for stoking, considerable improvement can be effected. On the other hand, smoke from domestic chimneys in cities makes very considerable contributions to the general pollution. The increased use of smokeless fuels are costly and in short supply so the possibility of a smokeless zone in Fulham is a target for the future - the not too distant futur e - it is to be hoped. FACTORIES ACT. 1937. Regular inspections of factories, both mechanical and nonmechanical have been carried out and special attention has been paid to new factories. Much has been done to improve the sanitary conditions in factories by the provision of additional sanitary conveniences and lavatory (hand) basins with hot and cold water, and experience has shown that these additional amenities are appreciated and used. Factory canteens have been enlarged and improved, morning "breaks" and mid-day meals can be taken in a more congenial atmosphere in many places. Many factories are close to residential property and when nuisances have arisen, managements have co-operated with the Council in reducing noise and vibration, especially at night. Although the standard of the larger factories is high, there are still a number of small factories where little can be done to improve working conditions due to lack of space and congestion. Premises Inspections No: of written notices Factories without mechanical power (initial visits) 94 _ Factories with mechanical power (initial visits) 49 _ Other premises under the Act (building operations and works of engineering construction) 2 _ Number of re-inspections of all factories 1,150 _ Total 1,295 _ (42) No: of cases in which defects were found:- Particulars Found Remedied Want of cleanliness 26 26 Inadequate ventilation 7 7 Ineffective drainage of floors 13 12 Sanitary Conveniences: (a) Insufficient 11 11 (b) Unsuitable or defective 25 25 (c) Not separate for the sexes 2 2 Other offences against the Act (not including those relating to Outwork) - - Total 84 83 No prosecutions were instituted under the Factories Act, 1937, during 1953. FACTORY DRAINAGE No: of drains inspected 299 No: of existing drains tested 223 No: of new drains water tested 160 No: of drains cleared 19 No: of sinks renewed 75 SMOKE ABATEMENT Complaints received 22 Total number of observations made (external) 1,185 Total number of inspections made (internal) 177 (43) WINDBORNE DEPOSITS OF GRIT. ASH & SOOT No: of complaints received 63 No: of re-inspections 718 NOISE No: of complaints received 15 No: of complaints remedied 7 No: of re-inspections made 187 PART VIII. of the FACTORIES ACT. OUTWORK Nature of Work Not of Outworkers on list Boot making 6 Wearing Apparel 104 Box making 2 Upholstery 6 Toy making 46 Lampshades 2 Fancy goods 28 Miscellaneous 14 Paper Bags 2 Total 210 (44) HEATING APPLIANCES (FIREGUARDS) ACT. 1952. THE HEATING APPLIANCES (FIREGUARDS) REGULATIONS. 1953. The Council have authorised the Medical Officer of Health and the Sanitary Inspectors to inspect and test appliances required by the above Act and Regulations to be fitted with guards, and the 121 dealers in the Borough were circularised drawing their attention to the main requirements. Fireguards must be fitted to gas fires, electric fires and oil heaters which are so designed that they are suitable for use in residential premises and are of such a type that, without a guard, there is likelihood of injury by burning. The guards must be robustly made, constructed and fitted as specified in the Regulations, and the appliances and guards must be so constructed that the guards when in use with the appliance shall be securely attached thereto. It applies to such fires which are in the course of business sold, or let under a hire-purchase agreement or hired, or are offered or exposed for sale or letting under a hire-purchase agreement or on hire. The requirements are already in force as regards appliances manufactured since 1st October, 1953, but appliances manufactured before this date and not fitted with the requisite guard may be sold or let until the end of September, 1954. RAG FLOCK and OTHER FILLING MATERIALS ACT, 1951. Under this Act it is unlawful in the course of business to use filling materials to which the Act applies in any form of upholstery, the stuffing or lining of toys, baby carriages or of articles of such other kinds as may be prescribed except on premises registered by a local authority (in London a Metropolitan Borough Counoil). Six sets of premises are registered in Fulham. During 1953, the following samples of filling materials were purchased by the Sampling Officer and submitted to John Hudson, M.A., F.C.S., M.S.Ch.1., of High Wycombe, one of the Prescribed Analysts for the purpose of the Act:- Rag Flock 6 Coir fibre 7 Kapock 2 Feathers 1 Total 16 Analysis of all samples of filling materials submitted for examination proved them to be satisfactory in quality. (45) PHARMACY and POISONS ACT. 1933 - THE POISON RULES PHARMACY & MEDICINES ACT. 1941. The retail sale of poisonous substances by shopkeepers who are not registered pharmacists is controlled by the Acts and Rules made thereunder. The Poisons List, which has been prepared by the Poisons Board and confirmed by the Home Secretary, prescribes two Lists of Poisons - Part I and Part II. The sale of poisons included in Part I is restricted to registered pharmacists whilst those included in Part II may be sold to the general public not only by registered pharmacists but also by ordinary traders whose names are entered on a List of Persons entitled to sell such poisons, kept by the local authority. The Acts and Rules lay down certain requirements regarding type of container, labelling, storage, transport and sale of poisons, penalties being prescribed for non-compliance. Fees are payable to the local authority by persons whose names are entered on the List. At the end of 1953 there were 166 names in the Council's List and the following changes took place in the Register during the year:- No: of listed sellers on Council's Register at 1.1.53 171 Nos added during year 14. 185 No: who transferred their business or discontinued the sale of poisons 19 No: on Register at 31st December, 1953 166 297 Visits of inspection were made during the year under review and 13 samples of Part II Poisons were submitted for analysis all of which were reported to be satisfactory. PET ANIMALS ACT. 1951. This Act, which came into operation on 1st April, 1952, regulates the sale of pet animals and empowers a local authority (in London a Metropolitan Borough) to grant licences to keep a pet shop on payment of a fee not exceeding ten shillings,. During 1953, 10 licences were renewed and one new licence issued, appropriate conditions being applied to each. (46) SWIMMING BATH WATER SAMPLES. 1953. Samples of swimming bath water, details of the analyses of which follow, were uniformly good:- Date Bath Time Bacteria per c.c. B. Coli Free Chlorine parts per million 14.5.53 Ladies Morning 612 Negative 0.10 „ Afternoon 740 „ 0.08 24.6.53 Gents: Morning Nil „ 0.20 „ Afternoon Nil „ 0.25 29.9.53 Mixed Morning Nil „ 0.20 „ Afternoon Nil „ 0.50 INSPECTION OF BAKEHOUSES AMD BAKERS' SHOPS At the end of 1953, there were 37 bakehouses in use in the Borough nine of which are "basement" bakehouses. In addition, there were eleven retail bakers' shops without bakehouses attached. During the year under review 225 inspections were made. (47) INSPECTIONS OF FOOD PREMISES Type of Business No: on Register No: of Inspections Contraventions found Premises made fit Bakehouses (Non-basement) 28 113 31 21 Bakehouses (Basement) 9 80 7 6 Bread & Cake shops 11 32 7 7 Butchers' shops 73 512 36 28 Confectionery 47 40 - 2 Cooked Meat shops 7 45 3 1 Pasteurising Establishments 1) Bottled Milk Depots 2) Dairies 3) 250 - - Purveyors of Bottled ) Milk 117) Eel and Pie shops 4 24 - - Food Factories 5 100 2 4 Fishmongers' Shops 23 187 20 13 Fried Fish shops 35 151 10 8 General Food shops 268 708 49 28 Greengrocers and Fruiterers 119 242 26 29 Horseflesh butchers 2 42 1 - Ice Cream (Manufacturers and Dealers) 220 224 3 8 Licensed Premises 104 143 6 5 Restaurants and Working Class Dining rooms 152 1,152 98 62 Stalls 90 92 6 1 Stallholders' Storage premises 35 114 1 1 Other Food premises 29 130 8 7 Totals 1,384 4,381 314 231 (48) INSPECTION AND SUPERVISION OF FOOD Slaughtermen's Licences; The Slaughter of Animals Act, 1933, provides that no animal shall be slaughtered in a slaughterhouse or knacker's yard by any person who is not a holder of a licence granted by a local authority. A licence may only be granted to a person aged 18 years or upwards who is, in the opinion of the local authority, a fit and proper person to hold a licence. A licence remains in force for a period of up to three years and may be renewed from time to time at the discretion of the local authority. During 1953, two such licences were issued to slaughtermen resident in the Borough of Fulham. There are no slaughterhouses in the Borough. FOOD AND DRUGS ACT, 1938. Section 10. Examination of Food and Seizure of Unsound Food: Certain articles of food which are liable to be adulterated are controlled by sampling and chemical analysis by the Public Analyst, but foods which deteriorate in quality and become unfit for human consumption are supervised by inspection and seizure with subsequent condemnation by a Justice of the Peace and destruction. Section 10 of the Act empowers any authorised officer of the local authority to examine food for human consumption which is deposited for sale and if it appears to him to be unfit he may seize it and remove it in order to have it dealt with by a Justice of the Peace. If it appears to the Justice of the Peace that any food brought before him is unfit for human consumption he shall condemn it and order it to be destroyed or to be so dealt with as to prevent it from being used for human food. No action was necessary under this Section during 1953. (49) Voluntary Surrender of Food: In practice, shopkeepers make very little attempt to sell to the public any foodstuff which is unfit for human consumption and it is customary for retailers who find food they have purchased from wholesalers to be unsound at the time they receive it or to have become unfit after storage on their premises to notify the local authority and request an inspection by the district sanitary inspector who will, if satisfied after examination that the food is unfit, issue a certificate to that effect and arrange for its removal to, and destruction at, the Council's Refuse Destructor. Diseased or unsound meat and all other unsound food dealt with by the sanitary inspector becomes the property of the local authority whose duty it is to destroy it or otherwise dispose of it in such a way that it cannot be exposed for sale or used for human consumption. After removal from his premises a certificate is issued to the shopkeeper giving details of the foodstuffs dealt with which may enable him to obtain credit or compensation from his wholesale suppliers. During 1953, 2,029 Certificates of Condemnation were issued by the Food Inspectors relating to the under-mentioned voluntarily surrendered foods:- Meat 2,449½ lbs. Ham 314¼ " Sausages 709 " Fish 19 stone. Tinned foods 15,288 Packet foods 236 Bottled foods 23 Eggs 18½ -dozen. Salt herrings l½ -barrels. Offal 39 - lbs. Cheese 226 boxes Other foods 68½-lbs. (50) COMPLAINTS During 1953, 10 complaints (14 in 1952 and 22 in 1951) were received from members of the public regarding foreign matter etc., in food, each of which was fully investigated and reported to the Public Health Committee. The following are the details:- No: Nature of Complaint Action taken on recommendation of Public Health Committee 1 Paint on bread rolls Bakers warned by letter 2 Glass in loaf of bread Bakers warned by letter 3 Mouldy meat pies Explanation of retailers accepted 4 Mass of dirty currants in bun Baker warned by letter 5 Dirty milk bottle Dairy Company warned by letter 6 Dirty milk bottle Dairy Company warned by letter 7 Metal cap in milk bottle Dairy Company warned by letter 8 Insect in loaf of bread Baker warned by letter *9 Dirty milk bottle Referred to Hammersmith Borough Council in whose area the bottle was washed and filled 10 Splinter in loaf of bread Baker warned by letter * Legal proceedings instituted by Hammersmith 3orough Council and a fine of 20/- imposed on Dairy Company at West London Police Court on 15th March, 1954. (51) FOOD ESTABLISHMENTS Regular inspections were carried out during the year 1953 resulting in 293 requests to the persons responsible requiring the execution of essential work. In no case was it necessary to institute legal proceedings. Details of the more important improvements which have been effected in food premises during the year are given below:- Water heaters 24 New sinks provided 27 New W.C's. provided 10 W.C's. repaired and cleansed 18 Kitchens, preparation rooms etc. redecorated 200 Floors renewed or repaired 20 Shop fronts repaired or redecorated 45 New dustbins 49 Counter cases for the protection of food 12 New windows 3 Improvements to ventilation 7 Counter refrigerators 4 New chopping block 1 Gas stoves repaired or renewed 2 Fishfriers renewed 4 Cold stores reconstructed 4 New refrigerators 9 New counters 2 Grease traps provided 2 Premises re-designed 4 Yards cleaned and repaired 10 Refuse removed 14 Under the provisions of Section 14 of the Food and Drugs Act, 1938 premises used for the preparation of certain specified articles of food must be registered with the local authority. At the end of 1953 there were 64 premises on the Register concerned in the preparation of preserved foods and 223 premises on the Register relating to the manufacture or sale and storage of ice cream, as follows:- Premises registered for the manufacture, storage and sale of ice cream 3 Premises registered for storage and sale of ice cream 220 (52) BACTERIOLOGICAL EXAMINATION OF "CREAM" FILLED CONFECTIONERY During 1953, 164 samples of' synthetic and "butter" cream used as a filling in eclairs, doughnuts etc., were purchased for bacteriological examination. The importance of scrupulous cleanliness and care by persons handling this type of confectionery cannot be over-emphasized when one remembers that the cream-filling is an excellent medium for the growth of bacteria and is not subject to any form of heat-treatment before consumption. The following is a summary of the examination of the 164 samples:- Free from bacillus coliform 69 Bacillus Coliform (non-faecal) present in 84 Bacillus Coliform (faecal) present in 4 Staphylococcus Aureus present in 7 One of the four samples contaminated with faecal coli and six of the seven with staphylococcus aureus, although sold in Fulham shops or cafes, were actually prepared in bakehouses outside the Borough aid for this reason it is difficult to say definitely where the contamination occurred. In such cases, in addition to visiting the local shop and giving advice to the staff on food hygiene, the facts are communicated to the Medical Officer of Health for the district in which the bakery is situated for his information and appropriate action. Three samples contaminated with faecal coli and one with staphylococcus aureus were the product of Fulham bakeries and every assistance is given to the baker concerned in an effort to trace the source of infection. In every instance, subsequent samples have been examined and satisfactory reports received. SALE OF MILK REGULATIONS, 1939 During 1953, 200 samples of milk ware procured by the Sanpling Officer and submitted to the Council's Public Analyst for chemical analysis. Of these, 83 were purchased from milk roundsmen in the streets of the Borough during the early delivery, 21 were purchased on Sundays and 23 were taken at the early morning delivery to the Western and Fulham Hospitals. (53) 3 samples of milk were reported to be adulterated, the details beings:- No: Result of Analysis Action taken on recommendation of Public Health Committee 118 3.4% added water Purveyors warned by letter 129 2.7% added water Purveyors warned by letter 460 6% added water Purveyor warned by letter Samples 118 and 129 were purchased from the same vendors and on investigation it was proved that the extraneous water entered the milk through a defect in the processing plant. The following table gives the monthly average composition of all samples of milk examined in Fulham and it will be seen that the quality of the milk distributed in the Borough is well maintained and compares very favourably with the legal standards laid down in the Sale of Milk Regulations, 1939. Month No, of Samples Fat % Solids not fat % January 19 3.53 8.78 February 18 3.52 8.68 March 18 3.44 8.70 April 19 3.34 8.63 May 20 3.19 8.81 June 12 3.40 8.81 July 20 3.42 8.62 August 13 3.49 8.74 September 18 3.56 8.80 October 14 3.57 8.88 November 12 3.75 8.67 December 17 3.62 8.76 200 3.48 8.74 Legal Standards 3.00 8.50 Average composition of normal cow's milk 3.76 8.84 The time of year is one of the chief circumstances on which the variations in the composition of cows' milk depends and the year may be divided into four periods according to the character of the milk yielded. Thus, during period I, i.e. November, December and January, (54) milk is rich in fat and solids-not-fat. During the second period, February, March and April, the fat figure falls whilst the solids-not fat content remains practically the same. At the beginning of the third period, May to August, the fat content is less but tends to rise towards the end of the period; and September and October, the fourth period, sees an increase in both fat and solids-not-fat. It will be seen that Fulham's milk supply appears to follow the normal rise and fall. The arrangement whereby samples of milk are taken either at, or in course of delivery to, the hospitals, institutions, schools, etc., in the Borough was continued during 1953, and the following were taken for chemical analysis, the results being included in the complete result table on page 55. Institution No. of Samples Fulham Hospital 14 Western Fever Hospital 9 L.C.C. Schools 43 Meals Kitchens, etc. 6 Fulham Maternity Home 1 Day Nurseries 5 Total 78 REGISTRATION OF PURVEYORS OF MILK The Milk (Special Designation) (Pasteurised and Sterilised Milk) Regulations, 1949, provide that as from 1st October, 1954, all pasteurised milk shall be put into bottles or other containers in which it is to be delivered by retail at the premises at which it is pasteurised as soon as possible after pasteurisation. In the past, the majority of registered purveyors purchased their supplies of milk in churns from reputable wholesalers by whom it had been pasteurised in accordance with the legal requirements and either sold it in small quantities from a shop counter-pan or bottled it in their own dairies for distribution to their customers. As the Regulation which comes into force on 1st October, 1954, makes this practice illegal, most purveyors in the Borough have already made arrangements for their wholesalers to supply milk in bottles which have been washed, filled and sealed at the premises at which it has been pasteurised . (55) At the end of 1953, there were in Fulham one milk pasteurising establishment, 2 large hottled milk depots and 3 dairies which were continuing, for the time being, to wash, fill and seal bottles „ In addition, the occupiers of 117 retail shops were registered to sell milk in the properly closed and unopened receptacles in which it is delivered to their premises. Of these, 31 make daily deliveries to customers' houses, whilst the remainder merely sell bottled milk in their shops„ FOOD and DRUGS ACT. 1938 - 1950 Milk (Special Designation) (Pasteurised and Sterilised Milk) Regulations 1949/1953" Milk (Special Designation) (Raw Milk) Regulations. 1949/1950 To comply with the Milk (Special Designation) (Pasteurised and Sterilised Milk) Regulations, 194-9, Tuberculin Tested (Pasteurised) and Pasteurised Milk must not give a reading of more than 2.3 Lovibond blue units in the phosphatase tests and must not decolourise methylene blue in thirty minutes in the laboratory at atmospheric shade temperature not exceeding 65° F until between 9 a„m. and 10 a.m. on the day following that on which the sample was collected. To comply with the Milk (Special Designation) (Raw Milk) Regulations, 1949, Tuberculin Tested and Accredited Milk must not decolourise methylene blue within 4½ hours if the sample is taken between 1st May and 31st October, or within 5½ hours if taken between 1st November and 30th April. Tuberculin Tested (Sterilised) and Sterilised Milk when submitted to the turbidity tests must show no sign of turbidity. During 1953, 110 samples of milk were purchased by the Sampling Officer and submitted to the appropriate tests. Of these, 27 were taken at the early morning delivery to the hospitals in the Borough and 31 were taken at schools under the control of the London County Council. The following table gives details of these samples:- Grade of Milk No: of samples tested Phosphatase Test Methylene Test Turbidity Test Passed Failed Void Passed Failed Void Passed Tuberculin Tested 13 13 — - 13 — - — (Pasteurised) Pasteurised 84 80 — 4 81 — *3 — Sterilised 13 - - - - - - 13 Void due to atmospheric shade temperature exceeding 65° F. (56) The milk now retailed in Fulham is slther the product of "tuberculin tested" herds or has been "pasteurised" or "sterilised" in accordance with the provisions of the above Regulations. The use of these special designations is only permissible by persons duly licensed by the local authority. Licences issued under these Regulations are renewable annually on the 1st January, principal licences being granted to retailers occupying premises within the Borough, whilst supplementary licences are issued to purveyors who distribute milk in Fulham from premises situated outside. The following are details of licences granted for the year 1953:- No: of licences to retail Tuberculin Tested milk 80 No: of Supplementary Licences to retail Tuberculin Tested Milk 10 No: of licences to pasteurise milk 1 Nos of licences to retail pasteurised milk 101 No: of supplementary licences to retail pasteurised milk 10 No: of licences to retail sterilised milk 118 No: of supplementary licences to retail sterilised milk 10 (57) ICE CREAM (HEAT TREATMENT) REGULATIONS, 19A7 - 1952 These Regulations control the preparation and subsequent treatment of ice cream „ Ice Cream must be kept at a temperature of not more than 28° F. and should the temperature rise above 28° F. the ice cream must be subject to further heat treatment and again kept at a temperature not exceeding 28° F. The Methylene blue test is recommended as a guide for ascertaining the bacteriological cleanliness of ice cream, the time taken to decolourise Methylene blue being recorded and the samples graded as follows Provisional Time taken to reduce Grade Methylene blue 1 4½hours or more 2 2½ to 4 hours 3 ½ to 2 hours 4 Less than ½ hour During 1953, 75 samples of ice cream were examined and graded as follows Taken Grade Wrapped from Total 1 38 30 68 2-11 3-33 4 - 1 3 3 Totals 38 37 75 In addition to the above, 31 iced lollies were examined, all of which satisfied Grade I. Samples falling within Grade I and 2 are regarded as satisfactory, whilst Grades 3 and A indicate carelessness in hygiene at some stage in the manufacture, handling or storage of the ice cream. It is the practice in Fulham to investigate fully when samples fall within the latter grades. (58) THE FOOD STANDARDS (ICE CREAM) ORDER. 1953. This Order which became operative on 1st June, 1953, rescinded the Food Standards (Ice Cream) (Amendment) Order, 1952, which was a temporary measure under which the standards for ice cream were reduced to avoid a reduction in the supply owing to a shortage of milk powder and fats. The standard laid down for ice cream (but not water ice or ice lollies) in the 1951 Order, vizs fat not less than 5 per cent, 10 per cent sugar and milk solids other than fat, 7½ per cent was reintroduced . During 1953, 36 samples of ice cream were purchased for chemical analysis by the Public Analyst all of which were reported to be genuine, a summary of the results being:- Percentage of fat Nos of samples Less than 5 per cent 1 5 per cent - 7½ per cent 7 7½ cent - 10 per cent 19 Over 10 per cent 9 The average composition of all samples was 8.79 per cent of fat. FOOD AND DRUGS ACT. 1938 - 1950 During the year under review, 800 samples of food and drugs purchased by the Sampling Officer were submitted to the Council's Public Analyst for chemical analysis. The samples were taken under the various Acts, Orders and Regulations relating to foodstuffs. The Public Analyst reported adversely on 39 of the samples examined, 3 of which were milk and are referred to on p.p. 59&6l.In one case only were legal proceedings instituted, the following being the details:- Article Result of Analysis Result of legal Proceedings Preserved Pork Sausages 15.3 per cent deficient in meat Manufacturer fined £6. 0.0, Costs £6. 6.0. (These sausages were not manufactured in Fulham) (59) Action taken on recommendation of the Public Health Committee in connection with the other articles of food which were reported to be not in accordance with accepted standards is as follows:- Sample No: Article Result of Analysis Action taken 5 Suet Possessed strong odour of decomposition and contained bacteria. Improperly refined. Advice given to butcher by whom suet was prepared 80 Pork sausages Contained total meat 55%, 15.3% deficient in meat. Meat Products Order, 1952. Manufacturer fined £6. and £6. 6.0. Costs. 93 Barley flakes Consisted of ground rice Prepacked-obviously an error. 95 Sweetened condensed milk Contained volatile oil determined as butyric acid. .02% odour and taste of butyric acid. Inferior. Remainder of stock surrendered for destruction. 113 Canned cherries Objectionable fish oil flavour. Slight interior pressure and tinplate badly stained. Not of the quality demanded. Remainder of stock surrendered for destruction. 118 Milk Contained 8.21% solids not fat. Not less than 3.4% added water. Sale of Milk Regulations, 1939. Purveyor warned. 124 Semolina Too fine. 64% passed 40 mesh sieve. Not more than 40% should pass 40 mesh sieve. No action. 129 Milk Contained 8.27% solids not fat. Not less than 2.7% added water. Sale of Milk Regulations 1939. Taken from purveyor of sample No.118 to determine cause of added water. (60) Sample No: Article Result of Analysis Action taken 152 Pork sausages Contained total meat 54%. 16.9% deficient in meat. Pork sausages must contain not less than 65% meat. No action recommended by Public Health Committee in this instance. Sample No.80 being treated as test case. 157 Prunes Inferior, Very dried,unsightly appearance. Not of the quality expected No action. 164 Dried peaches Inferior. Very small, Possessed odour of apricots whilst cooking. No action 167 Mustard mixture Contained 0.22% allyl isothiocyanate and 8,9% moisture. 130 viable mould spores per gramme present. Food Standards (Mustard)(No.2) Order 1944 Amendment No.2 Order, 1948. Remainder of stock surrendered for destruction. 182 Flaked Tapioca Uneven in size containing lumps and powder. Could not be properly cooked. No action. 188 Canned Strawberries Rancid fish oily flavour. Remainder of stock withdrawn. 234 Pork sausages Contained 58% meat only; must contain 65% meat. Manufacturer warned by letter. 245 Vinegar Inferior. Contained 4.3% of acetic acid and considerable mould growth. Probably old stock. Remainder of barrel sold before result of analysis received. 257 Ground Almond substitute Contained 13.7% total oil. Mixture of soya flour, pea or bean flour and oatmeal. Ground almonds contain approximately 50$ almond oil. Result of analysis communicated to vendors. (61) Sample No Article Result of Analysis Action taken 356 Pork Sausages Contained 62% meat only. Manufacturer warned by letter. 359 Tapioca Uneven in size containing lumps and powder. Could not be cooked properly. Result of analysis communicated to vendors. 364 Strawberryflavoured powder Not strawberry flavour powder but essentially an imitation lemon powder with a pale yellowy-red colour. Misdescription due to error on part of shopkeeper. 408 Semolina Too fine. 62% passed 40mesh sieve. Not more than 40% should pass a 40sieve, No action. 449 Butter Free fatty acids 1,64% had a slight cheesy flavour and odour. Must not contain more than 1,5% free fatty acids. Result of analysis communicated to complainant. 460 Milk Contained 7.99% solids not fat, 6% deficient in milk solids not fat. Sale of Milk Regulations, 1939. Purveyor warned by letter. 491 Natural Orange juice Contained only 1,7 mg. ascorbic acid per 100 mls. of fruit juice. Must contain approx. 50 mgs. Matter taken up with manufacturers who replaced remainder of retailer's stock with fresh supply 505 Lard Rancid. Kreis test positive. Contained ,77% free fatty acids calculated as oleic acid. Matter taken up with retailer. 516 Lard Slightly brownish in colour. Contained 1,2% free fatty acids, Slightly overcooked. Inferior. No action. (62) Sample No: Article Result of Analysis Action taken 559 Beef Sausages Inferior. Taste slightly soapy due to addition of alkali. % Matter brought to notice of manufacturer . 567 Cut Peel Sugar crystallised in minute crystals. Stale stock. Inferior Remainder of stock withdrawn from sale, 588 Ice lolly Contained 1,6 parts per million of lead. Must not be more than 1 part per million Matter taken up with manufacturer. 594 Butter drops Cotained only 2.34% fat. 41% deficient in fat„ Must contain not less than 4% of butter Warning letter to manufacturer. 614 Ice lolly Contained lead 2.5 parts per million. Excess lead. Manufacturers interviewed and plastic moulds substituted for metal. 636 Loose cut peel Contained only 55.3 per cent total sugar. Deficient in sugar Attention of retailers and importers drawn to deficiency 648 Canned Pineapple Contained only 17.2% sugar. Tin plate of can attacked by acid juice. Fruit contained 104 parts per million of tin, and juice contained 47 parts per million of tin. Pineapple immature, woody and tasteless. Inferior. Result communicated to retailer at whose request sample analysed. 680 Dried milk Would not mix properly with water. Hydrogen ion concentration 5.6 inferior Milk slightly rancid before evaporation and acidity evaporated off during evaporation. Matter referred to local Food Office and tin replaced for complainant. (63) Sample No: Article Result of Analysis Action taken 714 Oil of Peppermint tablets B.P. Label gives the impression that tablets are something to do with B.P. whereas they are not, "Oil of" and "tablets" not in the same size print as Peppermint B.P. Incorrectly labelled No action. 716 Port Flavour Wine Cup Price 5/9 printed on label and normal price should be 2/- to 2/6. Misleading label to attract quick Christmas trade in market No action. 717 Sparkling Ginger and Rum Cup Labelled with illustrations of grapes and grapeleaves. Contained 5.5 lbs of sugar per 10-Gallons. Contained 104 grains of saccharin per 10-gallons. Nonalcoholic wine must contain not less than Tjp-lbs. sugar per 10-gallons and if sweetened mineral water must contain more than 82 grains of saccharin per 10-gallons. Retailer advised re label etc. 735 Cut Peel Contained total sugars 54.5% deficient in sugar No action 772 Chocolate Sundae Contained equivalent of 0.28% dry fat free cocoa. 7% deficient. Principal ingredient coconut with large quantities of sugar. Not chocolate sweetmeat and doubtful if it should be called Sundae since the term Sundae is restricted almost to iced confection Manufacturers asked to amend description of confectionery. (64) REPORT OF THE COUNCIL'S PUBLIC ANALYST Thomas McLachlan, A.C.G.F.C.. F.R.I.C. During the year 1953, 800 samples of foods and drugs were examined. Of these 20 were taken informally, and 780 formally. This included several samples submitted as a result of complaints, and one submitted privately. The number adulterated or incorrectly labelled was 39, or 4.9 per cent. The incidence of adulteration may be classified as follows:- Article No: of Samples examined No: of samples adulterated Milk 200 3 Other foods 596 35 Drugs 4 1 In general the food situation throughout the country is now improving rapidly and, whilst the public need the protection of the Food and Drugs Acts as much as ever to protect them from skilful sophistication, there is little doubt that many inferior products will disappear or be forced to improve in order to meet the natural competition of other foods. With the reappearance of proprietary products, however, the shelf life of foods in shops will tend to be prolonged and greater care will have to be devoted to the keeping properties of food on storage. Of the 200 samples of milk received only 3 were reported as adulterated . One sample contained 3.4 per cent and another 2.7 per cent of added water, The third sample was 6 per cent deficient in milk solids not fat, Some National Dried Milk povrier was submitted due to a complaint that it would not mix properly with water. This complaint was found to be justified, The hydrogen ion concentration or degree of acidity was 5.6 but the sample could not be condemned as sour, since it would be suitable for milk puddings. Your analyst considered that the milk was slightly rancid before evaporation and had left the casein insoluble in water. Some sweetened condensed milk possessed an odour and taste of butyric acid. It contained .02 per cent of volatile acid, determined as butyric acid and was reported as inferior. A sample of butter reported as adulterated possessed a cheesy odour and slight cheesy flavour; the free fatty acid content was 1.64 per cent and it gave a slight positive test for rancidity. Under (65) the Oils and Fats Order dripping and similar fats must not contain more than 1.5 per cent of free fatty acids, but a sample of butter such as this would be suitable for cooking purposes. Adverse reports were made on two samples of lard. One contained 1.2 per cent of free fatty acids and had a slightly brownish colour due to being slightly overcooked; the other contained .77 per cent of free fatty acids calculated as oleic acid and gave a strong positive Kreis test for rancidity. 2 Ice lollies contained excessive quantities of lead, 2.5 parts per million in one case and 1.6 parts per million in the other. A sample submitted as "Chocolate Sundae" contained only 0.28 per cent of dry fat-free cocoa. Any confectionery to be called Chocolate Confectionery must contain not less than 4 per cent of fat free dry cocoa. The principal ingredient of this preparation was coconut with large quantities of cherry, and although it was quite a satisfactory sweetmeat your analyst held that the description "Chocolate" was incorrect and was doubtful whether the name "Sundae" should be used since the term is restricted entirely to particular types of iced confections. Some butter drops were examined and found to contain only 2.34 per cent of fat. Butter drops, butter toffee, and similar articles of confectionery must contain not less than 4 per cent of butter; this sample was therefore 41 per cent deficient in fat. 4 samples of pork sausages were reported as deficient in meat content. They contained less than 65 per cent of meat, namely 54 per cent, 55 per cent, 58 per cent, and 62 per cent respectively. Some beef sausages were submitted because of the complaint that they had a soapy or bitter taste. The complaint was found to be justified, the slightly soapy taste being due to tho addition of alkali. At the present time many samples of meat products contained added alkali. The custom originated abroad and it is intended to prevent the separation of fat. It was suggested that the attention of the manufacturers should be drawn to the fact that many people are objecting to this flavour in sausages and similar commodities. A can of cherries possessed a metallic flavour which developed as a definite fish oil taste in the mouth and was most objectionable. The condition of the tinplate was badly stained, and they were reported as adulterated because they were not of the quality demanded. Some canned strawberries also possessed a slightly rancid fish-oily flavour, but the tinned iron surface of this can was not very badly attacked. A sample of canned pineapple slices in syrup contained only 17.2 per cent of sugar, and the pineapple itself was immature, woody, and tasteless. Tinned pineapple usually contains about 30 per cent of sugar. (66) The drained fruit contained 104 parts and the juice 47 parts per million of tin, due to the attack of the acid juice on the tin plate of the can. A bottle of Natural Orange Juice, described as "The undiluted juice and oil of sun ripened fruit, with added sulphur dioxide as preservative" was found to contain only 1.7 mg. of ascorbic acid per 100 mis. of fruit juice, whereas it should contain approximately 50 mgs. On taking the matter up with the manufacturers the sample wa3 found to be old stock and was withdrawn from sale. Some dried peaches were reported as inferior} they consisted of dried peaches but the halves were very small looking like apricots and, when cooked, they had an odour of apricots rather than of peaches. Some prunes were also reported as inferior as they were veiy dried and had an unsightly appearance, but were satisfactory when cooked . A bottle of Port Flavour Wine Cup was considered to have a misleading label. Whereas the normal price should be 2/- to 2/6d., the price printed on the label was 5/9d. A sample of Sparkling Ginger and Rum Cup also had a misleading label, being labelled with illustrations of grapes and grape leaves. Your analyst considered that from the titles of these products they were supposed to be Non-Alcoholic Wines. According to the Soft Drinks Order, 1947, as amended, non-Alcoholic Wines must contain not less than 7½-lbs. sugar per 10-gallons, whereas the Ginger and Rum Cup contained only 5.5-lbs sugar per 10-gallons. If it was claimed to be a sweetened mineral water, not more than 82 grains of saccharin should be present in 10-gallons whereas it contained 104 grains. 3 samples of Cut Peel were reported against. 2 were deficient in sugar, one containing only 55.3 per cent and the other 54.5 per cent. The third sample was very stale stock and the sugar had crystallised badly on the outside. 2 samples of semolina were considered to be too fine a product for that which the public understands as semolina. Your analyst considers that not more than 40 per cent 3hould pass a 40-mesh sieve, but in one case 64 per cent passed a No. 40-mesh sieve and in the other case 62 per cent passed. 2 samples of flaked tapioca were found to be uneven in size, containing lumps and powder. This made it impossible to cook the tapioca properly, and they were reported adulterated. A sample submitted as Barley Flakes was found to consist of ground rice. Some ground almond substitute was examined and found to be a mixture of soya flour, pea or bean flour and oatmeal. The fat content was 13.7 per cent whereas ground almonds contain approximately 50 to 60 per cent of oil, and this product could not therefore be a substitute (67) for ground almonds. Soya flour, pea or bean flour, and oatmeal are all very much cheaper than almonds, and this preparation was much more like almond luting than ground almonds. A sample submitted as Strawberry Flavoured Powder had a predominating flavour of lemongrass oil, and was essentially an imitation lemon powder. A sample of suet examined was found to be nearly 100 per cent fat, but it possessed a very strong odour of decomposition and contained over 100,000 bacteria per gramme. Your analyst considered it had been improperly refined. Possibly the butcher had wished to refine it very carefully but had insufficient knowledge of how to do this. A sample of mustard mix possessed a mouldy taste and contained 8.9 per cent moisture which is higher than is usual. It contained only 0.22 per cent of volatile oil of mustard as allyl isothiocyanate whereas the Food Standards (Mustard) (No.2) Order, 1944 (Amendment No.2) Order, 1948, requires mustard to contain 0.35 per cent of allyl isothiocyanate. It was also found to contain 130 viable mould spores per gramme of mustard. It was unfit for food purposes but could be used for mustard poultices, etc. A sample of vinegar contained 4.3 per cent of acetic acid but there was a considerable amount of mould present. It was thought to be old stock. Some peppermint tablets were considered incorrectly labelled. They were labelled "Oil of PEPPERMINT B.P. Tablets" giving the impression that they were something to do with the Pharmacopoeia whereas they were not. The words "Oil of" and "tablets " were not in the same size print as "Peppermint B.P." . Complaints were made about four other samples, but your analyst could find nothing the matter with them either chemically or by eating portions. The following items of legislation or proposed legislation were introduced during the year:- The most important of these was the Food and Drugs Bill, which had its first reading in the House of Lords in November. This Bill is primarily a consolidating bill and will enable a large volume of Emergency legislation to be made permanent. It will also tidy up some of the law under the existing Food and Drugs Acts, 1938 - 1950. Unless an Act of this nature were passed it would be difficult to retain a considerable number of Statutory Orders introduced by the Minister of Food during and since the war. Unlike much of the temporary legislation (68) of the last few years a considerable amount of thought is being given to this Bill and all interested parties should find an opportunity to have their views expressed in one or other of the Houses of Parliament. The Labelling of Food Order, 1953, was largely a re-enactment of the previous Labelling of Food Order, but it released what are commonly known as biscuits from the necessity of declaring their ingredients. It permits the labels of intoxicating liquors to be printed either with a light block print on a dark background or the reverse, it permits the addition of emulsifying salts and edible starch merely to be defined as such, when added to stated foods, and it allows preparations specified in the British Pharmacopoeia or the British Pharmaceutical Codex to be sold without a declaration of composition. On the other hand it requires French coffee and Vienna coffee to be labelled "coffee and chicory mixture" or "coffee with fig seasoning" in substantially as conspicuous wording as "French coffee" or "Viennese coffee" „ It also prohibits the sale of solutions containing more than 15% of acetic acid by anyone other than a pharmacist or an authorised seller of poisons unless the labels are marked "Dangerous - not to be used unless diluted" together with the relevant wording showing the concentration of acetic acid present. The Cream and Use of Milk (Revocation) Order, 1953, enabled home produced cheese and cream to come on to the market again by removing restrictions on manufacture and sale. It also permits the use of milk in the manufacture of bread, biscuits, pastries, cakes, ice-cream and confectionery generally. The Food Standards (Ice Cream) Order, 1953, re-enacted the Food Standards (Ice Cream) Order, 1951, and re-introduced the minimum fat content of 5%, sugar 10%, and milk-solids-not-fat 75% of the sugar must be sucrose, i.e. cane or beet sugar, and the other 25% may be invert sugar or sugars derived from the hydrolysis of starch. The Milk (Great Britain) Order, 1953, replaced with amendments the Milk (Control and Maximum Prices) Order, 1951, and from, the public analyst's point of view the essential factor in this Order is the permission to sell Channel Islands and South Devon milk containing less than 4 per cent of fat under their own names, so long as the prices charged are only those permitted for other milks In the same categories, i.e „ as ordinary milk, tuberculin tested milk, or tuberculin tested farm bottled milk. The Public Health (Condensed Milk) (Amendment) Regulations, 1953, re-enacted the provisions of Regulation 60 CAA of the Defence (General) Regulations and permits the sale of full cream unsweetened condensed milk imported by the Minister containing not less than 7.8% of fat and not less than 25.5% of all milk solids including fat. (69) The Flour Order, 1953, and the Bread Order, 1953, allow some relaxation in the control of flour and bread, Any flour, other than that obtained by the grinding of the whole wheat, must have prepared chalk added to it at the rate of 14-oz. per 280-lb. sack, and all flour of an extraction rate of less than 80% is required to have added to it iron, vitamin Bl, and nicotinic acid in sufficient quantity to ensure a minimum stated quantity of each. The Bread Order permits the sale of breads other than National Bread, so long as National Bread is available for sale when other varieties are sold. Mention was made in the report last year of the number of Meat Orders introduced. The Canned Corned Meat (Prices) Order, 1953, and its amending Order, and the Offals in Meat Products Order, 1953, removed all controls on meat products other than the prohibition of the use of certain offals in the composition of uncooked open meat products for sale for human consumption and the control of the retail price of canned corned meat. During the year there were three Orders relating to the use of oils and fats in food. The Oils and Fats Order, 1953; The Oils and Fats (Amendment) Order, 1953, and The Oils and Fats (No. 2) Order, 1953. These Orders relate primarily to the oils which may be sold with or without a licence from the Minister of Food, but whereas the first Order laid down standards for dripping and for horsefat for edible purposes, these standards were revoked by the repeal of the Order and the promulgation of the No. 2 Order. In many ways it is to be regretted that, when standards of quality, such as those relating to the quantity of free fatty acids in fats and oils, have once been introduced, they are not carried forward in some way in later Orders. The Public Health (Preservatives etc. in Food) (Amendment) Regulations, 1953, and the amending Order brought into permanent legislation the permission to employ diphenyl for the treatment of wrappers for citrus fruits. The Regulations also allow the use of sulphur dioxide as a preservative for certain dried vegetables, and, for a limited period, the continuance of the addition of borax to margarine. During the year the Food Standards Committee by its Preservatives Committee issued a Report regarding the addition of anti-oxidants to foods. This Report stated that there is no objection to the continuation of the use of certain anti-oxidants in the preparation of foods, such as ascorbic acid (Vitamin C), lecithin (a natural substance generally associated with fat in foods, especially in yolk of egg), tocopherols (vitamin E, present especially in the germ portions of seeds), citric and tartaric acids, all of which are naturally occurring products and therefore not considered as preservatives in the legal sense of the word. The Committee also considered that iso-ascorbic acid may be considered as similar to ascorbic acid. The Committee recommended, however, something new to British, though not to foreign, law - the legalisation of two other anti-oxidants, namely: propyl gallate not exceeding 0.01% and butylated hydroxyanisole not exceeding (70) 0.02%, the use of both of which is permitted in the United States and in Canada. The Committee expressed the opinion, however, that no additions should be made to butter and that a periodic review should be made of the necessity to use any anti-oxidants or to permit the use of others, not so far allowed. The Food Standards (Preserves) Order, 1953, replaced the earlier Food Standards (Preserves) Order, as modified in 1950, which had been in force since 1944, since one of the worst periods of the war. It abolished the distinction between fresh fruit and full fruit jams and modified the quantity of fruit required to be present in various jams. The main provisions remain, however, unaltered. Arising from the effects of this Order it is interesting to note that various manufacturers have endeavoured recently to place on the market various types of fruit flavoured spread analogous to lemon curd. Lemon cheese or lemon curd has been known for many years and shortly before the outbreak of the last war orange curd appeared on the market. The Food Standards (Preserves) Order makes provision for orange and lemon curds by requiring fruit curds to contain 4 parts of fat, 0.33 part of citric acid and 0.125 part of oil of lemon or 0.25 part of oil of orange, together with a certain quantity of egg and the soluble solid matter not less than 65 per cent. It will be appreciated that the stipulation that a fruit curd must contain either lemon or orange oil renders it almost impossible to market products such as banana or apricot curd without inventing a fresh description for them. The Saccharin Order, which had been in force in various forms since early in the war was revoked and a new Artificial Sweeteners in Food Order, 1953, introduced, This new Order prohibits the use of any artificial sweeteners other than saccharin in food, and results from doubts as to the harmlessness of dulcin and the believed harmful effects of P.4000. The Soft Drinks Order was revoked during the year and the Food Standards (Soft Drinks) Order, 1953, introduced to take its place. The chief effects of the new Order are to make provision for medicated and glucose beverages, which had hitherto been manufactured since the outbreak of the last war under licence, the application of minimum standards to drinks for diabetics and to ginger beer and herbal and botanical beers, and the omission of specific reference to non-alcoholic wine, non-alcoholic cider and non-alcoholic perry, which are now considered to fall under the heading of "any other description of soft drink containing fruit juice". The Order similarly makes allowance for soft drinks made from whole fresh oranges. This Order may give rise to questions of interpretation and legality. The High Court decided that there can be no such thing as "Non-brewed vinegar" because vinegar must be tho product of double fermentation and many people believe that (71) there can, therefore, be no such things as "non-alcoholic wines, non-alcoholic cider, and non-alcoholic perry". The term "non-alcoholic wine" has been used for many years, but non-alcoholic cider and non-alcoholic perry have not even the custom of long use to support them. Similarly there would appear to have been considerable confusion regarding the names by which drinks made from whole orange should be described and how much orange should be contained therein, but this point is one to be settled in the future. Article No: of Samples Examined No: of Samples Adulterated etc. Formal Informal Private Total Formal Informal Private Total Ale 11 - - 11 - - - - Almonds, ground 10 - - 10 - - Almond substitute, ground 1 - - 11 - - 1 Barley, flakes 1 - - 11 - - 1 Barley, pearl 3 - - 3 - - - Batter flour 7 - - 7 - - - Blancmange powder 1 - - 1 - - - Bread crumbs 1 - - 1 - - - Butter 37 - - 37 1 - - 1 Cheese 6 - - 6 - - Cheese, cream 1 - - 1 - - - - Cider 2 - - 2 - - - - Cocoanut, desiccated 2 - - 2 - - - Cocoanut, shredded 1 - - 1 - Confectionery 12 - - 12 2 - - 2 Cooking fat 12 - - 12 - - - Cooking fat, Kosher 2 - - 2 - - - - Cornflour 1 - - 1 - - - - Cream 1 - - 1 - - Curd, Lemon 2 - - 2 - - - Dripping 5 - - 5 - Flour 5 - - 5 - - - Flour, S.R. 13 - 13 - - Flour, Soya 1 - - 1 - - - Fruit, canned - 4 - 4 3 - 3 Fruit, cake, sweetened 1 - - 1 - - - Fruit, dried 33 - - 33 2 - 2 Fruit juice 1 - - 1 1 - - 1 Carried forward 173 4 - 177 8 3 - 10 (72) Article No: of Samples Examined No: of Samples Adulterated etc. Formal Informal Private Total Formal Informal Private Total Fruit, glace 3 - - 3 - - - Ice Cream 33 3 - 36 - - Ice Lollies 12 5 - 17 2 - - 2 Jam 22 - - 22 - - Lard 10 - 10 2 - 2 Macaroni 4 - - 4 - - - Margarine 5 - - 5 - - - Marmalade 1 - - 1 - - Meat 3 - - 3 - - - Meat Pudding 1 - - 1 - - - Milk 200 - - 200 3 - 3 Milk, condensed - 1 - 1 - 1 - 1 Milk Powder - 2 - 2 - 1 - 1 Mincemeat 18 - 18 - - - Mincemeat, dry 1 - - - 1 - - Mustard mix 1 - - 1 1 - - 1 N.B. Condiment 10 - - 10 - - Oatmeal 2 - - 2 - - Oats, Breakfast 2 - - 2 - - - Oil, teaseed 2 - - 2 - - - Paprika 1 - - 1 - - - Peas, canned - 1 - 1 - - - Peel, candied 1 - - 1 - - Peel, cut 11 - - 11 3 - - 3 Pepper, white 3 - 3 - Pie, meat 1 - - 1 - - - Pulses 15 - 15 - Rice, flaked 1 - - 1 - - - Rice, granular 1 - - 1 - - - Brought forward: 173 4 - 177 8 3 10 Carried forward: 537 16 - 553 19 5 - 23 (73) Article No: of Samples Examined No: of Samples Adulterated etc. Formal Informal Private Total Formal Informal Private Total Brought forwards 537 16 - 553 19 5 - 23 Rice, ground 1 - 1 - - - Saccharin tablets 22 - - 22 - - - Sago 5 - 5 - - - Sausages 63 - 63 5 - - 5 "black pudding 2 - 2 - - Sausage Rolls 2 - - 2 - - - Semolina 6 - - 62 - - 2 Soft Drinks 35 2 37 1 2 - 3 Soup Powder - 1 - 1 - - - - Spirits: Brandy 2 - - 2 - - - Gin 6 - - 6 - - - Rum 11 - - 11 - - - - Whisky 5 - - 5 - - - Suet 8 — — 8 1 — — 1 Suet, shredded 6 - - 6 - - Tapioca 9 - 9 1 - Tapioca, flaked 2 - - 2 1 - - 1 Tapioca, seed 1 - - 1 - - - - Tea 29 - - 29 Vinegar 17 - - 17 1 - - 1 Wine: Burgundy - - 1 1 - - - Ginger 4 - - 4 - - - Ruby wine, Port type. 1 - - 1 - - - - Sherry 2 - 2 - - - - Drugs:Camphorated oil - 1 - 1 - - - Peppermint tablets 1 - - 1 1 - - 1 Sulphur ointment 1 - - 1 - - Zinc & Castor Oil ointment. 1 - - 1 - - - - - - Totals 779 20 1 800 32 7 - 39 (74) (i) INDEX Page Acts of Parliament 31 Aintree Street Clearance Area 37 Area of Borough 7 Articles cleansed 24 Articles destroyed 35 Atmospheric Pollution4-0,41 Bacteriological Examinations; Medical Specimens 20 Milk 55,56 Cream Confectionery 52 Bakehouses & Bakers' shops 46 Bath Water Samples 46 Births 7 Birth and Death Rate Graph 10 Burial or Cremation of the Dead 24 Certificates of Habitation 37 Certificates re Contacts of Infectious Disease 17 Chest Clinic, Report of 18,19 Circulars, Ministers of Health and Food 32 Classification of Causes of Death 8 Clearance Area 37 Comparison between Birth and Death Rate 10 Complaints re Food 50 Condemnation of Unsound Food 48 Conveniences, Public 25,26 Cream Confectionery 52 Deaths, Classification of causes of Deaths and Birth Rate Graph ... Page Deaths, Infant 7,9 Deaths, Maternal 9 Death Rate 7,10 Destruction of Articles 35 Diseases, Infectious Notifications 13 Diseases, Notifiable 11,12 Disinfestation and Disinfection 35 Drainage 39 Dwellings completed by Fulham Borough Council 38 Dwellings, Number in Borough. 7 Dysentery 14 Dysentery (Sonne) 16 Epidemic Winter Vomiting 16,17 Examinations: Bacteriological 20 Medical. 20 Exclusion from work of Contacts of Infectious Disease 17 Factories Act 41,42 Film Shows 30 Food Borne Sonne Dysentery 16 Food Byelaws 45 Food Complaints 50 Food Condemnation 48 Food & Drugs Acts 48 Food Establishments 51 Food Inspection and Supervision 48 Food Premises, Inspections 47 Food Poisoning 14 Food Standards (Ice Cream Order) 58 8 10 (ii) Page Fulham Borough Council, dwellings completed 38 Fulham Chest Clinic, Annual Report 18 Habitation Certificates 37 Health Education 30 Health Guide Booklet 36 Health Hints 31 Health Services, L.C.C 27,28,29 Heating Appliances (Fireguards) Act, 1952 44 Heating Appliances (Fireguards Regulations, 1953 44 Heat Treatment (Ice Cream) 54 Hospitals in the Borough 21 Housing Act, 1936 36,37 Ice Creams Food Standards Order 58 (Heat Treatment) Regulations.. 57 Incidence of Measles and Whooping Cough 15 Incontinent Persons 23 Infant Deaths & Death Rate 7,9 Infectious Disease: Notifications 13 Rates 14 Inspection and Supervision of Food 47 Introduction 4,5,6 Laundry Services 35 Lectures and Discussions 30 Legal Proceedings 35 Legislation - New 33 Page Licences? Milk 56 Slaughtermen's 48 Live Births 7 L.C .C.: Estates, Rehousing 37 Health Services 27,28,29 Mass X-Ray Service. Visit of 20 Maternal Deaths 9 Medical Examinations 20 Measles Graph 15 Members of Public Health Committee 1 Milk: Bacteriological examination 55,56 Licences 56 Purveyors, Registration 54,55 Regulations, Sale of 52,53,54 Mortuary 24 National Assistance Act; Section 47 23 Section 50 24 National Assistance (Amendment) Act, 1951 23 New Legislation 33 Notifiable Diseases 11,12 Notification of Infectious Diseases 13 Notification of Tuberculosis (Graph) 19 Old Peopled Welfare 22 Old People, Visits to 22 Outwork 43