AC4342 HOL 47 The Metropolitan Borough of Holborn, ANNUAL REPORT OF THE MEDICAL OFFICER OF HEALTH FOR THE YEAR / 1949 J. A. STRUTHERS, M.D., m.R.C,p. D.p.h. Printed by Diprose, Bateman & Co., 4-5, Creed Lane, London, E.C.4. pc ask. 5/12/50 The Metropolitan Borough of Holborn. ANNUAL REPORT of the Medical Officer of health For the Year 1949. J. A. STRUTHEKS, m.d., m.r c.p., d.p.h. CONTENTS. Introduction 6 Section 1.—General Information and Statistical Summary 7 Section .2.—Births and Deaths 11 Section 3.—Infectious Disease 17 Section 4.—Sanitary Circumstances 24 Section 5.—Factories 36 Section 6.—Inspection and Supervision of Food 39 Section 7.—Tuberculosis 49 3 INDEX. PAGES Aged and Infirm Persons 35 Altitude 7 Ambulance facilities 9 Area of Borough 7 Bacteriological examinations— Ice cream 44 Infectious disease 21 Milk 43 Bakehouses 39 Births— Notification of 11 Rates 11 Registered live 11 Registered still 11 Bodies received at Mortuary 34 Bombed sites 28 Burial of the dead 35 Cancer 8 Cerebro-Spinal Meningitis 18 Chest Clinic 8 Cleansing Station 34 Committee, members of 5 Common Lodging Houses 24 Complaints 27 Day Nurseries 8 Deaths— Classification with age distribution 13 Infantile by causes, and age distribution 15 Number and rate, all ages 11 Puerperal 14 Rate, infants under 1 year of age 14 From tuberculosis 16 Diphtheria 18 Diphtheria immunisation 18 Disinfection 33 Disinfestation 33 Drainage 28 Dysentery 17 Emergency Bed Service 10 Erysipelas 18 Factories 24, 26, 36 Factories Act, 1937—Notices 36 Food & Drugs Act, 1938— Notices served 39 Work carried out 39 Food & Food Premises— Bakehouses 39 Ice cream 41, 42, 43 Milk supply 44 Unsound food condemned, Table 46 Food poisoning 18 Food sampling 45 General rate 7 PAGES Highways, area of 7 Hospitals in the Borough 9 Housing— Houses let in lodgings 25, 30 Housing Act, 1949 30 Notices 25 Overcrowding 30 Rent and Mortgage Interest (Restrictions) Acts 29 Underground rooms 30 Ice cream— Registration of premises 44 Bacteriological examination 44 Chemical samples 45 Fat content 44 Ice Cream (Heat Treatment, etc.) Regulations, 1947 44 Infantile mortality— Causes, and age distribution 15 Rate 14 Causes, since 1940 15 Infectious Diseases— Bacteriological examinations 21 Notifiable 17 Non-notifiable 19 Summary of notifications, 1949 20 Comparative figures for years 1920-1949 22, 23 Inspections by Sanitary Inspectors 24 Inquests 34 Licensed premises 45 Live births 11 Malaria 17 Marriages 8 Marriage rate 8 Mass Miniature Radiography 52 Maternal Mortality 14 Maternity and Child Welfare Centres 8 Measles 18 Milk- Bacteriological examinations 43 Chemical samples 42 Distributors on register 42 Licences granted 43 New legislation 40 Registrations 41 Mortuary 34 National Assistance Act, 1948 35 Notices served 25, 36, 39, 40 Notifiable diseases, list of 17 Notifications of births 11 Notifications of infectious diseases 20 Nuisances remedied 26 Nurseries, day 8 4 INDEX —continued. PACES Ophthalmia Neonatorum 18 Outworkers 37 Overcrowding 30 Penny rate, product of 7 Pharmacy and Poisons Act, 1933 29 Pneumonia 18 Poisons Rules, 1949 29 Poliomyelitis, Acute 18 Population , 11 Post-mortem examinations 34 Public Analyst 45 Public Health Committee, members of 5 Public Health (London) Act, 1936— Notices served 25, 40 Work carried out 26 Public Mortuary 34 Puerperal Pyrexia 19 Rats & Mice (Destruction) Act, 1919 26 Rat extermination 31 Rateable value 7 Registered live Births 11 Registered still births 11 Rent and Mortgage Interest (Restrictions) Acts, 1920-1939 29 Restaurants 39 Roads, length of 7 Rodent Control— Block control schemes 31, 32 Complaints 32 General 32 Sewers 33 PAGES Sampling 45 Sanitary circumstances of the area 24 Sanitary inspector's visits 24 Scabies 19 Scarlet fever 19 Shops Act, 1934—Notices 26 Slum clearance 30 Smallpox 19 Smoke abatement 28 Soil 7 Statistics and general information 7 Static water tanks 29 Statutory Notices 25 Still births 11 Tuberculosis— Deaths 49 Mass radiography 52 Notifications 49 Notifications and deaths since 1906 51 Summary of changes in register 50 Underground rooms 30 Unsound food 46 Vital statistics 8, 12 War-time reservoirs for emergency water supplies 29 Water certificates 28 Water supply 28 Whoooing cough 19 5 The Metropolitan Borough of Holborn. PUBLIC HEALTH COMMITTEE. The Mayor and Deputy Mayor are ex-officio members of all Standing Committees of the Council. The Mayor in 1948/49 was Councillor George E. Cox, J.P., and in the current year is Alderman J. H. Boraston, C.B., O.B.E., J.P. The Deputy Mayor in 1948/49 was Alderman Mrs. M. A. M. Chance, and in the current year is Councillor A. J. Matthews. 1948-1949. 1949-1950. Chairman— Chairman— Councillor A. H. Chaplin, B.A., F.L.A. Councillor M. P. Greengross. V ice-Chairman— Vice-Chairman— Councillor Mrs. M. E. Lyden. Councillor W. J. Ridd. Alderman Mrs. L. M. Herring. Alderman Mrs. M. A. M. Chance. Councillor Miss M. M. Buckatzsch, B.A. Councillor A. C. Bulger. „ S. C. Elphick. „ Miss C. E. Clayson. „ Miss D. E. Foster. „ Mrs. L. J. Coleman. „ M. P. Greengross. „ Miss M. R. Duncan. „ Mrs. K. Little. „ Miss D. E. Foster.* „ Mrs. D. Lonergan. „ A. Judd. „ Miss M. Oxlin. „ Miss B. M. Moir. „ Mrs. E. A. Pooley. „ Miss Ivy Simpson, B.Sc.†. „ G. B. M. Reed. „ G. Theobald. „ S. H. Watson. *Resigned 11.10.49. † Appointed to fill vacancy 8.11.49. 6 Public Health Department, Town Hall, 197, High Holborn, W.C.I. July, 1950. To the Mayor, Aldermen and Councillors of the Metropolitan Borough of Holborn. Your Worship, Ladies and Gentlemen, Herewith I beg to present a report upon the health and sanitary conditions of the Borough for the year 1949. I am, Your obedient Servant, J. A. STRUTHERS, Medical Officer of Health. 7 SECTION 1. General Information and Statistical Summary. General. Holborn, with an area of 405 acres, is the smallest of the Metropolitan Boroughs. It is about 1¼ miles long, extending from Tottenham Court Road in the West to Farringdon Road in the East, and averages about half a mile in width. Soil.—Most of the Borough is covered with Taplow Gravel to a depth of between 10 and 20 feet overlaying London Clay which varies in thickness from about 50-60 feet in the North of the Borough to about 80 - 100 feet in the South. In the North East corner there is a small area of London Clay without gravel cover, and in the extreme South East the London Clay is covered with brickearth. There is a deposit of alluvium in the valley of the old Fleet River in the extreme East of the Borough. Typical Sections are:— 1. Tottenham Court Road - Drift (i.e. including Taplow Gravels) 22½ feet. London Clay 63½ feet. 2. Grays Inn Made Soil 7 feet. Gravel 9½ feet. London Clay 40½ feet. 3. Lincoln's Inn Made Soil 13 feet. Gravel 5 feet. London Clay 113 feet. 4. Bernard Street Made Soil 10 feet. Sand and Gravel 11½ feet. London Clay 46 feet. Altitude.—The altitude varies from 40 feet above Ordnance datum in Farringdon Road in the East, to 92 feet above Ordnance datum in Torrington Place in the North West corner. In the South in Lincoln's Inn Fields the figure is 68 feet. Area of borough highways excluding footpaths - 325,400 super yards approx. Total length of roads about 25 miles. Population (1931) census 38,816 Population (Registrar General's mid 1949 estimate) 25,490 Number of persons per acre (estimated average) 63 Rateable Value £1,480,825 Product of penny rate, about £6,018 General rate for the year 15s. 6d. in the £. 8 TABLE No. 1. Marriages. The following table shows the number of marriages which have taken place in the Boroug since 1939, and the marriage rates for those years:- Year C. of E. R.C., Chapels and Supt. Registrar's Office. Total Marriages. Estimated Population. Marriage Rate per 1,000 Population. 1939 150 458 673 30,660 21.92 1940 124 376 533 23,470 22.86 1941 89 264 372 17,160 21.68 1942 83 253 336 16,580 20.21 1943 82 198 280 17,240 16.24 1944 86 208 294 18,020 16.32 1945 115 284 399 18,680 21.36 1946 86 277 363 21,190 17.13 1947 88 325 413 23,460 17.60 1948 65 349 414 24,960 16.59 1949 67 298 365 25,490 14.32 Summary of Vital Statistics. Live Births 325 Birth-rate (per 1,000 estimated population) 12.75 Deaths, all ages 284 Death-rate (per 1,000 estimated population) 11.14 Infant deaths 12 Infant death-rate (per 1,000 live births) 36.92 Maternal deaths Nil Maternal death rate (per 1,000 live births) Nil (per 1,000 live and still births) Nil Tuberculosis deaths 15 Tuberculosis death-rate (per 1,000 estimated population) .59 Cancer deaths 55 Cancer death-rate (per 1,000 estimated population) 2.16 Maternity and Child Welfare Centres. Telephone 10, John Street W.C.I CH Ancery 7467 London Medical Mission, Short's Gardens TEMple Bar 4533 Chest Clinic. T elephone University College Hospital, Huntley Street, W.C.1 EUSton 5050 Day Nurseries. Telephone Clark's Buildings, St. Giles High Street, W.C.2 TEMple Bar 7105 Kingsway Creche (Voluntary Day Nursery), Kingsway Hall, Kingsway, W.C.2 HOLborn 5676 9 Hospitals in the Borough. Name and Address of Hospital. Telephone No. Type of Hospital. Number of Beds. Hospital for Sick Children, Great Ormond Street, W.C.1. Holborn 9200. Special Teaching Hospital 302 London Homoeopathic Hospital, Great Ormond Street. Terminus 3091. Group 22, N.W. Regional Hospital Board. 168 The National Hospital, Queen Square. Terminus 7721. Special Teaching Hospital 154 Royal Westminster Ophthalmic Hospital, High Holborn, W.C.1. Temple Bar 1457. With Moorfields and Central Eye Hospital, Special Teaching Hospital. 100 St. Paul's Hospital, Endell Street, W.C.2. Temple Bar 0161. With St. Peter's Hospital, Henrietta Street—Special Teaching Hospital. 42 French Hospital, Shaftesbury Avenue, W.C.2. Temple Bar 5025-6. Voluntary Hospital. 14 Italian Hospital, Queen Square, W.C.1. Holborn 6002. Voluntary Hospital. (Opened 19th June, 1950) 47 Ambulance Facilities. The London County Council, as Local Health Authority, is responsible under Section 27 of the National Health Service Act, 1946, for the provision of ambulance facilities within the Administrative County of London. The Home Service Ambulance Department (Order of St. John of Jerusalem and British Red Cross Society) and the Hospital Car Service act as agents of the County Council in supplying some of the ambulance and car transport provided under the Act. The Headquarters of the London Ambulance Service are at The County Hall, Westminster Bridge, S.E.1. Ambulances may be summoned as follows:— (1) Accidents— Sudden illness in the streets, public places or places of employment. (Note—For sudden illness in the home a doctor, not an ambulance, should be summoned. Dial "999" (or follow the instructions given on the telephone instrument) and ask for— "AMBULANCE." (2) Maternity patients (who have booked a bed in a hospital or maternity home)— Very urgent illness in the home (provided a medical practitioner certifies that the case is one of life or death and arrange- ments have been made with a hospital for the patient's admission). Telephone— WATerloo 6000 CENtral 6301 REGent 4000 RELiance 3622 or NEW Cross 2645. 10 (3) Illness, infectious disease, etc.— Normally the hospital to which the patient is to be admitted will summon the ambulance, if one is necessary, by telephoning WATerloo 3311. This applies also to patients being discharged from hospital or attending there as out-patients. Emergency Bed Service. (King Edward's Hospital Fund for London). The Emergency Bed Service was founded in 1938 to assist general practitioners in finding beds for acute emergency cases. Since the 5th July, 1948, the Service, working in close co-operation with the Ambulance Service, has acted as agent for the four Metropolitan Regional Hospital Boards for the admission of all types of cases except mental and tuberculous. Since the 3rd October, 1939, the Central Office of the Emergency Bed Service at Old Jewry (MONarch 3000) has dealt with cases from the Central London area only, from 8.30 a.m. to 9 p.m. daily (including Sundays), branch offices having been established to deal with the outer part of Greater London. At night a full service is available at the Central Office for the whole of Greater London. 11 SECTION 2. Births and Deaths. STATISTICS FOR THE YEAR 1949. Population. The civilian population, as estimated by the Registrar-General, mid-1949, was 25,490 Comparable estimates for preceding years are set out on page 12. Registered Live Births. M. F. Total. Rate per 1,000 Estimated Population. Proportion per 1,000 Registered Live Births. Legitimate 153 138 291 11.42 895 Illegitimate 17 17 34 1.33 105 Total Live Births 170 155 325 12.75 - Comparable figures for preceding 20 years are set out on page 12. Registered Still Births. M. F. Total. Rate per 1,000 Live and Still Births. Legitimate 2 6 8 24.62 Illegitimate 1 1 2 6.15 Total Stillbirths 3 7 10 30.77 Notification of Births. The following figures for Holborn for 1949 have been supplied by the Divisional Medical Officer of the London County Council:— M. F. Total. Live Births 160 155 315 Stillbirths 3 6 9 Total Births Notified 163 161 324 The number of notified births in any year differs from the number of registered births owing to the difference in time allowed for notification and registration. Deaths—All Ages. M. F. Total. Rate per 1,000 Estimated Population. 162 122 284 11.14 Comparable figures for preceding 20 years are set out on page 12. 12 TABLE No. 2. Vital Statistics Since 1919. Year. Estimated Mid-Year Population. Net Registered Live Births. Net Deaths. All Ages. Under 1 Year of Age. Number. Rate per 1,000 Est'd. Population. Number. Rate per 1,000 Est'd. Population. Number. Rate per 1,000 net Live Births 1919 38,156 539 13.6 624 16.4 52 96.5 1920 39,676 827 20.89 603 15.2 55 66.5 1921 43,520 648 14.88 556 12.8 51 78.7 1922 42,850 664 15.49 570 13.3 48 72.3 1923 43,376 595 13.71 526 12.1 47 78.9 1924 43,250 578 13.36 529 12.2 47 81.3 1925 43,315 527 12.16 542 12.5 33 62.6 1926 43,200 535 12.38 522 12.1 48 89.7 1927 42,209 505 11.96 530 12.5 19 37.6 1928 39,280 473 12.0 531 13.5 27 57.1 1929 38,380 392 10.21 598 15.6 29 74.0 1930 38,380 405 10.55 488 12.7 36 88.9 1931 34,470 352 10.21 492 14.3 26 73.9 1932 36,440 349 9.57 517 14.2 25 71.6 1933 36,050 342 9.49 486 13.5 24 70.2 1934 36,000 309 8.58 440 12.2 22 71.2 1935 35,400 271 7.65 420 12.7 24 88.6 1936 34,850 289 8.29 418 11.99 18 62.3 1937 34,600 280 8.09 410 11.85 22 78.6 1938 34,350 250 7.28 358 10.51 19 76.0 1939 30,660 229 6.85 378 12.33 14 61.14 1940 23,470 218 9.29 504 21.47 14 64.22 1941 17,160 191 11.13 432 25.17 9 47.12 1942 16,580 188 11.34 250 15.08 9 47.82 1943 17,240 252 14.62 305 17.69 13 51.59 1944 18,020 207 11.49 302 16.76 11 53.14 1945 18,680 244 13.06 296 15.85 17 69.67 1946 21,190 298 14.06 292 13.78 12 40.27 1947 23,460 338 14.41 295 12.57 12 35.50 1948 24,960 361 14.46 283 11.34 7 19.39 1949 25,490 325 12.75 284 11.14 12 36.92 GRAPH No. 1 BIRTH AND DEATH RATES, 1896-1949. [To face page 12. 13 TABLE No. 3. Causes of., and Ages at, Death. Causes of Death. Net Deaths at the Subjoined Apes of "Residents" whether occurring within or without the District. Under 1 year. 1 and under 5 years. 5 and under 15 years. 15 and under 45 years. 45 and under 65 years. 65 and over. Totals. All ages. M F 1. Typhoid and para-typhoid fever - - - - - - - - - 2. Cerebro spinal fever - - - - - - - - - 3. Scarlet fever - - - - - - - - - 4. Whooping cough - - - - - - - - - 5. Diphtheria — - - - - - - - - 6. Tuberculosis of respiratory system - - - 3 8 3 12 2 14 7. Other forms of Tuberculosis - - - - 1 - 1 - 1 8. Syphilitic disease - - - - 1 1 1 1 2 9. Influenza - - - - 1 - - 1 1 10. Measles - - - - -- - - - - 11. Acute poliomyelitis and polioencephalitis - - - - - - - - - 12. Acute infectious encephalitis - - - - - - - - - 13. Cancer of buccal cavity and oesophagus - - - 1 1 3 1 4 5 14. Cancer of stomach and duodenum - - - - 3 6 5 4 9 15. Cancer of breast - - - - 3 3 1 5 6 16. Cancer of all other sites - - - 3 12 19 22 12 34 17. Diabetes - - - - 1 - 1 - 1 18. Intra-cranial vascular disease - - - - 5 23 14 14 28 19. Heart disease - - - 1 17 58 38 38 76 20. Other diseases of the circulatory system - - - 1 - 8 5 4 9 21. Bronchitis 1 - - - 5 23 16 13 29 22. Pneumonia 3 - - - 2 8 9 4 13 23. Other respiratory diseases - - - - 1 2 2 1 3 24. Ulceration of stomach or duodenum - - - 1 3 3 5 2 7 25. Diarrhoea (under 2) 1 - - - - - 1 - 1 26. Appendicitis - - - - - - - - - 27. Other digestive diseases - - - 1 1 5 4 3 7 28. Nephritis - - - 1 1 2 1 3 4 29. Puerperal and post abortive sepsis - - - - - - - - - 30. Other maternal causes - - - - - - - - - 31. Premature birth 1 - - - - - 1 - 1 32. Congenital malformations, birth injury, infantile disease 6 - - - - - 4 2 6 33. Suicide - - - - 2 3 3 2 5 34. Road traffic accidents - - - - - 1 1 - 1 35. Other violent causes - - - 2 - - 1 1 2 36. All other causes - 1 - 5 6 7 13 6 19 12 1 - 19 74 178 162 122 284 14 Death Rate of Infants under One Year of Age. No. Holborn. London. England and Wales. All infants 12 Rate per 1,000 live births 36.92 29 32 Legitimate infants 11 Rate per 1,000 legitimate live births 37.80 — — Illegitimate infants 1 Rate per 1,000 illegitimate live births 29.41 — — Rates for preceding 10 years:— Year. All Infants. Legitimate. Illegitimate. 1939 61.1 49.5 148.1 1940 64.2 54.4 117.1 1941 47.1 36.8 107.1 1942 47.8 47.6 50.0 1943 51.6 40.5 133.3 1944 53.1 46.8 83.3 1945 69.7 71.1 63.8 1946 40.3 32.0 83.3 1947 35.5 37.4 22.7 1948 19.4 18.6 26.3 1949 36.9 37.8 29.4 Deaths from Puerperal Causes. (i.e., deaths classed by the Registrar-General to pregnancy or childbirth). Deaths. Rate per Sepsis. 1,000 Live and Still Other Causes. Births. Total. Puerperal Sepsis Nil - - - Other maternal causes Nil — — — Comparable figures for preceding 10 years:— 1939 1 — 4.13 4.13 1940 Nil — — — 1941 Nil — — — 1942 2 10.53 — 10.53 1943 1 3.90 — 3.90 1944 Nil — — — 1945 Nil — — — 1946 Nil — — — 1947 2 2.96 2.96 5.92 1948 Nil — — — 1949 Nil — — — GRAPH No. 2. INFANTILE MORTALITY, 1896-1949. [To face page 14. 15 TABLE No. 4. Deaths of Infants under one of age. Cases of, and ages at, death. Cause of Death. age. Under 1 Day. 1 Day to 1 Week. 1-2 Weeks. 2-3 Weeks. 3-4 Weeks. Total Under 4 Weeks. 4 Weeks to 3 Months. 3-6 Months. 6-9 Months. 9-12 Months. Total Under J Year. Bronchitis - - - - - - - 1 - - 1 Pneumonia — 2 — — — 2 - — — 1 3 Diarrhoea - - - - - - - 1 - - 1 Premature Birth 1 — — — — 1 — — — — 1 Congenital malformations, birth injury, infantile disease 1 3 2 — — 6 — — — — 6 2 5 2 — — 9 — 2 — 1 12 TABLE No. 5. Infantile Mortality. Cause of Death. 1940 1941 1942 1943 1944 1945 1946 1947 1948 1949 Whooping Cough - - - - - - - - 1 — Syphilitic Disease — - - - - - - - - Bronchitis 1 - - - - - - 1 — 1 Pneumonia 4 1 1 4 4 1 — 1 — 3 Diarrhoea 4 1 - 1 3 1 1 1 1 1 Other digestive diseases - - - - - - 1 - - - Premature Birth 1 2 4 3 — 5 2 7 3 1 Congenital malformations, birth injury, infantile disease 4 3 3 3 2 8 6 1 2 6 Other violent causes — — 1 — — — 1 — — — All other causes — 1 — 2 2 2 1 1 — — 14 9 9 13 11 17 12 12 7 12 16 Deaths from Tuberculosis—All Ages. No. of Deaths. Death Rate per 1,000 estimated population. Pulmonary 14 .55 Other forms 1 .04 15 .59 Comparable figures for preceding 10 years: — Year. No. of Deaths. Rate per 1,000 estimated population. 1939 20 .65 1940 24 1.02 1941 22 1.28 1942 30 1.81 1943 21 1.22 1944 15 .83 1945 16 .86 1946 13 .61 1947 18 .77 1948 13 .52 1949 15 .59 17 SECTION 3. Infectious Diseases. The undermentioned diseases are compulsorily notifiable in Holborn: — Diseases. Authority for Notification. Anthrax L.C.C. Order dated 23.3.1909 and Public Health (London) Act, 1936—Section 305. Cholera Public Health (London) Act, 1936—Sections 192 and 304. Continued Fever Do. Diphtheria Do. Dysentery Infectious Disease (London) Regs., 1927. Encephalitis, Acute Public Health (Acute Poliomyelitis, Acute litis and Meningococcal Infection) Regulations, 1949, and L.C.C. Order dated 27.2.1912. Enteric Fever Public Health (London) Act, 1936—Sections 192 (including Paratyphoid) and 304. Erysipelas Do. Food Poisoning Food and Drugs Act, 1938—Section 17. Glanders L.C.C. Order dated 23.3.1909 and Public Health (London) Act, 1936—Section 305. Hydrophobia Do. Malaria Infectious Disease (London) Regulations, 1927. Measles County of London (Measles and Whooping Cough) Regulations, 1938 to 1948. Membranous Croup Public Health (London) Act, 1936—Sections 192 and 304. Meningococcal Infection Public Health (Acute Poliomyelitis, Acute Encephalitis and Meningococcal Infection) Regulations, 1949, and L.C.C.1 Order dated 27.2.1912. Ophthalmia Neonatorum Public Health (Ophthalmia Neonatorum) Regulations, 1926 to 1937, and L.C.C. Order 1910. Plague Local Government Board Order, 1900. Pneumonia Infectious Disease (London) Regulations, 1927. (Primary and Influenzal) Poliomyelitis, Acute Public Health (Acute Poliomyelitis, Acute Encephalitis and Meningococcal Infection) Regulations, 1949, and L.C.C. Order dated 27.2.1912. Puerperal Pyrexia Public Health (Notification of Puerperal Pyrexia) Regulations, 1926. Relapsing Fever Public Health (London) Act, 1936—Sections 192 and 304. Scabies County of London (Scabies) Regulations, 1943. Scarlet Fever Public Health (London) Act, 1936—Sections 192 and 304. Smallpox Ditto. Tuberculosis Public Health (Tuberculosis) Regulations, 1930, 18 Diseases. Authority for Notification. Typhoid Fever Public Health (London) Act, 1936—Sections 192 (Including Paratyphoid) and 304. Typhus Fever Do. Whooping Cough County of London (Measles and Whooping Cough) Regulations, 1938 to 1948. For each of the above a fee of 2/6d. is payable by the Local Authority to the medical practitioner if the case occurs in his private practice, or 1 /- if the case occurs in his practice as medical officer of a public body or institution. During the year 269 cases of infectious disease were notified, of which 55 were removed to hospital. These are tabulated in age groups (see Table No. 6, page 20). Comparative figures of infectious disease for the years 1920-1949 are also shown (see Table No. 7, pages 22 and 23). Cerebrio-Spinal Meningitis. One person admitted to hospital suspected to be suffering from this disease was actually found to be suffering from influenza. Diphtheria. Two cases were notified and were both removed to hospital. One was re-diagnosed as laryngitis whilst in hospital. One person admitted to hospital for observation was found to be suffering from tonsilitis. Graph No. 3, facing this page, shows a comparison between the incidence of diphtheria and the number of persons immunized against diphtheria during the years 1920 to 1949. Erysipelas. Six cases were notified and three were removed to hospital. One case was re-diagnosed in hospital as seborrhiœc dermatitis. Food Poisoning. Three cases were notified and removed to hospital. In one case, a boy aged three months, the causative organism was found to be Salmonella Typhimurium. 1 he other two cases were husband and wife and the causative organism was not discovered. Measles. . 172 cases were notified and 31 were removed to hospital. Two of the cases removed to hospital were subsequently re-diagnosed as German measles and respiratory catarrh respectively. Ophthalmia Neonatorum. Three cases were notified and two were removed to hospital. Pneumonia (Acute Primary and Acute Influenzal). Nine cases were notified and two were removed to hospital. Poliomyelitis. Three cases were notified and removed to hospital, one case being finally rediagnosed as lymphocytic meningitis. One of the other two cases died in hospital. GRAPH No. 3 DIPHTHERIA, 1920-1949. [To face page 18. 19 Puerperal Pyrexia. Four cases were notified, three of which were removed to hospital. Scabies. Four cases' were notified and information regarding five other cases was received from the School Medical Officer, London County Council. Scarlet Fever. 15 cases were notified, 10 of which were removed to hospital. Smallpox. In April, 1949, a ship arrived at the Port of London having had on board a fatal case of smallpox. 34 passengers, presumed to be contacts, who came to Holborn after disembarkation, were kept under surveillance by this Department for a period of 16 days. In cases where they left the area before the 16th day the Medical Officer of Health of the district to which they were proceeding was informed. Six persons, working in Holborn, who were contacts of cases or suspected cases occurring outside the area, were also kept under observation. Another case residing outside Holborn attended a medical board in Holborn during the incubation period and the staff of the board, numbering 40, were kept under surveillance whilst at work. Two Holborn residents who attended the board on the same day were also kept under observation. Tuberculosis. See page 49. Whooping Cough. Five cases were notified, one of which was removed to hospital. Other Diseases coming to the notice of the Department. Disease. No. of Cases. No. removed to Hospital. Abortion 1 1 Abortion, incomplete 1 1 Abortion, septic 5 5 Cerebral embolism, infective 1 1 Chicken pox 34* 8 Gastro-enteritis 9† 8 German Measles 3 Mumps 23 19 Pneumonia, Bronchial 1‡ 1 Ringworm 1 — * One case was re-diagnosed urticarial rash. † One case was re-diagnosed dietetic disorder. Two cases died. ‡Admitted to hospital as P.U.O. 20 TABLE No. 6. Summary of Infectious Disease Notifications 1949. (Corrected). Age Groups. Diseases. Under 1 1—2 2—3 3—4 4—5 5—10 10-15 15—25 25—45 45—65 65 & over Totals Total m f m f m f m f m f m f m f m f M f m F m f M f Diphtheria - - - - - - - - - - - - 1 - - - - - - - - - 1 — 1 Erysipelas - - - - - - - - - - - - - - - - - - - 4 1 — 1 4 5 Food Poisoning 1 - - - - - - - - - - - - - - - - - 1 1 - - 2 1 3 Measles 2 4 12 15 22 14 14 16 17 13 14 21 1 — — 3 1 1 — — — — 83 87 170 Ophthalmia Neonatorum 1 2 - - - - - - - - - - - - - - - - - - - - 1 2 3 Pneumonia — — 1 — — — — — — — - 1 — — — — 1 2 2 — — 2 4 5 9 Poliomyelitis - - - - - - - - - - - - - - - - 1 1 - - - - 1 1 2 Puerperal Pyrexia - - - - - - - - - - - - - - - 2 - 2 - - - - - 4 4 Scabies - - - - - - - - - - - - - - - - 1 2 - 1 - - 1 3 4 Scarlet Fever — — 1 — — — — 2 — 1 6 2 1 — — 1 — 1 — — — — 8 7 15 Tuberculosis (Pulmonary) — — — 1 — 1 — 1 — — — — 2 - 2 8 12 6 8 — — 1 24 18 42 Tuberculosis (Non-Pulmonary) — — — — — — — — — — 1 — — 1 1 — 1 2 — — — — 3 3 6 Whooping Cough 2 — — — — 1 1 1 - - - - - - - - - - - - - - 3 2 5 21 Bacteriological examinations. The Borough Council provides bacteriological diagnoses free of charge in connection with certain diseases. This work is carried out by the Royal Institute of Public Health and Hygiene, 23 Queen Square, W.C.1. During the year 92 specimens were submitted for examination with the following results: — Disease. Positive. Negative. Total. Diphtheria. (Nasal and throat swabs). 1 62 63 Enteric Fever (Blood for Widal reaction). — 1 1 Food Poisoning: Blood — 1 1 Faeces — 2 2 Food — 10 10 Ice Cream — 7 7 Tuberculosis (Sputum). — 3 3 Vincent's Angina (Swabs). 2 10 12 Miscellaneous: — Faeces - 3 3 Streptococcus Haemolyticus} Swabs Streptococcus Viridans 5 2 7 3 - 3 22 TABLE No. 7. Comparative Figures of Infectious Disease for the ears 1920-1949. Disease. 1920 1921 1922 1923 1924 1925 1926 1927 1928 1929 1930 1931 1932 1933 1934 1935 1936 1937 1938 1939 1940 1911 1942 1943 1944 1945 1946 1947 1948 1949 (Population) 39,676 43,520 42,850 43,376 43,250 43,315 43,200 42,209 39,280 38,380 38,380 34,470 36,440 36,050 36,000 35,400 34,850 34,600 34,350 30,660 23,470 17,160 16,580 17,240 J18,020 18,680 21,190 23,460 24,960 25,490 Cerebro- Spinal Fever — 2 1 1 — 1 2 - 1 - - 4 1 3 1 1 2 1 1 3 7 7 1 1 — 1 2 2 - Diphtheria (including Membranous Croup) 146 167 108 98 68 76 73 54 57 72 80 69 76 75 74 93 60 76 49 19 7 14 17 17 5 11 12 3 2 1 Dysentery — 1 — — 1 - — — 2 2 — 2 1 — 2 6 6 10 10 — — — — 2 13 2 6 — 4 — Encephalitis Lethargica 3 — 1 — 6 1 1 — — 1 1 - 1 1 1 1 - — — 2 — — — — — 1 — — — — Enteric Fever 6 6 4 2 2 6 5 4 10 5 4 4 4 1 3 2 2 — — 1 1 3 1 6 1 — 1 1 1 — Erysipelas 22 18 14 14 22 13 14 21 23 22 29 17 17 19 12 18 19 10 15 13 12 3 7 3 8 3 4 8 6 5 Food Poisoning Notifiable as from 12th July, 1932. 11 5 - — 3 5 2 - - - - - - 1 - 1 2 3 Malaria 3 1 — 1 1 — — 1 1 1 - - 1 1 1 3 2 3 - 1 - — - 1 - - — — — — Measles Notifiable as from 9th September, 1938. 8 39 34 58 219 33 103 107 157 87 170 Ophthalmia Neonatorum 16 8 10 6 10 9 6 9 10 6 5 7 4 6 6 4 3 3 5 4 4 1 5 4 4 1 4 3 3 3 Pneumonia (Acute primary & Acute-influenzal) 26 44 64 48 63 55 39 48 59 89 49 40 28 37 38 21 30 34 21 28 14 18 20 22 14 6 17 15 9 9 Polio-encephalitis Acute - - - - - - - - - - - - - - - - - - - - - - - - - - 1 1 — — Poliomyelitis Acute 3 — 1 2 — 2 — - — — 1 1 2 - - - - - - - - - - - - 1 — 5 1 2 *Puerperal Fever 1 1 — 3 2 2 3 3 4 1 3 2 1 3 3 4 2 4 — - - 1 2 2 2 2 - 1 1 * Puerperal Pyrexia Notifiable as from 1st October, 1926. 1 8 7 5 6 4 6 5 2 4 3 2 2 3 3 2 7 3 1 4 5 5 2 4 Scabies Notifiable as from 1st August, 1943. 54 99 125 106 43 16 4 Scarlet Fever 125 190 147 102 88 86 84 59 111 130 90 57 57 96 115 50 67 38 59 56 20 16 23 30 20 14 24 29 13 15 Smallpox — 1 1 - - - - - 1 43 14 3 1 1 — — — — - - — — — — — - — - - — Tuberculosis, Pulmonary 1ll 96 68 50 75 63 66 91 91 76 76 80 73 50 83 68 77 66 71 64 44 47 45 51 41 59 55 47 39 42 Tuberculosis, Non-Pulmonary 12 21 14 10 12 11 26 20 14 12 10 8 16 9 6 5 13 10 8 5 3 6 8 3 9 9 5 4 8 6 Whooping Cough 15 129 110 93 95 113 96 82 104 153 33 44 108 23 65 99 76 60 53 71 7 42 48 38 30 11 43 23 74 5 489 685 543 430 445 438 416 400 495 618 401 4 408 335 412 379 365 322 296 278 161 194 242 456 280 364 392 348 268 269 *Ceased to be notifiable as from 30th July, 1948. 24 SECTION 4. Sanitary Circumstances. Visits made by the Sanitary Inspectors during 1949. Public Health (London) Act, 1936. Number of Inspections. Dwelling Houses 504 Houses Let in Lodgings 417 Common Lodging Houses 6 Offices 78 Rag and Bone Shops 31 Smoke Observations 146 Drainage Work and Testing 2,783 Other Inspections 1,740 Re-inspections of above 2,310 Housing Act, 1936. Number of Inspections. Houses 12 Underground Rooms 93 Overcrowding Visits 189 Re-inspections of above 6 Factories Act, 1937. Number of Inspections. Factories with mechanical power 84 Factories without mechanical power 31 Firms employing outworkers 1 Outworkers' Rooms 15 Re-inspection of above 143 Electrical Stations and Sites of Building Operations 66 Food and Drugs Act, 1938. Number of Inspections. Dairies and Milk Shops 64 Ice Cream sale and storage 127 Ice Cream manufacture 107 Restaurants and Kitchens 1,189 Bakehouses 60 Butchers' Shops 190 Fish Shops 47 Fried Fish Shops 80 Other Food Shops 417 25 Food and Drugs Act, 1938. Number of Inspections—continued. Market Streets 154 Licensed Premises 87 Re-inspections of above 707 (Restaurants and kitchens — 517) (Bakehouses — 6) (Fish Shops — 47) (Food Shops — 45) (Licensed Premises — 92) Miscellaneous Inspections. Pharmacy and Poisons Act, 1933 7 Rats and Mice (Destruction) Act, 1919 463 Shops Act, 1934 17 Re-inspections of above 52 Visits, etc., re. Infectious Disease 388 Scabies 3 Aged and Infirm Persons 50 Police Courts 1 Verminous Persons 2 Various 1,859 Total 14,726 Notices Served. Public Health (London) Act, 1936. Intimation Notices — 249. Dwelling Houses 75 Houses Let in Lodgings 132 Offices 6 Food premises 21 Factories 3 Block Dwellings 1 Sites 4 Licensed Premises 7 Statutory Notices — 44. Dwelling Houses 11 Houses let in Lodgings 29 Food premises 2 Sites 2 Housing Act, 1936. Houses Let in Lodgings 23 26 Factories Act, 1937. Power Factories 3 Non-Power Factories 1 Food and Drugs Act, 1938. Hotels 2 Restaurants 27 Dairies 1 Licensed premises 10 Food Shops 1 Staff Canteens 1 Bakehouses 3 Snack Bars 1 Shops Act, 1934. 1 Rats and Mice (Destruction) Act, 1919 4 Public Health (London) Act, 1936. The following is a summary of the work carried out during the year as a result of Notices served under the Public Health (London) Act, 1936, in respect of nuisances found to exist in dwelling houses and houses let in lodgings: — Water Supply. Proper and sufficient supply provided 8 Waterclosets. Cleansed 23 Water supplied, flushing cistern repaired 9 Repaired, new pans provided 17 Position or construction improved 7 Unstopped 2 Soil pipes. Repaired, renewed or ventilated 3 Rainwater pipes. Repaired or renewed 4 Drains. Repaired 7 Unstopped, cleansed 1 Sinks. Waste pipes repaired, sinks renewed 15 27 Yards, Areas and Washhouses. Cleansed 2 Paved, or paving repaired 3 Drained 2 Houses and Workshops, etc. Cleansed 7° Dilapidations repaired and made good 114 * Ventilation improved 2 Dampness. Roofs repaired 31 Gutters repaired 5 Other works to prevent dampness 34 Ashbins, and Ashpits. Provided, repaired 7 Various. Accumulations of refuse removed 11 Other defects 18 Complaints. During the year 866 complaints were received in respect of the following uisances:— Rodent infestation 262 General dilapidation and disrepair 91 Obnoxious smells 65 Dampness 60 Vermin 48 Accumulations of refuse 46 Inadequate or unsuitable W.C. accommodation 36 Defective or choked drains 29 Defective roof 24 Absence of artificial lighting to common staircase 21 Inadequate or unsuitable dustbin accommodation 12 Overcrowding 11 Smoking chimneys 11 Noise 8 Defective flues 6 Inadequate water supply 6 Aged and infirm persons 5 Nuisance from animals 4 Unsound food 4 Impure water supply 2 Miscellaneous 64 Inadequate ventilation 2 28 Water. 1. Water for drinking and commercial purposes in this area is supplied by the Metropolitan Water Board and has been satisfactory both in quantity and quality. 2. There is a piped supply, and bacteriological examinations of the raw water are made by the Metropolitan Water Board, who also perform chemical analysis. 3. The water is not known to have any plumbo-solvent action. 4. No action has been necessary in respect of contamination. 5. All dwelling houses have a piped supply, and standpipes are normally used only in cases of emergency, such as repair of mains. Five certificates were issued under Section 95 of the Public Health (London) Act, 1936, certifying the provision of a proper and sufficient supply of water in respect of three new blocks comprising 88 flats, and two blocks comprising 22 flats which had been rebuilt. Two complaints were received during the year in relation to drinking water. In each case it was found that the storage tanks had become dirty. These tanks were cleansed and no further complaints were received. Eight premises were supplied with a proper and sufficient water supply following the service of notices. Drainage. During the year 2,783 inspections were made by the Sanitary Inspectors in connection with drainage work; 116 applications for approval of proposed drainage work were submitted together with the necessary plans, and 113 Combined Drainage Orders were made. Smoke Abatement. During the year 11 complaints were received regarding smoke nuisances, and 146 observations were made. In most cases it was found that the nuisance was caused by unsatisfactory stoking, and conditions were remedied following advice being given by the District Sanitary Inspectors. In no case was it found necessary to serve a Notice under the Public Health (London) Act, 1936. The co-operation of the Ministry of Fuel and Power was sought in the early part of the year following complaints of smoke nuisance in respect of large business premises in the Borough where it was alleged that the nuisance was due to the inferior types of coal being supplied. Tests were made at the various premises by the Ministry's Engineer. In some cases advice was given which included instruction from a Stoker Demonstrator, and in others arrangements were made for a regular supply of a better type of fuel. Subsequent complaints were received in respect of only one of these premises during the remainder of the year. The Public Health Committee considered the desirability of setting up observation stations within the Borough, and as a result of the Committee's recommendation, the Council, in May, asked the Metropolitan Boroughs' Standing Joint Committee to consider the question of the distribution of observation stations throughout the London area with a view to stations being set up in the areas where they are most required. Bombed Sites. Accumulations of refuse on bombed sites present a considerable problem to local authorities. In very few cases are the accumulations such as to warrant the service of notice in respect of a " nuisance and there is also the difficulty of assessing responsibilitv for the accumulations During the year consideration was given to the adaptation of 29 certain bombed sites for use as children's playgrounds, and one site was so adapted by the Council. The question was also considered by the Metropolitan Boroughs' Standing Joint Committee, which recommended constituent Councils to make a bye-law governing fly tipping on vacant sites. Such a bye-law was made by this Council on the 27th July, 1949. Some assistance also is given by the War Damaged Sites Act, which became law on the 16th December, 1949. This Act empowers a local authority temporarily to take over war damaged sites itself or to let them for any purpose. It is suggested that this will enable local authorities to provide small gardens or playgrounds as a contribution towards the 1951 Festival of Great Britain. This question is being considered by the Council in the current year. Sites cleared by Council 13 Approximate number Of tons of refuse removed 64 Approximate cost of removal £160 Sites cleared as a result of the service of notices under the Public Health (London) Act, 1936 3 War-Time Reservoirs for Emergency Water Supplies. The war-time reservoirs for emergency water supplies were kept under observation throughout the summer months, with a view to the prevention of nuisance, and in particular to prevent the breeding of insects. Where necessary, arrangements were made for accumulations of water to be pumped out by the London Fire Brigade. It is pleasing to note that with the increase in rebuilding a number of these potential nuisance spots are disappearing. Pharmacy and Poisons Act, 1933. This Act and the Poisons Rules regulate the sale of poisons, and every local authority is required to keep a list of persons who are entitled to sell poisons included in Part II of the Poisons List. The Poisons Rules, 1949, which came into operation on the 11th April, 1949, consolidate with minor amendments the Poisons Rules, 1935, and the seven subsequent Poisons (Amendment) Rules, which are now revoked. The principal amendments are that insec ticides and fungicides containing dinitrocresols are no longer exempt from the provisions of the main Act, and containers of insecticides and fungicides containing dinitrocresols or certain compounds of phosphorus are required to bear a specified label. During the year 1949 the following applications were received for retention or entry in this Council's list: — Retention 36 New entries 1 Removals 1 Total 36 Rent and Mortgage (Interest) Restrictions Acts, 1920-1939. During the year one application was received from a tenant for a certificate under the above Acts regarding the state of repair of his premises. As inspection shewed that the premises were in a satisfactory state of repair, the application was refused. 30 Housing Acts, 1936 and 1949. The following is a summary of action under the above Acts during the year 1949:— Slum Clearance. Houses included in clearance areas Nil „ „ „ „ „ and demolished Nil „ repaired as a result of action under Secs. 9 and 10 Nil „ made the subject of demolition orders Nil „ demolished as a result of demolition orders Nil Parts of buildings made the subject of closing orders 1 „ „ closed by undertaking 4 Underground rooms made the subject of closing orders 22 „ closed by undertaking Nil Closing orders determined Nil No. of flats erected by the Council during the year 112 Note: The number of underground rooms which do not comply with the relevant Regulations, but which are occupied for human habitation, is 501. Houses Let in Lodgings. Number in Borough 311 Inspections made 417 Notices served 23 Complaints remedied under the Bye-Laws 30 Overcrowding. On the 1st January, 1949, 198 families were known to be living in overcrowded conditions. During the year a further 58 families were found to be living in overcrowded conditions. In 57 cases, overcrowding was abated during the year as follows: — Families rehoused by the Holborn Borough Council 14 Families rehoused by the London County Council 13 Accommodation found by other means 23 Size of family decreased by death or otherwise 7 During the year 189 visits were made by the Sanitary Inspectors in connection with conditions of overcrowding. In cases where overcrowding is abated, a warning letter is sent to the owner of the premises drawing attention to the relevant provisions of the Housing Act, 1936. The Housing Act, 1949. This Act, which came into operation on the 30th July, 1949. deletes the term " working classes " from many of the sections of the Housing Act, 1936. Included among the main provisions are Exchequer assistance for the improvement of housing accommodation either by local authorities or private owners; local authorities are empowered to provide, in return for payment, meals and refreshments; and laundry services; and to sell furniture to tenants on their housing estates. Power is given to local authorities to provide hostels for all age groups, including students and aged persons, to meet the needs of applicants who require accommodation otherwise than in a separate home. 31 Rodent Control. Block Control Scheme No. 2. This scheme, approved by the Ministry of Agriculture and Fisheries, was started in March, 1948, and was completed in March, 1949. The scheme covered that part of the Borough lying North of High Holborn and New Oxford Street, and West of Southampton Row and Woburn Place. The work falls naturally into three categories: — (1) The survey proper. This includes the circularising of business firms, the inspection of all premises, including pre-baiting in any cases of doubt, and also includes investigation of bombed sites, derelict premises and empty buildings. Under this heading the following figures show approximately the work carried out: — Total number of buildings 686 No. of business premises 887 included in the No. of dwellings 1,053 686 buildings. No. of bombed sites and derelict buildings 35 During the survey, where information was obtained that service companies in rat repression work had been or were engaged by the firms, contact was made, and the Council's officers worked in close collaboration with representatives of the firms. (2) Treatment. The next step was the treatment of all premises found to be infested—the degree of infestation varied considerably. The following figures show the number of premises infested, the bombed sites being fully treated in every case: — Business premises 114 Dwellings 106 Bombed sites and derelict buildings 35 The number of premises re-treated was as follows: — Business premises 2 Dwellings 2 Bombed sites and derelict buildings Nil At the same time as treatment was carried out advice was given, and firms and property owners encouraged to carry out necessary rat-proofing of premises. The number of visits to infested premises were:— Treatments visits 1,093 Other visits 1,737 The number of bodies recovered and the estimated kill was: — Rattus Rattus. Rattus Norvegicus. (Ship rat). (Common rat). Bodies recovered 239 33 Estimated kill 1,029 101 The estimated kill is a conservative figure based on the amount of poison known to have been taken. This is in accordance with the Ministry of Food formula. An indication of the co-operation received from all concerned is indicated by the fact that the service of notices under the Rats and Mice Destruction Act was not necessary. 32 Block Control Scheme No. 3. This scheme, which was started in March 1949,. and has yet to be completed, has been approved by the Ministry of Agriculture and Fisheries. The scheme covers that part of the Borough lying East of Woburn Place and Southampton Row to Gray's Inn Road, and North of High Holborn. Particulars of work carried out during the year under this scheme are as follow Blocks surveyed 26 Blocks treated 21 Business premises treated 27 Dwelling houses treated 130 Bombed sites and derelict buildings treated 45 Treatment visits 1,177 Other visits 2,192 Estimated kill (rattus rattus) 553 Bodies recovered (rattus rattus) 171 Estimated kill (rattus norvegicus) 62 Bodies recovered (rattus norvegicus) 18 The rate of progress achieved with this scheme was not as great as had been anticipated owing to a considerable increase in the work in connection with complaints of rat or mice infestation in the Borough as a whole, and to the reduction of staff from four rodent operatives to three in September. Complaints. Apart from Block Control Schemes 2 and 3, 262 complaints of rat or mice infestation were received and investigated during 1949. The following figures show the work carried out during the year arising from the complaints received: — No. of business premises visited 399 No. of dwelling houses visited 400 No. of business premises treated 310 No. of dwelling houses, treated 344 No. of business premises revisited 2,456 No. of dwelling houses revisited 1,777 Estimated kill 1,456 Bodies recovered (rattus rattus) 523 Bodies recovered (rattus norvegicus) 45 General. The following figures show the amount of rodent control work carried out during the year in connection with Block Control Schemes 2 and 3 and as a result of complaints received. Business premises treated 453 Dwellings treated 582 Bombed sites and derelict buildings treated 80 Treatment visits 4,232 Other visits 8,162 Estimated kill (rattus rattus) 2,917 Bodies recovered (rattus rattus) 933 Estimated kill (rattus norvegicus) 284 Bodies recovered (rattus novegicus) 102 33 Baiting of Sewers. In connection with the Block Control schemes, rodent repression work was also carried out in the Council's sewers, and the Borough Engineer and Surveyor has kindly supplied me with the undermentioned information of the treatment carried out during the year. The normal procedure is for two treatments to be carried out; treatment No. 1 being the use of sausage rusk plus 2½% line phosphide, followed after a month's interval by treatment No. 2 with bread mash plus 10% arsenious oxide. It will be seen that the double treatment carries over at the beginning: of the vear. DETAILS. DATE OF TREATMENT. 17th to 26th January, 1949. Treatmen No. 2 Treatment No. 1 27th June to 6th July, 1949. 8th to 15th August, 1949. T reatment No. 2 1. Total number of manholes in foul and connected systems 316 305 306 2. Bait base and poison used Bread mash Sausage rusk Bread mash and arsenious and zinc and arsenious oxide phosphide oxide 3. No. of manholes baited 267 294 295 4. No. of manholes showing prebait takes 225 272 264 5. No. of manholes showing complete prebait take (on one or both days) 148 202 165 6. Schemes of baiting used Two pre baits — one pois on bait 7. No. of bodies found 53 222 181 disinfecting Station Disinfection Number of rooms disinfected after tuberculosis 26 ,, „ ,, ,,, 99 scabies 4 „ „ „ „ „ other infectious diseases 84 Total number of rooms disinfected after infectious disease 114 Number of articles of bedding and clothing disinfected after tuberculosis 191 Number of articles of bedding and clothing disinfected after scabies 100 Number of articles of bedding and clothing disinfected after other infectious diseases 1,133 Total number of articles disinfected after infectious disease 1,424 Number of books disinfected after infectious disease 97 ,, ,, 99 toys ,, ,, ,, 67 Disinfestation. Number of rooms disinfested of vermin 253 „ „ articles of bedding and clothing disinfested of vermin 600 ,, „ books disinfested of vermin 30 34 In addition, the following work was carried out during the year in connection with the disinfestation of the furniture and effects of families removing to the Council's new blocks of flats:— Number of families whose furniture and effects were treated by hydrocyanic acid gas 112 Number of articles of bedding disinfested by steam 2,879 Number of toys disinfested 107 Number of books disinfested 4 Summary of 4,903 articles of bedding and clothing dealt with during the year: — Mattresses 550 Pillows 820 Pillow Cases 380 Bolsters 113 Bolster Cases 35 Blankets 1,000 Sheets 463 Clothing 1,542 Cleansing Station. During the year 98 verminous persons, 96 men and 2 women, were cleansed at the Council's Cleansing Station. 50 of the men were referred from Bruce House, Westminster, and 25 from Parker House, Parker Street. 94 school children were cleansed at the Station under the agreement between the Council and the London County Council, 94 being treated for head lice, and 12 in addition for scabies. Public Mortuary. The following are details of work carried out during the year at the Council's Public Mortuary: — Residents in Holborn. Residents outside Holborn. Total.[/##] No. of bodies deposited 45 280 325 No. of bodies deposited on: (a) Coroner's Warrants 41 275 316 (b) Undertakers' Requests 4 5 9 No. of Inquests 9 28 37 No. of Post Mortem Examinations 41 275 316 Causes of Death in Above P.M. Cases Accidents:— Street — 8 8 Domestic — 9 9 Others 1 3 4 Natural Causes 37 246 283 Misadventure — 2 2 Murder — — Nil Suicide 3 7 10 35 Aged Persons. Section 47 of the National Assistance Act, 1948, provides that, where certified by the Medical Officer of Health to be necessary for the purpose of securing the proper care and attention for persons who (a) are suffering from grave chronic disease or, being aged, infirm or physically incapacitated, are living in insanitary conditions, and (b) are unable to devote to themselves, and are not receiving from other persons, proper care and attention, a local authority may apply to a court of summary jurisdiction for an order to secure the removal of such aged and infirm persons. There were no cases arising during the year which called for action under the above Section by the Public Health Department, but visits were made in connection with the voluntary removal of aged and infirm persons living alone, to hospitals or other places, and in connection with the provision for such persons of home nursing and home help facilities. Burial of the Dead. Section 50 of the National Assistance Act, 1948, places upon the Borough Council the responsibility of causing to be buried or cremated the body of any person who has died in the area, or been found dead in the area, in any case where it appears that no suitable arrangements for the disposal of the body are otherwise likely to be made. During the year eight cases were dealt with. These had come to the notice of the Public Health Department from the following sources: French Hospital 3 London Homoeopathic Hospital 3 Coroner's Officer 2 On 1st March, 1949, the Minister issued Circular 13/49 informing Local Authorities that he had asked Hospital Management Committees and Boards of Governors of Teaching Hospitals to exercise their powers to arrange and pay for the burial or cremation of such persons dying in hospital. The provisions of this Circular do not apply to voluntary hospitals, of which there are two in the Borough, namely the French Hospital Shaftesbury Avenue, and the Italian Hospital, Queen Square. 36 SECTION 5. Factories. Most of the provisions of the Factories Act, 1937, are administered by the Ministry of Labour and National Service through H.M. Factory Inspectors. The Sanitary Authority is charged with the duty of enforcing the legislation as to sanitary accommodation in ail factories in its area, and, in those factories where mechanical power is not used, legislation with regard to cleanliness, overcrowding, temperature, ventilation, and drainage of floors. All factories must have an adequate supply of drinking water from a public main or some other source approved in writing by the Council. Particulars of inspections and other work carried out during 1949 are as follows:— Number of visits to:— Factories with mechanical power 84 Factories without mechanical power 31 Firms employing outworkers 1 Outworkers' rooms 15 Re-inspections of above 143 Electrical stations and sites of building operations 66 Notices served: — Factories Act, 1937. Public Health (London) Act, 1936. Food and Drugs Act, 1939. Factories 4 3 — Offices — 6 — Bakehouses — — 3 Restaurants and canteens — 21 28 Factories Act, 1937. The following particulars are furnished in accordance with Section 128 (3) of the above Act, with respect to matters under Part I and Part VIII:— Part 1 of the Act. 1. Inspections for purposes of provisions as to health. Premises. No. on Register. Number of Inspections. Written notices. Occupiers prosecuted. (i) Factories in which Sections 1, 2, 3, 4 and 6 are to be enforced by Local Authorities 246 66 1 — (ii) Factories not included in (i) in which Section 7 is enforced by the Local Authority 724 192 3 — (iii) Other Premises in which Section 7 is enforced by the Local Authority (excluding out-workers' premises) 22 66 — — Total 992 324 4 — 37 2. Cases in which defects were found. Particulars. Number of Cases in which Defects were found. Number of Cases in which Prosecutions were Instituted. found. Remedied. Referred To H.M. Inspector. By H.M. Inspector. Want of Cleanliness (S.1) 16 13 — 9 — Overcrowding (S.2) — — — — — Unreasonable Temperature (S.3) — — — — — Inadequate Ventilation (S.4) — — — — — Ineffective Drainage of Floors (S.6) — — — — — Sanitary Conveniences (S.7)— (a) Insufficient 1 4 — — —• (b) Unsuitable or Defective 19 16 — 2 — (c) Not separate for Sexes — — — — — Other offences against the Act (not including offences relating to Outwork) 6 6 — — Total 42 33 6 11 — Part VIII of the Act. Outworkers. Section 110 of the Factories Act, 1937, requires that where, in certain specified industries, work is given out by employers or contractors to be done by workers in their own homes, lists containing the names and addresses of such workers must be forwarded to the Local Authority. Part VIII has the object of preventing such work being carried out in premises which are insanitary or in which infectious disease is present. The following table gives the number and type of such premises in the Borough, and the nature of the work carried out:— Nature of Work. Section 110. Section 111. No. of Ouworkers in August List required by Sect. 110 (1) (c). No. of Cases of Default in Sending Lists to the Council. No. of Prosecutions for Failure to Supply Lists. No. of Instances of Work in Unwholesome Premises. Notices served. Prosecutions. Wearing Apparel— Making, &c. 169 Cleaning and Washing — — — Household Linen 15 — — — Lace, Lace Curtains and Nets — — — — — — Curtains and Furniture Hangings 1 — — — — — Furniture and Upholstery — — — — — — Electro-plate — — File Making — — — — — — 38 Nature of Work. Section 110. Section 111. No. of Outworkers in August List required by Sect. 110 (1) (c). No. of Cases of Default in Sending Lists to the Council. No. of Prosecutions for Failure to Supply Lists. No. of Instances of work in Unwholesome Premises. Notices served. Prosecutions. Brass and Brass Articles — — — — — — Pur Pulling — — — — — — Iron and Steel Cables and Chains — — — — — — Iron and Steel Anchors and Grapnels — — — — — — Cart Gear — — — — — — Locks, Latches and Keys — — — — — — Umbrellas, &c. — — — — — — Artificial Flowers 2 — — — — — Nets, other than Wire Nets — — — — — — Tents — — — — — — Sacks — — — — — Racquet and Tennis Balls — — — — — — Paper Bags — — — — — — The making of Boxes or other Receptacles or parts thereof made wholly or partially of Paper — — — — — — Brush Making — . — — — — — Pea Picking — — — — — — Feather Sorting — — — — — — Carding, &:c., of Buttons, &c. 2 — — — — — Stuffed Toys — — — — — — Basket Making — — — — — — Chocolates and Sweetmeats — — Cracker Bon-bon, Christmas Crackers, Christmas Stockings, &c. 50 — — — — Textile Weaving — — — — — — Lampshades — — — — — — Total 238 — — — — — Inspection of outworkers' premises 15 Cases of notifiable disease occurring in such premises Nil Firms in the Borough employing outworkers 31 No. of outworkers on lists submitted 238 No. of outworkers referred to other Boroughs 220 Total number of outworkers in Holborn 76 No. of outworkers in Holborn employed by Holborn firms 18 No. of outworkers in Holborn employed by firms outside the Borough 58 39 SECTION 6. Inspection and Supervision of Food. General. All premises where food is prepared, stored or exposed for sale for human consumption are inspected, and the following is a record of the inspections made during 1949: — Dairies and milk shops 64 Ice cream, sale or storage 127 Ice cream, manufacture 107 Restaurants and kitchens 1,189 Bakehouses 60 Butchers' shops 190 Fish shops 47 Fried fish shops 80 Other food shops 417 Market streets 154 Licensed premises 87 Re-inspections 707 Food and Drugs Act, 1938. Notices. During 1949. 46 notices were served on owners or occupiers of food premises, drawing attention to the lack of precautions against the contamination of food Details of the premises are as follows: — Bakehouses 3 Dairies 1 Food shops 1 Hotels 2 Licensed premises 10 Restaurants 27 Snack bars 1 Staff canteens 1 The following is a summary of the work carried out during the year as a result of Notices served under the Food and Drugs Act, 1938, in respect of food premises:— Siting of sanitary convenience or dustbin improved 3 Walls, ceilings, floors, windows or doors of food room repaired 53 Walls, ceilings or doors of food room cleansed 56 Suitable and sufficient means of ventilation provided and maintained 30 Suitable and sufficient means of lighting provided and maintained 5 Precautions taken to ensure that cleanliness was observed by persons employed in regard to food room, articles, apparatus and utensils 8 40 Suitable wash basins, soap, clean towels and clean hot and cold water provided for use of employees 21 Suitable provision made for the storage of foodstuffs 8 Suitable provision made for the cleansing of vegetables 6 Vermin (cockroaches) eradicated 2 Suitable provision made for the cleansing of utensils 7 Staff changing rooms provided 1 Accumulation of utensils removed 2 Machinery re-sited 1 Suitable provision made for the preparation of snacks 2 Defective manure storage pits repaired 1 Public Health (London) Act, 1936. Notices. 28 notices were served during the year under the above Act in respect of nuisances found to exist at food premises in the Borough. As a result of notices the following nuisances in food premises were abated during the year:— Water closets. Cleansed 8 Repaired, new pans, etc. 3 Ventilation improved 2 Artificial lighting provided 1 Position or construction improved 2 Urinals, repaired or cleansed 1 Rainwater pipes. Repaired or renewed 1 Sinks. Waste pipes repaired, sinks renewed 28 Other nuisances. Dilapidations repaired or made good 2 Accumulations of refuse removed 4 Other defects 3 Milk Legislation. During 1949 the following Acts, Order and Regulations became operative: — The Food and Drugs {Milk and Dairies) Act, 1944 (Appointed Day) Order, 1949. This Order provided that the Food and Drugs (Milk and Dairies) Act, 1944, came into operation on the 1st October, 1949. The Food and Drugs (Milk and Dairies) Act, 1944. This Act, as amended by the Transfer of Functions (Food and Drugs) Order, 1948, provides for the making of Milk and Dairies Regulations jointly by the Ministers of Health, Food, and Agriculture and Fisheries and requires such Regulations to provide for the transference of powers of registration of dairy farms and dairy farmers to the Ministry of Agriculture and Fisheries. The Act also provides for the power of making Milk (Special Designations) Regulations to be exercised jointly by the Ministers of Health, and Agriculture and Fisheries, and requires such Regulations to contain provision for the authority to be transferred to the Minister of Agriculture atnd Fisheries for the granting of licences to producers authorising the use of special designations in connection with raw milk. 41 Milk and Dairies Regulations, 1949. These Regulations made under Section 20 of the Food and Drugs Act, 1938, came into operation on the 1st October, 1949. They re-enatct with amendments the Milk and Dairies Regulations, 1926 to 1943. The principal changes brought about by the new Regulations are that a number of functions previously the responsibility of the Minister of Health, county councils and other local authorities have been transferred to the Minister of Agriculture and Fisheries. The powers conferred upon a Medical Officer of Health for stopping a supply of milk where he has evidence of its being infected have been extended to include any disease communicable to man by the consumption of milk, and in lieu of stopping the sale of milk, a Medical Officer of Health may make its sale conditional upon its being treated so as to render it safe to his satisfaction, i.e. by heat treatment. This condition of sale may also be imposed where a Medical Officer of Health has reason to suspect the milk of being infected. The Milk (Special Designation) Act, 1949. This Act, which came into force on the 1st October, 1949, provides that, in specified areas to be defined by the Minister of Food, the only milk which may be sold by retail is milk from herds which continue to satisfy a standard of veterinary inspection, e.g. "Tuberculin Tested" or "Accredited" milk or milk which has been subjected to a specified heat treatment, e.g. Pasteurisation or Sterilisation. As from the 1st October, 1953, the use of the designation "Accredited" is prohibited in specified areas. The Milk (Special Designation) (Raw Milk) Regulations, 1949. These Regulations re-enact with amendments the Milk (Special Designations) Regulations, 1930 to 1948 so far as they relate to raw milk. As provided for by the Milk and Dairies Act, 1944, the control of the production of designated raw milk is passed to the Minister of Agriculture and Fisheries. The Regulations also provide for the gradual raising of the standard of veterinary inspection necessary for a Tuberculin tested herd, until by 1st October, 1957, all tuberculin tested milk will be produced from attested herds, and after 1st October, 1954, the designation "Accredited" will no longer be permissible. The Milk (Special Designation) (Pasteurised and Sterilised Milk) Regulations, 1949. These Regulations re-enact with amendments the Milk (Special Designations) Regulations, 1936 to 1948, so far as they relate to pasteurised milk, and are concerned only with special designations in regard to heat treated milk — "Pasteurised" and "Sterilised." The latter designation is incorporated into the Regulations to legalise the sale of sterilised milk in areas to be specified by the Minister of Food under the Milk (Special Designations) Act, 1949. As from the 1st October, 1954, all pasteurised milk is required to be put into bottles or other containers in which it is to be delivered by retail, on the premises on which it is pasteurised. Registrations. The Milk and Dairies Regulations require every Local Authority to keep a register of all persons carrying on the trade of distributor in their district and of all premises which are used as dairies. "Dairy" does not include a shop from which milk is supplied only in the properly closed and unopened vessels in which it is delivered to the shop, or 42 other place in which milk is sold for consumption on the premises only. "Distributor" includes a purveyor of milk whether by wholesale or retail. Dairies registered during 1949 2 Dairies removed from register on cessation of sale of milk 1 Dairies on register at end of 1949 5 Distributors registered during 1949 11 Distributors removed from register on ceasing to trade as such 12 Distributors on register at end of 1949 75 Number of above distributors trading from premises outside Borough 25 Inspections made by Inspectors during 1949 64 Formal milk samples taken and submitted for analysis 212 During 1949, 212 formal samples of milk were taken, of which none were found to be adulterated. The following table shows the monthly variation of the chemical composition of the 212 samples. Month. Number of Samples examined. Total Solids Per cent. average. Solids Non-fat Per cent. average. Fat Per cent. average. January 18 12.43 8.87 3.56 February 17 12.27 8.81 3.46 March 19 12.22 8.86 3.36 April 16 12.18 8.79 3.39 May 18 12.18 8.86 3.32 June 18 12.25 8.93 3.32 July 17 12.17 8.81 3.36 August 18 12.25 8.82 3.43 September 19 12.54 8.92 3.62 October 16 12.52 8.89 3.63 November 18 12.68 8.90 3.78 December 18 12.56 8.86 3.70 Whole year 212 12.35 8.86 3.49 Legal minimum 11.50 8.50 3.00 43 These figures approximate closely to those of the previous ten years, averages of which are tabulated below :— Year. No. of Samples examined. Total Solids (average). Non-fatty Solids (average). Fat (average). 1939 97 12.42 9.00 3.42 1940 172 12.45 8.89 3.56 1941 124 12.63 8.96 3.73 1942 94 12.46 8.86 3.60 1943 96 12.42 8.91 3.51 1944 100 12.29 8.81 3.48 1945 94 12.45 8.87 3.58 1946 214 12.33 8.81 3.53 1947 216 12.36 8.84 3.52 1948 214 12.29 8.78 3.51 1949 212 12.35 8.86 3.49 Milk (Special Designations) Regulations. A person proposing to use a special designation authorised by the Regulations is required to apply to the licensing authority of the area in which the milk is to be sold, for a licence to use the designation. Upon being satisfied that the relevant provisions of the Regulations are complied with, a Licensing Authority grant a dealers licence to a distributor in respect of each of his premises within their area from which the designated milk is to be sold. Where a distributor holding a dealers licence to use a special designation in respect of milk sold from premises in one area, wishes to sell milk within the area of another Licensing Authority, the latter authority may issue a dealers supplementary licence authorising the use of the designation in their area. The Regulations which came into force on 1st October, 1949, abolished the payment of fees for licences, and included "Sterilised" as a snecial designation for the first time. During the year 69 licences were issued, details of which are as follows: — Dealers Licences. Dealers Supplementary Licences. To sell Tuberculin Tested milk 11 10 To sell Accredited milk — 1 To sell Pasteurised milk 15 12 To sell Sterilised milk 10 10 Milk — Bacteriological Examination. During the year, 38 samples of milk were submitted for bacteriological examination. 26 of these were supplied to schools in the Borough and seven to Day Nurseries. Four samples were found to be unsatisfactory but in each case the shade temperature exceeded 65 degrees Fahrenheit at the time when the samples were taken. The Medical Officer of Health of the London County Council was notified of the results of all school milk samples submitted for examination. In addition one sample was subjected to the animal inoculation test but no evidence of tubercle bacilli was observed on post mortem examination six weeks after inoculation. 44 Registration of Premises Used for the Manufacture. Storage or Sale of Ice Cream. Premises used for the manufacture, storage or sale of ice cream are required by Section 14 of the Food and Drugs Act, 1938, to be registered by the local authority. On the 1st January, 1949, 5 premises were registered for the manufacture, storage and sale of ice cream in Holborn; 34 premises were registered for storage and sale; and in one case premises were registered for storage only. During the year, 15 applications were received and approved in respect of premises to be used for storage and sale. A factory was established in the Borough and application for manufacture, storage and sale was approved. 6 premises were removed from the Register (5 registered for storage and sale and one registered for storage only), as they ceased to be used for this purpose. At the end of the year, therefore, 6 premises were registered for manufacture, storage and sale, and 44 premises were registered for storage and sale. Ice Cream (Heat Treatment, Etc.) Regulations, 1947. During the year, 190 samples of ice cream were submitted for examination by the Methylene Blue Test. The results in the grading suggested by the Ministry of Health were as follows:— Grade 1 27 Grade 2 57 Grade 3 61 Grade 4 31 14 samples were coloured ices which did not respond to the test. In the case of samples falling within Grades 3 and 4, letters were sent to the vendors drawing their attention to the poor grading. In such cases where the ice cream was manufactured outside Holborn, details were also sent to the Medical Officers of Health of the areas concerned. The results of all examinations of their own products were for warded to the large manufacturers for their information. Ice Cream—Bacteriological Examinations. During the year, 21 samples were examined for the presence of faecal coli, with the following results:— Absent in 1 ml. 19 Present in 1 ml. 2 Ice Cream—Fat Content. In accordance with Ministry of Food Circular MF. 3/49 dated 1st April, 1949, this Council co-operated with the Ministry and 34 samples of ice cream were submitted for fat content analysis. The results of the analyses were forwarded to the Ministry as requested and were as follows:— Fat Content. No. of Samples. 1%- 2% 1 2%- 3% - 3%- 4% 2 4%- 5% 3 6%- 6% 4 6%- 7% 4 7%- 8% 2 8%- 9% 7 9%-10% 6 10%-15% 4 15%-20% - 20%-25% 1 45 In the case of the sample where the fat content was below 2| per cent., informa tion was received from the Ministry that no administrative action was taken as the manufacturers had not signed an undertaking that their ice cream would have a minimum fat content of 2^ per cent., and they had, therefore, received no additional supplies of sugar and fats. A later sample from the manufacturers was found to have a fat content of 6.40%, Licensed Premises. There are 77 licensed premises in the Borough, and during the year 87 inspections and 92 re-inspections were carried out. Seven notices were served under the Public Health (London) Act, 1936, and ten notices were served under the Food and Drugs Act, 1938. In addition, 34 reports were submitted to the Licensing Justices, in respect of premises where application had ben made for the grant, re-grant or transfer of a licence under the Licensing (Consolidation) Act, 1910. Food Sampling. A total of 600 samples of foods and drugs were purchased and submitted to the Borough Analyst for chemical analysis during the year. 596 were formal samples and 4 were informal. Article. Number of Samples purchased Bacon 2 Baking Powder 4 Beer 1 Bread, Biscuits and Cakes 10 Butter 3 Cereals 26 Cheese 7 Cider 2 Cocoa 4 Coffee and Coffee Essences 6 Condiments 16 Confectionery 3 Dried Egg 2 Drugs 24 Essences and Flavourings 13 Fish, tinned, and Fish Preparations 14 Fruits, preserved, and Fruit Juices 16 Herbs and Spices 18 Ice Cream 38 Jams and Preserves 15 Jelly and Jelly Crystals 5 Lard and Cooking Fats 4 Margarine 4 Meat and Meat Preparations 55 Milk 212 Milk, condensed and evaporated 5 Pickles 6 Puddings and Pudding Mixtures 9 45 Article. Number of Samples purchased Salad Dressings 7 Sauces 10 Soft Drinks, Cordials 13 Soups 4 Suet 3 Sugar 4 Tea 4 Vegetables, dried 7 Vegetables, tinned 15 Vinegar 3 Wines and Spirits 6 One sample of pork sausage was found to be adulterated. The constituents were: Meat 35 per cent. Water, filler, etc. 65 per cent. l^oceedings were taken by the Ministry of Food, resulting in the vendor being fined £10 and £3 3s. Od. costs. Unsound Food. During the year 1940 the undermentioned unsound food was surrendered and destroyed or disposed of otherwise: — Commodity. Tons. Cwts. Qrts. Lbs. MILK. Condensed, sweetened, full cream _ 2 2 10 Condensed, unsweetened, skimmed — — — 7 Evaporated, unsweetened Milk — 3 1 23 FISH. Barracuta (tinned) - 1 2 14 Cat Fish (tinned) — - 2 3½ Cod (fresh) — 1 — — Cod Roe (tinned) — — — 24 Gattelbiter (tinned) — — — 6½ Haddock (fresh) — — 2 — Hake (tinned) — — - 18 Kippers (dried) — — 2 14 Mackerel (fresh) — — 1 14 Megrims (dried) - - 2 17½ Mussels (tinned) - - — 15 Oysters (tinned) - — - 11 Pilchards (tinned) — — 2 — Salmon (tinned) - - - 10 Sardines (tinned) — - — 1 Skate (fresh) - 3 2 - 47 Unsound food-continued Commodity Tons. Cwts. Qrts. Lbs. MEAT. Bacon — — — 14 Beef — — 3 20¼ Brawn — 1 2 23¼ Chicken — 4 — 2¾ Cooked Lamb — — — 21½ Corned Beef — 2 3 ¾ Duck — 2 2 8 Ham — — — 10¾ Irish Stew — — — 1 Jellied Beef — — 1 20 Jellied Veal — — — 20½ Luncheon Meat — 2 — 26¾ Meat Extract — — — ½ Meat Snack — — 1 — Meat Stew — — — 9¼ Minced Beef — — — 2¾ Mutton — — 4 17 Ox Liver — — — 10 Pork — — 1 1 Pork Meat — — — 6¼ Rabbits — 1 3 4 Rabbit (tinned) — — 2 27 Sausages — — — 25¾ Stewed Steak —- — — 4 Tripe — — 1 20 Veal Loaf — — — 5¼ Veal Pork and Beef Loaf — — 12 FRUIT. Apricots (tinned) — — — 12 Cherries (fresh) — — — 4 Grapefruit (tinned) — — — 8 Grapes (tinned) — — — 21¼ Oranges (fresh) — 1 1 10 Peaches (tinned) — — 2 17 Pears (tinned) — — — 3 Pineapples (tinned) — — — 7½ Plums (tinned) — — 2 20 Raisins (dried) — — 1 2 Tomatoes (tinned) — 2 3 9½ VEGETABLES. Arrowroot — — 1 27½ Beans (tinned) — 7 — 3¾ Beetroot (tinned) — — 1 16 Carrots (tinned) — — 7 22½ Mixed Vegetables (tinned) — — — 3¼ Onions 9 — — — Onions (jars) — — — 17 Peas (tinned) — — 2 3¾ Potatoes (tinned) — — — 4 48 Unsound Food-continued Commodity Tons. Cwt. Qtrs. Lb. OTHER FOOD. Anchovies — — — 7 Apple Sauce — — — 11 Biscuits — — — 3 Cheese — — 1 10 Cod Liver Paste — — 1 14½ Cods Roe Spread — — — 6½ Coffee — — — 7 Custard Puddings — 1 19 Fat — — 1 5 Grapefruit Juice — — — 24 Jam — — — 1 Jelly — — — 10 Marmalade — 2 6 Orange Juice — — — 25 Pickles — — 1 1 Pineapple Juice — — — 6 Peas Pudding — — — 4 Rice — 1 2 — Semolina — — — 14½ Soup — 1 — 22 Sweet Corn — — — 6 Tomato Juice — — — 3 Tomato Paste — 1 2 5 Barley Cornflakes — — — 17 Butter (Peanut) — — — 2 Chocolate — 2 — 3½ Chocolate Spread — 3 3 27 Crab Spread — — 2 17½ Fish Paste — — — ¼ Horseradish Sauce — — — ¾ Salad Cream — — — 2 Spaghetti — — — 7 Tomato Ketchup — — — 12½ Total 12 6 2 9½ 49 SECTION 7. Tuberculosis. The following table gives the number of new cases of tuberculosis notified, and deaths during 1949 of persons notified as suffering from the disease:— Age Periods. New Cases. Deaths. Pulmonary. Non-Pulmonary. Pulmonary. Non-Pulmonary. M. F. M. F. M. F. M. F. 0— 1 year — — — — — — — — 1— 2 years — 1 — — — — — — 2 — 5 years — 2 — — — — — — 5—10 years — — 1 — — — — — 10 —15 years 2 — — 1 — — — — 15—20 years 1 3 — — — — — — 20—25 years 1 5 1 — — — — — 25—35 years 7 4 1 2 — 1 — — 35—45 years 5 2 — — 1 1 — — 45—55 years 8 — — — 4 — — — 55—65 years 2 — — — 5 — 1 — 85—75 years — 1 — — 3 — — — 75 and over — — — — — 1 — — TOTAL 24 18 3 3 13 3 1 — 50 Summary of Changes in Tuberculosis Register During 1949. Pulmonary. Non- Pulmonary. Total. Cases on Register at 31st December, 1948 M. F. M. F. 108 90 12 23 233 Cases Added. Primary notifications 24 18 3 3 48 Transferred from other districts 12 14 2 — 28 Restored to Register 1 — — — 1 Death Returns 1 2 1 — 4 Totals 146 124 18 26 314 Cases Removed. Moved to other districts 21 13 2 3 39 Recovered 1 3 — 2 6 Died 13 3 1 — 17 Lost trace of — 1 1 — 2 Totals 35 20 4 5 64 Cases on Register at 31st December, 1949 111 104 14 21 250 The total number of new cases during the year was 81, equal to a notification rate of 3.25 per 1,000 population. The number of deaths from all forms of Tuberculosis during the year was 15, equal to a death rate of .59 per 1,000 population. [To face page 50. GRAPH No. 4 TUBERCULOSIS. Primary Notifications and Deaths, 1906-1949. 51 Tuberculosis Notifications and Deaths Since 1906. Notifications. Rate per 1,000 Population. Deaths. Rate per 1,000 Population. 1906 191 3.52 147 2.73 07 171 3.21 157 2.95 08 152 2.91 130 2.49 09 332 6.49 124 2.42 1910 170 3.39 111 2.21 11 187 3.81 116 2.36 12 210 4.37 111 2.29 13 204 4.35 100 2.13 14 135 2.88 103 2.20 15 198 4.90 86 2.13 16 218 5.71 80 2.10 17 149 4.22 95 2.69 18 163 4.43 105 2.86 19 94 2.46 75 1.97 1920 123 3.1 55 1.39 21 117 2.69 48 1.10 22 82 1.91 51 1.19 23 60 1.38 48 1.11 24 87 2.01 54 1.25 25 74 1.71 54 1.25 26 92 2.13 35 .81 27 111 2.63 55 1.3 28 105 2.67 47 1.2 29 88 2.29 44 1.15 1930 86 2.24 43 1.12 31 88 2.55 38 1.10 32 89 2.44 38 1.04 33 59 1.64 29 .80 34 89 2.47 32 .89 35 73 2.06 30 .85 36 90 2.58 35 1.00 37 76 2.20 27 .78 38 79 2.30 32 .93 39 69 2.25 20 .65 1940 47 2.00 24 1.02 41 53 3.09 22 1.28 42 53 3.19 30 1.82 43 54 3.13 21 1.22 44 50 2.78 15 .83 45 68 3.64 16 .86 46 60 2.83 13 .61 47 51 2.17 18 .77 48 47 1.88 13 .52 49 48 1.88 15 .59 52 Mass Radiography. The campaign for the early detection of Tuberculosis was continued during the year by Mass X-Ray Unit II of the North-West Regional Hospital Board. Facilities were afforded to persons living or working in Holborn for X-ray examination of chest and lungs on two occasions during the year, from 4th January to 3rd February, and from 5th to 22nd December. On each occasion a large number of firms in the Borough were invited to allow their employees to undergo examination by the Unit, and the managements proved very co-operative. So great was the response that on each occasion it was impossible to include all the volunteers in the particular programme and it was necessary to fit them into subsequent programmes when the Unit visited adjacent Boroughs. The following are particulars giving the results of the examinations:— Programme 1949. No. examined. Referred for large film. Failed to attend No abnormality. Referred to Chest Clinic. For re-check at later date. 4th. January to 3rd February Males 1524 29 1 16 8 4 Females 1176 18 2 6 10 — 5th to 22nd December Males 1430 29 — 20 7 2 Females 1170 8 — 2 5 1