AC 4368 POP 42 Metropolitan Borough of Poplar. Annual Report FOR THE YEAR. 1936 ON The Sanitary Condition and Vital Statistics of the Metropolitan Borough of Poplar. W. ALLAN YOUNG, D.S.O., M.D., Ch.B., D.P.H., Medical Officer of Health. Crusha &, Son, Ltd., Tottenham, Enfield, Palmers Green and Wood Green. Metropolitan Borough of Poplar. Annual Report FOR THE YEAR 1936 ON The Sanitary Condition and Vital Statistics of the Metropolitan Borough of Poplar. W. ALLAN YOUNG, D.S.O., M.D., Ch.B. D.P.H., Medical Officer of Health. 3 PUBLIC HEALTH COMMITTEE (November, 1935). Councillor Albert E. Easteal, J.P., Mayor (ex-officio). Chairman: Councillor J. A. Ashley. Vice-Chairman: Alderman J. H. Jones. Cllr. Ashley, J. A. Cllr. Goodway, T. J. Ald. Overland, A. W. (Ch.) Cllr. Bossley, J. W. Ald. Hammond, J. A. Cllr. Philp, F. C. Cllr. Boulton, H. Cllr. Harris, Mrs. A. L. Cllr. Stadward, Mrs. E. Cllr. Butchins, S. Ald. Jones, J. H. Cllr. Tyson, S. (V.Ch.) Cllr. Cressall, Mrs. Cllr. Mills, G. H. Cllr. Williams, Rev. H. N. F. MATERNITY AND CHILD WELFARE COMMITTEE (November, 1935). Councillor Albert E. Easteal, J.P., Mayor (ex-officio). Chairman: Councillor Mrs. N. F. Cressall. Vice-Chairman: Alderman Mrs. E. Stavers. Cllr. Baker, A. Cllr. Harris, Mrs. A. L. Cllr. Stadward, Mrs. E. Cllr. Bossley, J. W. Cllr. Sadler, Mrs. L. M. Ald. Stavers, Mrs. E. (V.Ch.) Cllr. Boulton, H. Ald. Sargent, A. R. Cllr. Stone, G. Cllr. Cressall, Mrs. N. F. (Ch.) Co-opted Members: Miss E. Herbert (Royal College of St. Katharine). Mrs. F. A. Cotton. Mrs. F. A. Sargent. Mrs. A.M. Sumner. Mrs. A. L. Topsom. 4 STAFF. Medical Officer of Health: W. ALLAN YOUNG, D.S.O., M.D. (Edin.), D.P.H. (Camb.). Assistant Medical Officer of Health and Tuberculosis Officer: G. O. Mitchell, M.D., M.R.C.P., D.P.H. Assistant Medical Officer of Health and Assistant Tuberculosis Officer: L. D. Richards, M.R.C.S., L.R.C.P., D.P.H. Public Analyst (Part time): ALBERT E. PARKES, F.I.C., F.C.S. GENERAL PUBLIC HEALTH SECTION, PUBLIC HEALTH OFFICE. Chief Clerk and Administrative Assistant: HAROLD DYER.† (a) H. A. Tibbatts.* C. H. Brown. *†‡§ (retired 30.6.36) (a) W. J. COLBORNE†† (a) H. J. Lanoley. *† (a) C. S. VVestbrook.*† (a) Wm. Johnson. *‡ Sanitary Inspectors: (a) S. Kelly.* (a) F. A. Smith. *‡ Miss D. A. E. landray.¶*‡|| (a) A. L. Dove, ††‡ (b) C. A. Grabham.*‡ (b) H. A. pearce.*†§‡ (c) H. W. Luke,††‡ (d) E. A. May.††‡ (d) G. L. BELSHAw††‡ (d) T. C. B. Rose,††‡ (from 15.4.36) (e) I. M. G. farries.†† (e) C. H. medland.††‡ (a) District Inspectors, (b) Food Inspectors and certain duties regarding child life protection. (c) Inspector for Houses divided into separate tenements, Common Lodging Houses, Seamen's Lodging Houses and Deputy Food Inspector, (d) Housing Inspectors. (e) Special Inspectors for Disinfestation. J. Chapman, C. F. Gregory, C. H. Bossley (resigned 26.6.36), R. T. Gratwick (resigned 31.3.36), F. S. Jolliffe, N. L. Brown (from 24.2.36), C. J. Cooley (from 6.4.36) and R. P. May (from 14.9.36) (District Inspectors' Assistants). A. S. Collyer (part-time unqualified Assistant to assist the Food Inspectors). F. J. White.* W. F. Roberts. Miss S. Fells. Mrs. E. Long. Clerks: A. Hamilton.†† J. T. Donovan. S. B. Leader. W. G. Barnett. D. G. Flynn. A. T. Burton. W. W. Martin (Office Boy). Caretaker and Messenger: C. E. Richardson. H. Harbott (Chauffeur). Vaccination Officer: P. Ryan. Public Vaccinators. Bow District Dr. D. G. Macrae. Bromley District Dr. C. Cotter. Poplar District Dr. H. J. O'Brien, Isle of Dogs Distnct Dr. H. J. Cardale (died). Dr. M. Blasker. The Medical Superintendents of St. Andrew's Hospital, Bow Institution and Bromley House Institution are the Public Vaccinators to their respective Institutions. *Cert. S.I.E. Board, †Cert. R.S.I. †† Cert. R.S.I. & S.I.E.J.B. ‡Cert. Meat and Food Inspector. §R.P.C. ¶C.M.B. ||H.V.Cert. (Board of Education). ‡‡3 years' General Nursing Certificate. 5 TUBERCULOSIS SECTION. Assistant Medical Officer of Health and Tuberculosis Officer: G. O. Mitchell. Assistant Medical Officer of Health and Assistant Tuberculosis Officer: L. D. Richards. Health Visitors: Miss H. Messem. Miss D. Wood.J Miss N. Roberts.** Dispenser: Miss K. Gentry. Clerks: Miss A. D. Frost. Miss J. Smith. Secretary to Care Committee: Miss l. Nugent. Nurse-Helper: Caretaker: Mrs. E. Tomlins (temporary). W. J. Parker. DISINFECTING STATION, YEO STREET. Disinfectors: W. Hodge‡ (Chief). F. Farrow. There are also two Apparatus Attendants and one Motor Driver. Four other men are employed in disinfestation work. Manufacture and Distribution or Electrolytic Disinfecting Fluid. Manufacturing: T. Kelleher and C. W. Shaw. There are also 3 Distributors, a Lorry Driver and Attendant. Shelter and Cleansing Station. Attendants: Mrs. A. Howe. Mrs. M. Allen. MORTUARY. Mortuary Keeper and Caretaker of Coroner's Court: D. Hogan. Relief Mortuary Keeper: C. Hagon. MATERNITY AND CHILD WELFARE SECTION. (Part-time Medical and Dental Staff). Clinic Medical Officers: Mrs. H. M. Gordon Clark, M.D., Ch.B. (Glasgow). *Miss E. Marian Layman, M.B., B.S. (London). Mrs. M. B. Graham Morton, M.D. Ch.B. (Glasgow). *Also Medical Officer-in-charge Artificial Light Treatment, ‡San. Insp. Cert. R.S.I. **H.V. Cert. R.S.I. 6 Dental Surgeon: C. Hammond Williams, L.D.S., It.C.S. (Eng.). Anaesthetist: S. Hutchinson, M.R.C.S. (Eng.), L.R.C.P. (Lond.). Chief Health Visitor: Miss J. M. Cardozo, R.R.C. Health Visitors: Miss E. A. Foskett.*¶ Mrs. M. J. Edgell.§ Miss M. Mallett* Mrs. E. K. Haythornthwaite.*¶ (c) Miss 6. I. Hill*¶ (c) Miss B. E. Letts*¶ (c) Miss M. H. Sutcliffe*¶† (c) Miss E. A. H. Williams.*¶ Miss A. Eaton*¶ Sister-in-Cbarge Artificial Light Treatment. Miss C. Harrison, Unqualified Assistant (Artificial Sunlight). Clerk: Miss K. D. Evans. Observation Wards. Wellington Road, Bow, E.3. Consulting Physician: H. St. H. Vertue, M.A., M.D., Ch.B. (Oxford.) Emergency Medical Officer: D. G. Macrae, M.R.C.S. (Eng.), L.R.C.P. (Lond.) Matron-in-Charge: Miss A. C. Andrews.*¶ Sister: Miss J. Boone (resigned 17th March, 1936). Miss K. Walker (from 2nd May, 1936). Two Staff Nurses, three Probationers, one Cook, one Maid and a Porter. Free Milk Scheme. Clerks: Miss K. Phslan. Miss C. Rudd. Miss V. S. Roberts. Investigation and Enquiry Officer (part-time): A. S. Collyer. *C.M.B. †Cert. S.I.E.B. §Cert. Mid. Colonial Medical Association ¶Three Years' General Nursing Certificate, ††Fully Trained at Children's Hospital. (c) New H.V. Certificate. 7 Public Health Office, Harley College, Bow Road, E.3. May, 1937. To the Mayor, Aldermen and Councillors of the Metropolitan Borough of Poplar. Mr. Mayor, Ladies and Gentlemen, I beg to submit my report upon the health of the Metropolitan Borough of Poplar for the year 1936. Statistics.—Once again the Registrar-General's estimate of the population is lower than we anticipated. His estimate of 140,300 is 3,400 less than that for the previous year. There was a slight decrease in the birth rate, but, on the other hand, there was a slight increase in the death rate, which was a little higher than the average for the past ten years. Respiratory diseases, measles, violence and diarrhoea contributed mainly to the increased general death rate and, apart from violence, also contributed to the higher infant mortality rate. The cold, damp and sunless earlier months of the year were probably responsible for the increase in respiratory diseases and, as mentioned in the body of the report, deaths from diarrhoeal diseases (other than dysentery and the typhoid group) were more numerous than usual, but an increase in these was also recorded in London generally. Infectious Disease.—Diphtheria showed a slight increase on the previous year, as did Scarlet Fever to a rather greater extent, and there was a definite increase in the number of cases of primary pneumonia. Housing.—Apart from the general work under the Housing Act— the inspection, etc., of underground rooms, the abatement of overcrowding which has been undertaken by the London County Council—various "areas" were the subject of representations either to the Borough Council or to the London County Council by Officers of the County Council. Public Inquiries into six Poplar "areas" which had been represented to the London County Council were held and evidence in support of the London County Council was given. These "areas'' together with others are referred to in detail in the Housing Section of this report. 8 Proposed New Buildings.—The Council has been unable to commence the building of either the new Disinfecting Station and Cleansing Station or the new Maternity and Child Welfare Clinic at Old Ford. It is hoped that the difficulties which have arisen may soon be overcome and the works started, as the accommodation at existing premises is unsuitable and very limited. Conferences.—The Council was represented at the following Conferences:— Royal Sanitary Institute—Southport, July 6th-uth. Sanitary Inspectors' Association—Harrogate, August 31st to September 5th. National Smoke Abatement Society—Science Museum, South Kensington, October 14th-17th. Central Council for Health Education—London, November 19th20th. Staff.—Several changes have taken place during the year and are indicated on the list of Staff, pages 4-6. I desire to thank the members of the Council for their continued interest in the work of the Department and to acknowledge the co-operation of Officers of other Departments of the Council. With a feeling of deep gratitude I thank the members of my Staff for their loyalty and the manner in which they have carried out their duties. Further, I again acknowledge my indebtedness to those who from time to time furnish information for inclusion in these reports. I am, Mr. Mayor, Ladies and Gentlemen, Your obedient Servant, W. ALLAN YOUNG, Medical Officer of Health. 9 Section A. NATURAL AND SOCIAL CONDITIONS OF THE BOROUGH. Area of Borough (excluding water) 2,136 acres Population (Census, 1931) 155,089 Population,Estimated Resident—mid-1936 (Reg.-General) 140,300 Number of Inhabited Houses (end of 1936) according to Rate Books 23,481 Rateable Value (October, 1936) £776,399 Sum represented by a Penny Rate (April, 1936) £3,030 Social Conditions, including the chief occupations of the inhabitants, and the influence of any particular occupation on public health. Poplar is an industrial district with a number of large factories and several docks. There are also many wharves along the river, which bounds the Borough on the south. 10 SUMMARY OF VITAL STATISTICS. (Registrar-General's Figures.) Total M. F. Live Births ^Legitimate 2,060 1,098 962 illegitimate 50 23 27 Birth Rate 15.0 per 1,000 of the estimated resident population. Totals 2,110 1,121 989 Still Births 64 30 34 Rate per 1,000 total (live and still) births 29.4. Total M. F. Deaths 1,747 932 815 Crude Death Rate 12.5 per 1,000 estimated resident population. Adjusted Death Rate 13.8. Deaths from Puerperal causes (Headings 29 and 30 of the RegistrarGeneral 's Short List):— Deaths. Rate per 1,000 total (live and still) births. No.29 Puerperal sepsis 1 0.46 No. 30 Other puerperal causes 3 1.38 Total 4 1.84 (A list of deaths from puerperal causes or otherwise associated with pregnancy, etc., is given on page 124.) Death Rate of Infants under one year of age:— All infants, per 1,000 live births 72 Legitimate infants, per 1,000 legitimate live births 69 Illegitimate infants, per 1,000 illegitimate live births 220 Deaths from Cancer (all ages) 212 „ Measles (all ages) 49 ,, Whooping Cough (all ages) 16 ,, Diarrhoea (under 2 years of age)* 35 11 Marriages. During the year the marriages of 3,008 persons were registered, giving a rate of 21.4 as against 18.9, 17.8, 17.9, 20.1 and 21.2 in the five years 1931-1935. Deaths. 1,758 deaths were registered as having occurred in the Borough. After correction for inward and outward transfers the nett total was 1.747, giving a crude rate of 12.5 and an adjusted rate of 13.8. Natural Increase. The natural increase of population represented by excess of births over deaths was 363. The principal causes of death are shown in the chart facing page 12. Heart disease, diseases of the Respiratory System (including Tuberculosis) account for the majority of the deaths, but in placing Heart disease first it should be noted that 73 per cent, of the deaths ascribed to this condition were of persons of 65 years or more. 12 Deaths during 1936 classified according to certain localities. (Old Table.) Names of localities adopted for the purpose of these statistics ; public institutions being shown as separate localities. 1st Quarter 2nd Quarter 3rd Quarter 4th Quarter Total. Poplar Sub—District (dwellings) 97 65 44 79 285 Bow and Bromley Sub—District (dwellings) 74 51 32 66 223 St. Andrew's Hospital 230 204 161 190 785 Poplar Institution 36 36 18 27 117 St. Clement's Hospital 61 41 50 54 206 Bromley House Institution — 1 — — 1 Poplar Hospital 23 21 24 23 91 River Thames 3 4 1 1 9 „ Lee 1 — 1 — 2 Limehouse Cut — 1 1 — 2 Bow Creek — — 1 — 1 Hertford Union Canal — — — — East India Docks — — — — West India Docks 1 — 1 2 South—West India Docks — — — 2 2 Millwall Docks — — 1 — 1 Poplar Dock — — — — Highways 5 6 4 11 26 Miscellaneous: (places of Employment,etc) 2 — 1 2 5 533 430 339 456 1,758 Deaths occurring outside the Borough, of persons belonging thereto (add) 109 101 71 67 348 Deaths occurring within the Borough, of persons not belonging thereto (deduct) 105 83 81 87 356 Deaths at all ages—nett 537 448 329 436 1,750 Principal causes OF death 1936. (Registrar-General's Classification ) Total Deaths during the year 1747- Males 932-Females 815. Percentage of deaths in Public Institutions to total deaths 69. The following table, compiled and furnished by the Registrar-General, is inserted at the request of the Ministry of Health. Causes of Death. Sex. All Ages 0— 1— 2— 5— 15— 25— 35— 45— 55- 65— 75— All Causes M 932 78 30 17 25 32 34 55 102 156 228 175 F 815 75 23 17 16 33 38 34 65 116 168 230 1 Typhoid and paratyphoid fevers M — — — — — — — — — — — — F — — — — — — — — — — — — 2 Measles M 33 9 14 9 1 — — — — — — — F 16 6 7 1 2 — — — — — — — 3 Scarlet fever M 1 — — 1 — — — — — — — — F 1 — — 1 — — — — — — — — 4 Whooping cough M 6 4 1 1 — — — — — — — — F 10 1 4 2 — — — — — — — — 5 Diphtheria M 6 1 1 4 — — — — — — — K 7 — — 4 3 — — — — — — — 6 Influenza M 9 — — — — 1 — 1 — 3 — 4 F 6 — — — — 1 1 — 1 — 1 2 7 Encephalitis lethargica M — — — — — — — — — — F — — — — — — — — — — 8 Cerebro-spinal fever.. M 1 — — — — 1 — — — — — F 2 1 — 1 — — — — — —— — — 9 Tuberculosis of respiratory system .. M 61 1 — 1 — 11 10 8 17 11 2 — F 39 — — 1 — 16 9 3 7 3 — — 10 Other tuberculous diseases M 7 1 1 1 1 2 — 1 — — — — F 10 4 1 3 1 1 — — — — — — 11 Syphilis M 3 — — — — — — — — 2 1 — F — — — — — — — — — — — 12 General paralysis of the insane, tabes dorsalis M 6 — — — — — — 1 2 3 — — F — — — — — — — — — — — 13 Cancer, malignant disease M 118 — — — — 1 2 8 13 31 45 18 F 94 1 — — — — 3 5 17 33 22 13 14 Diabetes M 7 — — — — — — — 3 1 2 1 F 11 — — — — — 1 — 1 2 6 1 15 Cerebral haemorrhage, etc. M 20 — — — — — — — 2 3 10 5 F 38 — — — — — — — 3 11 11 13 16 Heart disease M 279 — — — 4 3 4 6 20 43 101 98 F 286 — — — 1 5 10 13 12 37 80 128 17 Aneurysm M 6 —— — — — — — — 2 1 2 1 F — — — — — — — — — — — 18 Other circulatory diseases M 36 — — — — 1 1 — 3 8 8 15 F 29 — — — — — 1 2 4 6 16 19 Bronchitis M 48 7 2 — — — 1 1 8 6 12 11 F 35 4 4 — 1 — — — — 3 10 13 20 Pneumonia (all forms) M 71 15 10 1 3 2 2 7 9 9 9 4 F 52 13 4 3 — 2 3 2 3 3 10 9 21 Other respiratory diseases M 11 — — — — — 2 — 2 4 3 — F 4 — — — — — — — 2 — 2 — 22 Peptic ulcer M 11 — — — — 1 4 2 2 2 — F 2 — — — — — — — 1 1 — — 23 Diarrhoea, etc. M 15 12 — 1 — — — — — 1 1 — F 22 20 2 — — — — — — — — 24 Appendicitis M 7 — — — 2 1 1 1 — 1 1 — F 1 — — — 1 — — — — — — — 25 Cirrhosis of liver M 3 — — — — — — — — 1 2 — F 1 — — — — — — — 1 — — — 26 Other diseases of liver, etc. M — — — — — — — — — — — F 3 — — — — — — — 1 1 — 1 27 Other digestive diseases M 13 3 — — — 1 — 2 4 1 2 — F 15 — — — 1 — — 1 3 4 4 2 28 Acute and chronic nephritis M 17 — — — 1 — 2 — 2 5 4 3 F 28 — — — 1 1 1 1 3 6 9 6 29 Puerperal sepsis F 1 — — — — — — — 1 — — — 30 Other puerperal causes F 3 — — — — — — — — — — — 31 Congenital debility, premature birth, malformations, etc. M 28 25 1 — 1 — 1 — — — — — F 21 21 — — — — — — — — — — 32 Senility M 3 — — — — — — — — — — 3 F 8 — — — — — — — — — — 8 33 Suicide M 14 — — — — — — 6 1 4 1 2 F 7 — — — — 1 1 1 3 — 1 — 34 Other violence M 45 1 — 1 7 6 5 7 5 3 6 4 F 21 — — — 1 2 — 1 2 1 2 12 35 Other defined diseases M 47 — — — 1 3 1 2 7 13 14 6 F 41 1 1 1 4 4 6 6 2 7 3 6 36 Causes ill-defined or unknown M — — — — — — — — — — F 1 — — — — — — — — — 1 — Legit. Illegit. j Deaths under 1 year M 74 4 F. 68 7 Totals 142 11 TABLE II.—CAUSES OF, AND AGES AT DEATH DURING 1936. Causes of Death. (Manual of the International List of Causes of Death, 1931.) Total Deaths. Sex. Ages at Death—in Years. Number of Deaths of Residents of Wards. Nett Deaths in Public Institutions (at all ages) Nett Total Deaths in Public Institutions, etc. Causes of Death. Total All Ages Under 5 years. 5- 10- 15- 20- 25- 35- 45- 55- 65- 75 and over Bow. Bromley. Poplar. Poplar Institution. St. Andrew's Hospital. St. Clement's Hospital. Bromley House Institution. Poplar Hospital. See Footnotes. Outlying Institutions. 0- 1- 2- Total under 5years North. West. Central. South. Northwest. NorthEast. Southwest. SouthEast. Central. Northwest. West. East. Millwall. Cubitt Town. 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 All Causes Certified 1749 M 936 79 30 17 126 17 8 18 14 35 55 104 153 229 177 106 92 95 105 108 115 147 138 165 177 156 110 105 130 86 715 27 .. 43 28 348 1247 All Causes Certified F 813 74 23 17 114 11 5 16 17 40 33 66 113 165 233 Uncertified 1 M .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 1 .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 1 1 Uncertified F 1 .. .. .. .. .. .. .. .. .. .. .. .. 1 .. 1 Typhoid and Paratyphoid Fevers - M .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 1 Typhoid and Paratyphoid Fevers F .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 2 Measles 51 M 34 9 l5 9 33 1 .. .. .. .. .. .. .. .. .. 2 2 1 2 1 5 9 1 .. 6 5 4 4 9 .. 1 .. .. .. .. 44 45 2 Measles F 17 7 7 1 15 2 .. .. .. .. .. .. .. .. .. 3 Scarlet Fever 2 M 1 .. .. 1 1 .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 1 .. .. .. .. 1 .. .. .. .. .. .. 2 2 3 Scarlet Fever F 1 .. .. 1 1 .. .. .. .. .. .. .. .. .. .. 4 Whooping Cough 14 M 5 4 .. 1 5 .. .. .. .. .. .. .. .. .. .. .. .. .. 1 .. .. 5 1 2 2 .. 1 .. 2 .. 2 .. .. .. .. 8 11 4 Whooping Cough F 9 3 4 2 9 .. .. .. .. .. .. .. .. .. .. 5 Diphtheria 13 M 6 .. 1 1 2 4 .. .. .. .. .. .. .. .. .. .. .. .. .. 2 2 3 .. 3 .. 1 .. .. 2 .. 1 .. .. .. .. 12 13 5 Diphtheria F 7 .. .. 4 4 3 .. .. .. .. .. .. .. .. .. 6 Influenza 15 M 9 .. .. .. .. .. .. 1 .. .. 1 .. 3 .. 4 1 2 .. 1 3 1 2 .. 2 1 .. .. 1 1 .. 3 .. .. .. .. 1 4 6 Influenza F 6 .. .. .. .. .. .. .. 1 1 .. 1 .. 1 2 7 Encephalitis lethargica - M .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 7 Encephalitis lethargica F .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 8 Cerebro-spinal Fever 3 M 1 .. .. .. .. .. .. .. .. 1 .. .. .. .. .. .. .. 1 .. .. .. .. .. .. 1 .. 1 .. .. .. 1 .. .. .. .. 2 3 8 Cerebro-spinal Fever F 2 1 .. 1 2 .. .. .. .. .. .. .. .. .. .. 9 Tuberculosis of Respiratory system 100 M 61 1 .. 1 2 .. .. 5 6 10 8 17 11 2 .. 5 3 7 4 4 8 9 9 12 9 6 7 9 8 .. 56 .. .. .. 1 (a) 14 71 9 Tuberculosis of Respiratory system F 39 .. .. 1 1 .. .. 6 10 9 3 7 3 .. .. 10 Other Tuberculous Diseases 17 M 7 1 1 1 3 1 .. 1 1 .. 1 .. .. .. .. .. .. .. 2 .. 1 5 1 .. .. 5 1 1 1 .. 8 .. .. 2 .. 6 16 10 Other Tuberculous Diseases F 10 4 1 3 8 1 .. .. 1 .. .. .. .. .. .. 11 Syphilis 2 M 2 .. .. .. .. .. .. .. .. .. .. 1 1 .. .. .. .. .. .. .. .. 1 .. .. .. .. 1 .. .. .. .. .. .. .. 2 2 11 Syphilis F .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 12 General Paralysis of the Insane, tabes dorsalis 6 M 6 .. .. .. .. .. .. .. .. .. 1 2 3 .. .. .. .. .. .. .. .. .. .. .. 2 3 .. .. 1 .. 2 .. .. .. .. 3 5 12 General Paralysis of the Insane, table dorsalis F .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 13 Cancer, malignant disease 211 M 117 .. .. .. .. .. .. 1 .. 2 8 13 30 45 18 8 12 13 11 11 10 14 17 24 20 25 11 13 22 2 89 1 .. 3 1 (b) 45 141 13 Cancer, malignant disease F 94 1 .. .. 1 .. .. .. .. 3 5 17 33 22 13 14 Diabetes 18 M 7 .. .. .. .. .. .. .. .. .. .. 3 1 2 l 1 .. 1 1 .. 1 4 .. 1 2 3 2 .. 2 .. 7 .. .. .. .. 4 11 14 Diabetes F 11 .. .. .. .. .. .. .. .. 1 1 1 1 6 1 15 Cerebral haemorrhage, etc. 59 M 21 1 .. .. 1 .. .. .. 1 .. .. 2 4 8 5 4 .. 6 5 2 4 2 5 4 7 4 4 5 7 4 27 .. .. 3 1 (c) 6 41 15 Cerebral haemorrhage, etc. 1'' 38 .. .. .. .. .. .. .. .. .. .. 3 10 12 13 16 Heart Disease 565 M 279 .. 2 4 4 6 20 42 102 99 43 39 33 35 35 36 40 57 43 63 49 35 32 25 56 238 .. .. 4 8 (d) 50 380 16 Heart Disease F 286 .. .. .. .. 1 1 2 2 9 12 13 38 77 131 17 Aneurysm 6 M 6 .. 2 1 2 1 .. 1 1 .. .. .. .. 1 1 .. .. 1 1 .. .. 1 .. .. .. 1 (e) .. 2 17 Aneurysm F .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 18 Other circulatory diseases 67 M 36 .. .. .. .. .. .. .. .. 1 .. 2 8 10 15 1 4 6 9 5 3 3 5 4 5 9 5 .. 8 5 20 1 .. 1 1 (f) 14 42 18 Other circulatory diseases F 31 .. .. .. .. .. .. .. .. .. 1 2 4 7 17 19 Bronchitis 85 M 51 6 2 .. 8 .. .. .. .. .. 1 8 10 13 11 4 4 1 5 6 11 8 5 9 8 5 5 5 9 3 46 .. .. .. .. 2 51 19 Bronchitis F 34 5 4 .. 9 l .. .. .. .. .. .. 2 10 12 20 Pneumonia (all forms) 123 M 70 15 10 1 26 2 2 .. 2 2 7 8 9 8 4 14 5 7 10 7 5 9 9 16 10 7 11 5 8 7 54 .. .. 10 2 (g) 15 88 20 Pneumonia (all forms) F 53 13 5 3 21 .. .. 2 .. 3 2 2 4 9 10 21 Other Respiratory Diseases 12 M 7 .. .. .. .. .. .. .. .. 1 .. 4 1 .. .. .. .. .. .. 1 2 1 .. .. 2 3 2 .. .. .. 5 .. .. .. .. 1 6 21 Other Respiratory Diseases F 4 .. .. .. .. .. .. .. .. .. .. 3 .. 1 .. 22 Peptic Ulcer 12 M 11 .. .. .. .. .. .. .. .. 1 4 2 2 .. .. 1 2 1 .. 1 1 1 1 2 .. 1 .. 1 .. .. 4 .. .. .. .. 3 7 22 Peptic Ulcer F 1 .. .. .. .. .. .. .. .. .. .. 1 .. .. .. 23 Diarrhoea, etc. 38 M 16 14 .. 1 15 .. .. .. .. .. .. .. .. 1 .. 1 .. .. 3 3 1 7 7 5 1 3 4 3 .. .. 19 .. .. 4 1 (h) 10 34 23 Diarrhoea, etc. F 22 20 2 .. 22 .. .. .. .. .. .. .. .. .. .. 24 Appendicitis 8 M 7 .. .. .. .. 2 .. 1 .. 1 1 .. 1 1 .. 1 .. .. .. .. .. .. 1 2 1 1 1 .. 1 .. 4 .. .. 2 .. 2 8 24 Appendicitis F 1 .. .. .. .. .. 1 .. .. .. .. .. .. .. .. 25 Cirrhosis of Liver 4 M 3 .. .. .. .. .. .. .. .. .. .. .. 1 2 .. 1 1 .. 1 .. .. 1 .. 1 .. .. .. .. 1 2 25 Cirrhosis of Liver.. F 1 .. .. .. .. .. .. .. .. .. 1 .. .. .. 26 Other diseases of liver, etc. 3 M .. .. .. .. .. .. .. .. .. .. .. .. .. 1 1 .. .. 1 .. 1 .. .. 1 .. .. 2 26 Other diseases of liver, etc. F 3 .. .. .. .. .. .. .. .. .. 1 1 1 27 Other Digestive diseases 30 M 16 3 .. .. 3 .. .. 1 .. 1 2 4 1 3 1 1 1 1 2 5 2 3 1 2 4 2 3 2 1 .. 19 .. .. 2 .. 9 30 27 Other Digestive diseases.. !«' 14 .. .. .. .. .. 1 2 5 4 2 28 Acute and Chronic Nephritis 47 M 17 .. .. .. 1 .. .. 2 4 3 4 3 1 1 2 4 2 6 5 5 7 3 1 5 5 .. 18 .. .. 1 .. 10 32 28 Acute and Chronic Nephritis F 30 .. .. .. 1 1 .. 2 1 1 4 4 U 5 29 Puerperal Sepsis 1 F 1 .. .. .. .. .. .. .. 1 .. .. .. .. .. .. .. .. .. 1 .. .. .. .. .. 1 1 29 Puerperal Sepsis 30 Other Puerperal causes 3 F 3 .. .. .. .. .. .. .. 3 .. .. .. .. .. .. .. .. 2 .. 1 .. 2 .. .. .. .. 2 Birth, Malformations, etc. 45 M 26 24 1 .. 25 .. 1 .. .. .. .. .. .. .. .. 3 3 3 4 2 4 3 2 2 5 5 3 3 3 .. 22 .. .. 1 .. 16 39 [31 Congenital Debility, Premature F 19 19 .. .. 19 .. .. .. .. .. .. .. .. .. .. 32 Senility 11 M 3 .. .. .. .. .. .. .. .. .. .. .. .. 3 .. 2 2 2 .. 1 •* .. .. .. 3 1 .. .. .. .. .. 1 1 32 Senility F 8 .. .. .. .. .. .. .. .. .. .. .. .. 8 33 Suicide 21 M 14 .. .. .. .. .. .. .. .. 6 1 4 1 2 2 4 3 1 2 .. 1 1 5 1 .. .. 1 .. 5 .. .. .. 2 (i) 7 14 33 Suicide F 7 .. .. .. .. .. .. 1 ?, 3 1 .. 34 Other violence 66 M 45 1 .. 1 2 4 2 2 4 6 7 5 4 5 4 4 2 3 3 4 6 5 5 7 5 8 3 5 6 1 26 .. .. 4 10 (k) 24 65 34 Other violence F 21 .. .. .. 1 .. 2 .. 1 2 1 1 12 35 Other defined causes 93 M 52 .. .. .. 2 1 2 .. 3 2 7 13 16 6 8 5 3 2 9 5 7 8 10 14 8 5 4 4 5 33 1 .. 4 .. 33 76 35 Other defined causes F 40 1 .. 1 2 1 2 4 .. 7 .. 2 7 3 6 36 Causes ill-defined, or unknown 1 M .. .. .. .. .. .. .. .. .. .. .. .. .. .. 1 .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 1 1 36 Causes ill-defined, or unknown .. F 1 .. .. .. .. .. .. .. .. .. .. .. •• 1 .. All Causes M 936 79 30 17 126 17 8 18 14 35 55 104 153 229 177 X 107 92 95 105 108 115 147 138 165 177 156 110 105 130 86 715 27 .. 43 28 349 1248 All Causes F 814 74 23 17 114 11 5 16 17 40 33 66 113 166 233 1 Totals 1750 153 53 34 240 28 13 34 31 75 88 170 ) 266 395 410 J Footnotes: (a) Highway, 1, (6) Highway, 1. (c) Highway, 1 (rf) Highways, 6; West India Docks, 2. (e) Highway, 1. (/) Highway. 1. (g) Observation Wards, 1; West India Docks, 1. (h) Royal College of St. Katharine, 1. (j) River Lee, 2. (k) Highways, 4; River Thames, 2; Limehouse Cut, 1; Millwall Dock, 1: On Railway, 1; At Railway Goods Yard, 1. 13 TABLE III. Infantile Mortality. Nett Deaths from stated Causes in Weeks and Months under One Year of Age. Causes of Death Under 1 week. 1—2 weeks. 2—3 weeks. 3—4 weeks. Total under 1 month. 1—3 months. 3—6 months. 6—9 months. 9—12 months. Nett total Deaths under 1 year. No. of Deaths in each Quarter. Poplar. How and Bromley Whole Borough 1 2 3 4 Measles — — — — — — 1 10 5 11 5 16 3 13 — — Whooping Cough — — — — — — 2 2 3 1 6 7 4 — — 1 Diphtheria — — — — — — — — — — — — — — — — Influenza — — — — — — — — — — — — — — — — Tuberculosis of Nervous System — — — — — — 1 1 — 2 — 2 — 1 — 1 Tuberculosis of Intestines and Peritoneum — — — — — — — — — — — — — — — — Other Tuberculous Diseases — — — — — — — 4 — 2 2 4 2 2 — — Syphilis — — — — — — — — — — — — — — — — Meningitis — — — — — — 1 — — 1 — 1 — 1 — — Convulsions — — — — — — — — — — — — — — — — Bronchitis — 1 — — 1 4 3 1 1 4 6 10 5 2 — 3 Pneumonia — — — — — 8 5 9 6 18 10 28 15 6 1 6 Other Respiratory Diseases — — — — — — — — — — — — — — — — Inflammation of the Stomach — — — — — — — — — — — — — — — — Diarrhoea and Enteritis — — 1 — 1 4 7 16 8 21 15 36 2 16 9 9 Hernia, Intestinal Obstruction — — — — — — — 1 — 1 — 1 1 — — — Congenital malformations 6 — — — 6 3 — — — 4 5 9 2 3 3 1 Congenital Debility and Sclerema — — — — — — — — — — — — — — — — Icterus — — — — — — — — — — — — — — — — Premature Birth 21 — — 1 22 4 — — — 13 13 26 7 5 7 7 Injury at Birth 3 — — — 3 — — — — 3 — 3 1 1 1 — Disease of Umbilicus — — — — — — — — — — — — — — — — Atelectasis 2 1 — — 9 — — — — 2 1 3 — 1 — 2 Suffocation—in bed or not stated how — — — — — — — — — — — — — — — — Other causes 1 — 1 1 3 2 — 2 — 2 5 7 3 — 1 3 All causes 33 2 2 2 39 25 25 46 23 85 68 153 45 53 22 33 Live Births {Legitimate 2,060* Nett Deaths {Legitimate 142* in the year {Illegitimate 50* in the year {Illegitimate 11* *Registrar—General's figures. Neo—Natal Death Rate. 1931. 1932. 1933. 1934. 1935. Average 1931— 1935. 1936. Nett Births 2,739 2,616 2,295 2,267 2,215 2,426 2,110 Registrar—General) Deaths under 1 month 74 65 67 43 52 60 39 Neo—Natal death rate per 1,000 nett Births 27.0 24.8 29.2 19.0 23.5 24.7 18.5 14 Births, Maternal Mortality and Infantile Mortality. The following Table shows the Birth rate, Maternal Mortality rate and the number and rate per 1,000 births of:— (a) Deaths of infants under 2 weeks old; (b) Deaths of infants from 2 weeks to 12 months old; (c) Deaths of infants under 1 year of age (total and visited by the Health Visitors), during the twenty years 1917 to 1936. Year. Live Births. Birth rate per 1,000 population Maternal Mortality. Deaths of Infants: Deaths of visited infants. rate per 1,000 Under 2 weeks. 2 weeks to 12 months. Total under one year. Total under one year. Rate per 1,000 visited. Live Births. Total Births. No. Rate. No. Rate. No. Rate. 1917 3,700 23.1 2.70 — 87 23.5 265 71.6 352 95 215 79 1918 3,203 20.4 4.01 — 79 24.7 265 82.7 344 107 173 68 1919 3,949 24.6 2.78 — 106 26.8 222 56.2 328 83 243 69 1920 5,457 34.1 3.48 — 121 22.2 326 59.7 447 82 213 48 1921 4,478 27.2 3.57 — 92 20.5 282 62.9 374 83 243 66 1922 4,417 26.6 3.17 — 108 24.5 241 54.5 349 79 147 38 1923 4,256 25.6 3.29 — 101 23.7 154 36.1 255 60 163 44 1924 3,831 22.9 1.30 — 75 19.5 202 52.7 277 72 128 38 1925 3,831 22.7 3.13 — 73 19.0 215 56.1 288 75 174 50 1926 3,658 21.6 3.97 — 75 20.5 183 50.0 258 70 136 39 1927 3,309 19.8 2.72 — 68 20.6 150 45.3 218 66 138 42 1928 3,228 19.9 2.47 — 64 19.8 166 51.4 230 71 152 49 1929 3,064 19.1 3.26 — 77 25.1 153 49.9 230 75 123 40 1930 3,056 19.3 1.31 1.26 66 21.6 101 33.5 167 55 102 34 1931 2,739 17.5 2.55 2.47 60 21.8 151 55.1 211 77 139 50 1932 2,616 17.2 4.20 4.07 57 21.8 109 41.6 166 63 74 28 1933 2,295 15.4 1.74 1.70 59 25.7 64 27.9 123 54 81 34 1934 2,267 15.5 3.53 3.40 37 16.3 103 45.4 140 62 72 31 1935 2,215 15.4 3.16 3.06 47 21.2 55 24.8 102 46 95 41 1936 2,110 15.0 1.89 1.84 35 16.6 118 55.9 153 72 — — (Tables showing the causes of death are given as follows:— Deaths under 1 year, page 13. Deaths from puerperal causes, page 124.) 15 TABLE IV. Birth.rates, Death.rates, and Analysis or Mortality in the Year 1936. Rate per 1,000 Population. Annual Death.rate per 1,000 Population. Hate per 1,000 Live Births. Percentage of Total Deaths. All Causes. Typhoid and Paratyphoid Fevers. Small. pox. Measles. Scarlet Fever. Whooping Cough. Diphtheria. Influenza. Violence. Diarrhœa and Enteritis (under 2 years). Total Deaths under One Year. Certified by Registered Medical Practitioners. Inquest Cases. Certified by Coroner after P.M. No Inquest. Uncertified Causes of Death. Live Births Stillbirths. *England and Wales 14.8 0.61 12.1 0.01 — 0.07 0.01 0.05 0.07 0.14 0.52 5.9 59 *122 County Boroughs and Great Towns, including London 14.9 0.67 12.3 0.01 — 0.09 0.01 0.06 0.08 0.14 0.45 8.2 63 *143 Smaller Towns (Populations 25,000. 50,000 at Census 1931) 15.0 0.64 11.5 0.00 — 0.04 0.01 0.04 0.05 0.15 0.39 3.4 55 *London Administrative County 13.6 0.53 12.5 0.01 — 0.14 0.01 0.06 0.05 0.14 0.52 14.4 66 Poplar Borough 15.0 0.46 12.5† — — 0.35 0.01 0.11 0.09 0.11 0.47 16.6 72 88.6 6.2 5.1 0.1 †Crude rate. The adjusted rate is 13.8. Puerperal Sepsis. Others. Total. *The Maternal Mortality Rates for England and Wales are as follows:— Per 1,000 live births 1.40 2.41 3.81 Per 1,000 total births 1.34 2.31 3.65 The Maternal Mortality Rates for Poplar are as follows:— Per 1,000 live births 0.47 1.42 1,89 Per 1,000 total births 0.46 1.38 1.84 *Provisional figures furnished by the Registrar-General. 16 TABLE Y. (1936). Cities and Boroughs. Estimated Resident population (Mid-1936) Live Births, Annual rate per 1,000 population. Deathrate per 1,000 population. Deaths of Infants under one year to 1,000 births. LONDON 4,141,100 13.6 12.5 66 West Districts. Crude Adjusted Faddington 139,200 13.8 12.98 12.81 72 Kensington 176,100 12.7 12.5 11.7 73 Hammersmith 127,700 15.1 12.5 12.9 60 Fulham 141,300 14.9 12.6 12.7 64 Chelsea 56,500 11.3 13.7 11.6 53 City of Westminster 124,100 8.5 11.1 11.4 65.8 North Districts. St. Marylebone — Hampstead 90,700 10.4 10.2 9.6 65.8 St. Fancras 183,900 13.0 13.5 13.8 79 Islington 304,100 15.24 12.44 12.56 61 Stoke Newington 50,350 13.7 11.4 10.9 44.6 Hackney 209,100 14.4 12.0 12.6 62.9 Central Districts. Holborn 34,850 8.29 11.99 12.83 62 Finsbury 60,800 13.8 14.0 15.3 81 City of London 9,100 7.5 11.4 12.65 147 East Districts. Shoreditch 85,400 14.9 12.8 14.1 75 Bethnal Green 96,900 13.5 12.7 14.3 98 Stepney 207,800 14.7 12.6 14.7 100.09 Poplar 140,300 15.0 12.5 13.8 72 South Districts. Southwark 152,200 14.8 13.1 59 Bermondsey 100,400 15.4 12.8 14.6 60 Lambeth 277,500 13.9 12.5 12.4 59 Battersea 145,500 14.63 13.06 12.93 59.21 Wandsworth 343,000 11.46 11.79 10.96 58 Camberwell 229,300 13.93 12.64 12.64 58.86 Deptford 98,900 15.7 12.2 12.6 50 Greenwich 95,900 13.82 11.36 11.58 49 Lewisham 224,000 13.0 10.8 10.9 55 Woolwich 146,500 13.8 11.2 11.8 59 Note.—The information relating to London supplied by the Registrar-General and that for individual Boroughs by the Medical Officers of Health. 17 (This summary is inserted for comparison with those shown in previous reports.) 1931. 1932. 1933. 1934. 1935. 1936. Population, estimated by Registrar-General:— 156,300 152,400 149,300 146,370 143,700 140,300 Births, Live, rate per 1,000 population 17.5 17.2 15.4 15.5 15.4 15.0 Death rate from all causes, per 1,000 population Crude 12.4 121 12.4 12.3 11.0 12.5 Adjusted 13.8 13.4 13.8 13.7 12.3 13.8 Deaths under 1 year of age, rate per 1,000 nett births 77 63 54 62 46 72 Deaths over 65 years of age, rate per 1,000 total population 5.0 5.2 5.4 5.3 5.2 5.7 Zymotic diseases:— Death rate per 1,000 population 0.4 0.5 0.4 0.7 0.2 0.8 Proportion of 1,000 deaths 34.5 40.6 29.0 58.3 21.4 67.0 Tuberculosis, all forms:— Death rate per 1,000 population 1.1 10 1.0 0.9 0.9 0.8 Proportion of 1,000 deaths 87.5 83.3 79.1 73.8 81.9 67 .0 Respiratory diseases (excluding phthisis):— Death rate per 1,000 population 2.2 1.7 11 1.7 1.0 1.6 Proportion of 1,000 deaths 181.8 140.7 87.7 142.2 93.8 126.5 * Smallpox, Measles, Scarlet Fever, Whooping Cough, Diphtheria and Mem. Croup, Typhoid Fever and Diarrhoeal Diseases. 18 Mortuary and Coroner's Court. The number of bodies deposited in the Council's Mortuary, Cottage Street, Poplar, during the year was 208:— Residents Non.Residents* Totals Males Females Males Females Age not stated (i .e. unknown, newly born) . 9 4 3 1 17 Stillborn — — — — — Under 1 year 6 1 — — 7 1 to 5 years 2 1 1 — 4 5 to 15 years 8 4 3 — 15 15 to 25 years 2 1 3 — 6 25 to 45 years 18 6 6 1 3i 45 to 65 years 35 12 11 9 67 65 years and upwards 26 21 2 12 61 Totals . 106 50 29 23 208 •Brought from outside the Borough for the convenience of the Coroner. Inquests were held on 124 (post-mortem examinations, 59), and 75 other post-mortem examinations were made by order of the Coroner. The total number of post-mortem examinations made was 134. Nine bodies were brought to the Mortuary for custody (8 from Fever Hospitals and 1 from elsewhere). In several instances post-mortem examinations were made at the Poplar Mortuary and inquests held at either Stepney or Shoreditch Coroner's Courts. Removal of Dead Bodies from Foreshore. In reply to a communication from the Assistant Commissioner, New Scotland Yard, the Council agreed that in cases of emergency, where for some unforeseen circumstances the undertaker appointed by the Council was not available, the Police could call in their own undertaker, provided the cost to the Council was not more than £2 per case. 19 Section B. GENERAL PROVISION OF HEALTH SERVICES FOR THE BOROUGH. (1) Public Health Officers of the Authority. A list of the Staff is shown at the commencement of the Report, pages 4-6. (2) Nursing in the Home. Agreements with local nursing associations are in operation, the fees payable being at the rate of is. 3d. per visit. (For number of cases visited and total visits paid, see Table in Maternity and Child Welfare Section of this Report.) (3) Midwives. The number of midwives practising in the area is 13. No arrangements are made for subsidising midwives in the Borough, but compensation is paid to midwives, when, on the advice of a Clinic Medical Officer, the patient has been confined in an Institution. (4) Poor Law Out Relief. The following information was furnished by the London County Council:— Number of persons in receipt of domiciliary relief (excluding medical relief only). Cost. No. of persons in receipt of medical relief only. Week ended 4th January, 1936 6,878 £2,720 59 4th July, 1936 6,156 £2,294 28 (5) Laboratory Facilities. (a) Chemical Analysis. Arrangements are made with an analytical chemist who is approved by the Minister of Health. All examinations are carried out at the Public 20 Analyst's own laboratory which is situate at Bank Buildings, 161, Bow Road, E.3. The report of the Public Analyst is given on page 77. (n.b.—Examination of samples of milk for tubercle and bacteriological counts in designated milks are made at the Lister Institute.) (b) Bacteriological. (i) All sputa examinations are made at the Council's Tuberculosis Dispensary. (ii) Examination of diphtheria swabs and Widal tests and examination of stools and urine are carried out by arrangement with the Seamen's Hospital Society, Dreadnought Hospital, Greenwich. (iii) Wasserman tests and examination of smears are done at the London Hospital under the Venereal Disease Scheme for London. (6) New Legislation. During the year the following legislation, etc., came into operation:— Milk (Special Designations) Order, 1936. Came into operation 1st June, 1936, and revoked the Special Designations Orders of 1923 and 1934. The designations "Certified," "Grade 'A' (T.T.)," "Grade 'A' " and "Pasteurised" were abolished and replaced with the designations "Tuberculin Tested," "Accredited" and "Pasteurised." The persons already licensed were informed of the changed designations. The Council delegated its powers to the Public Health Committee and agreed that the fees payable should be as laid down in the Fourth Schedule of the Order. 21 Public Health (London) Act, 1936. Came into operation 1st October, 1936, and consolidated certain public health legislation regarding London. It repeals, either wholly or in part, 82 other Acts. Merchandise Marks Act, 1926. In March, a further Order in Council was received from the Ministry of Agriculture and Fisheries regarding the marking of certain meat. Agricultural Produce (Grading and Marking) Act, 1928. Various orders under this Act were issued during the year. (7) Hospitals. (i) Fever and Smallpox. Hospitals for patients suffering from these diseases are provided by the London County Council. (ii) T uberculosis. Residential Institutional Treatment for tuberculous patients is provided by the London County Council. (iii) Other Hospitals. There are no hospitals in the Borough provided or subsidised by the Council. There are two General Hospitals, Poplar Hospital (supported voluntarily), and St. Andrew's Ho pital (maintained by the London County Council). Other Institutions in the Borough are:— Poplar Institution; St. Clements Hospital (late Bow Institution); Langley House; Bromley House Institution; all of which are maintained by the London County Council. 22 (iv) Children. At the Observation Wards two five-cot wards and an isolation ward are provided for children suffering from malnutrition, etc. (See report of Consulting Physician, page 126.) The Royal College of St. Katharine also have accommodation for 12 cots for children suffering from malnutrition, etc. During the months April to October, 6 of the cots are used for tonsillectomy cases. (8) Institution for unmarried mothers, etc. There is one such Institution in the Borough, and, although it is not in any way connected officially with the Council, it receives a grant of £249 per annum from the London County Council. (9) Ambulance facilities. The ambulance services are provided by the London County Council. (10) Clinics and Treatment Centres. Maternity and Child Welfare Centres, Ante-Natal Clinics and Day Nurseries. (See Maternity and Child Welfare Section, page 108.) Tuberculosis Dispensary. (See page 94, where a list of accommodation and hours of sessions, etc., is shown.) There are several school treatment centres in the Borough maintained by the London County Council. There is no centre in the Borough for the treatment of venereal disease. Posters published by the London County Council giving addresses of the nearest clinics are displayed in the public urinals throughout the Borough. These posters also state that a complete list of Hospitals where treatment is available can be had on application at the office of the Public Health Department. (11) Maternal Mortality. All maternal deaths and all cases of Puerperal Fever and Puerperal Pyrexia are specially investigated. (See Maternity and Child Welfare section, page 124.) 23 (12) Health Visiting. The Maternity and Child Welfare work of the Borough is divided between the M. and C.W. section of the Public Health Department and the Royal College of St. Katharine. The latter body is responsible for approximately one-third of the Borough, namely, the central portion lying between Bow Road and East India Dock Road. With few exceptions, infants are visited on the nth day after birth, or as soon as possible thereafter. An endeavour is made to pay eight visits during the first year of life, six in the second year, four in the third year, three in the fourth year, and one or two in the fifth year. 24 Section C. SANITARY CIRCUMSTANCES OF THE BOROUGH. Public Cleansing Services. Included under this heading is the collection, removal and disposal of household and trade refuse; street cleansing; gully and cesspool emptying, and snow removal. I am indebted to Mr. Rees J. Williams, A.M.Inst.C.E., the Borough Engineer and Surveyor, for the following particulars:— House Refuse. A bi-weekly collection service is in operation, bins being placed on the kerb by the householder. The container system has been adopted in connection with flats and institutions. Number of petrol vehicles engaged in the work 22 Number of horse-drawn vans engaged in the work I Number of men engaged in the work 80 Trade Refuse. This is collected when requested. Street Cleansing. Important roads are swept daily and nightly; other roads daily by beat system. In certain roads the beats are covered several times per day. A new type of orderly truck of lighter construction, fitted with pneumatic tyred wheels and two portable bins, has been introduced to replace the wooden trucks, which were heavy, cumbersome and noisy. A dustless system of collection of street sweepings is in operation in half of the Borough, and has proved so successful that it is being extended to the remaining portion of the Borough. Motor sweeping machines engaged on street cleansing 2 Motor vehicles employed on the collection of street sweepings 3 Horse-drawn vans employed on the collection of street sweepings 9 Number of men engaged 136 Street Watering. Four motor street watering tanks supplemented by 6 horse-drawn vans constitute the street watering service. Sanitary Inspectors' Work. Tabulated Statement of Inspections, Insanitary Conditions found existing, and Re-inspections during the year 1936 DISTRICT. Totals. (District Inspectors.) Housing Inspectors,* Totals. No. 1. No. 2. No. 3. No. 4. No. 5. No. 6. No. 7. No. 8. Mr. G. L. Belshaw. "Mr. E. A. May. Mr.T.C.B Rose. Number of Complaints received 532 245 879 480 448 820 576 380 4,360 - - - 4,360 Number of Insoections Dwelling Houses House-to-House 72 — - - 70 38 - - 180 161 111 167 619 On Complaint 613 245 877 462 481 822 569 300 4,369 2 1 - 4,372 After Infectious Disease 94 72 146 148 156 98 99 87 900 - - — 900 Factories, including Factory Laundries 6 32 10 22 23 3 6 8 110 — —- — 110 Workshops, including Workshop Laundries 15 30 5 13 13 12 10 5 103 — —- — 103 Workplaces, other than outworkers 53 8 6 34 18 11 19 6 155 — —- — 155 Outworkers 9 - 1 30 - - - 40 — — — 40 Stables 14 3 6 33 113 25 22 20 236 — — — 236 Smoke observations 1 13 4 24 37 15 11 8 113 — 1 — 114 Miscellaneous visits and inspections (including visits to tious Disease contacts, school inspections, etc.) 496 163 639 237 667 978 240 663 4,083 240 278 253 4,854 Re-inspections 2,783 2,754 2,390 1,869 3,146 1,987 3,337 2,364 20,630 585 548 744 22,507 Premises requiring amendment (a) Dwelling-houses 595 286 883 501 458 740 601 282 4,346 97 74 112 4,629 (b) Other premises 10 13 20 37 73 13 19 5 190 - - - 190 Service of Intimations, etc.: Intimations served 622 339 761 539 446 784 592 286 4,369 97 96 113 4,675 ,, complied with 367 190 402 365 356 536 242 283 2,741 72 68 61 2,942 Notices served 241 53 308 207 119 243 339 67 1,577 22 28 35 1,662 ,, complied with 200 57 172 162 97 159 174 67 1,088 19 19 19 1,145 Final Notices served 42 18 125 47 21 70 170 9 502 3 8 5 518 ,, complied with 45 17 135 58 25 60 153 9 502 3 8 4 517 Summonses applied for 3 22 5 - 19 12 - 61 - - - 61 Work done, number of instances not included above: (a) After legal proceedings — — 20 2 - 19 17 - 58 - - - 58 (b) Voluntarily 17 12 86 11 113 23 24 — 286 — 1 - 287 Defects, etc., found in Dwelling Houses: Nuisances, etc., found. Works completed. Drainage: Drains defective 47 38 63 25 15 ,, obstructed 15 30 154 34 191 29 35 27 435 — - — 435 470 Waste pipes defective, etc. 33 21 54 53 60 37 48 27 392 1 - — 393 364 Rainwater pipes not disconnected - 1 4 6 89 30 - 1 329 12 8 16 365 373 W.C.'s and flushing apparatus defeotive 36 47 122 130 48 81 10 24 — — — 24 78 Dampness (not due to defects shown elsewhere) 60 50 216 77 228 oo 519 231 26 575 8 10 3 596 541 Water: Supply cut off - 2 1 1 6 1 19 1,400 37 23 38 1,498 1,351 Dust Receptacles: Insufficient or defective 96 30 82 132 89 3 67 1 15 — — — 15 23 Miscellaneous: 133 72 701 10 22 8 741 746 Rooms, etc., dirty and/or verminous 315 250 820 349 484 792 241 Cases of overcrowding - 3 5 3 toy 5 9 3,740 105 89 77 4,011 3,896 Yards, etc., not properly paved or drained 31 120 104 54 96 1 94 26 26 — — — 26 14 Roofs defective 309 325 460 180 206 32 360 107 557 6 18 8 589 598 Rainwater pipes and gutters defective 48 176 200 70 178 213 158 52 2,160 15 32 43 2,250 2,274 Public House Urinals requiring cleansing - 4 3 7 5 94 - 7 976 11 26 9 1,022 1,002 Other nuisances or defects 360 450 2,643 437 1,198 1,371 1,582 372 26 8,413 - - - 26 23 Defects found in Factories, Workshops, etc.: 138 177 264 8,992 9 142 Sanitary defects 1 9 5 7 32 13 12 5 84 - 84 71 W.C. accmmodation, insufficient or unsuitable - - 2 1 4 2 1 - 10 — — — 10 8 Overcrowding - - - 1 - - - — 1 — — — 1 2 Stables: — — — Manure receptacles defective, etc. - - 2 9 1 2 - - 14 - - - 14 22 Accumulations found - 2 2 - 5 - - 3 12 - — — 12 16 Re-housing* Number of families re-housed by— 1. Poplar Borough Council .. .. *. .. - - - - - - - - - - - - 2. London County Council — — —- — — — — — — - - Number of visits by Assistants (not included above) 2,239 2,354 5,125 3,087 4,940 3,513 3,860 — 25,118 - - - ♦The Housing Inspectors were engaged on House-to-house inspections under the Public Health (London) Act, and in inspections, etc., in connection with "Areas," referred to on pages 51 and 52. Messrs. Belshaw an" May were also engaged on the overcrowding survey 22 days and 4 days respectively. 18 Mr. Belshaw also deputised for District Inspectors on 43 days. 25 Gully Cleansing. A programme of conversion of brick gullies of 170 gallons capacity to pot gullies of 30 gallons capacity is being proceeded with, and improved sanitary conditions result from this work. Three mechanical gully emptiers are employed and three men (including driver) are engaged with each vehicle, and the gullies receive regular attention. Number of street gullies in the Borough:— Brick gullies 2,776 Pot gullies 401 3,177 Number of gully cleansings:— Pot (30 gallons) 1,333 Brick (170 gallons) 9,418 10,751 Refuse Disposal. All refuse is discharged into barge at Northumberland Wharf. The introduction of three hydraulic hoists has rendered possible the discharge of loads at all states of the tide. Refuse is tipped at Bowers Gifford, near Pitsea, in strict accordance with the Ministry of Health's suggested precautions for "controlled" tipping. SUMMARY FOR THE YEAR 1936. House Refuse 29,465 tons Trade Refuse 341 Street Sweepings 5,454 Gully Detritus 1,093 Solid Market Refuse 1.923 The. Work of the District Inspectors—see summarised statement facing this page. Combined Drainage.—The following drainage works were approved by the Public Health Committee:— No. 96, Stainsby Road (88-98) £65 Nos. 136-138, Upper North Street £100 26 The Work of Lady Sanitary Inspector. Tabulated statement of Inspections, of Insanitary Conditions found existing, and of Reinspections, etc.t during the year. Factories and Workshops newly discovered and Registered 12 Number of Inspections of:— Factories, including Factory Laundries 157 Workshops, including Workshop Laundries 69 Workplaces 37 Workrooms — Homeworkers'premises 624 Reinspections of above 28 Premises requiring amendment 15 Defects Found:— 1. Nuisances under Public Health (London) Act:— Found. Remedied. Referred to D.S.I. Referred to H.M. Imp. Want of cleanliness 3 1 2 — Want of ventilation — — — — Overcrowding — — — — Want of drainage of floors — — — — Other nuisances 2 1 1 — Sanitary accommodation Insufficient — — — — Unsuitable or defective 7 4 — — Not separate for sexes — — — — Want of cleanliness 5 5 — — 2. Offences under Factory and Workshop Acts Action Taken Regarding Above:— Intimations served 8 ,, complied with 7 Notices served 1 ,, complied with 1 Final Notices served — Legal Proceedings taken — Nuisances remedied without service of Intimations, etc. .. 10 Other Matters:— Visits re cases of Scabies 221 ,, Verminous children 23 ,, Outworkers'lists 4 ,, Infectious Disease on Homeworkers' premises 3 ,, School Exclusions, etc. 1,201 ,, aged and infirm persons 2 Other visits and inquiries 35 Inspections of Schools re Sanitary accommodation 46 Visits to prospective tenants of London County Council's Flats, eto. 7 Ineffective calls 383 27 Report of the Inspector for Houses Divided into Separate Tenements, etc. (a) Houses divided into separate Tenements, etc. Number of Houses on Register at end of 1935 267 ,, ,, removed from Register during 1936 22 245 ,, ,, registered during 1936 70 ,, ,, on Register at end of 1936 315 Visits for registration purposes 179 Declarations, for information, sent out — ,, with information, returned — Rooms measured, etc 12 Houses registered 70 Notices of registration sent out 85 Inspections: (a) Night inspections 27 (b) First annual inspections 166 (c) Other routine inspections 121 (d) On complaints 57 (e) On account of re-housing 7 Re-inspections 657 Miscellaneous visits, enquiries, etc. 354 Number of informal notices served 225 ,, ,, ,, complied with 134 ,, Notices served 9i ,, „ complied with 50 ,, Final Notices served 29 ,, cases in which legal proceedings were taken 4 Work done as a result of Final Notice or legal proceedings, number of cases 29 Number of rooms cleansed and freed from vermin 182 Overcrowding, cases discovered 6 ,, ,, abated 10 Mixed sleeping, cases discovered — ,, ,, abated — 28 Number of nuisances referred to District Inspectors: (a) Defective or obstructed drains 8 (b) Defective roofs, guttering, etc. 11 (e) Water supply in tenement houses 2 (d) Miscellaneous 82 Remarks: During the year the Inspector was engaged on the overcrowding survey for 19 days and paid 250 visits in connection with abatement of overcrowding. (b) Common Lodging Houses. The following 5 Common Lodging Houses were licensed to 30th June,1937. (1) 65, Bow Lane—Sidney Moore (40 men). (2) 196, Bow Road—Mrs. Elizabeth Betts (50 men—reduced later to 34 men). (3) East London Hostel, Garford Street (Salvation Army)— Evangeline Booth (294 men). (4) 378. Old Ford Road—Mrs. Elizabeth Hooper (18 men). (5) 38, Pennyfields—Thomas Alfred Felton (46 men). 171 inspections of Common Lodging Houses, including 24 night inspections, were made in 1936. Homeless Persons. In connection with a census of homeless persons which it had been the practice of the London County Council to take for a number of years, the Council co-operated by furnishing information as to the number of beds occupied and vacant at Common Lodging Houses in the Borough on the night of 21st February. The total of licensed beds was 454 and beds occupied 367. The number of men known to be in receipt of Public Assistance was 24, and 3 beds were paid for by charitable organisations. 29 (c) Seamen's Lodging Houses. The Public Health Committee licensed the following Seamen's Lodging Houses to 30th June, 1937:— Premises. Licensee. No. of Men. 411, East India Dock Road, Poplar Rev. Samuel King (The National Sailors'Society) 22 The Queen Victoria Seamen's Rest, Jeremiah Street, Poplar Rev. Thomas Athey Embleton (The Seamen's Mission) 115 *235, West Ferry Road, Poplar Herbert Edward Barker (The British Sailors' Society) 12 45 inspections of Seamen's Lodging Houses, including 7 night inspections, were made in 1936. Merchant Shipping Act, 1894, and Order in Council, 13th July, 1917. Legal proceedings were instituted against Mr. Subjul Khan, 79, Kerbey Street, for letting lodgings to seamen without being licensed. (The man had been warned on two previous occasions.) Fined £3 and £2 2s. costs. The offence was repeated on 7th May and legal proceedings were again instituted. £5 penalty and £5 5s. costs. During the year three persons were officially warned that under the Order in Council none but duly licensed persons may let lodgings to seamen. *These premises were transferred to the London County Council on 31st December, 1936, and ceased to be used as a Seamen's Lodging House. They have since been demolished. 30 Factory and Workshop Acts. Table A. Table giving number and inspections, etc., of Bakehouses, Laundries, Workshops, Workplaces,Places where food is prepared, Milk premises, Cowsheds, Slaughterhouses, Offensive Businesses, Ice Cream premises, and Homeworkers' premises:— Premises. On Register during year 1936. Number of Inspections. Number of Intimations. Number of Notices. Number of Final Notices. Number of Prosecutions. Male. Female. Total. Bakehouses (Factories) 53 - 53 230 107 - - - Bake houses (Workshops) 8 — 8 21 18 - — - Bakehouses (Domestic Workshops) .. 4 - 4 12 6 ___ _ - Factories (Laundries and Miscellaneous Factories) 147 119 266 286 26 4 1 - Laundries (Workshops) — 2 2 2 — — — - Laundries (Domestio Workshops) - - - - - - - - Workshops 178 57 235 172 14 1 1 - Workshops (Domestic) 23 — 23 14 — — — - Workplaces 249 22 271 400 46 8 2 - Workplaces (Domestic) 48 — 48 39 2 1 — - Places where food is sold or prepared 1062* - 1062 2043 342 - - - Milk Premises 90 — 90 337 3 — — - Cowsheds 1 1 23 — — — - Slaughterhouses (a) 7 — 7 41 28 — — - Other offensive trade premises 5 - 5 46 7 - Ice Cream premises 2031 — 203 266 4 — — - Homeworkers' premises 19 446 465 630 - - - - In this Table and in Table C on next page "reminders" that periodical cleansing was due are included as "Intimations." * Power is used in 86 of these premises. + 34 ,, ,, + ,, ,, (a) Includes three registered Slaughterers of Poultry. (Lists of Slaughterhouses and other offensive trade premises are given on pages 36 and 67.) 31 Table C. Factories , Workshops , Laundries , Workplaces and Homeworkers I .—INSPECTION. Premises. Number of Inspections. Written Notices. Prosecutions. Intimation. Statutory. Final. Factories 516 133 4 1 — (Including Factory Bakehouses and Laundries) Workshops† 195 32 1 1 - (Including Workshop Laundries.) Domestic Workshops‡ 26 6 _ - Workplaces 4 0 46 8 2 — Domestic Workplaces 39 2 1 — — Places where food is sold or prepared§ 2,043 342 - - - Homeworkers'Premises 630 — — — Total 3,849 561 14 4 — † Including Workshop Bakehouses. ‡ Including Domestic Bakehouses and Laundries. § The inspections of factories where food is prepared are included. Power is used in 86 of the oremises. 2.—DEFECTS FOUND * (Corresponding figures for 1935 are shown in brackets). Particulars. Number of Defects. Number of Prosecutions. Found. Remedied. Referred to H.M. Inspector. (1) (2) (3) (4) (5) Nuisances under the Public Health Act: Want of cleanliness 541 (547) 539 (547) Want of ventilation 2 (2) 2 (2 > —. Overcrowding .. — - — Want of drainage of floors — — - — Other nuisances.. 68 (62) 67 (62) - — Sanitary accommodation insufficient — (1) — (1) - — unsuitable or defective 18 (28) 18 (28) — — not separate for sexes - (1) (1) — — Offences under the Factory and Workshop Act:— Illegal occupation of underground bakehouse(s. 101) .. - - - - Breach of special sanitary requirements for bakehouses (ss. 97 to 100) - - - - Other offences .. — (1) - — (1) - (Excluding offences relating to work which are included in Table D of this Report.) Total ( 29 626 (1) _ * These detects refer to premises as mentioned above under table of Inspection. 32 Nature of Work. Outworkers' List (Seotion 107). Outwork in unwholesome premises, (Section 108). Outwork in infected premises, (Sections 109, 110). Table D.—Home Work. Lists received from Employers. Notice served on Occupiers as to keeping or sending lists. Prosecutions. Instances. Notices served. Prosecutions. Instances. Orders made (S. 110). Prosecutions (Sections 109, 110) Twice in the year. Once in the year. Failing to keep or permit inspection of list- Failing to send lists. Total Lists. Outworkers. Total Lists. Outworkers Contractors. Workmen . Contractors. Workmen. (1) (2) (3) (4) (5) (6) (7) (8) (9) (10) in) (12) (13) (14) (15) (16) \Vearing Apparel— Making, etc. 60 134 445 2 — 2 63 18 Cleaning and Washing Household Linen Laoe, laee ourtains and nets Curtains and furniture hangings Furniture and Upholstery Eleotro-plate File Making Brass and Brass Articles Fur pulling Cables and Chains Anchors and Grapnels Cart Gear Locks, Latohes and Keys Umbrellas, eto. Artificial Flowers Nets, other than wire nets Tents Sacks Racquet and Tennis Balls Paper,eto., Boxes, Paper Bags 10 — 78 1 6 12 3 Brush Making Pea Picking Feather Sorting Carding,etc. ,of buttons,eto. Stuffed Toys Basket Making Chocolates and Sweetmeats Cosaques, Christmas Crackers, Christmas Stockings, etc. Textile Weaving Miscellaneous 2 1 62 1 — 2 3 3 Totals 72 135 585 4 — 10 78 — — — — — 24 — — 33 List of Outworkers, Factory and Workshop Act, 1901 (S. 107). Class of Homework. 1936 Number of Lists received. Number of Addresses of Outworkers. Due Feb. 1st. Due Aug. 1st. Forwarded to other Authorities. Received from other Authorities. No. of Lists. No. of Outworkers. No. of Lists. No. of Outworkers. Due Feb. 1. Due Aug. 1. Due Feb. 1. Due Aug. 1. Total 39 346 37 384 231 243 250 241 Tailoring, etc. 28 269 26 279 190 192 179 170 Shirtmaking 2 13 2 20 9 12 3 2 Miscellaneous 4 25 3 40 13 20 61 65 Boxes 5 39 6 45 19 19 7 4 Table E. Registered Workshops and Workplaces. Workshops and Workplaces, etc., on the Register (s. 131) at the end of the vear. Number. (1) (2) Important classes of workshops, such as workshop bakehouses, may be enumerated here. Bakehouse Workshops 8 Bakehouse Domestic Workshops 4 Laundries Workshops 2 Laundries Domestic Workshops — Workshops 235 Domestic Workshops 23 Workplaces 271 Workplaces Domestic 48 Places where food is sold or prepared 1062* Total number of workshops and workplaces, etc., on Register 1653 * Power is used in 86 of these premises. Table F. Class. Number. (1) (2) Matters notified to H.M. Inspector of Factories:— Failure to affix Abstract of the Factory and Workshop Act (s. 133).. 1 Action taken in matters referred by H.M. Inspector as remediable under the Public Health Acts, but not under the Factory and Workshop Act (s. 5) Notified by H.M. Inspector 5 Reports (of action taken) sent to H.M. Inspector 1 Other (Communications) 13 Underground Bakehouses (s. 101):— Certificates granted during the year In use at the end of the year 19 34 Shops Act, 1934. Under the provisions of this Act 5, exemption certificates regarding sanitary accommodation were granted. Notices calling attention to contraventions of the Act regarding ventilation were served in three instances. At the end of the year one notice regarding ventilation was outstanding and a builder had instructions to carry out the work. Smoke Abatement. 94 observations were made and 22 nuisances recorded. 33 complaints were received from the London County Council. 12 intimations and 1 notice were served. In addition, 9 cautions were issued. It was not necessary to institute legal proceedings in any instance. In this connection it should be mentioned that no formal action is taken on the receipt of a complaint by the London County Council, but observation is kept by our own inspectors and nuisances are then followed up. During the year, officers of the London County Council interviewed the Medical Officer of Health regarding complaints as to the emission of smoke and grit from premises in West Ham, particularly the West Ham Electricity Station. Observations were carried out jointly with officers of the London County Council and, as a result, a statutory notice was served. This source of smoke nuisance is still under observation by officers of the two authorities. Methods of observation and standards in use since 1927 are similar to those of the National Smoke Abatement Society. The Council made a grant of £1 is. to the National Smoke Abatement Society, and Councillors J. A. Ashley and H. Boulton were appointed as the Council's representatives to the National Smoke Abatement Council till October, 1937. 35 Swimming Baths and Pools. It was mentioned in last year's Annual Report that, following upon the issue of the Ministry of Health Circular 1503, arrangements were being made with the London County Council for the bacteriological examination of water from the swimming baths in the Borough, including the London County Council Open Air Bath at Millwall. In July, 1936, an agreement was entered into with the London County Council for the bacteriological examination of 25 samples each year at the Group Laboratory, Mile End Hospital, at an annual charge of £65. Only £10 of this sum (in respect of samples taken from the London County Council Open Air Bath) is chargeable to the Public Health Committee—the balance is a charge to the Baths Committee. The samples are collected and examined by the Bacteriologist in charge of the Group Laboratory, Mile End. During the year, 14 samples of bath water were taken and examined as follows:— East India Dock Road—1st class Bath 2 samples- t East India Dock Road—2nd class Bath 3 samples. Roman Road—1st class Bath 2 samples. Roman Road—2nd class Bath 3 samples. Glengall Road Bath samples. Violet Road Open Air Bath 1 sample. Millwall Open Air Bath (London County Council)1 sample. The Bacteriologist reported that from the bacteriological point of view the results were very satisfactory. In no case was B.coli detected in 5 c.c. of bath water. B.Welchii was present on two occasions, but in view of the ubiquitous nature of this organism, and the fact that being a spore bearer it resists chlorination, its presence is now and again to be expected. The specimens were taken from about two inches below the surface, three-quarters of the way down the bath, towards the deep end. Reports regarding the Poplar Baths were sent to the Baths Superintendent for the information of the Baths Committee, and a copy of the report regarding the London County Council Open Air Bath was sent to the Chief Officer of the Parks Department, London County Council. 36 Houses Let in Lodgings. The report of the Inspector is given on page 27. Offensive Trades. The following are the offensive trade premises in the Borough:— Address. Proprietors. Business. 80, Whitepost Lane Sheppy Glue & Chemical Fat melters. East London Soap Works 10-16, Aberfeldy Street.. E. R. Cook & Co., Ltd. Nathan Cohen & Sons Soap boilers. Dresser of fur skins. *43, Whitepost Lane Kestenbaum Bros., Petzold Fur Dyeing and Dressing Works, Ltd. ,, ,, 12, Coborn Road.. M. Shriebhand Slaughterer of poultry. 221, Roman Road W. E. Prideaux ,, ,, *105, Grundy Street H. Jacobovitch ,, ,, * Licence expires 31st March, 1937. For number of inspections see Table A page 30. Rag and Bone Dealers Four infringements of the byelaws made by the London County Council under Section 9 of the London County Council (General Powers) Act, 1908, were reported. Legal proceedings were taken in two instances. One defendant was fined 20s. and the o.her was ordered to pay 10s. costs. Letters of caution were sent in two other cases. Licensed Premises Urinals. 26 urinals on licensed premises were found to be insanitary, and were subsequently cleansed. Water Certificates. 15 certificates regarding 404 houses and flats were issued under the provisions of the Public Health (London) Act. Increase of Rent and Mortgage Interest (Restrictions) Acts. 51 certificates were issued to tenants, and at the request of owners 32 certificates that the work had been done were also issued. 37 Stables. 158 stables were inspected and reported upon, the total number of inspections being 248. The following infringements of the Bye-laws were dealt with:— Accumulations of manure, or premises otherwise not clean 24 Floors not properly drained — Dung receptacles:— (a) Not provided 7 (b) Defective — (c) Not covered 5 Other defects 11 34 intimations, 5 notices and 2 final notices were served. The works required were completed before the end of the year in most instances. Customs and Inland Revenue Acts, 1890-1891, and Revenue Act, 1903. No applications for certificates for exemption under the Customs and Inland Revenue Acts, 1890-1891, and the Revenue Act, 1903, were made during the year. Street Trading. A record is kept in the Public Health Office of street traders who have been licensed to deal in foodstuffs. All new applications are reported upon prior to licences being granted, and all storage premises are kept under supervision and periodically inspected. Rats and Mice (Destruction) Act, 1919. The number of complaints received during the year was 83. No notices were served under the Rats and Mice (Destruction) Act, 1919. 38 The services of the rat-catcher who is employed by the Works Department are utilised by the Public Health Department in the following manner:— (1) The Sanitary Inspector when investigating a complaint of rats offers the occupier the services of a rat-catcher, and if these are accepted, visits the premises with the rat-catcher. (2) In cases where runs are traced under the footpaths, etc., arrangements are made with the Borough Surveyor's Department for the paving stones to be raised and for the rat-catcher to be present at the same time as the Sanitary Inspector for the tracing of runs, etc. A monthly report of the premises visited by the rat-catcher, baits laid, rats caught, etc., is submitted to the Public Health Department. SUMMARY OF RAT-CATCHER'S WORK, (i) Dwelling-houses. No. of Premises. No. of Baits. No. of dead Rats. No. of Rats caught in Traps. Total No. of Rats. Laid. Taken. Dead. Alive. Council 134 8,959 1,223 77 21 8 106 Private 752 27,153 10,648 1,025 294 341 1,660 Total 886 36,112 11,871 1,102 315 349 1,766 (ii) Sewers, etc. No. of Sewers, etc. No. of Baits. No. of dead Rats. No. of Rats caught in Traps. Total No. of Rats. Laid. Taken. Dead. Alive. Sewers 122 10,192 4,382 264 1 — 265 Conveniences, etc. 25 39 Inspection of Schools. The public elementary schools were inspected during the year. A few minor defects were discovered and reported to the London County Council. There is only one private school in the Borough. The accommodation was satisfactory and the sanitary arrangements sufficient and kept in a cleanly state. Rag Flock Act, 1911. 21 samples were taken. 15 samples were satisfactory, and 6 did not comply with the prescribed standard of cleanliness. Legal proceedings were taken in 3 cases for being in possession of the rag flock and in one case for selling, and letters of caution were sent in 2 other cases. No action was taken in the sixth case, the excess of chlorine being very slight. Rags—Certificates. At the request of a certain firm dealing in wiping rags, certificates that the rags have undergone a cleansing process are issued after inspection by an officer of the department. A fee of £5 5s. is paid for inspection and the granting of certificates up to 70, with an additional is. 6d. for each certificate in excess of that number. During the year 170 certificates were issued. Hairdressers' Premises. The number of inspections of hairdressers' premises was 83. Cleansing was necessary at 2 of the premises, and other nuisances found numbered 4. Five intimations and 3 notices were served. The requirements of these documents were complied with. Canal Boats. It has been mentioned in previous reports that the old type of canal boat is seen but infrequently on the canals in this Borough. Only one such boat was seen in 1936, and this could not be inspected as there was nobody on board and the cabin was locked. During the year visits were paid to the canals and locks, but the traffic consisted of non-residential "dumb" barges. Exhumations. Two notices of exhumation were received. 40 Legal Proceedings. Public Health (London) Acts, 1891 and 1936, Metropolis Management Acts, etc. Address. Nature of Complaint. Result. Inspector. 122, East India Dock Road Main roof defective and other defects 7 days' order; £2 penalty; £2 8s. costs Colborne, W. J. 113, Upper North Street Main and back addition roofs defective and other defects Work done; £5 penalty; £2 5s. costs do. 38, Whitethorn Street Various defects 7 days' order; £2 8s. costs Westbrook, C. S. 18, Sherwood Street Main and scullery roofs defective and other defects Work done; £2 penalty; £2 2s. costs do. 161, Fairfoot Road Main roof defective; no ashpit £2 penalty; £2 2s. costs do. 7, Upper North Street Various defects Work done; £2 5s. costs Colborne, W. J. 14, Arnold Road Various defects Work done; £2 5s. costs Westbrook, C. S. 47, Blackthorn Street Various defects Work done; £2 5s. costs do. 92, Upper North Street Main roof defective Work done; £2 5s. costs Colborne, W. J. 48, Sabbarton Street Various defects 7 days' order; £3 penalty; £2 8s. costs do. 46, Sabbarton Street Main roof defective and other defects 7 days' order; £3 penalty; £2 8s. costs do. 23, Ellesmere Street Main roof defective Work done; £2 5s. costs do. 30, Marshfield Street Various defects 7 days' order; £2 penalty; £2 8s. costs Langley, H. J. 36, Marshfield Street Various defects 7 days' order; £3 penalty; £2 8s. costs do. 27, Swaton Boad Main roof defective and other defects 7 days' order; £3 penalty; £2 8s. costs Westbrook, C. S. 1, Hancock Boad .. Main roof defective and other defects Work done; £2 5s. costs do. 6, Tibbatts Boad Main roof defective and other defects Work done; £2 5s. costs do. 17, Cordelia Street Main roof defective and other defects 7 days' order; £2 penalty; £2 8s. costs Colborne, W. J. 8, Arcadia Street Back addition walls and ceiling damp and defective Work done; £1 penalty; £2 5s. costs do. 103, Swaton Boad Main roof defective and other defeots Work done; £1 penalty; £2 5s. costs Westbrook, C. S. 165, Fairfoot Road Main roof defective and other defects Work done; £1 penalty; £2 5s. costs do. 16, Chilcot Street Various defects 14 days' order; £2 8s. costs Colborne, W. J. 16, Ship Street Water service pipe to W.C. defective; flushing apparatus overflows Work done; £2 8s. costs Dove, A. L. 23, Ellesmere Street Main roof defective and other defects 7 days' order; £2 8s. costs Colborne, W. J. 58, Brunswick Road Main roof defective and other defects Work done; £2 5s. costs Johnson, W. 23, Pennyfields Drains obstructed and other defects; no water supply 7 days' order; £2 8s. costs .. Colborne, W. J. 41 Address. Nature of Complaint. Result. Inspector. 36, Sabbarton Street Main roof defective and other defects 7 days' order; £2 penalty; £2 8s. costs Colborne, W. J. 250, Devons Road Various defects 7 days' order; £2 penalty; £2 8s. costs Westbrook, C. S. 11, Hawgood Street Main roof defective and other defects 7 days' order; £2 8s. costs do. 287, Manchester Road Main roof defective and other defects 7 days' order; £2 8s. costs Dove, A. L. 98, Glengall Road Main roof defective 7 days' order; £2 8s. costs do. 394, Manchester Road Main roof defective and other defects Work done; £2 5s. costs do. 86, Devons Road Various defects 14 days' order; £2 penalty; £2 8s. costs Westbrook, C. S. 196, Devons Road Various defects 14 days’ order; £2 penalty; £2 8s. costs do. 21, Eagling Road Various defects Work done; £2 5s. costs do. 11, Hawgood Street Failed to comply with Magistrate's Order £7 penalty; £2 2s. costs do. 10, Newcastle Street Main rear rainwater pipe and hopper head, back addition gutter overflow £2 penalty; £2 2s. costs Dove, A. L. 196, Devons Road Failed to comply with Magistrate's Order £3 penalty; £2 5s. costs Westbrook, C. S. 11, Perring Street Main roof defective and other defects £2 penalty; £2 5s. costs do. 4, Newcastle Street Various defects Work done; £1 penalty; £2 5s. costs Dove, A. L. 31, Marshfield Street Various defects Work done; £1 penalty; £2 5s. costs do. 36, Marshfield Street Main roof defective and other defects Work done; £1 penalty; £2 5s. costs do. 38, Marshfield Street Back addition roof defective and other defects £1 penalty; £2 5s. costs do. 36, Glengall Road Various defects Work done; £2 penalty; £2 5s. costs do. 42, Glengall Road Main roof defective and other defects £2 penalty; £2 5s. costs do. 42, Glengall Road Failed to provide a sufficient ashpit £1 penalty; £2 2s. costs do. 42, Marshfield Street Back addition and scullery roofs defective and other defects Work done; £2 penalty; £2 5s. costs do. 9, Coldharbour Various defects Work done; £2 5s. costs Luke, H. W. 119, Upper North Street Main roof leaky and other defects £2 penalty; £2 8s. costs Colborne, W. J. 29, Ellesmere Street Main roof gutter in rear insecure Work done; £2 5s. costs do. 25, Ellesmere Street Washhouse roof defective and other defects Work done; £2 5s. costs do. 21, Ellesmere Street First floor back room ceiling damp Work done; £2 5s. costs do. 36, Sabbarton Street Failed to comply with Magistrate's Order £5 penalty; £2 2s. costs do. 6, Ferry Street Main and scullery roofs leaky and other defects 14 days' order; £1 4s. costs Dove, A. L. 3, Lion Street First floor back room ceiling damp 28 days' order; £2 8s. costs Colborne, W. J. 186, Devons Road Various defects 7 days' order; £2 penalty; £2 8s. costs Westbrook, C. S. 190, Devons Road Main roof defective 7 days' order; £1 penalty; £2 8s. costs do. 194, Devons Road Main roof defective and other defects 7 days' order; £2 penalty; £2 8s. costs do. 6, Newcastle Street Top floor front room ceiling wet and main roof leaky and defective Work done; £2 5s. costs Dove, A. L. 42 London County Council Byelaws with Respect to Houses Divided into Separate Tenements. Address. Nature of Complaint. Result. Inspector. 9, Coldharbour (Summons under Public Health (London) Act, 1936, q. v.) — — Merchant Shipping Act, 1894, and L.C.C. Byelaws under Section 214. Subjul Khan, 70, Kerbey Street, E. 14 Let lodgings to seamen, not boing licensed under L.C.C. Byelaws £3 penalty; £2 2s. costs Luke, H. W. Subjul Khan, 70, Kerbey Street, E. 14 Let lodgings to seamen, not being licensed under L.C.C. Byelaws £5 penalty; £5 5s. costs do. Rao Flock Acts, etc. Address. Nature of Complaint. Result. Inspector. J. Brogden, 161, Tredegar Road, E.3 In possession of rag flock which contained chlorine 150 parts per 100,000 Summons dismissed under Probation of Offenders Act; £2 2s. costs Smith, F. A. Flock & Wadding Mills, Ltd., “Athol Works,” Athol Street, E. 14 Sold to above Defendant rag flock which did not conform to the standard of cleanlinoss £1 penalty; £7 7s. costs do. Harold Noble, 20, Railway Street, E. 14 In possession of rag flock which contained chlorine 185 parts per 100,000 Summons withdrawn; costs paid, £5 5s. Johnson, W. (This Defendant issued summons against the Warrantor—this summons was adjourned sine die.) A. H. Harrison, “Stronghold Works,” West Ferry Road, E.14 In possession of rag flock which contained chlorine 61 parts per 100,000 Summons withdrawn; agreed costs paid, £5 5s. Langley, H. J. London County Council Byelaws—Rag and Bone Dealers. Address. Nature of Complaint. Result. Inspector. Wm. Jas. Cannon of 36, Pond Road, Stratford Exchanged toys for rags 10s. costs Dove, A. L. Jas. Lock, 74, Paul Street, West Ham Exchanged toys for rags £1 penalty do. 43 Food and Drugs (Adulteration) Act, 1928. Article. Result of Analysis, etc. Result. Inspector. Mercury Ointment Deficient in mercury 65% Dismissed under the Probation of Offenders Act; £3 3s. costs Grabham, C. A. Liniment of Turpentine Deficient in camphor 40% and in soft soap 30% Dismissed under the Probation of Offenders Act; £2 2s. costs do. Milk Deficient in fat 73% Dismissed under the Probation of Offenders Act; £2 2s. costs do. Minced Meat Contained sulphur dioxide 65 parts per million £5 penalty; £2 costs do. Milk Deficient in fat 40% £50 penalty; £10 10s. costs Pearce, H. A. Milk Deficient in non-fatty solids 0.2% Summons not served and not proceeded with (Same defendant as in preceding case. Magistrate stated ho was doubtful if he had power to strike defendant off the register, and refused to do so .) Cornflour Contained foreign starch 50% Dismissed under the Probation of Offenders Act; £2 4s. costs Grabham, C. A. Minced Beef Contained sulphur dioxide 140 parts per million £2 penalty; £2 2s. costs do. Note.—Letters were sent to 3 vendors in respect of other unsatisfactory samples. Public Health (Meat) Regulations, 1924. Defendant. Offence. Result. Inspector. — C., of 115, Canfield Road, Woodford Bridge, Essex While engaged in the transport of meat did not take precautions to prevent exposure of meat to contamination £2 penalty Pearce, H. A. H. B., of 290, Devons Road, E.3 While engaged in the handling and transport of meat did not take reasonable precautions to prevent exposure of meat to contamination £1 penalty do. S. J., of 75, Aberfeldy Street, E. 14 While engaged in the handling and transport of meat did not take reasonable precautions to prevent exposure of meat to contamination £1 penalty do. E. J. S., of 39, Parkers Row, Bermondsey While engaged in the handling and transport of meat did not take reasonable precautions to prevent exposure of meat to contamination £1 penalty do. J. W., of 59, Carson Road, E. 13 While engaged in the handling and transport of meat did not take reasonable precautions to prevent exposure of meat to contamination £1 penalty do. 44 Summary of Penalties and Costs. Penalties. Costs. £ s. d. £ s. d. Public Health (London) Acts, 1891 and 1936 .. 75 0 0 134 8 0 Metropolis Management Acts — — L.C.C. Byelaws—Houses divided into separate Tenements Merchant Shipping Act, 1894, and L.C.C. Byelaws (Seamen's Lodging Houses) 8 0 0 7 7 0 Rag Flock Acts and Regulations 1 0 0 19 19 0 L.C.C. Byelaws—Rag and Bone Dealers 1 0 0 0 10 0 Food and Drugs (Adulteration) Act, 1928 57 0 0 24 3 0 Public Health (Meat) Regulations, 1924 6 0 0 - Totals £148 0 0 £186 7 0 £334 7 0 London County Council (General Powers) Act, 1928, sec. 28, and Public Health (London) 1936, sec. 224. Removal of infirm persons. It was necessary to obtain Magistrates' Orders for the removal of 3 persons to institutions. Three other persons were removed without recourse to Court Orders. 45 Copy of a Return to the London County Council. Premises. No. in Borough on 31st December, 1936. No. of Inspections. No. of Prosecutions. Common Lodging Houses 5 171 — Seamen's Lodging Houses 2 (excluding 1 closed 29/12) 45 2* Cowsheds (Licensed) 1 23 — Slaughterhouses (Licensed) 4 27† — Poultry Slaughterhouses 3 14 — Other Offensive Trades 5 46 — Milkshops 90 337 — Ice Cream Premises 203 266 — Restaurants and Eating Houses 1,062 2,043 — Registered Foster-Mothers 13 20 by Sanitary Inspectors, 208 visits by Chief Health Visitor. Nurse Children kept 13 *2 summonses for letting lodgings to seamen when not licensed. †In addition, 854 visits were made in connection with the examination of carcases. Smoke Nuisances. (1) No. of observations 94 (4) No. of Statutory Notices served 1 (2) No. of intimations served 12 (5) No. of legal proceedings (6) No. of convictions — — (3) No. of complaints received (from L.C.C.) 33 (7) Amount of penalty and costs imposed in each case — Cleansing and Disinfection. No. of adults cleansed 105 No. of rooms cleansed (a) After infectious diseases. 1850 No. of children cleansed 3653 (b) for vermin 1727 Water Supply to Tenement Houses. No. of premises supplied 5 No. of prosecutions — Sanitary Officers. Male. Female. No. of Sanitary Inspectors (whole-time) 16 1 ,, ,, ,, (part-time) — — No. of Health Visitors (whole-time)—Borough Council M. & C.W., 9; Tuberculosis, 3. ,, ,, ,, (part-time)—Nil. ,, ,, ,, (Voluntary Association)—M. & C.W., 9. 46 Housing. 1. Total No. of houses in the Borough 23,952 10. No. of houses (wholly or in part) the subject of Closing Orders (excluding underground rooms) - 2. No. of houses occupied by the working classes 23,464 11. No. of Closing Orders determined (i.e., houses made fit) - Public Health Act— 3. No. of houses inspected on account of complaints or illness No. of Intimations served 5,272 4,715 12. No. of houses erected by the Borough Council for working classes during year 52 4. No. of statutory notices served 1,662 13. Houses Let in Lodgings— No. in Borough No. of inspections No. of prosecutions No. of complaints remedied under the By-laws (not included under any other heading) 315 1,568 1 57 5. No. of houses repaired or nuisances remedied 4,560 Housing Acts (1925-35)— 6. No. of houses inspected— house to house (Housing Consolidated Regs., 1925) 7. (a) No. of houses included in representations by the Borough Medical Officer under Sec. 1 of H.A., 1930 .. (6) No. of houses demolished following representation by Borough Medical Officer under Sec. 1 of H.A., 1930 30 26 14. Underground Rooms— No. occupied but unfit under Sec. 18 of H.A., 1925, as modified by Sec. 84 of H.A., 1935 No. closed under Sec. 84 of H.A., 1935 5 8. No. of houses repaired under Sections 17 and 18 of H. A., 1930:— (a) By owners (b) By L.A. in default of owners 15. Overcrowding (Housing Act, 1935)— No. of houses inspected under Sec. 1 of H.A., 1935 (Included in return for year 1935) — No. of families found to be living in overcrowded conditions, Sec. 1 of H.A., 1935 No. of overcrowded families who have obtained alternative accommodation 44* 9. No. of houses demolished:— (a) In pursuance of orders under Sec. 19 of the H. A., 1930 (b) Voluntarily 1 * This figure relates to L.C.C. and P.B.C. properties only. Infectious Diseases. Infectious diseases—cases notified under local orders (excluding cases coming to knowledge otherwise than by notification). Disease. Cases notified. Period. Measles Not notifiable - - German Measles - - Whooping Cough - - Rheumatic Fever (0-16) - - Chicken Pox - - Zymotic Enteritis 56 1st June to 30th September. 47 Section D. HOUSING. STATISTICS. Number of new houses and tenements erected during 1936:— (a) Total (including numbers given separately under (b) ) 290 (i) By the Local Authority 52 (ii) By other Local Authorities 198 (iii) By other bodies or persons 40 (b) With State assistance under the Housing Acts:— • (i) By the Local Authority:— (a) For the purposes of the 1930 Act (Slum ance) 52 (b) For the purposes of the 1935 Act (Overcrowding) Nil. (c) For other purposes Nil. The following section on Housing has been prepared in accordance with Circular 1,561 (England) of the Ministry of Health, 1936:— 1.—Inspection of Dwelling Houses during the Year. (1) (a) Total number of dwelling-houses inspected for housing defects (under Public Health or Housing Acts) 6,809 (b) Number of inspections made for the purpose 28,077 (2) (a) Number of dwelling-houses (included under subhead (1) above, which were inspected and recorded under the Housing Consolidated Regulations, 1925 - (b) Number of inspections made for the purpose — (3) Number of dwelling-houses found to be in a state so dangerous or injurious to health as to be unfit for human habitation 30 (4) Number of dwelling-houses (exclusive of those referred to under the preceding sub-head) found not to be in alt respects reasonably fit for human habitation 4,532 3. Action under Statutory Powers during the Year. (a) Proceedings under Sections 17, 18 and 23 of the Housing Act, 1930— (1) Number of dwelling-houses in respect of which notices were served requiring repairs - (2) Number of dwelling-houses which were rendered fit after service of formal notices:— (a) By owners - (b) By local authority in default of owners - (6) Proceedings under Public Health Acts— (1) Number of dwelling-houses in respect of which notices were served requiring defects to be remedied 1,567 (2) Number of dwelling-houses in which defects were remedied after service of formal notices:— (a) By owners 1,561 (b) By local authority in default of owners - (c) Proceedings under Sections 19 and 21 of the Housing Act, 1930— (1) Number of dwelling-houses in respect of which Demolition Orders were made 2 (2) Number of dwelling-houses demolished in pursuance of Demolition Orders 1 (d) Proceedings under Section 20 of the Housing Act, 1930— (1) Number of separate tenements or underground rooms in respect of which Closing Orders were made 5 (2) Number of separate tenements or underground rooms in respect of which Closing Orders were determined, the tenement or room having been rendered fit - 49 4. Housing Act, 1935—Overcrowding. L.C.C. P.B.C. Total. (a) (i) Number of dwellings overcrowded at the end of the year 159 334 493 (ii) Number of families dwelling therein 159 335 494 (iii) Number of persons dwelling therein 1,023 2,643 3,666 Number of equivalent adults 848 2,266½ 3,114½ (b) Number of new cases of overcrowding reported during the year 22* 20* 42* (c) (i) Number of cases of overcrowding relieved during the year 26 18 44 (ii) Number of persons concerned in such cases 161 124 285 Number of equivalent adults 131½ 106 237½ (d) Particulars of any cases in which dwelling-houses have again become overcrowded after the Local Authority have taken steps for the abatement of overcrowding .. 3 3 (see note below.) (e) Any other particulars with respect to overcrowding conditions upon which the Medical Officer of Health may consider it desirable to report (see page 54). Note.—Owing to the limited accommodation available at the moment, it is not possible for the Borough Council to provide adequate accommodation for every case of gross overcrowding, and in the case of these 3 families, although they have been rehoused, overcrowding still exists, but it has been alleviated to a marked degree. *Almost wholly due to the increased ages of children. 50 Number of Houses owned by the Local Authority. (a) Held under the Housing Acts:— (i) With State assistance:— Under the 1919 Act—New Housing 150 Rehousing 36 186 ,, ,, 1923 Act—New Housing 61 Rehousing 24 85 ,, 1924 Act 544 ,, ,, 1930 Act (including 150 built during the last 2 year;) 181 996 (2) Without State assistance:— Houses converted to tenements (tenements) 30 1,026 (3) Purchase for eventual demolition 11 (b) Held under other powers:— (1) Purchase fcr alternative accommodations 2 (2) Other properties 7 9 51 Housing Acts, 1925-35. The progress of areas during 1936 has been as follows:— (I) Re-presented in 1936. No. Area. Approx. area, including added lands, (acres). Number of Date of Council's resolution declaring Area. Remarks. Title. Houses in area. Families. Persons In area. Added lands. (a) Poplar Borough Council:— 25 Paradise Cottages (Gray Street) 0.10 7 7 21 — 7.1.37 Clearance only. 34a Sarah Cottages (Lindale Street) 0.04 5 5 14 — 7. 1.37 Clearance only (3 further houses represented early 1937). 36 Ebenezer Place (Chrisp Street) 0.046 4 6 26 — 7.1.37 Clearance only. 62 Milton Place 0.097 9 10 54 — 7.1.37 Clearance only. 79 61, Upper North Street and 110, Hind Street 0.07 4 tenements and 1 house 5 32 7.1.37 Clearance only. (6) London County Council:— 78 Spring Gardens Place 0.15 7 25 4.2.36 Clearance only. Inquiry at Poplar 20.5.36. Order confirmed. 28 & 51 Bow Road (areas Nos. 1-8) 4.26 39 (and 39 other properties) 110 115 31.3.36 Development of Bow Road Island site. Inquiry at Poplar Council Offices 14.12.36. 56 & 57 Devas Street (areas Nos. 1-5) (a) 11.299 305 (and 136 other properties) 2,1 64 14.7.36 (b) 2.622 98 - 4 63 (b) To be acquired compulsorily under Part III, Housing Act, 1925. 52 (II) Represented prior to 1936. Area. ??? Whether additional lands acquired. No. of persons in added lands. Acreage of total area. No. Title. No. of houses. No. of persons. Date of resolution. Remarks and position at 31st December, 1936.[???] (a) Poplar Borough Council: 26 Pennyfields 4 7 28.9.33 No — 0.035 Premises demolished. 3 Collins Place 8 54 28.9.33 Yes 6 0.23 12 flats erected on site (Collins House). 16 Old Ford Road (Taylors Buildings) 5 24 20.12.34 No 0.07 Only one house occupied. 16a Old Ford Road 3 19 27.9.34 No - 0.048 Premises demolished. 27 Ford Road (No. 1) 5 29 24.1.35 Yes 22 0.16 Seven (of nine) houses vacant. 46 Ford Road (No. 2) 3 14 24.1.35 No — 0.055 One house empty and partly demolished. 65 Harrow Lane 15 96 24.1.35 Yes 25 0.31 Site cleared and dwellings in course of erection. 65a Poplar High Street 2 11 24.1.35 No — 0.006 Premises empty. 77 Wendon Street and Ruston Street 8 55 23.1.36 No — 0.14 Premises being emptied. Clinic to be erected on site. (6) London County Council: 5 Ranwell Street (1 & 2) 37 158 25.7.33 Yes 59 1.437 Dwellings erected on site. 8 Perring Street 37 445 18.12.34 Yes 116 2.7 Inquiry held at Council Offices, Poplar, 17.4.36. Confirmation Order, 14.7.36. Area being cleared and dwellings in course of erection. 14 (pt) Orchard Place (Nos. 1, 2 & 3) 60 409 17.7.34 No — 1.25 Area cleared. 11 Sophia Street (Nos. 1-8) 137 993 18.12.34 Yes 484 5.25 Site being cleared and dwellings in course of erection. 64 Coldharbour (3 areas) 12 55 12.2.35 No — 0.33 Areas cleared. 35 Gaselee Street 44 243 9.4.35 Yes 94 1.12 Inquiry at Poplar Council Offices, 17.2.36. Confirmation Order, 4.6.36. Area cleared and dwellings in course of erection. 73 Cuba Street (2 areas) 61 367 14.5.35 No — 1.4 Confirmation Order, 8.2.36. Clearance only. In progress. 52 High Street, Bow 18 117 14.5.35 Yes 17 0.81 Inquiry at Poplar Council Offices, 17.4.36. Order confirmed. Rehousing of occupants in progress. 14 (Dt) Orchard Place (No. 4) 6 49 25.6.35 No — 0.3 Area cleared. 20 Vesey Street (2 areas) 44 250 30.7.35 Yes 46 1.04 Inquiry at Council Offices, Poplar, 17.2.36. Houses being emptied. 38 Dock Cottages (2 areas) 71 322 19.11.35 Yes 143 2.7 Inquiry to be held 22.2.37. 53 Poplar Area No. 33. "London County Council Bromley Maltings Housing Scheme."— Considerable progress has been made by the L.C.C. during the year. Many of the old properties have been acquired and blocks of flats have been erected. Underground Rooms.—Orders were made prohibiting the use of the following underground rooms for any purpose other than the storage of non-edible articles:— 25, Libra Road Front and back basement rooms. 38, Cotton Street Back basement room. 105, Sussex Street .. Back basement room. The owners have given an undertaking not to permit the following underground room to be used for any purpose other than the storage of non-edible articles:— 158, Poplar High Street.. Back basement room. Regulations re Underground Rooms.—In view of the amendment of Section 18 of the Housing Act, 1925, by the Housing Act, 1935, the Council considered the revision of the Regulations made in 1927. The model regulations of the Ministry of Health were adopted and these were confirmed by the Minister of Health on 30th December, 1936. Several underground rooms, which come within the ambit of the new regulations and where the occupants have already agreed to accept alternative accommodation, were represented early in 1937. Individual Houses. (a) 89-91, Guildford Road.—Notices under Section 17 were served by the Council in 1934 and, following an appeal to Bow County Court, the work was carried out by the Borough Council in default of the owner. Difficulty was experienced in collecting the Council's costs, but after lengthy proceedings the whole of the Council's costs were paid in July, 1936. (b) 30, Saltwell Street.—Represented by Medical Officer of Health on 18th February. Demolition Order was made by the Council on 23rd April and served on 6th May. The premises have been demolished. (c) 1a, Whitethorn Street.—Represented by the Medical Officer of Health on 16th July, 1936. The owner voluntarily agreed the house was unfit for habitation and provided alternative accommodation for the tenants. A Demolition Order was made by the Council and served on 1st December. 54 Overcrowding. During the year 24 new instances of overcrowding were officially recorded. Seventeen of the more serious cases were reported to the Public Health Committee. Twenty-three letters have been sent to tenants and sub-tenants calling their attention to the fact that overcrowding is a nuisance. A number of cases were referred to the Town Clerk for submission to the London County Council, or to the Borough Council's Housing Committee for housing accommodation. In respect of five houses, upon the instructions of the Public Health Committee, nine intimations were served. The overcrowding was abated or eased as follows:— Abated. Eased. Rehoused by L.C.C. 12 (10) — P-B.C 2 (2) — Other accommodation found 29 (26) 2 (2) 43 (38) 2 (2) (Numbers in brackets are cases recorded prior to 1936.) In cases where overcrowding has been abated or eased by rehousing, letters are sent to responsible persons calling attention to the fact that overcrowding is a nuisance, and should the premises again become overcrowded the facts will be reported to the Public Health Committee. Overcrowding Survey. The overcrowding survey directed to be carried out under the Housing Act, 1935, was commenced at the end of October, 1935, and completed in January, 1936. The report which was submitted to the Council upon this matter was printed in the Annual Report for 1935 (Appendix, page 138). 55 Accommodation provided during 1936. The Town Clerk afforded the following information regarding the number of families rehoused during the past year:— Families accommodated . Number of persons (approx.). (a) By the Poplar Borough Council in:— (1) Newly erected houses or flats 44 203 (2) Adapted buildings — — (3) Vacancies re-let (a) New properties.. 37 (b) Adapted or miscellaneous properties — 37 210 81 413 (b) By the London County Council on direct application:— (1) (i) Ordinary cases 493 (ii) Rehousing cases 344 (iii) Special hardship cases .. 20 (iv) Tenants transferred (20) .. — (2) Housing Act, 1935, cases:— (i) Ordinary 35 (ii) Tenants transferred (12) — 892 ** Total . . 973 ** It is not possible to give the approximate number of persons accommodated under this heading. 56 Verminous Premises and Rooms. The service of notices regarding 437 premises and the contents of rooms at 27 premises was authorised by the Public Health Committee. Verminous rooms are brought to the notice of owners upon the "Intimations," which are followed, if necessary, by Statutory Notices as there are usually other nuisances or defects upon the premises. Notices are also served under Section 123 of the Public Health (London) Act, 1936. A fluid insecticide is issued at the Disinfectant Depots, and sprayers loaned to tenants in order to rid rooms and contents of bugs. 40£ gallons of insecticide were distributed during the year. Eradication of Bed Bugs. Summary of the Work done by the Special Inspectors for Disinfestation . Number of premises inspected 1.385 Number of re-inspections after disinfestation 1.145 Miscellaneous visits and revisits 4.154 Total 6,684 Number of premises and rooms disinfested:— Council properties 96 rooms 624 Other properties 499 rooms 998 Totals 595 1,622 (These figures represent the actual number of premises and rooms dealt with and do not include secondary or subsequent treatments.) Number of articles disinfested:— (a) Beds, bedding, etc. (steam disinfestation).. 28,873 (b) Furniture treated with hydrocyanic acid gas in vans during transit 3.990* (c) Furniture sprayed with Solution "D," etc. 9.771 (d) Miscellaneous (pictures, leather goods, wireless sets, crockery and ornaments) 29.245 ♦Total of articles enumerated on inventories prior to removal. 57 The following reports were submitted by the individual Inspectors:— (i) Mr. I. M. G. Farries, who is responsible chiefly for the disinfestation of properties owned by the Poplar Borough Council. Council Properties. (1) (a) Number of Council houses (tenements) found to be infested ill (b) Number of Council houses (tenements) disinfested .. 96 The remaining 15 tenements will be dealt with when transfer to other premises is effected. (2) The methods employed for freeing infested houses from bed bugs:— Notification of all Council tenements becoming vacant or believed to be infested is sent to the Public Health Department by the Housing Department, with a request for inspection and, if necessary, disinfestation. Where vacant premises are found to be infested, orders are sent to the Works Department and Electricity Department for such stripping of woodwork, etc., as appears necessary, this work being supervised by a Sanitary Inspector. All woodwork which is removed is treated with a blow-lamp, the premises are then fumigated with sulphur dioxide for a period of 24 hours, and finally sprayed with a liquid insecticide. Occupied premises believed to be infested are inspected, and the Housing Department is notified of the result of inspection with a recommendation as to the treatment to be carried out in accordance with the extent of infestation found. Very slight cases are treated by stripping of woodwork followed by spraying of the structure and furniture; more severe cases are recommended for transfer to another tenement, the furniture being treated with HCN in transit and the bedding steam-disinfested. The premises thus vacated are then inspected, stripped and fumigated with sulphur dioxide, the procedure being the same as for ordinary vacated tenements. Where premises are fumigated with sulphur dioxide, the gas is generated by burning a mixture of sulphur 95%, potassium nitrate 5%. The chemicals are bought in bulk and mixed thoroughly before using. 58 (3) The methods employed for ensuring that the belongings of tenants are free from vermin before removal to Council houses:— The furniture of all prospective Council tenants is inspected a few days prior to commencement of tenancy and, if found to be infested, one of the following two methods is employed to free the furniture from vermin, according to whether the infestation is slight or severe:— (x) Spraying of furniture with or without steam disinfestation of bedding. (2) HCN fumigation of furniture in vans during transit to Council houses and steam disinfestation of bedding. (4) Whether the work of disinfestation is carried out by the Local Authority or by a contractor:— HCN fumigation of furniture is carried out by a contractor, and spraying of furniture and steam disinfestation of bedding is carried out by the staff of the Public Health Department. (2) Mr. C. H. Medland, who is concerned chiefly with the disinfestation of private dwelling-houses. Disinfestation of Private Houses. On complaints being received of verminous conditions the premises are visited by the District Inspector, who serves Intimations to abate the nuisances, and a letter offering the Council's co-operation in taking such remedial action as may be necessary is included. It is found that the majority of property owners and tenants avail themselves of this service, which is free of charge. When notification is received that this remedial work is being put in hand, the Sanitary Inspector in charge of disinfestation meets the owner, or his representative, at the premises concerned. Arrangements are then made for the walls and ceilings to be stripped, and for the removal of the architraves and mouldings. When this has been done the Council's workmen enter the premises; infested articles of bedding and clothing are removed for steam disinfestation, and furniture treated with a blowlamp or vermicide; the doors, windows, ventilators and fireplaces are then sealed and a mixture of 95% commercial sulphur and 5% potassium nitrate is burnt in the room. Whenever possible the room is left for 24 hours, and when opened is carefully examined for the presence of vermin; as a precautionary 59 measure the room is also sprayed with a vermicide, which also acts as a deodoriser. Tenants are advised as to the precautions to be taken against re-infestation, periodic visits are made to ensure that the premises remain free from vermin, and further treatment is applied, if necessary. It will be seen from the data appended that the percentage of re-infestation in premises revisited is 18.6; the re-infestations are due to the following causes:— 1. Vermin being carried from an infested to a clean room in the same house. 2. Purchase of second-hand infested furniture. 3. Vermin brought in from outside places. 4. Indifference on the part of some tenants to the presence of vermin. 5. The limited scope of treatment that can be applied where premises are occupied and for the reasons given below. The presence of match-boarded walls, partitions and ceilings, cracked and bulging walls with open-jointed brickwork and defective floors in so many of the premises to be treated has meant that a successful and safe fumigation is impossible. Sulphur dioxide is an irritant and is dangerous to use under such conditions, having regard to the fact that it is but rarely possible to fumigate whole houses and that the remaining rooms of the house are occupied whilst fumigations are carried out. Treatments have been applied to 298 premises, but only in 17 cases has the whole house been fumigated. Number of premises reported to Public Health Committee (P. H. (L.) A., 1936) 437 Number of premises treated without service of notices 62 Total number of premises treated .. .. 499 Total number of treatments applied .. 1,480 Fumigations to 608 rooms in 298 houses; number of treatments .. .. .. 683 Sprayings to 390 rooms in 201 houses; number of treatments .. .. .. .. .. .. 797 60 Articles treated:— Bedding—by steam disinfestation 4.783 by spraying 3,792 8,575 Furniture—by blowlamp or vermicide .. 8,386 Miscellaneous articles, including pictures, leather goods, wireless sets, crockery and ornaments 29,052 Total 46,013 Re-inspections 153 premises treated prior to June, 1936, were re-inspected. 28 premises were found to b£ re-infested and further treatment given. Percentage of re-infestation, 18.6. Disinfestation—Shelter for Persons temporarily vacating Premises. The Public Health Committee and Housing Committee considered a reference from the Metropolitan Boroughs' Standing Joint Committee as to the need for the promotion of legislation to empower Metropolitan Borough Councils to provide temporary accommodation for persons removed from their dwellings while the premises undergo disinfestation for vermin. Although the Public Health (London) Act requires authorities to provide temporary shelter or accommodation for infectious disease contacts and also to provide cleansing stations and allow verminous persons the use of cleansing apparatus, there appeared to be no provision for temporary accommodation for cases of disinfestation. The Council informed the Standing Joint Committee they were in favour of the promotion of such legislation. The Public Health Committee authorised the Medical Officer of Health to use the Infectious Disease Shelter where such a course was necessary for dealing with cases of vermin infestation. 61 Section E. INSPECTION AND SUPERVISION OF FOOD. By-laws for the Protection of Food. In August the London County Council forwarded copies of By-laws made by the Council on 28th July, 1936, under section 6 of the London County Council (General Powers) Act, 1932, for promoting within the County of London (excluding the City of London) sanitary and cleanly conditions in the manufacture, preparation, storage, transport or exposure for sale of any article intended to be sold for food, together with a copy of a report which had been submitted to the London County Council on the matter. The report stated that it had not been found possible to accept (by reasons of undertakings given when the General Powers Act, 1932, was passed) suggestions regarding provision of water supply and washing facilities for and the personal cleanliness of persons engaged in the handling of foodstuffs, and pointed out that so far as shops were concerned suitable washing facilities could be required under the Shops Act, 1934. Certain other matters could not be specifically included in the byelaws by reason of the undertakings given; for example, the prohibition of the wrapping of food in newspapers, the provision of refuse receptacles, etc.; but it was thought some of these matters might be capable of control generally under certain of the proposed byelaws. These byelaws were confirmed by the Minister of Health and came into operation on 1st January, 1937. The work of inspecting premises where food is prepared, sold, or stored is carried out by two qualified food inspectors, who ensure that foodstuffs are handled with care and protected from contamination. Milk Supply. (a) Cowsheds. The cowshed in the Borough was inspected on 23 occasions. Application for a licence was considered by the Public Health Committee, as follows:— 17-19, Morville Street—Mr. John Henry Chandler—licensed to keep 19 cows. (b) Dairies and Milkshops. At the end of the year there were in the Borough 90 registered premises where raw milk is sold. These premises were kept under strict observation, 337 inspections being made. 62 3 intimations were served in respect of want of cleanliness and i other defect. The necessary work was done without need for further action by the department. 9 persons (including 3 itinerant vendors) were registered as retail purveyors of milk, 6 being on account of change of ownership of premises. The following retail purveyors also were registered during the year:— 32 for sale of Sterilized Milk in Sealed Bottles (23 on account of change of Ownership). 2 for sale of Raw Milk in "Sealcones" (1 on account of change of Ownership). 20 for sale of Raw Milk in Sealed Bottles (10 on account of change of Ownership). 11 for sale of Raw Milk in Sealed Cartons. Note.—2 Wholesale Purveyors of Raw Milk were registered and 1 Wholesale Purveyor of Sterilised Milk. (All three Purveyors have addresses outside the area of the Borough.) (c) Milk (Special Designations) Orders, 1923 and 1936. Licences Issued dubing the Yeab. Designation. Bottlers. Pasteurisers. Dealers in Sealed Bottles only. Supplementary Licences. Grade "A" (Tuberculin Tested) 6 — 29 9* Grade "A" Pasteurised.. — 1 — 2 Grade "A" — — 2 — Pasteurised — 2 13 iot Certified — — 4 3 Totals 6 3 48 24 ♦Includes one licence for sale of Tuberculin Tested milk under Milk (S. D.) Order. 1936. f Includes one licence for sale of Pasteurised milk under Milk (S. D.) Order, 1936. The bottling establishments have been under constant supervision and, for the purpose of renewal of licences,special inspections were made and reports submitted. 63 (d) Bacteriological Examination of Milk. Number of Samples Examined for Bacteria (Total Count and B.Coli)—111. Designated Milk. Where taken: Number satisfactory . Number unsatisfactory. Action taken. On delivery at— From Dealers— Railway tations. L.C.C. Hospitals, and Schools Before bottling. After bottling. Grade "A" (Tuberculin Tested) — — — — — — Tuberculin Tested 3 — 15 30 (6) 42 6* | *6 letters to bottlers and 4 letters to Medical | Officers of Health of I other Authorities. Pasteurised — 22 12f 23 57 — Grade "A" Pasteurised — — —•. 1 1 — | Grade "A" — — — 2 2 — [ Accredited — — — 2 2 — Tuberculin Tested Pasteurised.. — — — 1 1 — Totals 3 22 27 59 105 6 The figures in parentheses denote number of unsatisfactory samples and are included in the totals. t 8 for B. Coli count only. 64 (e) Examination of Milk for Tubercle Bacilli (Biological Examination). Number or Samples Examined—38. (An extract from a report of the London County Council of samples of bulk milk taken on delivery and at cowsheds in the Borough is given on page 65.) Number reported: Remarks. Tubercle bacilli absent. Tubercle bacilli present. Examination incomplete. Designated Milks:— Grade "A" 2 — — Accredited 2 — — Grade "A" (Tuberculin Tested) — — — Tuberculin Tested 8 — — Grade ' 'A'' Pasteurised 1 — — Tuberculin Tested Pasteurised 1 — — Pasteurised 12† — — Other Milks:— Sterilised 2 — — Bottled (from Dairies) 8 — 1* *Further sample taken. ,, (from Cowsheds) 1 — — Totals 37 — 1 † 4 of these were taken at L. C. C. schools. 65 In addition to the samples shown in the table on page 64, the London County Council took samples of milk for biological examination for the presence of tubercle Bacillus, as follows:— Premises. Grade. Examination. Complete. Examination Incomplete. Tuberculous. 3 Dairies Ungraded 17 1 1* Grade "A" or Accredited 24 — 1† Grade "A" T.T 3 — — 44 1 2 *No trace of tuberculosis in herd at time of consequent inspection. †Cow believed to be source of infection slaughtered under T.B. Order. Inspection by L .C .C. Veterinary Officers in cowsheds:— Pemises. Date Inspected. No. of Cows. Cows suffering with Mastitis. Induration 17 and 19, Morville Street 4.2.36 12 — — 28.4.36 12 1 — 23.7.36 12 2 1 29.10.36 11 5 1 Three samples were taken at cowsheds and examined for tubercle and all proved to be negative. (f) Milk delivered, to Hospitals and Schools. The arrangements for taking samples at St. Andrew's Hospital, St. Clement's Hospital, and Bow Road Open-Air School, belonging to the London County Council, and at Poplar Hospital, have continued throughout the year. Samples have also been taken at Poplar Institution and Bromley House Institution (both L.C.C. Institutions). As the milk supplied to some of the L.C.C. Institutions is "Pasteurised" milk, bacteriological examinations are carried out in addition to chemical analysis. (See table, page 63.) 66 During the year 21 samples were taken at 18 elementary schools. All the samples were genuine. Ice Cream. Daring the year, 17 Owners or Occupiers were registered for the manufacture, storage or sale of ice cream. Of these 15 were for sale only. The number of Ice Cream vendors now on Register is 203. 266 Inspections of the above premises were made during the year. Cleansing of premises was necessary in 8 instances; 2 other nuisances existed. Four intimations were served, and the necessary cleansings were carried out and other nuisances abated. Meat Inspection. (1.) Retail Meat. The Meat and Food Inspectors, during the course of their inspections of retail butcher's shops, find that the general condition of meat which is exposed for sale is satisfactory. A very large proportion of the meat sold in the Borough is imported. The bulk of the remainder is slaughtered either in this Borough or in adjoining Boroughs, and a small proportion of home-killed meat is obtained from Smithfield Market. Cleanliness, storage, marking, etc., are satisfactory, as the provisions of the Public Health (Meat) Regulations and the Meat Marking Order made under the Merchandise Marks Act are rigidly enforced, copies of the latter being supplied to the retailers. Number of inspections of retail butchers' shops and meat and offal stalls 3,751 N umber of cases in which meat has been found unsound 1 (2.) Ante-Mortem Inspection—Nil. There is no central abattoir in the Borough where a Veterinary Superintendent is employed. The slaughterhouses are visited regularly by the London County Council Veterinary Surgeon. (3.) Post-Mortem Inspection at Slaughterhouses. Class of Animal. Total Killings. Number Inspected. CONDEMNATIONS. Tuberculosis. Other Diseases. Entire Carcases. Parts of Carcases. Organs, etc. Entire Carcases. Parts of Carcases. Organs, etc. Lungs. Livers. Mesenteries. Omenta. Pancreas. Spleens. Tripes. Hearts. Kidneys. Intestines. Udders. Heads. Tongues. Lungs. Livers. Mesenteries. Omenta. Pancreas. Spleens. Tripes. Hearts. Kidneys. Intestines. Udders. Heads. Tongues. Cattle 256 256 — — 35 8 15 6 1 1 — — — — — 15 15 — — 2 6 — 7 — — — 1 — — — 8 7 Cows 397 397 6 6 130 30 57 26 22 13 12 4 5 8 8 52 52 — 5 38 44 3 20 — 5 7 7 7 2 14 12 9 Calves 463 463 — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — Sheep and Lambs 3,460 3,460 — — — — — — — — — — — — — — — 5 3 526 179 — — — 5 — 6 — — — — — Pigs 1,235 1,235 — 5 30 19 79 8 — 9 — 17 — — — 49 49 4 1 222 35 1 3 1 2 — 18 — — — — — 67 Slaughterhouses. 1. Bow Lane (East side).—Messrs. Henry Wickes & Sons, Ltd. 2. 220, Roman Road.—Mr. Arthur Edmund Fisher. On condition that the slaughtering of cattle on the premises was limited to the requirements of the shop attached to the premises. 3. 288, Roman Road.—Mr. Charles Valentine Applegate. On the understanding that the Licensee was to kill small cattle only at these premises. 4. 48-50, West Ferry Road.—Mr. John William Faulconbridge (trading as J. Faulconbridge & Son). 27 inspections of slaughterhouses were made and 16 "reminders" that periodical cleansing was due were served. The cleansings were carried out without need for further action. Slaughter of Animals Act, 1933. With regard to licensing of slaughtermen, the Public Health Committee agreed that primary licences be granted for a period of three years at a fee of 2s. and subsequent renewal be made at a fee of is. Eleven licences for three years were renewed. Slaughter of Animals by Mohammedans. The Medical Officer of Health has been authorised to issue, on personal application, "occasional" licences for a period of 14 days at a fee of 6d. Applicants, when applying for licences, must state where and at what time it is proposed to slaughter animals. 31 licences were issued during the year. Slaughterer of Poultry. The business of a slaughterer of poultry is carried on at three premises in the Borough, and inspections of these premises numbered 14. 12 "reminders'' that periodical cleansing was due were served, and the necessary work was carried out without need for further action. Bakehouses. At the end of the year there were 65 bakehouses in use, of which 19 are underground. In 53 bakehouses machinery is used. Each bakehouse in the Borough was inspected at least twice during the year, the total inspections numbering 263. 130 "reminders" that periodical cleansing was due were sent out. 68 Cleansing was found to be necessary on one occasion, and was carried out after service of an Intimation. Places where Food is Sold or Prepared (other than Premises referred to elsewhere). The number of premises in the Borough where the sale or preparation, etc., of food is carried on is 1,062—Eating Houses, 183; Fruiterers, etc., 119; Fish Shops, 78; Butchers' Shops, 52; other premises (mainly "general'' shops), 630. 2,043 visits were paid to these premises during the year. Want of cleanliness was found in 52 instances, and 24 other defects existed. In addition to 306 "reminders" that cleansing of fish shops was due, 36 intimations were served. The necessary works were carried out without need for further action by the department. 69 Reports of Food Inspectors. (1) Mr. C. A. Grabham. Totals. Inspections. Intimations. etc., served. Notices served. Stat. F inal. Bakehouses— Factories 80 51 — — Workshops 8 10 — — Dom. Workshops 10 4 — — Slaughterhouses 16 12 — — Cowhouses 3 — — — Milkshops 107 3 — — Restaurants and Eating Houses 109 5 — — Fried Fish Vendors and Fish Curers— Where power is used 144 90 — — Others 135 85 — — Stalls 1,713 — — — Other places where food is sold, etc.— Where power is used 37 — — — Others 430 4 — — Ice Cream Premises— Where power is used 32 2 — — Others 89 1 — — Wharves, etc., where food is prepared or stored, etc.— Where power is used — — — — Others 70 — — — Markets— Morning 155 — — — Evening 78 — — — Miscellaneous 212* — — — Total Delects, etc., Found. Remedied. Referred to D.S.I. Defects, etc., Found: 1. Nuisances under Public Health (London ) Act— Want of cleanliness 40 40 5 Want of ventilation 2 2 — Other nuisances 23 20 3 2. Offences under Factory and Workshop Act — — — *Including 7 inspections under the Shops Act find 19 inspections under the Infant Life Protection Act. 70 Slaughterhouses : Number of Visits 513 Number of Carcases Inspected:— Oxen 159 Bulls 2 Cows 188 Calves 231 Sheep 1,658 Lambs 519 Pigs 607 Organs condemned and destroyed consequent on slaughterhouse visits Heads and Tongues condemned and destroyed See table facing page 66. Number of Samples procured: (a) Under Food and Drugs (Adulteration) Act 395 (b) Under Special Orders and Regulations— 53 (i) Number satisfactory .. 49 (ii) Number not satisfactory 4* * Action taken in respect of unsatisfactory samples: (a) Legal proceedings — (b) Letters sent to Vendors, Bottlers, etc. 4 (e) Reported to appropriate Government Department, etc. 3 Public Health (Foreign Meat) Regulations— Certificates issued 87 Visits to Factories 173 Assistant's Time—Hours 4103/4 71 (2) MR . H. A. PEARCE . Totals. Inspections. Intimations, etc., served. Notices served. Stat. Final. Bakehouses— Factories 150 56 — — Workshops 13 8 — — Dom. Workshops 2 2 — — Slaughterhouses 25 16 — — Cowhouses 20 — — — Milkshops 230 — — — Restaurants and Eating Houses 166 8 — — Fried Fish Vendors and Fish Curers— Where power is used 70 40 — — Others 211 109 — — Stalls 2,722 — — — Other places where food is sold, etc.— Where power is used 110 — — — Others 559 1 — — Ice Cream Premises— Where power is used 22 — — — Others 123 1 — — Wharves, etc., where food is prepared or stored, etc.:— Where power is used — — — — Others 2 — — — Markets— Morning 219 — — — Evening 77 — — — Miscellaneous 92* — — — Total Defects, etc. Found. Remedied. Referred to D.S.i. Defects, etc., Found: 1. Nuisances under Public Health (London) Act— Want of cleanliness 24 24 — Want of ventilation — — — Other nuisances 11 5 6 2. Offences under Factory and Workshop Act. — — — * Including 13 inspections under the Shops Act, and one inspection under the Infant Life Protection Act. 72 Slaughterhouses : Number of Visits 341 Number of Carcases Inspected:— Oxen 94 Bulls 1 Cows 209 Calves 232 Sheep 743 Lambs 540 Pigs 628 Organs condemned and destroyed consequent on slaughterhouse visits Heads and Tongues condemned and destroyed See table facing page 66. Number of samples procured: (a) Under Food and Drugs (Adulteration) Act 398 (b) Under Special Orders and Regulations 73 (i) Number satisfactory 71 (ii) Number not satisfactory .. 2* *Action taken in respect of unsatisfactory samples: (a) Legal proceedings — (b) Letters sent to Vendors, Bottlers, etc. 2 (c) Reported to appropriate Local Authority 1 Public Health (Foreign Meat) Regulations— Certificates issued 5 Visits to Factories 12 Assistant's Time—Hours 398½ 73 The following were also condemned by Mr. C. A. Grabham and destroyed:— 95 casks Grape Fruit Juice, (375 gallons). 4 casks Lemon Juice (160 gallons). 128 casks Orange Juice (5,120 gallons). 1 cask Apricot Pulp (40 gallons). 15 casks Lemon Skins. 71 tins Grape Fruit Juice (71 gallons). 335 tins Bitter Orange Pulp (3,350 gallons). 243 tins Pineapple Juice (243 gallons). 39 8oz. tins Pineapple Juice. 4 tins Sheep Tongues. 12 tins Fish Paste. 6 tins Raspberries. 4 tins Black Currants. 16 tins Golden Berries. 3 tins Strawberries. 32 tins Pineapples. 1 tin Cherries. 1 tin Pears. 2 tins Peaches. 233 tins Lobster. 239 tins Salmon. 3 tins Brisling. 1,337 tins Sprats. 34 tins Herrings. 1 tin Crab. 330 tins Tomatoes. 2 tins Ox Tongue. 8 tins Artichokes. 15 tins Prawns. 52 tins Crayfish. 9 tins Bloaters. 32 tins Mushrooms. 21 tins Peas. 5 tins Sardines. 7 tins Haricot Beans. 1 tin Spinach. 14 tins Celery. 2 tins Sugar Cones. 5 tins Gruyere Cheese. 1 tin Macedonie. 3 tins Apples. 3 tins (small) Cream. 1 tin Ham. 26 lib. tins Corned Beef. 2 61b. tins Corned Beef. 3 61b. tins Jellied Veal. 5 71b. tins Tomato Puree. 33 tins Condensed Milk. 1 tin Full Cream Milk. 13 tins Evaporated Milk. 4 jars Herring Roes. 12 cases Desiccated Coconut (12 cwt.). 24 cartons Assorted Jellies. 2 small bags Whelks. 1 basket Black Cherries. 8st. Skate. 5st. (approx.) Soles. 40 Chickens. 12 Turkeys. ½ ton of Sausages were disposed of as waste material. The following were also condemned by Mr. H. A. Pearce and destroyed:— 12 casks Grape Fruit Juice (480 gallons). 4 casks Orange Juice (160 gallons). 601b. Peas. 18 tins Salmon. 4 tins Herrings. 4 tins Smoked Haddock. 203 tins Sprats. 7 tins Tomato Puree. 1 tin Bloaters. 1 tin Herrings and Tomatoes. 1 61b. tin Beef. 6 61b. tins Meat Paste. 591b. Fresh Haddock. 7 boxes Cod Fillets (7st.) 1 hock Bacon (51bs.). 36 bags Onions. 20 baskets Raspberries. 101b. Pears. 31b. Tomatoes. 11lb. Plums. The following unsound foodstuffs were released on condition that they were not used for human consumption:— 20 188/496 qrs. Wheat For animal food. 41 480/496 qrs. Wheat „ „ 5 109/496 qrs. Wheat „ „ 7 315/496 qrs. Wheat „ „ 1 256/480 qrs. Wheat „ „ 20 tons Kiln Dried Wheat „ „ 22J qrs. Kiln Dried Wheat „ „ 20 tons Kiln Dried Wheat „ „ 45 tons Kiln Dried Rice For poultry food. 2 278/400 qrs. Barley „ „ 1 218/480 qrs. Maize „ „ 1 284/480 qrs. Maize „ „ 214 lb. Maize „ „ 199 1b. Maize For animal food. 63 casks Tallow For grease making. During the year the following consignments were placed under stop:— 50 cases (each 10 1lb. tins) Bitter Orange Pulp.—Subsequently the contents of 34 cases in this consignment were found to be unsound and were condemned and destroyed. The remaining 16 cases were released to another Authority and the local Medical Officer of Health informed. 27 cases Corned. Beef.—Subsequently released for dogs' food. 2 cases Desiccated Coconut.—Subsequently released for technical purposes. A consignment of tinned Cauliflower consisting of 20 cases (each 100 tins) is being exported from time to time in small quantities. (Placed under stop during 1935.) 75 Food and Drugs (Adulteration) Act, 1928. The results of the analyses of 813 samples were reported to the Public Health Committee during the year:— Sample. Number examined, 1936. Number Adulterated. Action taken. Legal Proceedings. (See page 43.) Letters of caution sent. 1. Drugs. Ammoniated Tincture of Quinine Tablets 2 — — — Borax 2 — — — Lime Water 6 — — — Liniment of Turpentine 2 1 1 — Malt Extract 2 — — — Oil, Camphorated 6 — — — Ointments: Iodine 2 2 — 2 Sulphur 2 — — — Zinc 2 — — — Pills, Mercury 2 — — — 2. Spirits. Gin 3 — — — Rum 2 — — — Whisky 10 1 — 1 3. Other Articles. Bacon 4 1 — — Barley, Pearl 6 — — — Bread 4 — — — Brawn 4 — — — Bread and Butter 6 — — — Butter 47 — — — Cake 6 — — — Cheese 11 3 — — Cordials 7 — — — Cornflour 3 2 1 — Cream 6 — — — Cream, Table 2 — — — Dripping 14 — — — Egg Powder Substitute 2 — — — Fish Paste 2 — — — Flour 2 — — — Flour, Self-raising 2 — — — Fruits, Canned and Dried 6 — — — Golden Syrup 1 — — — Ground Ginger 2 — — — Ice Cream 2 — — — Jam 4 — — — Carried forward 186 10 2 3 76 Sample. Number examined, 1936. Number Adulterated. Action taken. Legal Proceedings, see page 43.) Letters of caution sent. Brought forward 186 10 2 3 Lard 6 — — — Lemon Curd 6 — — — Lemonade Crystals 4 — — — Margarine 46 1 — 1 Marmalade 4 — — — Meat 12 1 1 — „ Minced 2 1 1 — „ Paste 4 — — — „ Cooked 4 — — — Milk 391 19 2 9 „ Condensed 16 1 — — Milk Jelly Crystals 2 — — — Mincemeat 4 — — — Mustard 4 — — — Peas, Tinned 4 — — — Peel, Candied 2 — — — Pepper 4 — — — Pickles 4 — — — Bice 4 — — — Sago 2 — — — Sardines and Silds 4 — — — Sauce 6 — — — Sausages 18 — — — Shredded Suet 10 — — — Spice, Mixed 2 — — — Steak and Kidney Puddings 2 — — — Sugar 2 — — — Sweets 10 — — — Table Jelly 10 — — — Tea 4 — — — Treacle 1 — — — Tripe 4 — — — Vinegar 22 1 — 1 Vinegar, Malt 3 — — — Wines, Non-alcoholic 2 — — — Wine Essence, Ginger 2 — — — Totals, 1936 813 34* 6 14 Totals, 1935 822 37** 10 16 * Including 5 informal samples. ** Including 7 informal samples. Of the samples of milk, 254 were procured from itinerant vendors, 89 on Sundays and 165 on weekdays. All these samples were genuine. 77 Milk ; and Cream not Sold as Preserved Cream. (A) Number of Samples examined for the presence of preservative. (B) Number in which preservative was reported to be present, and percentage of preservative found in each case. Milk 391 Nil. Cream 6 Nil. Annual Report of the Public Analyst. During the year 1936, 813 samples were examined under the Food and Drugs (Adulteration) Act. All samples were submitted by the Inspectors. No sample under the Act was submitted by the Public. 169 of the samples were purchased informally. 34 samples were found to be adulterated, 29 formal and 5 informal. In addition, 36 other samples were of inferior quality or doubtful purity. The adulteration was at the rate of 4.2 per cent. as compared with 4.1 per cent. for the whole of London, and 5.5 per cent. for the whole of England and Wales in 1935. The rate of adulteration in the Borough for the past ten years was as follows:— Year. No. of Samples examined. Percentage of adulteration. 1936 813 4.2 1935 822 4-5 1934 849 6.3 1933 799 4.5 1932 818 4.0 1931 801 7.6 1930 807 6.7 1929 801 8.7 1928 807 11.0 1927 793 10.1 Average 811 6.8 78 The number of samples examined was at the rate of 5.65 per 1,000 of the population, as compared with 9.95 per 1,000 for the whole of London, and 3.60 per 1,000 for the whole of England and Wales in 1935. 391 samples of milk were examined, of which 19, or 4.9 per cent., were found to be adulterated and 16 other samples were of inferior quality or doubtful purity. The milk adulteration in the Borough for the past ten years was as follows:— Year. No. of Milks examined. Percentage of adulteration. 1936 391 4.9 1935 383 3.7 1934 451 7.8 1933 382 3.9 1932 367 2.2 1931 392 3.3 1930 426 4.0 1929 284 4.9 1928 386 4.4 1927 351 4.6 Average 381 4.4 The average milk adulteration for the whole of London was at the rate of 3.7 per cent., and for the whole of England and Wales 7.4 per cent, in 1935. Condensed Milks. 16 samples of condensed milk were examined, 1 of which was unsatisfactory, being deficient in milk solids. Preservatives. There were 5 contraventions of the Preservatives Regulations. 2 Minced Beefs, contained sulphur dioxide. 3 Cheeses, contained formaldehyde. 79 Other samples examined during the year were:— For the Public Health Department:— 21 Rag Flocks, 5 of which were unsatisfactory. 6 Pasteurised Milks. 2 samples under the Pharmacy and Poisons Act, 1 of which was unsatisfactory. For the Borough Engineer's Department:— 3 Sewages. ALBERT E. PARKES, F.I.C., Public Analyst. Butter and Margarine Acts. The following is the number of premises in the Borough registered under the above-mentioned Acts:— Margarine. Butter. Wholesale Dealer. Manufacturer. Factory. Wholesale Dealer in Milk-blended. 23 — 4 — Agricultural Produce (Grading and Marking) Act, 1928. There are no premises registered for storage of English eggs. Merchandise Marks Act and Orders. Occupiers of shops and stallholders have been supplied with appropriate circulars respecting marking of foreign produce. Inspections and observations have been made from time to time and where necessary attention has been drawn to breaches of the Orders. Manufacture of Preserved Foods. No applications for the manufacture of preserved food were submitted. The number of premises now on the register is 49. 80 Food Poisoning. During the year 12 notifications were received. Investigations into the 12 notified cases resulted in them being classified as follows:— True cases 4 Personal susceptibility 3 Not true food poisoning or doubtful cases 5 The four true cases were as follows:— Sporadic cases 4 These cases recovered without serious illness. Certification of Certain Food Products for Export to the Dominions and Foreign Countries. In view of the requirements of the Food Laws in operation in the Dominions and elsewhere, the system of certification for food products which are derived from the flesh of cattle, sheep, swine or goats, or from game or poultry, and are prepared or packed in England and Wales for export, has been continued. Certificates were issued in connection with 92 consignments of foodstuffs: Canada (12), Australia (32), United States of America and Dependencies (21), India (12), other countries (15). 185 visits were paid to factories and 20 tons 6 cwts. 3 qrs. 1 st. 5 lbs. of foodstuffs were inspected and passed for export. Public Health (.Imported Food) Regulations, 1925. Notices were received from time to time from the Port of London Sanitary Authority respecting tallow which had been released under suitable guarantees for soapmaking, lubricating oils, etc. Pharmacy and Poisons Act, 1933. This Act received Royal Assent on 28th June, 1933, but came into operation on various ' 'appointed days.'' The portions of the Act to be enforced by Local Authorities came into operation on 1st May, 1936. The Secretary of State of the Home Office issued ' 'The Poisons List'' and ' 'The Poisons Rules.'' Local Authorities are required to secure compliance with the provisions of Part 2 of the Act by persons who are not authorised sellers of poisons controlled by the Pharmaceutical Society, and for this purpose must appoint inspectors. 81 Local Authorities must keep a list of persons entitled to sell poisons included in Part 2 of the Poisons List. Applications by persons desiring to have their names entered in the list must be made on the prescribed form. The Poisons Rules prescribe the fees payable for entering the name and also for retaining it on the list. The Authority may refuse to enter, or may remove, the name of any person who fails to pay the prescribed fees or is, for any sufficient reason relating to the applicant or his premises, not fit to be on the list. An aggrieved person may appeal to the court of quarter sessions. The Council, upon the recommendation of the Public Health Committee:— (a) Delegated their powers under this Act to the Public Health Committee. (b) Appointed the Medical Officer of Health, the two Meat and Food Inspectors (Messrs. C. A. Grabham and H. A. Pearce), with Mr. H. W. Luke, the Deputy Meat and Food Inspector, in case of emergency, as Inspectors under the Act. (c) Approved of arrangements made with the Public Analyst, Mr. A. E. Parkes, for the analysis of samples taken under the provisions of this Act at a fee of 12s. 6d. per sample. (d) Agreed that in the event of legal proceedings being necessary they should be taken by the Council's Solicitors, Messrs. C. V. Young & Son. Later in the year the Home Office issued two Memoranda:— (a) For the guidance of manufacturers, wholesalers, etc., and (b) Regarding the provisions of the Act affecting purchase of poisons for use in agriculture and horticulture. The number of names entered in the Council's list of persons entitled to sell poisons in Part 2 of the Poisons List was 45 in respect of 54 premises. 82 Section F. PREVALENCE OF, AND CONTROL OVER, INFECTIOUS AND OTHER DISEASES. Notifications. 1,336 cases of Infectious Disease were notified during the year. In addition there were 114 other cases notified as Infectious Diseases in which the diagnosis was not confirmed. The notification rate was 9.5, compared with 10.9 in 1935. Mortality from Diphtheria, Scarlet Fever and Enteric Fever. Diphtheria. Scarlet Fever Enteric Fever. Cases 406 433 9 Deaths 13 2 — Fatality Rate 3.2 0.45 — Scarlet Fever. The total notifications received numbered 461 and the total removals were 456. Of these, 28 cases were later certified to be not suffering from Scarlet Fever, leaving a total of 433 cases, the attack-rate being 3.2 per 1,000 population. Two deaths occurred. Diphtheria. The total notifications received numbered 481 and the total removals to hospital were 481. 75 patients were certified to be suffering from other diseases, leaving a total of 406 cases, the attack-rate being 2.9 per 1,000 population. 13 deaths occurred, giving a fatality rate of 3.2 per cent. Diphtheria Immunisation. Applicants are dealt with at the Hackney Borough Council Clinic for which the Poplar Council pay a sum of 10s. for a complete immunisation and certificate, and 2s. 6d. for a certificate of natural immunity These charges are on the undertaking that the Poplar children do not require a special clinic. TABLE VII. Notifiable diseases during the Year 1936. (53 Weeks.) Notifiable Disease. Cases Notified in Whole Borough. Number of Cases admitted to Hospital. Total Deaths in Age-Periods. At all Ages. At Ages—Years. At all Ages. At Ages—Years. Under 1. 1 to 2. ' 2 to 3. 3 to 4. 4 to 5. 5 to 10. 10 to 15. 15 to 20. 20 to 35. 35 to 45. 45 to 65. 65 and upwards. Under 1. 1 to 2. 2 to 3. 3 to 4. 4 to 5. 5 to 10. 10 to 15. 15 to 20. 20 to 35. 35 to 45. 45 to 65. 65 and upwards. Smallpox — — — — — — — — — — — — — — — — — — — — — — — — — — — Diphtheria (including Membranous Croup) 406 4 14 22 39 51 180 55 10 18 8 4 1 406 13 — 1 — 3 2 7 — — — — — — Erysipelas 63 3 1 — — 1 2 2 3 5 7 23 16 27 — — — — — — — — — — — — — Scarlet Fever 433 5 14 33 28 57 167 65 26 34 3 1 — 428 2 — — 1 1 — — — — — — — — Typhus Fever — — — — — — — — — — — — — — — — — — — — — — — — — — — Enteric Fever (inoluding Paratyphoid) 9 — — — — — 1 — 1 5 — 2 — 9 — — — — — — — — — — — — — Relapsing Fever — — — — — — — — — — — — — — — — — — — — — — — — — — — Continued Fever — — — — — — — — — — — — — — — — — — — — — — — — — — — Puerperal Fever 5 — — — — — — — — 3 1 1 — 5 1 — — — — — — — — — — 1 — Puerperal Pyrexia 15 — — — — — — — — 9 5 1 — 14 — — — — — — — — — — — — — Cerebro-Spinal Fever 5 1 1 1 1 — — — — 1 — — — 5 3 1 — — 1 — — — — 1 — — — Acute Poliomyelitis 2 — — — — — — — — 1 — — — 2 — — — — — — — — — — — — — Acute Encephalitis Lethargica — — — — — — — — — — — — — — — — — — — — — — — — — — — Ophthalmia Neonatorum 5 5 — — — — — — — — — — — 4 — — — — — — — — — — — — — *Zymotic Enteritis 56 26 10 1 1 — 1 1 2 6 3 4 1 24 38 34 1 1 — — — — — — — 1 1 Pneumonia, Acute Primary 316 41 49 23 14 17 32 8 7 28 17 50 30 133 81 † 22 9 3 1 2 1 — 1 5 6 15 15 ,, Acute Influenzal 17 2 — — — — 3 — 1 4 1 5 1 — 1 † — — — — — — — — — — 1 — Dysentery 4 — — 1 2 — 1 — — — — — — 4 — — — — — — — — — — — — — Totals 1336 87 89 81 85 120 388 131 50 114 45 91 49 1061 138 57 11 5 6 4 8 — 1 6 6 18 16 † Notified patients only. This table does not include cases in which the original diagnosis was not confirmed. * Notifiable 1st June to 30th September, but the number of deaths relates to the whole year. (An analysis of cases and deaths by Wards is given in a separate Table on next page.) TABLE VIIa. Notifiable diseases, cases and deaths by wards, 1936. Notifiable Disease. Cases Notified. Deaths. Whole Borough. Bow. Bromley. Poplar. Whole. Borough. Bow. Bromley. Poplar. North. West. Cent. South. Northwest. NorthEast. SouthWest. SouthEast. Cent. Northwest. West. East. Millwall. Cubitt Town. North. West. Cent. South. NorthWest. NorthEast. SouthWest. SouthEast. Cent. NorthWest. West. East. Millwall. Cubitt Town. Smallpox — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — Diphtheria including Membranous Croup) 408 18 19 16 22 23 74 60 21 25 18 28 24 28 30 13 — — — — 2 2 3 — 3 — 1 — — 2 Erysipelas 63 3 2 2 6 5 y 4 5 3 4 6 4 3 7 — Scarlet Fever 433 9 16 19 21 32 39 38 33 70 36 23 23 41 33 2 — — — — — — — — 1 — — — — 1 Typhus Fever — — — — — — — — — — — — — — — — — — — — — — — — — — — — — Enteric Fever (including Paratyphoid) 9 1 — — — 4 — — — — 1 — 1 1 1 — — — — — — — — — — — — — — — Relapsing Fever — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — Continued Fever — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — Puerperal Fever 5 — 1 — 1 1 1 — — — 1 — — — — 1 — — — — — — — — — — — — — — Puerperal Pyrexia 15 — — 1 1 1 2 1 — 2 1 1 1 3 1 — — — — — — — — — — — — — — — Cerebro-Spinal Fever 5 — — 1 — 1 — — — 1 — 1 1 — — 3 — — 1 — — — — — — 1 — 1 — — Acute Poliomyelitis 2 1 — — — — — — — — — — — — — — — — — — — — — — — — — — — — Acute Encephalitis Lethargica — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — Ophthalmia Neonatorum 5 1 — — 1 — 1 — 1 — — 1 — — — — — — — — — — — — — — — — — — * Zymotice Enteritis 56 2 1 2 3 8 9 9 4 5 2 5 3 3 — 38 1 — — 3 3 1 7 7 5 1 3 4 3 — Pneumonia, Acute Primary 316 23 11 6 25 16 32 28 24 32 24 22 28 28 17 80 † 6 3 4 8 5 4 7 7 12 8 2 3 7 4 „ Acute Influenzal 17 — 2 — 2 1 3 — 2 1 — 1 1 3 1 1 † — 1 — — — — — — — — — — — — Dysentery 4 — — — — — — 1 — — — — — 1 2 — — — — — — — — — — — — — — — Totals 1336 58 52 47 82 92 170 141 90 139 87 89 86 111 92 138 7 4 5 11 10 7 17 14 21 10 6 8 11 7 * † See notes at foot of Table VII. 83 The number dealt with during the year was as follows:— Cases referred to Hackney during 1936 74 Certificates of immunisation received during 1936 44 Certificates of natural immunity received during 1936 10 Re-Schick only 3 Course incomplete (patient removed from Borough) 1 Cost £24 Diphtheria Anti-toxin. 208,000 units of diphtheria anti-toxin were issued to medical petitioners during the year. The main supply of anti-toxin is kept at the Public Health Office and is available for the use of medical practitioners in the Borough. By the courtesy of the Medical Superintendent of St. Andrew's Hospital, a supply is kept at that hospital for the use of medical practitioners who apply when the Public Health Office is closed. 144,000 units were issued from St. Andrew's Hospital during the year. Care is taken to see that old stock is replaced periodically. Diphtheria ''Carriers.'' As the result of investigations carried out at schools, one case was referred to the Special "Carrier" Clinic at the London Hospital and was allowed to resume school attendance after treatment. Arrangements were made for two other cases to attend the "Carrier" Clinic, but the patients were notified and removed to hospital as suffering from Diphtheria. Enteric Fever. Eleven notifications of cases of Typhoid Fever and Paratyphoid Fever were received and the patients were removed to hospital. In 2 cases the diagnosis was not confirmed. There were no deaths. Bacteriological Examinations. 1,996 swabbings were examined. Of these, 226 gave positive results (11.3 per cent.). In addition, one virulence test gave a positive result and one gave a negative result. Two blood specimens from doubtful cases of Typhoid Fever gave negative results. All the examinations were carried out at the Seamen's Hospital, Greenwich. Smallpox. No cases of Smallpox were notified during the year. Vaccination. The following particulars regarding vaccination have been taken from the Vaccination Officer's reports:— 84 Extract from the Report of the Vaccination Officer, respecting tho Vaccination of Children whose Births were registered from 1st January to 31st December, 1935, inclusive:— Registration Sub-Districts. Number of Births registered 1st Jan. to 31st Dec., 1935. Number of Births entered by 31st January, 1937, In "Vaccination Register." Number of Births which on 31st January, 1937, remained unentered in "Vaccination Register." Number of Births neither entered in the "Vaccination Register'' nor accounted for in Columns 8, 9 and 10. Total number of Certificates of Successful Primary Vaccination of Children under 14 received during the calendar year 1936. Number of Statutory Declarations of Conscientious Objection actually received during the calendar year 1936. Col. 1 Successfully vaccinated . Co!. II Col. IV Number in respect of whom Statutory Declarations of Conscientious Objection have been received. Col. V Died unvaccinated. Postponement by Medical Certificate. Removals to Districts the Vaccination Officers of which have been duly apprised. Removals to places unknown, cases not found, etc. Insusceptible of Vaccination. Had Smallpox. (1) (2) (3) (4) (6) (6) (7) (8) (9) (10) (11) (12) (13) Bow and Bromley 1178 151 1 — 765 65 — 26 23 147 400 1118 Poplar 535 77 — — 352 22 — 4 13 67 Total 1713 228 1 — 1117 87 — 30 36 214 400 1118 Note.—(a) The total of the figures in Columns 3 to 11 should agree with the figure in Column 2.—The number of children successfully vaccinated after the declaration of conscientious objection had been made was—Nil. (b) The figures in Columns 2 to 11 should not include re-registered births. The total number of copies of certificates for the year 1936 sent to other Vaccination Officers was 122 M. 379. 85 Return showing the numbers of persons successfully vaccinated and re-vaccinated at the cost of the rates by the Medical Officers of Institutions and the Public Vaccinators during the year ended 30th September, 1936. POPLAR BOROUGH COUNCIL. Name of the Institution or Vaccination District. Name of Medical Officer or Public Vaccinator. Numbers of Successful Primary Vaccinations of persons:— Number of Successful Re - vaccinations— i.e., Successful Vaccinations of persons who had been successfully vaccinated at some previous time. Observations. Under one year of age. One year and upwards. Total. The figures for the Institutions should be shown separately. Totals 241 96 337 50 Bromley Dr. C. Cotter 69 40 109 20 Two primary vaccinations included as re-vaccinations (4 mos.) Poplar Dr. H. J. O'Brien 71 31 102 15 Bow Dr. D. G. Macrae 79 18 97 11 Millwall Dr. M. Blasker 19 6 25 3 St. Andrew's Hospital Dr. .J. R. M. Whigham — 1 1 1 Poplar Institution Dr. J. R. M. Whigham 3 — 3 — St. Clement's Hospital Dr. E. T. Pinhey — — — — Col. 1 2 3 4 5 6 7 M. 379a. 86 The following analysis of the Report of the Vaccination Officer reveals the fact that 85 per cent, of the children whose births were registered in 1935 were not protected by successful vaccination:— Births registered 1,713 Deduct:— Died unvaccinated 87 Removals to other districts 30 Removals to places unknown, etc. 36 I53 Surviving residents 1,560 Successful vaccinations numbered 228 | 229= 14.7 per cent. Insusceptible of Vaccination 1 Had Smallpox _— Conscientious Objections declared 1,117 Vaccinations postponed on Medical Certificates Number not accounted for 214 1,331=85.3 Per Total unvaccinated children •• 1,560 Public Health (Smallpox Prevention) Regulations, 1917. There were no vaccinations or re-vaccinations performed by the Medical Officer of Health during the year. Plague. No case of this disease was notified during the year. Anthrax, Glanders and Hydrophobia in Man. No cases of these diseases occurred. London Notification of Glanders Order , 1907. No notice was received from the Veterinary Inspector of the London County Council of the existence of glanders at premises in the Borough. Erysipelas. 63 cases of Erysipelas were notified but there were no deaths from this disease. 87 Public Health (Puerperal Fever and, Puerperal Pyrexia) Regulations, 1926. The Consulting Obstetrician appointed under the above Regulations, Dr. Malcolm Donaldson, was not called in to any case during the year. The following is a summary of the cases notified, etc., during the year:— Puerperal Fever. Puerperal Pyrexia. Cases notified 5 15* Removed to L.C.C. Fever Hospitals 3 2 Treated in other Hospitals 2 12 Treated at home — 1 Consultant called in — — Deaths 3** 1† * Excludes one later reported to be Puerperal Fever. ** †See list of maternal deaths, page 124. Continued and Typhus Fevers No case of continued fever occurred. No case of typhus fever occurred. Cerebro-Spinal Fever. Six cases of Cerebro-Spinal Fever were notified and were treated in hospital. In one case, the diagnosis was not confirmed, leaving a total of 5 cases. Four patients received serum treatment and one recovered. The other three died (one in 1937). One other case died soon after admission to hospital and did not receive serum treatment. Acute Poliomyelitis. Three cases were notified and removed to hospital. In one case the diagnosis was not confirmed, leaving 2 cases. Acute Polio-Encephalitis. No cases of Acute Polio-Encephalitis were notified. Acute Encephalitis Lethargica. No cases were notified. No deaths were certified as being due to Encephalitis Lethargica. 88 Cases of Encephalitis Lethargica are kept under observation until the acute stage has passed. Subsequently, periodical visits are made and reports as to the condition of patients are forwarded to the London County Council. From time to time reports as to cases admitted to the Encephalitis Lethargica unit at the Northern Hospital are received from the London County Council. The following is a summary of the reports received regarding 24 patients:— (a) From Institutions (13). Patient. Notified. Institution. Report. Remarks. E. B. — Northern Hospital Sleeps well at night; not sleepy in daytime. Right arm rather rigid. Speech explosive after 15 seconds, effort time lag reduced to 3 seconds Genuine P.E.L. H. B. ? 1929 Northern Hospital Sleeps well at night; is not drowsy in the day. Behaviour good now. Mild generalised Parkinsonism. Definite general improvement since being put on Stramonium Genuine P.E.L. E. A. B. — Northern Hospital Sleeps well at night; is not lethargic by day. Speech now much improved. Marked improvement shown since taking Stramonium Genuine P.E.L. J. T. C. Northern Hospital Sleeps well by night; is not very lethargic in daytime. Is having Stramonium, which does not seem to be having much effect Genuine P.E.L. G. E. — Northern Hospital Oculo-gyric crises at least two or three times each week. Mild degree of Parkinsonism Genuine case of encephalitis lethargica. E. F. 1921 Rampton State Institution, Retford Now sleeps well. Feebleminded; deteriorating. Spastic right leg Post-Encephalitic with Parkinsonism B. F. — Northern Hospital Sleeps well at night; rather drowsy by day. Occasional oculo-gyric crises—mild generalised Parkinsonism Genuine P.E.L. R. G. 1929 Claybury Mental Hospital Some mental deterioration. Conduct irresponsible. Mask-like rigidity of face— slight Ptosis bilateral with tremors of eyelids. Gait somewhat spastic; speech slow Post-encephalitio dementia. 89 Patient. Notified. Institution. Report. Remarks. G. J. 1933 Northern Hospital Very lethargic by day; sleeps well at night. Movements slow and weak. Festinant gait. Definite improvement since being put on Stramonium Genuine P. E.L. R. L. — Northern Hospital Sleeps well at night; not sleepy in daytime. Leftsided Parkinsonism—getting progressively more rigid Genuine P.E.L. H. R. — Northern Hospital Very lethargic during day. Wasting and loss of power in upper and lower limbs. Is very helpless and unable to do much for himself— getting worse within the past few months Genuine P. E.L. L. St. G. — Leavesden Mental Hospital Sleepy by day; no insomnia by night. Intelligence deteriorating gradually Genuine E. L. R. S. — The Manor, Epsom Age 20, but mental age 8-9 years. Occasionally mischievous and unruly. No evidence of Parkinsonism or other nervous lesions ? Encephalitis lethargica. (6) From Sanitary Inspectors (II). Patient. Report. Treatment. Apparently recovered. Much improved. Remarks. A. B. — — Paralysis increasing. Quite helpless Nil. T. C. — — No change Nil. G. H. — — No change By private practitioner. T. G. At work — — — J. I. — — No change By private practitioner. E. M. — — No change Nil. J. N. — — No change By private practitioner. J. P. At school — — — A Sm. Said to be well — — — A. Su. — — Physical condition worse By private practitioner. W. W. — — No change—partial paralysis By private practitioner. 90 Post-Vaccinal Encephalitis, etc. No case of Post-Vaccinal infection was reported. Measles. 1,981 cases of Measles and German Measles were reported to the Medical Officer of Health from various sources (principally from L.C.C. schools). 452 of the cases were admitted to hospitals. 51 deaths were attributed to Measles. Copy of L.C.C. Questionnaire. Measles Epidemic, 1935-36. (1st November, 1935—31st August. 1936.) Borough of Poplar. I. Please complete the following table with regard to the incidence and mortality of Measles during the above period. Ages Under 1 1 and under 2 2 and under 3 3 and under 4 4 and under 5 5 and under 6 6 and under 7 7 and under 8 8 and under 14 14 and over Total No. of Cases 96 229 192 277 457 346 190 65 36 8 1,896* No. of Deaths 16 22 4 3 3 1 1 — 1 — 51* German Measles — 1 — — 4 6 5 2 4 — 22 * These figures include 5 cases which were not notified prior to death. 2. Please complete the following table as to the number of cases removed to hospital, other than hospitals under the control of the London County Council, during above period and the number among these which proved fatal. Type of Hospital. No. of Cases admitted. No. of Deaths. Voluntary hospitals and other institutions (not under control of the Council) Nil. Nil Removals to L.C.C. Fever Hospital 436 44 Removals to L.C.C General Hospitals (St. Andrew's) 1 l At home . . 6 51 91 Removed with other causes and re-diagnosed as Measles (not included in removal figures, but included in total of cases) 8 Ditto ditto but contracted Measles 1 Cases normally resident outside Borough but removed from General Hospitals within Borough to L.C.C. Fever Hospitals (not included in totals) 4 3. Arrangements with regard to home-nursing. (a) Direct employment of nurses, whole or part-time. No nurses directly employed. (b) Contract with District Nursing Association. Please include cost (per capitum or block grant). District Nursing Associations supply nurses and are paid at the rate of is. 3d. per visit. During the period under review there were 2,403 visits on account of Measles at a cost of £150 3s. gd. (c) Number of homes visited.—157. (.d) Number of visits made to homes.—2,403. 4. To what extent was (1) convalescent measles serum, (2) human adult serum, used for prevention or attenuation in connection with cases not removed to hospitals under the control of the Council and with what results? 5. To what extent was any other form of treatment used in connection with cases not removed to hospitals under the control of the London County Council, e.g., drugs, anti-scarlet serum, vitamin therapy, etc., and with what results? 6. Have you any suggestions for improving the administrative procedure in connection with the scheme of co-operation in the schools in future epidemics? No. 92 7. Please state whether, in your opinion, the admission to school of home contacts of Measles had any effect on the incidence of the disease. Also state whether you are in favour of allowing home contacts to attend school whilst under supervision during the next epidemic. Our Health Visitors believe that many of the babies who have contracted Measles and died were infected by susceptible contacts who have contracted infection at school and brought it home. 8. Other remarks (if any). Nil. Zymotic Enteritis (notifiable from 1st June to 30th September.) Diarrhoeal diseases (other than Dysentery and the Typhoid group which are referred to elsewhere in this report) would appear to have been rather more prevalent than usual in the period when notification was not in force, judged by the higher mortality in 1936. The total deaths classified by the Registrar-General to Diarrhoea and Enteritis were 37, of which 35 were of children under 5 years of age. Only 13 of the deaths occurred amongst patients who had been notified, and it would appear, therefore, that it would be advisable to consider the question of making Zymotic Enteritis (Diarrhoea with Vomiting) in children under 5 years of age notifiable throughout the year. This would enable the Department to investigate the condition and the possible sources of infection, and to endeavour to ensure adequate treatment at an earlier stage of the disease than is now possible. (A summary of the notified cases which were visited by the Health Visitors is given in the Maternity and Child Welfare Section, page 116.) Pneumonia. 316 cases of Acute Primary Pneumonia and 17 cases of Acute Influenzal Pneumonia were notified during the year, 133 of the patients being treated in hospitals. 81 notified patients died—80 Acute Primary Pneumonia and 1 Acute Influenzal Pneumonia. 93 Malaria. No cases of Malaria were notified during the year. Dysentery. Six cases were notified and were treated in hospital. In two instances the diagnosis was not confirmed. There were no deaths. Ophthalmia Neonatorum. A complete summary of cases notified and visited is given in the Section of this Report dealing with Maternity and Child Welfare, page 121. Altered Diagnosis Cases. 114 patients who had been notified and removed to hospitals as suffering from infectious disease were later certified to be suffering from some condition other than that which was notified:— 28 Scarlet Fever; 75 Diphtheria; 1 Puerperal Fever; 1 Cerebrospinal Fever; 2 Enteric Fever and Paratyphoid Fever; 2 Dysentery; 1 Acute Poliomyelitis; and 4 Zymotic Enteritis. The final diagnosis in the 28 Scarlet Fever cases was:— Erythema 2 Measles 4 Rubella 2 Tonsillitis 6 Laryngitis 1 Disease not specified *13 28 * These were reported "Not notifiable," "Negative case," etc. The final diagnosis in the 75 Diphtheria cases was:— Tonsillitis 34 Laryngitis 6 Varicella 1 Scarlet Fever 2 Gastro-Enteritis 1 Measles 4 Disease not specified *27 75 * These were reported "Negative case," "Not notifiable," etc. In addition, there were 8 cases reported as Bacteriological Diphtheria. These have been included as cases of Diphtheria. 94 Cancer. The number of deaths from Cancer for the last ten years is shown below:— Year. Males. Females. Total. 1927 120 120 240 1928 115 89 204 1929 114 96 210 1930 136 75 211 1931 121 100 221 1932 130 75 205 1933 116 89 205 1934 123 126 249 1935 129 92 221 1936 118 94 212 Tuberculosis Dispensary. The Council's Tuberculosis Dispensary is at No. 1, Wellington Road, Bow, E.3, and the following table shows the accommodation, hours of sessions, etc.:— Accommodation. Day and time of session. Type of session. Two Tuberculosis Officers' Rooms, Dispensary, Monday, 4.30 p.m. Children attending School. X-Ray Room, Waiting Room, Dressing Room, Monday, 6 p.m. Adults who are working. accommodation for Health Visitors, Clerks and Resident Caretaker. Tuesday 11 a.m. and 2 p.m. Any person not at work or not attending School. Thursday Friday Tuberculosis Officer's Report. Statistics for 1936. The three following tables comprise the annual return for 1936 required by the Ministry of Health. The first provides a concise summary of the work carried out during the year at the Dispensary, while the other two show the classification of all patients remaining on the Dispensary Register on December 31st, together with a cumulative summary of all cases who have ever attended the Dispensary. 95 Return for the year 1936. 1. Return showing the work of the Dispensary. Diagnosis Pulmonary. Non-Pulmonary. Total. Adults. Children. Adults. Children. Adults. Children. Grand Total M. F. M. F. M. F. M. F. M. F M. F. A.—New Cases examined during the year (excluding Contacts):— 657 (a) Definitely Tuberculous 87 42 3 7 8 13 10 5 95 55 13 12 175 (b) Diagnosis not completed — — — — — — — — 2 7 7 7 23 (c) Non-Tuberculous — — — — — — — — 128 137 105 89 459 B.—Contacts examined during the year:— 403 (a) Definitely Tuberculous 5 2 2 — — — — 5 2 2 — 9 (b) Diagnosis not completed — — — — — — — — 2 2 2 — 6 (c) Non-Tuberculous — — — — — — — — 92 128 83 85 388 C.—Cases written off the Dispensary Register as:— 948 (a) Recovered .. 16 14 3 4 3 11 10 8 19 25 13 12 69 (b) Non-Tuberculous (including any such cases previously diagnosed and entered on the Dispensary Register as Tuberculous) — — — — — — — — 231 275 193 180 879 D.—Number of Cases on Dispensary Register on December 31st:— 770 (a) Definitely Tuberculous 279 234 12 34 39 43 57 43 318 277 69 77 741 (6) Diagnosis not completed — — — — — — — — 4 9 9 7 29 I. Number of cases on Dispensary Register on January 1st, 1936 804 2. Number of cases transferred from other areas, and cases returned after discharge under Head 3 in previous years 40 3. Number of cases transferred to other areas, cases not desiring further assistance under the scheme, and cases "lost sight of" 86 4. Cases written off during the year as Dead (all causes) 100 5. Number of attendances at the Dispensary (including Contacts) 6,764 6. Number of Insured Persons under Domiciliary Treatment on December 31st 176 7. Number of consultations with Medical Practitioners:— 8. Number of visits by Tuberculosis Officers to homes (including personal consultations) 647 (a) Personal 24 (b) Other 271 9. Number of visits by Health Visitors to homes 7,288 (a) Specimens of Sputum etc., examined P. II. 368 Dispensary 831 (b) X-RAY examinations made Screen 6 Films 363 11. Number of "Recovered" cases restored to Dispensary Register, and included in A (a) and A (b) above 2 12. Number of "T. B. plus" cases on Dispensary Register on December 31st 420 96 Comments on Table I. Items A and B.—The total new cases and contacts examined during the year show a decrease of 23 as compared with 1935. The 657 new cases of Item A is a composite figure made up as follows: 402 cases (excluding contacts) attending for the first time during 1936, and 255 cases examined during preceding years (including contacts examined during preceding years) and discharged as non-tuberculous, who presented themselves for re-examination during 1936 with suspicious symptoms. These cases are grouped together under Item A according to instructions in the Ministry of Health's Memorandum 37/T. Revised. Of these 657 new cases, 175 were found to be suffering from Tuberculosis. 403 new contacts (Item B) were examined during the year, and of these, 9 were found to be suffering from Tuberculosis. Item 5.—The number of attendances at the Dispensary during 1936, namely 6,764, shows an increase of 670 over the number for 1935, and now becomes the largest recorded since 1923. Item 8.—The visits paid by the Tuberculosis Officers show an increase of 43 over the total for 1935, and the present figure of 647 is the highest recorded. Item 9.—In addition to the 7,288 visits paid by the Health Visitors for dispensary purposes (an increase of 724 over the number for 1935), 299 "non-dispensary" visits were paid under the Public Health (Tuberculosis) Regulations, 1930. Item 10.—The number of X-ray examinations at St. Andrew's Hospital shows an increase of no over the figure for 1935. The X-ray plant at the Dispensary continues to be used for screening purposes when the occasion arises, chiefly for cases undergoing artificial pneumothorax treatment. Included in the 831 specimens of sputum, etc., examined at the Dispensary were 7 specimens of urine examined for the presence of tubercle bacilli. Comments on Tables II and III. These returns continue to remain optional. During the year 69 cases were removed from the Dispensary Register as ''recovered'' (there were 71 in 1935), and are analysed in Item C on Table I. These have been added to those similarly removed in former years in the appropriate columns on Tables II and III. During the year one case of nonpulmonary tuberculosis developed pulmonary tuberculosis, and has been accordingly transferred from Table III to Table II. 2. PULMONARY TUBERCULOSIS. Showing in summary form (a) the condition at the end of 1936 of all Patients remaining on the Dispensary Register; and (6) the reasons the removal of all cases written off the Register. The table is arranged according to the years in which the patients were first entered on Dispensary Register as definite cases of Pulmonary Tuberculosis, and their classification at that time. Condition at the time of the last record made during the year 1936. Previous to 1926. 1926. 1927. 1928. 1929. 1930. Class T.B.+. Class T.B.+. Class T.B.+. Class T.B.+ . Class T.B.+ . Class T.B. +. Class T.B.—. Group I. Group II. Group III. Total, (T.B. + ) Class T.B.—. Group I. Group II. Group III. Total (T.B.+). Class T.B.—. Group I. Group II. Group III. Total (T.B. + ). Class T.B.—. Group I. Group II. Group III. Total (T.B.+ ). Class T.B.—. Group I. Group 11. Group III. Total (T.B. + ). Class T.B.—. Group I. Group II. Group III. Total (T.B.+). / (a) Remaining on J?is1 pensary Register on December 31st. Disease Arrested Adults M. 2 2 6 1 9 — 1 3 — 4 — 1 — — 1 1 — 1 — 3 2 — 5 5 2 1 — 3 F. 2 2 6 — 8 — — — — — 1 — 1 — 1 1 — 2 — 2 1 2 2 — 4 — 2 3 — 5 Children 1 1 1 — 2 1 — — — — — — — — — — 1 — — 1 2 — — — — 1 — — — — Disease not Arrested Adults M. 1 1 3 — 9 — — 4 — 4 — 1 1 — 2 — 3 3 — 6 — 1 5 — 6 1 3 4 — 7 F. 1 3 6 — 9 — — 2 — 2 1 2 — 2 — 4 — 4 — 1 1 — 2 — 2 1 1 4 Children 1 — — — — — — — — — — — 1 — 1 — — — — — — — — — — 1 — 1 — 1 Condition not ascertained during the year — — — — — — — — — — — — 1 — 1 — — 1 — 1 — — — — — — — — — — Total on Dispensary Register at Dec. 31st 8 9 27 1 37 1 1 9 — 10 0 2 6 — 8 1 4 11 — 15 3 7 10 — 17 8 9 10 1 20 (b) Not now on Dispensary Register and reasons for removal therefrom. Discharged as Recovered M 41 22 — 55 2 1 4 — 5 2 1 0 3 5 5 1 — 6 1 1 — — 1 4 I 2 3 Adults F. 60 22 26 — 48 6 2 1 — 3 4 2 2 — 4 4 1 — 5 3 5 — — 5 3 1 — 1 Children 81 7 11 — 18 5 — — — — 9 — 1 — 1 3 — — — — 2 2 — — 2 5 — — — — Lost sight of or otherwise removed from Dispensary Register 41 36 82 4 122 18 7 15 1 23 22 14 11 — 25 22 7 14 — 21 5 10 21 2 33 20 16 20 3 39 Dead Adults M. 12 21 68 19 108 3 4 27 4 35 — 9 19 5 33 10 8 25 5 38 4 13 23 9 — 5 8 36 14 58 F. 7 15 43 9 67 — 5 24 2 31 3 6 27 6 39 2 2 25 3 30 7 12 28 6 46 4 6 24 7 37 Children 1 — 6 — 6 — — 1 1 1 — 1 1 2 4 — 2 — 2 1 — 1 — 1 1 2 2 — 4 Total written off Dispensary Register 251 123 269 32 424 34 19 71 8 98 46 32 63 12 107 46 26 68 8 102 23 43 73 17 133 42 34 84 24 142 Grand Totals 259 132 296 33 461 35 20 80 8 108 48 34 69 12 115 47 30 79 8 117 26 50 83 17 150 50 43 94 25 162 (a) Remaining on Dispensary Register on December 31st. 1931. 1932. 1933. 1934. 1935. 1936. Disease Arrested Adults M. 3 3 4 — 7 3 7 1 — 8 1 4 — — 4 4 — — — — — — — — — — — — — F. 2 1 1 — 2 3 — 3 — 3 2 4 1 — 5 2 — 1 1 — — — — — — — — — — Children 5 1 — — 1 1 — — — — 2 — — — — 2 — — — — — — — — — — — — — — Disease not Arrested Adults M. — 3 3 1 7 1 8 9 — 17 1 20 9 — 29 3 9 11 — 20 9 9 14 — 23 17 13 33 2 48 F. 1 2 4 1 7 1 10 6 — 16 5 7 10 — 17 10 12 8 — 20 10 11 21 2 34 12 7 20 2 29 Children — — — — — — — — — — 1 3 1 — 4 3 4 1 — 5 1 — — — — 7 — 3 — 3 Condition not ascertained during the year — 1 1 — 2 1 — — — — — — — — — 2 — — — — 1 1 — — 1 — — — — — Total on Dispensary Register at Dec. 31st 11 11 13 2 26 10 25 19 — 44 12 38 21 — 59 26 25 21 — 46 21 21 35 2 58 36 20 56 4 80 (6) Not now on Dispensary Register and reasons for removal therefrom. Discharged as Recovered Adults M. 2 1 — — 1 — — — — — — — — — — — — — — — — — — — — — — — — — F. 1 1 1 — 2 — — — — — — — — — — — — — — — — — — — — — — — Children 1 — — — — — — — — — — — — — — — — — — — — — — — — — — — — Lost sight of or otherwise removed from Dispensary Register 12 13 8 3 24 8 16 11 — 27 12 12 9 1 22 14 12 13 — 25 9 6 9 — 15 5 3 4 — 7 Dead Adults M. 4 12 25 12 49 — 12 14 9 35 4 12 22 16 50 5 8 15 9 32 2 2 20 6 28 2 — 10 5 15 F. 1 4 14 16 34 3 3 18 16 37 1 13 19 11 43 2 3 16 3 22 1 1 4 5 10 — — 1 1 2 Children — 1 1 1 3 1 — 1 — 1 — — 2 1 3 1 — 1 — 1 — — — — — 2 — — — — Total written off Dispensary Register 21 32 49 32 113 12 31 44 25 100 17 37 52 29 118 22 23 45 12 80 12 9 33 11 53 9 3 15 6 24 Totals 32 43 62 34 139 22 56 63 25 144 29 75 73 29 177 48 48 66 12 126 33 30 68 13 111 45 23 71 10 104 3. NON-PULMONARY TUBERCULOSIS. Showing in summary form (a) the condition at the end of 1936 of all patients remaining on the Dispensary Register; and (b) the reasons for the removal of all cases written off the Register. Condition at the time of the last record made during the year 1936. Previous to 1926. 1926. 1927. 1928. 1929. 1930. Bones & Joints. Abdominal. Other Organs. Periph'al Glands. Total. Bones & Joints. Abdominal. Other Organs. Perirh'al Glands. Total. Bones & Joints. Abdominal. Other Organs. Periph'al Glands. Total. Bones & Joints. Abdominal . Other Organs. Periph'al Glands. Total. Bones & Joints. Abdominal. Other Organs. Periph'al Glands. Total. Bones Joints. Abdominal. Other Organs. Periph'al Glands. . (a) Remaining on Dispensary Register on December 31st. Disease Arrested Adults M 1 — — — 1 — — — — — — — — — — — — — — — 1 — — — 1 1 — 2 — 3 F 1 — 2 — 3 — — — — — — — — — — — — — — — — — — — — 1 — — — 1 Children 1 — — 1 2 2 — — 1 3 — — — — — — — — 1 1 3 — — — 3 4 — 1 — 5 Disease not Arrested Adults M. — — — — — — — 1 — — 1 — — — 1 — — — — — — — — — — — — 2 — 2 F. 1 — 1 1 3 — — — — — 2 — — — 2 — — — — — — — — 1 1 — — 1 — 1 Children — — — — — — — — — — 2 — — — 2 — — — — — 3 — — — 3 2 — — 2 4 Condition not ascertained during the year — — — — — — — — — — — — — — — — — — 1 1 1 — — — 1 1 — — — 1 Total on Dispensary Register, December 31st 4 — 3 2 9 2 — 1 1 4 5 — — — 5 — — — 2 2 8 — — 1 9 9 — 6 2 17 Transferred to Pulmonary — — — 1 1 — — — — — — — — 2 2 — — — — 2 — — 1 1 2 — — — — — (b) Not now on Dispensary Register and reasons removal therefrom. Discharged as Recovered Adults M. 7 2 4 5 18 — 2 — 1 3 2 — — — 2 — — — 2 4 1 1 — 6 — 1 — 1 2 F. 7 — 5 7 19 — — 3 3 — — 1 1 2 2 — — — 2 1 — — 3 4 1 — 2 — 3 Children 21 8 12 61 102 — 2 1 7 10 6 2 — 9 17 4 3 — 3 10 3 2 2 5 12 3 5 1 7 16 Lost sight of or otherwise removed from Dispensary Register 10 — 9 20 39 3 2 2 4 11 3 1 — 6 10 6 3 2 6 17 5 1 2 3 11 8 1 2 4 15 Dead Adults M. 2 — — — 2 3 — — — 3 — — — — — — — 1 — ] 1 — — — 1 — — — — — F. 1 — — — 1 — — — — — — — — — — 1 — — — 1 1 — — — 1 — — — — — Children 2 — — 1 3 1 — — — 1 1 — — — 1 — — — 1 1 1 — — — 1 — — — — — Total written off Dispensary Register 50 10 30 94 184 7 6 3 15 31 12 3 1 16 32 13 6 3 12 34 16 4 5 11 36 12 7 5 12 36 Totals of (a) and (b) (excluding those transferred to Pulmonary) 54 10 33 96 193 9 6 4 16 35 17 3 1 16 37 13 6 3 14 36 24 4 5 12 45 21 7 11 14 53 —(a) Remaining on Dispensary Register on December 31lst. 1931. 1932. 1C33. 1934. 1935. 1936. Disease Arrested Adults M. — — — 1 1 — — — — — 1 — — — 1 — — — 1 1 — — — — — — — — — — F. 2 — — — 2 1 — — 1 2 — 1 1 — 2 1 1 1 — 3 — — — — — — — — — — Children 2 1 — 1 4 — — 1 4 5 — 2 — 5 7 1 1 1 3 6 — — — — — — — — — — Disease not Arrested Adults M. 1 — 2 — 3 2 — 3 — 5 1 — 2 — 3 — — 2 1 3 — — 1 2 3 5 — 3 — 8 F. 1 — 2 — 3 2 — — — 2 — 1 — — 1 — — 1 3 4 1 1 — 1 3 3 — 2 5 10 Children 4 — 1 5 2 — 1 — 3 3 — 4 7 1 — 7 8 5 2 — 7 14 5 1 2 7 15 Condition not ascertained during the year — — — 1 1 — — — — — 1 — — — 1 — — — — — — — — — — — — — — Total on Dispensary Register, December 31st 10 1 4 4 19 7 — 5 5 17 6 4 3 9 22 1 3 2 5 15 25 6 3 1 10 20 13 1 7 12 33 Transferred to Pulmonary 2 — — — 2 — — — 1 1 — — — 1 — — — — — — — — — — 1 — — — 1 (b) Not now on Dispensary Register and reasons for removal therefrom. Discharged as Recovered Adults M. 3 — 1 — 4 — — — — — — — — — — — — — — — — — — — — — — — — — F. 1 2 1 1 5 — — — — — — — — 1 1 — — — — — — — — — — — — — — — Children 3 1 1 6 11 — 2 — 2 4 1 — — — 1 — — — — — — — — — — — — — — — Dost sight of or otherwise removed from Dispensary Register 8 — 2 3 13 4 — — 5 9 — 1 3 3 7 3 — O 6 11 3 1 — 1 5 1 1 2 Dead Adults M. 2 — — — 2 1 — — — 1 1 1 2 — — 1 1 — — — — 1 — — 1 — 1 F. 1 1 — — 2 — — — — — — — — — — — — — — — 1 — — — — — — — — — Children 1 — — — 1 — — — — — — — _ — — — — — — — — — — — — — — — 1 1 Total written off Dispensary Register 19 4 5 10 38 5 2 — 7 14 2 1 3 5 11 3 — 3 6 12 4 1 — 2 7 1 — 2 1 4 Grand Total of (a) and (6) (excluding those transferred to Pulmonary) 29 5 9 14 57 12 2 5 12 31 8 5 6 14 33 6 2 8 21 37 10 4 1 12 27 14 1 9 13 37 97 Additional Statistics not dealt with in the preceding Tables:— Patients sent away for institutional treatment 234 Patients in receipt of extra-nourishment during year 84 Patients in receipt of extra-nourishment on December 31st 45 Reports on child contacts to Divisional School Medical Officer 104 Letters to General Practitioners concerning patients 391 Reports to General Practitioners on official forms 128 Progress reports received from General Practitioners 48 Clinical reports to London County Council 563 Reports to Ministry of Pensions — Shelters on loan during the year 2 Shelters on loan on December 31st 2 Beds and bedding on loan during the year Cases 19 Beds and bedding on loan on December 31st 12 During the year 21 new cases and 18 old cases have attended Colindale, Grove Park, Victoria Park and St. Andrew's Hospitals for 438 artificial pneumothorax refills. This number shows an increase of 114 over that for 1935, and may possibly continue to increase further. 2 new cases and 2 old cases of Lupus have attended the London Hospital during the year for 58 applications of Finsen light and 515 applications of general light. Patients receiving artificial pneumothorax treatment and patients needing Finsen or general light treatment are treated on the recommendation of the Tuberculosis Officer, the cost of treatment being charged to the Borough Council. During the year 4 tuberculous children and 1 non-tuberculous child were recommended for admission to Open Air Schools, and 9 children were recommended for boarding out under the London County Council's Contact Scheme. Last year it was reported that the Borough Council had agreed to co-operate with the Royal College of Physicians in an investigation into the early stages of Tuberculosis, on behalf of the Prophit Trust. During 1936, 19 contacts were examined at the Dispensary by the Prophit Scholar, working under the supervision of the Tuberculosis Officer. 98 Dental Treatment. Tuberculous patients requiring dental treatment are referred to St. Andrew's Hospital under an agreement with the London County Council. During the year 15 patients were referred, and the Dental Officer reports on the work done as follows:— Patients 15 Attendances 26 Extractions 48 General Anaesthetics 13 Local Anaesthetics 3 Report of the Secretary to the Tuberculosis Care Committee. The Poplar Tuberculosis Care Committee continues to meet monthly at the Dispensary to deal with matters affecting the general welfare of persons suffering from tuberculosis. In June, 1936, the London County Council's Revised Scheme for the Treatment of Tuberculosis and their circular for the guidance of Care Committees—"Social Service in connection with Tuberculosis"—were submitted to the Public Health Committee, who directed that the work of the Care Committee should be carried on as hitherto. There were 11 meetings of the Tuberculosis Care Committee during 1936 and 208 individual cases were dealt with. Of these, 159 were in need of some kind of practical assistance, and this was provided in 136 cases by the Care Committee's voluntary fund, the Poplar Tuberculosis Fund. The remaining 23 cases were referred to other agencies, which included the Public Assistance Committee, the British Legion and United Services Fund, and the Red Cross Society. Grants have also been obtained from the Hospital Sunday Fund and Society for Relief of Distress in cases in which dentures, etc., have been required. Twenty cases have been referred to the London County Council for the provision of clothing for sanatorium during the year. The Committee of the Poplar Tuberculosis Fund has met 11 times and the Fund has provided 70 needy patients with clothing and boots. Fares have been paid for relatives to visit patients away in sanatoria on 21 occasions, and 18 destitute persons in hospitals or sanatoria have been given small pocket-money allowances. Other assistance given by the Fund has included the provision of dentures, spectacles and surgical appliances, payment of arrears of rent and removal expenses to enable patients to obtain better housing accommodation, payment of laundry expenses for women patients unfit to do this kind of work themselves, etc. 99 Once again a considerable proportion of the income of the Poplar Tuberculosis Fund has been derived from the Sunday opening of two local cinemas—the Poplar Hippodrome and the Poplar Pavilion. In November, however, the Committee was informed that the London County Council had decided to remove the name of the Poplar Tuberculosis Fund from the list of charities eligible to receive contributions from this source as it was felt that the Tuberculosis Care Committee should be able to obtain such assistance as was required from other voluntary organisations or from Public Assistance authorities. A strong protest against this decision was sent to the London County Council by the Borough Council, in which it was pointed out that it would be quite impossible, in Poplar at any rate, to carry on the work of the Care Committee effectively without the assistance of the Poplar Tuberculosis Fund, 60 per cent, of the income of which was derived from the contributions of the cinemas. As a result of this protest the decision of the London County Council was rescinded and the Fund was reinstated on the list of charities eligible for this assistance. Even with these contributions assured, it has been necessary for the Committee to make continuous endeavours to augment the income of the Fund, and during the year a collection at the Regal Cinema (by kind permission of the proprietor), a Dancing Display and a very successful Christmas Sale were organised. Other contributions, indicating that the value of the work of the Fund is appreciated in many quarters, have come from the Poplar Benevolent Society, the National Deposit Friendly Society, the Prudential Societies, the Alexandra Rose Day Committee, several local Lodges of the Independent Order of Odd Fellows, and various other subscribers. The Annual Report and Balance Sheet of the Poplar Tuberculosis Fund are published at the end of the financial year. The Handicraft Class, an occupational centre for patients unfit for, or unable to obtain, ordinary work, continues to meet weekly at the Dispensary. There were 15 names on the register at the close of 1936, and an average attendance of 12 members proves that the Class is appreciated. Goods made in the Class were disposed of at an Exhibition and Sale of Handicrafts organised by the Standing Conference of Metropolitan Borough Tuberculosis Care Committees and held at the Carpenters' Hall in June, at the Ex-Servicemen's Armistice Exhibition at the Imperial Institute in November, and at the Christmas Sale at the Dispensary. The Poplar Tuberculosis Care Committee is represented on the Standing Conference of Metropolitan Borough Tuberculosis Care Committees and 2 meetings of the Conference were attended during the year. 100 PUBLIC HEALTH (TUBERCULOSIS) REGULATIONS, 1930. Part I.—Summary of Notifications during the period from the 1st January, 1936, to the 31st December, 1936, in the area of the Metropolitan Borough of Poplar (to which this Return relates). Age Periods. Formal Notifications. Total Notifications. Number of Primary Notifications of New Cases of Tuberculosis. 0- 1- 5- 10- 15- 20- 25- 85- 45- 55- 65- Total (all ages). Pulmonary—Males 1 — 2 2 11 16 24 19 22 12 4 113 177 ,, Females 1 2 2 1 10 17 17 6 2 2 1 61 107 Non-Pulmonary—Males — 5 7 4 3 3 9. 1 1 — — 26 30 ,, Females 2 2 4 4 1 4 4 3 2 — — 26 29 Col. (1) (2) (3) (4) (5) (6) (7) (8) (9) (10) (11) (12) (13) (14) Part II.—SUPPLEMENTAL RETURN. New cases of Tuberculosis coming to the knowledge of the Medical Officer of Health during the above-mentioned period, otherwise than by formal notification. Age Periods. 0- 1- 5- 10- 15- 20- 25- 35- 45- 55- 65- Total. Pulmonary—Males — — 1 — — 2 — 4 2 2 2 1 14 ,, Females — — 1 — — 1 2 4 2 — — — 10 Non-Pulmonary—Males — 1 — — 2 1 3 — — 1 — — 8 ,, Females — 3 3 — — — — 1 — — — — 8 The source or sources from which information as to the above-mentioned cases was obtained should be stated below:— Source of Information. Number of Cases. Pulmonary. NonPulmonary. Death Returns from Local Registrars 3 4 transferable deaths from Registrar-General 3 — Posthumous notifications 4 4 "Transfers" from other areas (other than transferable deaths) 8 8 Other Sources, if any (specify) Forms 1 & 2 6 — PART III.—NOTIFICATION REGISTER Pulmonary. Non-Pulmonary. Total Cases. Number of cases of Tuberculosis remaining at the 31st December, 1936, on the Register of Notifications kept by the Medical Officer of Health of the Metropolitan Borough Males. Females. Total. Males. Females. Total. 371 310 681 133 127 260 941 Number of cases removed from the Register during the year by reason Withdrawal of notification 1 — 1 — 1 1 2 Recovery from the disease, cured 18 21 39 22 16 38 77 Diagnosis not confirmed 7 3 10 3 — 3 13 Death 75 45 120 13 9 22 142 101 Public Health (Tuberculosis) Regulations, 1924 and 1930. Summary of Quarterly Returns to the London County Council. Quarter ended March. June. September. December. Number of Cases on Register at commencement of quarter 1,096 1,049 1,002 966 Number of New Cases notified 65 57 51 54 Number of Cases restored to Register, etc. 21 13 9 8 Number of Cases removed from Register 133 117 96 87 Number of Cases on Register at end ofquarter. Pulmonary 751 727 704 681 Non-Pulmonary 298 275 262 260 Totals 1,049 1,002 966 941 Particulars of new cases of Tuberculosis and of all Deaths from the disease:— Age Periods. New Cases. Deaths. (Reg. General's figures). Pulmonary. NonPulmonary. Pulmonary. NonPulmonary. M. F. M. F. M. F. M. F. Under 1 1 1 1 5 1 — 1 4 1 — 1 3 5 5 1 1 2 4 5 — 2 2 7 4 — — 1 1 10— 2 1 6 5 15— 13 11 4 1 11 16 2 1 20— 16 19 6 4 25— 28 21 2 5 10 9 — — 35— 21 8 1 3 8 3 1 — 45 — 24 2 2 2 17 7 — — 65— 14 2 — — 11 3 — — 65 and upwards 5 1 — — 2 — — — Totals 127 71 34 34 61 39 7 10 The ratio of non-notified Tuberculosis deaths to total Tuberculosis deaths was 8.5%. Disinfecting Station, Cleansing Station and Shelter. The Council is still considering the question of plans and sites for the new Disinfecting Station referred to in the Annual Report for 1935. Early in 1937, meetings of representatives of the Committees concerned were held and, as a result, it is hoped the Council will be able to get the approval of the Ministry of Health to the erection of the new Disinfecting and Cleansing Station. 102 Disinfecting Department. Totals. Rooms Disinfected 1,850 Premises visited re Disinfection 1,995 Articles Disinfected. Smallpox. Other Infectious Diseases. Tuberculosis . Scabies and Verminous. Miscellaneous. Totals (a) From Infected Premises — 10,081 357 1246* 380 12,064 (b) From Cleansing Station — — — 38,390t — 38,390 (c) From Contacts — 27 — — — 27 Totals — 10,108 357 39,636 380 50,481 * Scabies only. †Verminous and Scabies. Articles destroyed by request, 247. Vermicide—Quantity issued from Depots, 40½ gallons. Cleansing Station. M. F. Totals. Verminous persons cleansed 12 1 13 ,, children ,, 287 1,678 1,965 Scabies cases, cleansed, adults 30 62 92 ,, ,, children 800 888 1,688 Total cleansings 1,129 2,629 3,758 All verminous children are treated with special comb. Motor Vehicles. Vehicle. Speedometer register (miles). Petrol consumption (gallons). Average m.p.g. Blue Van 4,238 284 14.9 Brown Van 4,457 288½ 15.4 Lorry 4,660 273½ 17.0 Medical Officer of Health's Car 6,053 436½ 13.8 Special Vehicle for Contacts 4,245 388 10.9 103 Electrolytic Disinfecting Fluid. The electrolytic disinfecting fluid as manufactured contains approximately 9-10 grammes per litre of free chlorine and is broken down to a strength of approximately 4 grammes per litre for distribution. During the year 1936, 57,750 gallons were manufactured and broken down to 121,680 gallons of weaker solution for distribution. The production of the solution at a strength of 4 grammes of available chlorine per litre has averaged 132,737 gallons per annum for three years at an average annual cost of £2,088, the cost per gallon thus being nearly 4d. Quantity Produced. As Manufactured. As Issued. (i.e., Weaker Solution.) Electricity Consumed. Gallons. Gallons. Units. No. 1 Apparatus 41,400 19,530 9,998 No. 2 Apparatus 40,980 19,410 9,981 No. 3 Apparatus 39,300 18,810 9,609 Totals 121,680 57,750 29,588 1,095 gallons were supplied to London County Council Elementary Schools for spraying and cleansing floors of classrooms. 104 Cleansing of Verminous School Children. The arrangements for cleansing of verminous school children were continued throughout the year. Quarter. Number of Children Cleansed. Total number of Cleansings. Amount payable by L.C.C. to the Borough Council. 1936. £ s. d. March 531 919 69 1 0 June 602 875 72 9 0 September 591 777 68 11 0 December 477 1,118 73 14 0 Totals 2,201 3,689 £283 15 0 Miss Landray made 23 visits in connection with verminous schoolchildren and 221 visits in connection with children suffering from Scabies. Arrangements were made for the children to be bathed, and for bedding and clothing to be disinfested. Cleansing of Persons. During the year, 105 persons—including 9 from common and seamen's lodging houses (see next page)—applied for baths and for their clothes to be disinfested. 105 Verminous Persons in Common Lodging Houses, etc. The number of persons from Common Lodging Houses and Seamen's Lodging Houses, etc., cleansed at the Council's Cleansing Station, Glaucus Street, during the year was:— Lodging House, etc. Male. Female. Total. 196, Bow Road — — — 65, Bow Lane — — — 378, Old Ford Road — — — 38, Pennyfields — — — Salvation Army Home, Bow Road — — — East London Hostel, Garford Street 9 — 9 411, East India Dock Road — — — 9 — 9 From Common Lodging Houses without the Borough of Poplar (by agreement with L.C.C. at a charge of is. per person cleansed) — — — Totals 9 — 9 For cleansing of verminous rooms see page 56. Public Health Education. Report by Mr. T. Wigley. A distinguished authority on public health, Dr. Rene Sand, has wisely pointed out that the advancement of hygiene is dependent upon four essential factors: scientific discoveries, extension of sanitary organisation, intervention of the medical profession in a preventive sense, and awakening and education of the hygienic sense of the population. Up to a certain point the last factor dominates the other three, for the maintenance of research laboratories, the development of the health services and the preventive action of the medical profession involve expenses 106 which must be borne by everyone. Moreover, public health legislation and services curtail individual liberty, and people will consent to these expenses and inconveniences only when they are health-conscious. Throughout the past year the work of public health education has gone on steadily, and we have good grounds for hope that personal and social hygiene are increasingly better understood and appreciated in practice throughout the Borough than ever before. The subjects chosen by various groups have extended from the care of the body to the care of the mind, from practical hygiene to "From infancy to age." Public interest in recent discussions concerning diet and disease has been reflected in the demand for lectures on "Food and Drink," "The Study of Food Values," "Common Errors in Diet," etc. In this way the results of the latest research are being made available for all, and the way to health is seen to lie less through the bottle of medicine than through a way of living and an organisation of personal life in habits which make for health. Not only chronic diseases, but the condition vaguely called ill-health, may not infrequently yield to comparatively simple measures when these are understood and personally applied; much of existing disease is quite unnecessary, and while we rightly treat sickness and disease when they appear, the need of imagination and good sense which will spend money on promoting good health through understanding is even more urgent. The opportunity for questions follows each lecture, and a brisk discussion generally takes place, which reveals both a desire to learn and an appreciation of this educational service provided by a far-sighted Health Authority. Again and again I have been impressed by the genuine enthusiasm with which knowledge has been received, and the regrets that such information was not available long ago, when there would have been more years left in which to profit by it. The fact that many meetings demand a health lecture at regular intervals is in itself a testimony to the wide recognition that here is a demand being met which touches the life of man, woman and child, personally and in community; it is a demand for fuller life through knowledge to power. 107 SUMMARY . Number of Centres at which lectures were given 20 Number of lectures given (January-December, 1936) 175 To men and boys 18 (Attendances 385) To women and girls 144 ( „ 8,733) To mixed audiences 13 ( „ 410) 175 (Total attendances 9,528) EXPENDITURE YEAR ENDING 3IST MARCH, 1937. £ s. d. Grant to Central Council for Health Education 5 0 0 Printing, Stationery and Postage 0 18 11 Fees to Lecturers 350 14 0 Total £356 12 11 In addition to the grant to the Central Council for Health Education, the following grants were made:— To the National Society for the Prevention of Venereal Diseases, £2 2s., and To the Industrial Health Education Society, £2 2s. 108 Section G. MATERNITY AND CHILD WELFARE. The Maternity and Child Welfare work is divided between the Borough Council and the Royal College of St. Katharine, the Borough Council taking approximately the areas north of Bow Road and south of East India Dock Road; the Royal College of St. Katharine being responsible for the intermediate area, except for a small area in the vicinity of the Maternity and Child Welfare Centre in Wellington Road. Ministry of Health Circular 1550—Children under School Age. Under date 29th May, 1936, the Ministry of Health addressed a Circular to all Maternity and Child Welfare Authorities (England) regarding the health of young children between the ages of 18 months and 2 years. The Circular asked the Council to review their arrangements for supervising the health of young children and inform him as soon as possible of the result of their consideration of the Circular. The Medical Officer of Health submitted a report detailing the services already available in the Borough and making certain recommendations. The Council, upon the recommendation of the Maternity Committee, agreed that in the financial estimates for the year 1937 provision be made for an additional Health Visitor for work on the Isle of Dogs and the institution of two additional Infant Welfare sessions, one at Simpsons Road and the other at 54, West Ferry Road. It was also agreed that when the new Old Ford Clinic is established, two further Infant Welfare sessions be introduced and an additional Health Visitor be appointed for work in the Bow area. A copy of the Medical Officer of Health's report was sent to the Ministry of Health with an assurance that the needs of the toddlers would receive the continued attention of the Council. Co-operation with Voluntary Organisations, etc. (a) Royal College of St. Katharine. Arising from the Minister of Health's proposed scheme under Section 101 (6) of the Local Government Act, 1929, for the grant period 1st April, 1937, to 31st March, 1942, a letter was received from Canon T. Gardner, MATERNITY AND CHILD WELFARE CLINICS. Situation . Nature or Accommodation. Clinics. (a) Provided by the Borough Council:— Simpsons Road, Poplar Medical Officer's, Weighing and Waiting Rooms (Weighing Room also used for Artificial Sunlight Treatment) Infant Consultations: Wednesdays, 10.30a.m. to 12.30 p.m. and 2 to 4 p.m. Ante-Natal: Mondays, 10.30 a.m. to 12.30 p.m. and 2 to 4 p.m. Post-Natal: once monthly. Sewing Class: Thursdays, 2 to 4 p.m. Artificial Light Treatment: (By appointment only) Tuesdays and Thursdays, 9.30 a.m. to 12.30 p.m. and 2.30 to 4.30 p.m.; Saturdays, 9.30 a.m. to 12.30 p.m. Methodist Mission, Old Ford Road Medical Officer's Room and Weighing and Waiting Room combined Infant Consultations: Tuesdays and Fridays, 2 to 4 p.m. Ante-Natal: Fridays, 10.30 a.m. to 12.30 p.m. Methodist Chapel, Manchester Road Medical Officer's, Weighing and Waiting Rooms Infant Consultations: Wednesdays, 10.30 a.m. to 12.30 p.m., and 2 to 4 p.m. 54, West Ferry Road Ditto Ditto Ditto Infant Consultations: Fridays, 2 to 4 p.m. Wellington Road Medical Officer's, Weighing and Waiting Rooms, Dispensary Infant Consultations: Thursdays, 10.30 a.m. to 12.30 p.m., nd 2 to 4 p.m. Dentist's Room, Recovery Room, Artificial Light Room Ante-Natal: Alternate Wednesdays 2 to 4 p.m. Artificial Light Treatment: (By appointment only) Mondays, Wednesdays and Fridays, 9.30 a.m. to 12.30 p.m., and 2.30 to 4.30 p.m. Dental: (By appointment only) Tuesday and Wednesday, 10 a.m. to 12 noon. Provided by the Royal College of St. Katharine:— Special Clinic: (By appointment only) Fridays, 2 to 4 p.m. 228-230, Brunswick Road Two Medical Officers' Rooms; 1 Weighing and 2 Waiting Rooms; 1 Dental Clinic; 1 Artificial Light Room and Waiting Room; 2 Observation Wards, with Kitchen, Bathroom and Out-Patient Room for mothers Infant Consultations. Tuesdays, Thursdays and Fridays, 2 p.m. Sewing Class: Mondays, 2 p.m. Denial: (By appointment only) Thursdays 9.30 a.m. and 1.30 p.m. Artificial Light Treatment: (By appointment only) Mondays to Fridays, 9.30 a.m. to 12.30 p.m., and 2 to 4.30 p.m. Ante-Natal: Tuesdays, 9.30 a.m. Tonsil Clinic: (By appointment only) Once weekly. Remedial Exercise: (By appointment only) Mondays, 2.30 p.m., and Thursdays 10 a.m. Post-Natal Clinic: Wednesdays, 9.30 to 12.30 The Lighthouse Mission, Blackthorn Street Medical Officer's Room and Large Hall for weighing and waiting Infant Consultations: Wednesdays, 2 p.m. Trinity Hall, Augusta Street Ditto Ditto Ditto Infant Consultations: Wednesdays, 2 p.m. 109 Chairman of the Chapter of the Royal College of St. Katharine, making a request that the grant of £4,442 paid to the Royal College annually for the last quinquennial period may be continued. The letter further stated:— "In making this application I am desired to emphasise how much the Chapter value the cordial relationship which exists between the Public Health Department of the Council and the Royal College, ensuring such a pleasant and stimulating influence on the work in which we are both engaged." During the year also a scheme of co-operation was arranged between the Royal College of St. Katharine and the Nursing Sisters of St. John the Divine which would provide an efficient domiciliary midwifery service in the Borough. It has been included in the scheme that there should be similar co-operation between the Nursing Sisters of St. John the Divine the Borough Council Ante-natal Clinics, and the whole of the scheme and would be carried out in the closest co-operation with the Borough Council's Maternity and Child Welfare Department. This scheme has been made possible by the provision of assistance by the Royal College of St. Katharine to the Nursing Sisters of St. John the Divine. On hearing details of the scheme the Maternity and Child Welfare Committee expressed great satisfaction and wished to place on record their appreciation of the services rendered by the Royal College of St. Katharine and the Nursing Sisters of St. John the Divine for the benefit of the women of the Borough. (b) Co-operation with St. Andrew's Hospital. (i) In order to further improve the co-operation between the Borough Council's Ante-natal Clinics and St. Andrew's Hospital, meetings of the Clinic Medical Officers and the Medical Staff of the Maternity Department of St. Andrew's Hospital have been held. (ii) Training of Midwives.—At the request of the Matron of St. Andrew's Hospital, arrangements were made for nurses undergoing midwifery training at St. Andrew's Hospital to visit the Maternity and Child Welfare Clinics in order that they may have some knowledge of the work carried on at Infant Consultation. 44 nurse-midwives attended our clinics during the year. (c) The Queen Mary Day Nursery and Social Settlement. The Minister of Health has approved of the inclusion in the scheme of £500 contribution towards the Queen Mary Day Nursery and Social Settlement in connection with the work of the Day Nursery and Creche. The new building was opened early in 1937. 110 (d) Co-operation with the General Hospitals. From experience it was found that the records of many of the children under 5 years of age attending the clinics were incomplete in respect of serious illnesses which had necessitated hospital treatment. The officials of five hospitals in the neighbourhood where the majority of Poplar children are treated were interviewed by the Medical Officer of Health. Through their kind and willing co-operation a scheme was arranged whereby a report on each Poplar child treated in their hospitals is sent to the Medical Officer of Health. The report, in addition to giving information regarding the clinical condition of the child, calls attention to any after-care which is required, and so enables our Health Visitors to follow up and see that the Hospital recommendations are carried out. Books of 100 forms are supplied to each hospital, together with "Business Reply" envelopes, in order to reduce to a minimum the work of the Hospital staffs. 523 reports were received from St. Andrew's Hospital 423 from Voluntary Hospitals 100 (In addition to the above the London County Council sent 602 reports of children discharged from the Fever Hospitals, and again the Health Visitors follow up to see that the Hospital recommendations are carried out.) (e) Co-operation with the Education Authority. (a) 44 of the senior girls undergoing training at the London County Council Domestic School, Dingle Lane, attended Simpsons Road Clinic for instruction in mothercraft. (b) 1,833 case sheets relating to the children who reached the age of 5 years were forwarded to the Education Department. 853 special reports were also forwarded regarding children attending school, not yet 5 years of age. (f) Co-operation with the Invalid Children's Aid Association. The Council at their meeting on 29th November, 1934, agreed— 1. To make a grant of £10 per annum to the Invalid Children's Aid Association (local branch) towards the cost of providing surgical appliances for children under the age of 5 years; 111 2. (a) That an amount of £30 (affording 4 weeks' convalescent treatment for 15 cases, at 10s. a week) be included in the annual estimates and earmarked for this purpose; (b) That any such child for whom convalescent treatment is desired must be referred to the appropriate Maternity and Child Welfare Centre for examination by the Clinic Medical Officer for his, or her, approval; (c) That payment of the Convalescent Home account and collection of any monies towards the cost of the treatment be undertaken by the Invalid Children's Aid Association, who shall submit each month an account to the Borough Council for payment of the balance. The Association assisted 14 children in obtaining surgical appliances and provided convalescent treatment in 17 cases during 1936. Centres. In the table facing page 108 will be found a list of the Maternity and Child Welfare Centres in the Borough, together with the days and hours of clinics and the accommodation available at each centre. The number of attendances at the Centres during the last 10 years is shown below:— Borough Council. Royal College. 1927 36,110 23.588 1928 41,420 27.653 1929 38,504 28,250 1930 40,924 32,173 1931 42,340 34.275 1932 48,167 35,413 1933 50,599 35,713 1934 48,048 34,600 1935 45,101 33,253 1936 44,099 29,478 Old Ford Clinic. Reference was made in last year's Annual Report to the preparations made for the erection of a modern clinic in Old Ford. It has not been possible to put the work in hand on account of the difficulty of rehousing the tenants occupying this site, but at the end of the year only two houses were partly occupied. 112 The original plans and specifications allowed for the footings and ground floor walls to be built of such strength as to permit of the erection of a first floor at a future date. At the end of September, 1936, a communication was received from the Medical Officer of Health of the London County Council stating that although in 1934 it was not thought desirable to provide further facilities for medical and dental treatment of school children in the district, the whole position had recently been altered owing to the premises now occupied by the School Treatment Centre in Monteith Road being required for educational purposes by 31st March, 1937. He therefore desired to know whether it was still possible to plan the proposed new Maternity and Child Welfare Clinic building at Old Ford so as to provide accommodation for a treatment centre, eye (refraction), dental and minor ailments, on the first floor. Plans for a proposed lay-out of the first floor were prepared by the Borough Surveyor's Department and discussed with a representative of the County Medical Officer of Health. At the beginning of October the County Medical Officer of Health wrote to the Town Clerk enquiring whether the Borough Council would give the necessary facilities, provided satisfactory arrangements could be made as to the payments to be made by the County Council to the Borough Council, and suggested that an inclusive figure should be arrived at later covering rent, rates, cleaning and heating. The Maternity and Child Welfare Committee agreed to alter the present plans in order to afford the necessary facilities required by the London County Council, subject to satisfactory financial arrangements, and that in view of the first floor accommodation being required as soon as possible after 31st March, 1937, and the Housing Committee asked to rehouse the persons occupying the site as speedily as possible in order that the erection of the Clinic might be put in hand. At the end of the year the matter was still in abeyance, but in April, 1937, a satisfactory arrangement regarding payment was arrived at, and we hope the building will be proceeded with in the next few months. Miss J. M. Cardozo, Chief Health Visitor, reports as follows:— Home Visiting. (See Table, page 116.) This most important part of the work is still complicated by the large number of inward transfers. The importance of obtaining the goodwill and co-operation cf the mother cannot be over-estimated, and to obtain this many visits are necessary to these new families, especially 113 when—as is so often the case—no records have been received regarding them. The Health Visitor gives advice, but it is for the mother to carry it out, and it is upon her that the health and well-being of the children depend. To ensure satisfactory supervision of children under 5 years who are attending school, arrangements are made to see them during the dinner interval and after 4 p.m. Ante-natal Visits. The visits to expectant mothers are of the greatest value. Home conditions are seen, difficulties discussed, the mother's confidence gained, and the importance of early booking explained to her. Many visits are paid re failure to keep appointments at the Antenatal Clinics, or at St. Andrew's Hospital. Requests were received from various Hospitals outside the Borough asking that mothers who had booked with them might be visited. This was done and reports sent to the respective Hospitals. Clinics. (See Table, page 117.) Infant Consultations.—One of the difficulties is to secure the attendance at the Clinics of the 3-5 year-olds, especially if they are going to school. The mothers are being urged to bring them at regular intervals until they are 5 years old. Ante-natal Clinics.—The Ante-natal Clinics have been well attended, and the increased co-operation with all those concerned with the care of the expectant and lying-in mothers has made the work more satisfactory. The mothers are realising the advantage of medical supervision during pregnancy. Here, also, the importance of early booking is explained to the mother. There was one maternal death amongst the mothers who attended the Borough Ante-natal Clinics (whole Borough). Post-natal Clinics.—The number of mothers attending this Clinic is increasing yearly:— 1935 80 1936 120 114 But there is still much to do through visiting and propaganda to convince the mothers of the value of a complete examination within six weeks of delivery. Mothers are so inclined to accept without complaint backache and a general feeling of ill-health after confinement; and it is only by explaining to them that it is to avoid these complaints, and to avert unnecessary suffering, that post-natal supervision is provided, and if more serious conditions are discovered these can be remedied in the early days with the minimum of difficulty. Talks on Health and Housewifery. During the latter part of the year talks were given on economical and efficient catering and cooking, and after the installation of the electric cooker at Simpsons Road Clinic we were able to give practical demonstrations. It was emphasised that unsuitable, badly chosen food and careless cooking caused as much malnutrition as too little food, and that the most expensive foods are far from being the most nutritious. The talks included "Thinking Ahead and Planning," "Food Values," ' 'Shopping and Storing.'' Economical dinners were planned and cooked. The mothers were keenly interested and took notes. Some most satisfactory reports have been received from the families of mothers who have carried out the instructions received at the Clinic. Our thanks are due to the voluntary workers at the Clinics and to the Royal College of St. Katharine for their ready help in all things concerning the welfare of the mothers and children of the Borough. Also to the Societies who have given grants towards the cost of artificial dentures. 115 Ante-Natal Clinic, Public Health Department. 1,151 live births and 36 stillbirths were notified in the area served by the Public Health Department during the year 1936. The following table shows the distribution of these births:— Live Births. Stillbirths. Doctors' patients 93 3 Midwives' patients 312 3 St. Andrew's Hospital 399 16 East End Maternity Hospital 183 7 Other Institutions 164 6 Per Registrar's Returns (information not ascertainable) — 1 1,151 36 Of this number the following attended our Ante-Natal Clinics:— Doctors' patients 6 Midwives'patients 170* St. Andrew's Hospital 305 East End Maternity Hospital 15 Other Institutions 11 507 * This number refers to the cases in the practices of private midwives. The patients of midwives attached to nursing associations attend the associations' antenatal clinics. Clinic Attendances. Number of individual patients 716 New Cases 642 Total attendances 2,390 Average attendance per session 16.4 (compared with 30.3 at R. Coll. double sessions) Home Visitation by Health Visitors. First visits 837 Revisits 1,552 116 STATISTICAL SUMMARY OF HOME VISITING FOR 1936. Public Health Department. The Royal College of St. Katharine. Total 1936. Total 1935. Cases Visits. Cases Visits. Cases. Visits. Cases. Visits. Ante-Natal:— No. of Cases 837 — 664 — 1,501 — 1,496 — Primary visits — 837 — 664 — 1,501 — 1,496 Re-visits — 1,552 — 1,845 — 3,397 — 3,678 Infant Child Welfare visits:— Primary visits (Infants) — 1,079 — 935 — 2,014 — 2,112 Removed before visit — 18 — 33 — 51 — 80 Died before visit — 21 — 15 — 36 — 45 Stillbirths — 31 — 33 — 64 — 70 Re-visits— Under 1 — 7,790 — 8,860 — 16,650 — 17,981 1—5 — 19,023 — 21,646 — 40,669 — 44,172 Removed — 775 — 675 — 1,450 — 1,475 Died — 60 — 64 — 124 — 76 ‡Ophthalmia Neonatorum:— No. of Cases notified 5 — — — 5 — 10 — Primary visits — 5 — — — 5 — 10 Re-visits — 14 — — — 14 — 14 Removed to Hospital 4 — — — 4 — 5 — *Enteritis:— (a) No. of Cases reported — — — — — — 3 — (a) Primary visits — — — — — — 3 Re-visits — — — — — — — 4 Removed to Hospital — — — — — — — — Died — — — — — — — 2 (b) No. of Cases notified (Z.E.) 14 — 28 — 42 — 22 — (b) Primary visits — 14 — 28 — 42 — 22 Re-visits — 5 — 59 — 64 — 52 Removed to Hospital 28 — — — 28 — 2 — Died — 4 — 10 — 14 — — Measles:— No. of Cases under 5 years 744 — 554 — 1,298 — 35 — Primary visits — 744 — 554 — 1,298 — 35 Re-visits — 256 — 246 — 502 — 10 Removed to Hospital 377 — — — 377 — 22 — Died — 22 — 19 — 41 — — Primary visits:over 5 years — 461 — 265 — 726 — 8 Re-visits — 118 — — — 118 — 6 Whooping Cough:— No. of Cases 332 — 170 — 502 — 540 — Primary visits — 332 — 170 — 502 — 540 Re-visits — 139 — 120 — 259 — 334 Removed to Hospital 57 — — — 57 — 55 — Died — 4 — 10 — 14 — — †Puerperal Fever:— No. of Cases notified 5 — — — 5 — 11 — Primary visits — 5 — — — 5 — 11 Re-visits — 10 — — — 10 — 18 Removed to Hospital 5 — — — 5 — 11 — Died:— (a) Notified Cases.. 3 — — — 3 — 4 — (b) Non-notified Cases — — — — — — 2 — †Puerperal Pyrexia:— No. of Cases notified 15 — — — 15 — 19 — Primary visits — 15 — — — 15 — 19 Re-visits — 31 — — — 31 — 32 Removed to Hospital 14 — — — 14 18 — Died 1 — — — 1 — — — Maternal Deaths:— Maternal Deaths (number) 6 — — — 6 — 10 — Primary visits — 6 — — — 6 — 10 Re-visits — 16 — — — 16 — 28 Miscellaneous Visits — 730 — 451 1,181 — 1,150 Total Visits:— Primary — 3,568 — 2,697 — 6,265 — 4,461 Re-visits — 30,549 — 34,005 — 64,554 — 69,033 Total Visits paid, 1936 — 34,117 — 36,702 — 70,819 — — Total Visits paid. 1935 — 34,243 — 39,251 — — — 73,494 * Zymotic Enteritis is notifiable from 1st June to 30th September. † All cases are visited by Health Visitors of the Public Health Department. Enquiries re Maternal Deaths are made by the Public Health Department. 117 The following table shows the attendances at each of the Clinics during the year 1936:— Bow West Ferry Road. Manchester Road. Simpsons Road. Wellington Road. P.H. Dept. Total. Royal College of St. Katharine Total. Ante-Natal Clinics:— Attendances 762 — — 1,279 349 2,390 1,516 Average per session 15.2 — — 18.3 13.4 16.4 30.3Dble. Session. Infant Consultations:— First attendances 241 133 152 226 229 981 919 Total attendances 6,395 3,986 5,882 6,706 6,889 29,858 18,420 Average per session 62.7 79.7 56.6 64.5 67.5 64.6 73.7Dble. Average attendance of Session. each child 9.6 9.5 12.5 8.5 8.6 9.4 8.1 Light Clinics:— Attendances — — — 3,481 5,672 9,153 3,347 Average per session — — — 15.6 19.6 17.8 15.9 Dental Clinics:— Attendances — — — — 1,362 1,362 1,112 Average per session — — — — 13.0 13.0 9.4 Sewing Class — — — 1,086 — 1,086 1,658 Garden attendances — — 2,125 Mothers' Clinic (PostNatal) 250 250 524 Remedial Clinic — — — — — — 776 Total attendances at all Clinics:— 1936. 1935. P .H. Department 44,099 45,101 Royal College of St. Katharine 29,478 33.253 Total 73,577 78,354 Special Ante-Natal Consulting Clinic—St. Andrew's Hospital. The number of patients seen at the Ante-Natal Consultation Clinic was as follows:— (a) Referred by private practitioners 13 (b) Referred by clinic medical officers 30 43 118 Sale of Food Accessories, etc. The following table shows the sales of food accessories, simple remedies, and materials for making clothing, which are sold at cost price to mothers attending the clinics, and payments at clinics for various services:— £ s. d. Dried Milk, 8,108 lbs 574 6 4 Special Milk, 465 lbs 32 18 9 Dried Milk, Humanised, 115 lbs 11 10 0 Aberdeen Emulsion 1 12 0 Dusting Powder 12 0 Medicinal Paraffin 6 7 5 Medical Sundries 15 7 2 Dentures 103 17 3 Materials at Sewing Class 14 18 6 Convalescent Treatment 12 10 6 Virol 16 15 6 Oil and Malt 66 10 7 Concentrated Food 73 1 3 Payments for Gas (Dental Clinic) 4 5 0 Accouchement Sets 7 0 Cod Liver Oil 20 9 8 Total £963 0 11 In addition to the foregoing, by arrangement with local chemists, vouchers are issued for certain food accessories, etc., to be supplied by the chemists at cost price. i ,300 such vouchers were issued during the year. Convalescent Treatment, etc. Convalescent Treatment (mothers with babies) 36 cases. ,, ,, (mothers alone) 2 ,, ,, (children under 5 years) 27 Loan of maternity bag, containing clothing, etc. 18 Grants by Maternity and Child Welfare Committee during the Calendar Year, 1936. Part payment of Midwives' Fees 28 (at 13s. 6d.). Compensations to Midwives 9 (10s. in each case). Maternity Outfits at half-price 54 119 The Committee provided dentures to three necessitous mothers who were unable to complete their payments, the cost to the Committee being £5 0s. 6d. [The following tables refer to the whole Borough.) Statistics Respecting Infants Born in 1935. All births, including those occurring in outlying districts, but belonging to the Borough 2,370 Doctors in attendance 243 Midwives in attendance 702 Delivered in institutions 1,420 Not stated 5 Moved into Borough 148 2,518 Stillborn (Stillbirths per 1,000 births, 25.2) 70 Died before visit 49 Not requiring or desiring visits 68 – 187 Visited 2,331 Removed within the year 402 Died during visitation 95 497 Remaining under supervision end of first year 1,834 Mortality per 1,000 visited 40.7 The 1,834 children visited during 1935 and remaining under supervision at the end of their first year of life, were fed during the first six months of life as follows:— Breast-fed 71.9 per cent. Mixed feeding 20.4 „ Hand-fed 7.7 „ The 95 children who died during the first year of life, were fed during the first six months of life as follows:— Breast-fed 22.1 per cent. Mixed feeding 35.8 „ Hand-fed 42.1 „ 120 Below is a statement comparing the mortality rates per 1,000 visited of children fed by the various methods:— (a) Babies breast-fed 16 (b) „ who received mixed food (breast and hand) 83 (c) ,, hand-fed 221 S tillbirths. (This refers to the whole Borough.) 65 Stillbirths were investigated during the year 1936. Number of Stillbirths 66 Doctors in attendance 3 Midwives in attendance 8 Delivered in Institutions 53 B.B.A 1 (Doctor's case) One other stillbirth was registered, but information regarding this could not be obtained. Ophthalmia Neonatorum. Five cases of Ophthalmia Neonatorum were notified during the year:— (This table refers to the whole Borough.) Year. Cases. Vision unimpaired. Vision impaired. Total Blindness. Deaths Notified. Treated. At home. In hospital. 1927 48 44 4 48 — — — 1928 59 48 11 58 — — 1 1929 56 51 5 56 — — — 1930 42 38 4 42 — — — 1931 37 36 1 37 — — — 1932 27 18 9 27 — — 1 I 933 23 15 8 23 — — — 1934 21 10 11 21 — — — 1935 10 5 5 10 — — — 1936 5 1 4 5 — — — 121 Cases Notified and Visited. Number of notifications received 5 Very slight cases 1 Sight of one eye damaged — Recovered 5 Occurred in Institutions 4 Occurred in the practice of medical practitioners — Occurred in the practice of midwives 1 Admitted to hospital as in-patients 4 Treated as hospital out-patients 1 Treated privately — Visited by nurse 2 Zymotic Enteritis. During the months of June, July, August and September the clinical condition of Enteritis and vomiting is notifiable in this Borough, and during that period of 1936 there were 42 cases notified in children under five years of age and of these 13 died—12 under 1 year of age and 1 two years of age. Of the 42 cases notified 35 occurred at home and 7 in institutions. Fourteen of the cases were treated at home and 28 in institutions. Of the 14 treated at home one died, and of the 28 treated in institutions 12 died. In spite of careful inquiries no common factor was discovered. Summary of Cases under Five Years of Age. Month Notified. Number of cases Place of onset. Treated. Died. At home. In Institution. At home. In Institution. At home. In Institution. June 10 9 1 5 5 1 3 July 15 12 3 4 11 — 6 August 9 9 — 5 4 — — September 8 5 3 — 8 — 3 Totals 42 35 7 14 28 1 12 Age Groups:— Under 1 year 28 1 to 2 years 11 2 to 3 years 2 3 to 4 years 1 4 to 5 years — 42 122 The 28 cases under one year of age were fed as follows:— Breast-fed, 4; Mixed feeding, 4; Hand-fed, 20. (Note.—See comments by Medical Officer of Health in the section relating to Infectious Diseases, page 92.) Home Nursing. By arrangement with the Nursing Associations nursing is provided (with the consent of the practitioner attending a patient) and paid for by the Council at the rate of is. 3d. per visit, in cases of Ophthalmia Neonatorum, Measles, Whooping Cough, Pneumonia, Zymotic Enteritis, Pemphigus, Puerperal Fever and Puerperal Pyrexia. The following is a summary of visits paid by Nurses during 1936:— (This table refers to the whole Borough.) E.L.N.S. St. John Divine. St. John's Isle of Dogs. Totals. Cases Visits. Oph. Neon. Cases 2 — 2 Visits 51 — — 51 Slight Inflamma tion of Eyes* Cases 22 2 2 26 — Visits 268 13 13 294 Measles Cases Under 5 91 16 24 131 — 5-10 49 6 3 58 — Visits Under 5 1,124 269 258 1,651 5-10 644 73 35 — 752 Pneumonia Cases Under 5 28 2 — 30 — 5-10 8 — — 8 — Visits Under 5-10 383 12 — — 395 5-10 162 — — 162 Pemphigus Cases 4 — 1 5 — Visits 54 — 16 — 70 WhoopingCough 4 — — 4 Visits Under 5 82 — — — 82 Zymotic Enteritis Cases — — — — — Visits — — — — — Puerperal Pyrexia Cases — — 1 1 — Visits — — 11 — 11 Totals Cases 208 26 31 265 — Visits 2,768 367 333 — 3,468 *Reported by L.C.C. 123 The following table relates to visited children of ages 1 to 5 years:— Year of Birth. 1931 1932. 1933. 1934. Remaining under supervision: End of first year — — — 1,877 ,, second year — — 1,803 — ,, third year — 1,942 — — ,, fourth year 1,921 — — — Inward Transfers 128 112 120 109 Visits discontinued — — 2 3 Outward Transfers 208 195 214 219 Died 8 12 15 27 Remaining under supervision: End of second year — — — 1,737 ,, third year — — 1,692 — ,, fourth year — 1,847 — — ,, fifth year 1.833 — — — Mortality per 1,000 visited: Second year — — — 13.6 (9.2) Third year.. — — 7.8 (7.0) — Fourth year — 5.8(4.8) — — Fifth year 3.9 (3.1) — — — The figures in parentheses are the rates for the previous years. Maternal Deaths.—The Council agreed that the investigation of maternal deaths should continue to be carried out on the lines suggested by the Ministry of Health. There were 7 deaths associated with pregnancy, etc., investigated and the maternal mortality rate was 3.22 per 1,000 total births (live and still.) (Note.—The Registrar-General's return quoted earlier in this Report shows only 4 maternal deaths, giving a rate of 1.84 per 1,000 total births.) 124 List of Maternal Deaths. Cause of Death. Attended at Institution. Attended at home by Treated in Institution subsequently. No. of previous pregnancies. Received Ante-natal care or Treatment at M.C.W. Clinic. Elsewhere. Puerperal Sepsis (1 case). Septicaemia. Haemolytic streptococcal septic infection of uterus after miscarriage (10 weeks pregnancy). Natural causes P.M. Inquest — Doctor (emergency) Yes. 7 — — Other Puerperal Causes (3 Cases). (1) Pulmonary embolism due to recent delivery of stillborn child. Coroner's P.M. without Inquest Yes. — Yes. — — Yes. (2) Acute oedema of lungs. Cardiac failure. Postpartum shock — Doctor. No. 1 — (3) Septicaemia. Mammary abscess Yes. — Yes. 2 Yes. — Other Deaths Associated with Pregnancy (3 Cases). (1) Auricular fibrillation. Mitral stenosis. Fulltime confinement, 23/4/36 (Classified to Heart Disease.) Yes. — Yes. — — Yes. (2) Septic infection of uterus and miscarriage after irrigation with fluid. Self-induced miscarriage. P.M. (Classified to Suicide.) — Doctor (emergency) Yes. 1 — — (3) Carcinoma of rectum. Delivery of full term stillborn child (Classified to Cancer.) Yes. — Yes. 9 — — 125 The Council have given serious consideration to the question of maternal mortality, and for some years past arrangements have been made with a Consulting Obstetrician to visit cases of Puerperal Fever and Puerperal Pyrexia in consultation with general practitioners (see page 87). The arrangements made with two Consulting Obstetricians for their services to be available at the request of a general practitioner attending any midwifery case which presented special difficulty or abnormality at or after the confinement, were continued for 12 months from 1st April, 1936. (During 1936, a Consulting Obstetrician was called in to one case.) Infantile Mortality. The infantile mortality rate was 72. Infant Life Protection. Number of Foster Mothers under supervision at 31st December, 1936 13 Number of Foster Children under supervision at 31st December, 1936 13 Number of new Foster Mothers registered during 1936 5 Number of children legally adopted during 1936 1 Number of children who attained the age of 9 years during 1936 1 Under Supervision during some part of 1936:— Foster Mothers 26 Foster Children 31 Number of visits:— Chief Health Visitor, or Deputy 208 Male Inspectors 20 The Foster Mothers and homes are all satisfactory and although in some cases the payments are in arrears, this has made no difference to the way in which the children have been cared for. The health of the children was good. Those under 5 years of age attend the Infant Welfare Consultations. 126 Student Health Visitors. During the year five Student Health Visitors from the Royal College of Nursing have been given a course of practical training. Post-Graduate Course. Two Health Visitors attended a Post-graduate Refresher Course during the year. Training of Probationers at the Observation Wards. As in previous years lectures have been given by the Matron, and the Probationers have also attended the Courses arranged by the National Society of Day Nurseries. Observation Wards. Report of Dr. H. St. H. Vertue, Consulting Physician at the Maternity and Child Welfare Observation Wards. In-patients. Total Admissions during the Year 63 Nature of Cases admitted:— Malnutrition 15 Difficulty in Artificial Feeding 12 Neurosis 12 Rickets 13 Debility after Illness 6 Difficulty in Breast Feeding 2 Miscellaneous 3 63 Results of Treatment:— Recovered 42 Improved 18 Transferred to Hospital 2 Died 1 Remarks.—We continue to note a number of cases of rickets, mostly of minor degree, but undoubtedly rickets. In view of the availability of free cod-liver oil, free milk and sunlight treatment this fact indicates 127 that there is still much to be done in education on matters of diet and hygiene. We also note the number of neurotics, mostly food-refusers and screamers. This class of case takes a bigger and bigger preponderance nowadays. But I have dealt with this matter in a previous report. On the other hand not so many babies are artificially fed by hopelessly wrong and mistaken methods as formerly; nor are severe disturbances due to bad methods (or no methods) of bottle-feeding as common as they were. It should be stated, too, that though rickets still occurs fairly frequently it is of much less degree than it used to be. Really gross rickets (florid rickets as it is called) is becoming a rarity. We have to chronicle with regret the departure of Sister Boone, who during her years as Sister in the Observation Wards won such golden opinions from staff and parents alike. We extend a cordial welcome to Sister Walker in her place. Out-patients. Total Attendance at Out-patients 329 Number of New Patients 167 Nature of New Cases seen:— Difficulty in Breast Feeding 74 Difficulty in Bottle Feeding 9 Cases for Admission 52 Various Consultations 32 Remarks.—The different classes of case sent for consultation are too numerous to describe in detail, but they make a varied and interesting part of the work. Assistance in breast-feeding is regarded as one of our most important activities. There were 369 attendances for testfeeding and re-establishment. I append the results obtained:— On the Breast only 36 Partly breast-fed and partly artificially-fed 28 Artificially-fed only 2 Failed to complete attendances 8 Failure to breast-feed is still far too common. It is an open question whether more babies would not be breast-fed if other foods were not so "puffed." In this respect, however, the mothers of Poplar show a far better record than would be obtained from those who, having more means and time, ought to set a good example in this and signally fail to do so. H. ST. H. VERTUE, M.D. 128 Artificial Sunlight Treatment. Report of Dr. E. M. Layman, the Medical Officer in charge of Light Clinics. I have pleasure in submitting my report on the work of the Light Clinics during the past year. 347 children and 60 mothers remain for report, after omitting those who failed in attendance. Of the 347 children, a further 15 unfortunately made scant or irregular attendance, often unavoidably. No results can be recorded of these. The attending children, 332, are classified as follows:— Rickets (14 severe, 12 mild) 26 cases (A few of the mild cases were purely muscular in type.) Knock Knee 10 ,, Disturbed Dentition 102 ,, Malnutrition 43 ,, Debility 84 ,, After Illness 37 ,, Prematurity 12 ,, Enlarged Tonsils, Adenoids and Adenitis 9 ,, Various Disorders 9 ,, Results Obtained in these Groups. Marked Success Success Moderate Success Failed to Improve Rickets 26 8 11 7 0 Knock Knee 10 2 4 3 1 Disturbed Dentition 102 43 49 10 0 Malnutrition 43 18 11 11 3 Debility 84 25 24 25 10 After Illness 37 14 15 6 2 Prematurity 12 6 4 2 0 Enlarged Tonsils, etc. 9 3 3 2 1 Various Disorders 9 2 2 2 3 Total 332 121 123 68 20 129 Notes on the Groups. Rickets. A long course is required, and eventually marked improvement is obvious or often a complete cure. The mothers, who persevered admirably in attending, have been rewarded by seeing the good effects. One or two severe cases of bony change were referred to Hospital and had more drastic treatment, returning after this for more Light. The slighter cases recovered. Disturbed Dentition. I here include the numerous ailments associated with teething, some of which are severe afflictions which deprive the child of sleep. Response to ultra violet ray is almost always prompt and good, the calming effect being especially noticeable (and welcomed) in the home. The general health, pari passu, markedly improves. Debility. I have sub-divided this group, classing 23 as cases of Nervous Debility. This well-worn diagnosis might be replaced by the term Emotional Maladjustment. These children, in poor health and appetite, were unhappy, unstable, morbidly solitary and so on. Jealousy was an obvious cause in some, and often unconscious. I am pleased to find that the combined physical and mental tonic of the Clinic greatly aided the patients in their recovery. They are an important group, since the unconscious enjoyment of life in childhood is irreplaceable afterwards. A few ("failures") among the badly debilitated had to be recommended for convalescent treatment as they needed change of air, diet and environment. Prematurity. It is generally accepted that all premature infants need "plenty of sunshine." This small group responded very well to ultra violet rays, and I hope more cases will come to us. Mothers. Of the 60 mothers reported on, two were referred for necessary hospital treatment early in the course. The remaining 58 I classify with the results obtained. 130 Marked Success Success Moderate Success Ante Natal and Post Natal 18 9 7 2 Rheumatism and Neuritis 14 9 3 2 Debility 16 7 5 4 Various Disorders 10 2 5 3 Total 58 27 20 11 In addition to definite cure, or relief, of distressing symptoms, mothers often tell us of the added sense of well-being they experience under ultra violet rays. I hope more mothers will make time to come on their own account. Too many, while sparing no effort for the children, persistently ignore their own health. I appreciate, however, the practical home difficulties of attendance in many cases. In conclusion, I thank all concerned in the work of the Light Clinics for their steady interest and aid. I am deeply indebted to the Sister-inCharge for her unvarying devotion to the needs, comfort and happiness of children and mothers, and I much appreciate the efficient running of the Department in her hands. E. M. LAYMAN. Statistical Summary. January 1st to December 31st, 1936. Bow. Poplar. Totals. Number of attendances 5,672 3,48I 9,153 ,, ,, sessions 290 223 513 ,, ,, patients 349 267 616 131 Royal College of St. Katharine. Report of Dr. H. K. Waller, Senior Medical Officer of the Royal College of St. Katharine. Statistics for the year ended 31 st December, 1936. (Figures for the same period last year are included for comparison.) Number of Visits. 1935. 1936. First visits to Expectant Mothers 641 664 Re-visits to Expectant Mothers 1,890 1,845 First visits to children 1,142 1,016 Re-visits to children 35,578 33,177 39.251 36,702 Total number of children on register 4,797 4,579 Attendances at Clinics. Infant Clinics. New cases 908 919 Attendances—Under 1 year 9.305, 8,509 1—3 years 7,825 6,757 3—5 years 3,957 3,154 21,087 18,420 Average attendance per clinic 84.35 73,7 Number of individual children 2,354 2,251 Number of individual mothers 1.937 1,818 Ante-Natal Clinics. New cases 502 489 Total attendances 1,455 1,516 Average attendance per clinic 27.9 30,3 Number of individual mothers 559 537 132 Mothers' Clinics. 1935. 1936. New cases 231 188 Total attendances 654 524 Average attendance per clinic 13.08 10.5 Number of individual mothers 274 213 Dental Clinics. Mothers. New cases 179 142 Total attendances 812 652 Average attendance per clinic 11.27 9.2 Number of individual mothers 318 261 Children. New cases 253 199 Total attendances 672 460 Average attendance per clinic 13.4 9.4 Number of individual children 343 238 Artificial Sunlight Clinics. New cases 191 206 Total attendances 3,284 3,347 Average attendance per clinic 16.58 15.9 Number of individual children 212 239 Number of individual mothers 5 6 Garden attendances for open-air treatment 2,596 2,125 Remedial Exercises and Massage Clinics. New cases 73 67 Total attendances 986 776 Average attendance per clinic 10.6 8.8 Number of individual children 80 76 Number of individual mothers 11 7 Sewing Class. New cases .. 55 68 Total attendances 1.707 1.658 Average attendance per class 38.8 37-7 Observation Ward. Number of children admitted 59 65 Average duration of stay .. .. days 41-37 40.4 133 Tonsil Clinic. 1935. 1936. Number of children admitted 118 100 Average duration of stay days 5 5 Out-Patients ' Departments . Test-Feeding Department. Total attendances 971 1,228 Number of mothers who attended with their babies for test feeds 216 184 Treatments. Mothers. Total treatments given to mothers 386 152 Number of individual mothers treated 74 44 Children. Total treatments given to children 2,133 2,809 Number of individual children treated 392 409 The rest of the work in this Department is the treatment of minor ailments, such as conjunctivitis, otitis media, eczema, impetigo and other skin affections. Breast-Feeding Cases. Total women referred 184 Attendances 1,228 Average attendance per woman 6.5 Treatment. Mothers 44 Attendances 152 Children 409 Attendances 2,809 In about as many again bottle-feeding had, at the first attendance, been too long in existence to make the attempt to change worth while. Ante-Natal Department. Births. In the area allotted to St. Katharine's there were 1,015 live and 30 still-births during the year, making a total of 1,045. There were 11 cases of twins. 134 Attended St. Katharine's Ante-Natal Clinic. Doctors' patients 118 6 (5.0%) Midwives' patients 284 145 (51.0%) St. Andrew's Hospital 421 255 (60.6%) East End Maternity Hospital 167 11 (6.5%) Other institutions 55 1(1.8%) 1,045 418 In all 537 individual patients have attended this Clinic during the year, making 1,516 visits, or 2.8 visits apiece. The average attendance per Clinic has been 30.3. There were 489 new cases during the year. The detection of anaemia by estimating the percentage of haemoglobin is now conducted as a routine. This work is done by voluntary assistants, using the acid haematin method. Ferrous carbonate in capsules of to grains is the form of iron now prescribed and is well taken. Its distribution is easier than the Mist. Feri et Ammon. Citratis, and it is better tolerated during pregnancy than ferrous sulphate. Improvement from 30 per cent, to 90 per cent, has been recorded. Post-Natal Department. 213 women have been seen during the year, 188 being new cases. They have averaged 2.5 visits apiece. The total attendances have been 524, or 10.5 per session. Of these a large proportion have been seen soon after delivery in connection with insufficient lactation. The commonest findings are uterine sub-involution and anaemia. They respond well to treatment with ergot and iron. Observation Ward. 64 infants were admitted to the cots during the year and made an average stay of 40 days each. The reasons for admission were as follows:— Nutritional disorders 21 Illness of Mother 12 Preparation for tonsillectomy 10 Recovery from tonsillectomy 6 Otitis Media 6 Nervous disorders 3 135 Skin diseases 2 Rickets 1 Asthma 1 Fibrosis of lung 1 Congenital heart disease 1 64 Results of admission Fully recovered 33 Improved 27 Not improved 2 Transferred to Hospital 1 Died 1 64 In addition 100 children were admitted for the surgical removal of unhealthy tonsils and adenoids. All made good recoveries. The routine length of stay in the ward for this operation is 5 days. Specially delicate children are admitted earlier and kept longer afterwards. Out-Patient Department . The work of this department falls into two categories. The first and more important is the investigation of difficulties in breast-feeding. A large number of women are referred from the infant clinics for their powers of nursing to be ascertained, and in the course of the year a good many instances of threatened failure are corrected and attain to full lactation. A high proportion are due solely to the need of detailed instruction in the technique of nursing. The special importance of these is that they occur in the early weeks and at a stage when mistakes in artificial feeding are of great danger to the child. Thus an instance was met of a baby under a month of age having been taken off the breast and given seven times the appropriate daily allowance of food; another of the same age was receiving a fifth of what it needed. Both babies were restored to breast-feeding. It is clear from a study of the cases seen that an abundance of milk during the lying-in period is no guarantee of its continuance. From the reports received from midwives and lying-in institutions there is no doubt the early promise of easy breast-feeding must often be 136 deceptive, and that the difficulties encountered later are not at that stage expected to arise. In about half our cases a forecast of success has been contradicted within a few weeks. For this reason it would be of the greatest assistance to the mothers, as well as of benefit to the babies, if those in charge of the lying-in period would advise their patients that despite a promising beginning difficulties in breast-feeding are quite likely to be encountered later, but that with a little help and supervision they can usually be overcome. This is particularly needed in the case of first confinements. If a confident forecast that feeding is securely established has been conveyed, the health visitor has often great difficulty in persuading a woman that she should have the point confirmed by attending the clinic. As would be expected the amount of improvement which can be effected in cases where the yield of milk is declining, becomes less as the interval after delivery lengthens. Up to the end of the fourth week a few days attendance is usually sufficient, after that it has to be longer. Success is then less likely, not only because the degree of involution is greater, but also because the necessary visits are often more than the women can manage if their homes are situated any distance away. 184 women were referred to the department during the year, or roughly a sixth of the number delivered in the area. Had they been seen at the clinics early enough it is probable that twice the number could have been helped that were in fact helped either to improve or safeguard their powers of breast-feeding. The rest of the work in this department is the treatment of minor ailments such as conjunctivitis, otitis media, eczema and impetigo. Lactation Cases. Women referred 184 Average attendance 6.5 Total attendances 1,228 Treatment Cases. Women 44 Attendances 152 Children 409 Attendances 2,809 137 Maternity and Child Welfare Dental Clinic. Report of Mr. C. Hammond Williams, L.D.S., R.C.S. (Eng.), Dental Surgeon in Charge of the Maternity and Child Welfare Dental Clinic. I beg to submit my report of the dental work carried out in connection with the Maternity and Child Welfare Department for the year ended 31st December, 1936. The following is a summary:— 104 Sessions have been held. 1,362 Total attendances. 102 Permanent teeth have been filled. 266 Temporary teeth have been filled. 40 Permanent teeth extracted with local anaesthesia. 1,242 Permanent teeth extracted under nitrous oxide anaesthesia. 1,405 Temporary teeth extracted under ethyl chloride anaesthesia. 197 Scalings. Dressings, dentures and minor treatment also. 441 New patients have been seen during the year, and an average of just over 13 patients has been maintained per session. I have to report on the innovation adopted last January of holding two regular sessions per week, which has resulted in increasing the total number of sessions by 30. The result of this increase in working time is the number of temporary teeth saved and a considerable increase in the number of scalings. I am particularly glad to report on the former of these two items, as formerly it was distressing to be able to undertake the extractions only, leaving teeth slightly decayed which could only result in the necessity for further extractions in a comparatively short time. As regards the latter item, the increase is very gratifying too. Scaling and gum treatment generally are of the greatest importance in maintaining a healthy oral condition. During the year I have noticed the increase in the number and type of patients who are keen to keep their own teeth healthy, and every encouragement should be afforded here. 138 It will be observed that the attendance per session has been lowered from 17 to 13. This, as I explained in my last report, is necessary to give time for the conservative work done. A considerable increase in the number of new patients will be noted. This, again, is a very good sign, and coupled with the fact that old patients return for further treatment when necessary, signifies that our efforts are successful. As far as other items of treatment are concerned, our figures compare very favourably with those of 1935. A considerable number of dentures has been fitted, and in this connection I may add that we supply dentures at a figure very considerably below hospital prices. Even so, in many cases the cost is beyond the means of some of our patients. I should be glad if I may take this opportunity of thanking again all those whose help and co-operation in running the dental clinic is so very valuable to me. C. HAMMOND WILLIAMS, L.D.S., R.C.S. (Eng.). Supply of Milk to Expectant Mothers. In the early part of the year the Council, upon the recommendation of the Maternity and Child Welfare Committee, resolved that in addition to supplying milk during the last three months of pregnancy, milk be supplied to those expectant mothers coming within the Council's scale at any period of pregnancy when specially recommended by Clinic Medical Officers. Free Milk Scheme. Milk is supplied to expectant and nursing mothers and to children under 3 years of age (in special circumstances 5 years). Dried milk is supplied under the scheme, with the exception that Tuberculin Tested milk is supplied in special cases (infants) where the Medical Officers in charge of the Council's Child Welfare Clinics consider its use specially desirable. It is a condition of the supply of free milk that unless prevented on medical grounds, all recipients should be seen at regular intervals at their nearest Maternity and Child Welfare Centre. 139 During the 53 weeks ended 2nd January, 1937, 8,661 applications for free milk were received, of which 7,439 were granted. (The number of persons granted milk was 10,830.) Orders were issued for 98,000 pints of Tuberculin Tested milk, and 33,295 pounds of dried milk, the total commitments amounting to approximately £3,984. In addition, orders were issued for 1,569 bottles (40Z.) of iron solution and 12,077 bottles (40Z.) of cod liver oil. 547 cases were investigated by the Enquiry Officer. All cases were found satisfactory. Distribution from ist January, 1936, to 31ST December, 1936. "A." lbs. "G." lbs. "S." lbs. C.L.O. (40Z. bottles.) Iron Solution. (40Z. bottles.) Double strength 23,252 5.033 3,061 11,067 575 457 The following table shows in comparative form the applications, etc., during the last ten years:— Year. Applications. Applications granted. Cost (approx) £ Orders issued. Cases investigated by I.O. Unsatisfactory cases. Fresh. (Pints) Dried, (lbs.) 1927 11,702 11,117 5,961 294,515 16,896 598 10 1928 8,449 7,772 3,090 11,639 40,909 343 2 1929 6,849 6,146 2,471 16,810 30,729 588 - 1930 7,216 6,693 2,820 28,247 33,147 610 2 1931 10,562 8,816 3,718 57,736 39,366 656 1 1932 14,914 13,213 5,459 73,512 60,094 633 - 1933 15,859 13,878 5,845 78,373 64,206 646 - 1934 12,762 11,098 5,069 78,902 53,387 493 1 1935 10,568 9,348 4,807 109,102 42,626 384 - 1936 8,661 7,439 3,984 98,000 33,295 547 - Supply of Extra Nourishment—Co-operation with London County Council. The scheme of co-operation with the Public Assistance Committee has worked smoothly and no case has been reported to be adversely affected. The amount chargeable to the Public Assistance Committee during 1936 was approximately £860. 140 INDEX. Sections of the Report:— Page A. Statistics and Social Conditions 9 B. General Provision of Health Services 19 C. Sanitary Circumstances of the Area 24 D. Housing 47 E. Inspection and Supervision of Food 61 F. Infectious Disease 82 G. Maternity and Child Welfare 108 Age Mortality 17 Agricultural Produce (Grading and Marking) Act, 1928 79 Altered Diagnosis Cases 93 Analyst's Report 77 Ante-natal Clinics, Attendances:— (а) Public Health Department 115 (б) Royal College of St. Katharine 130 Ante-natal Consultant Clinic at St. Andrew's Hospital 125 Anthrax 86 Antitoxin, quantity issued 83 Area, Population, etc. 9 Artificial Sunlight Treatment 128 Bacteriological Examinations 83 ,, Examination of Milk 63 Bakehouses 67 Bed-bug Eradication 56 Births and Birth Rates 10, 14, 17 Butter and Margarine Factories 79 Canal Boats 39 Cancer, Deaths from 94 Cerebro-spinal Fever 87 Cleansing Station 102 Clinics, M. & C.W. Facing 108 Clinics, Tuberculosis 94 Combined Drainage 25 Committees 3 Common Lodging Houses 28 Consultants:— 1. Puerperal Fever, etc. 86 2. Obstetric 118 Continued and Typhus Fevers 87 Convalescent Treatment 111 Coroner's Court 18 Cowsheds 57 Customs and Inland Revenue Acts, Certificates 37 Day Nursery 109 Deaths and Death Rates 10-17 Deaths, Classified Causes, Table Facing 13 ,, Infantile, Table 13 Dentists' Reports 95, 134 Diarrhoea and Enteritis, Deaths 10 Diphtheria 82 Diphtheria Immunisation 82 Disinfectant, Electrolytic 103 Disinfecting Department 102 141 INDEX—(continued). Page Disinfestation 56 Dysentery 93 Electrolytic Disinfecting Fluid 103 Encephalitis Lethargica 87 Enteric Fever 83 Erysipelas 86 Exhumations 39 Export of Meat Foods 80 Factory and Workshop Acts—Tables 30-33 Food, Supervision of 61 Food and Drugs Acts, etc. 75 Food Inspectors' Reports 69-74 Food Poisoning 80 Free Milk Scheme 138 Fumigation by HCN 56 Glanders 86 Hairdressers' Premises 39 Health Education 105 ,, Scrvices 19 ,, Visitor, Chief, Report of 112 Home Nursing 122 Home Visiting Summary 116 Houses Let in Lodgings 27 Housing 47 Hydrophobia in Man 86 Ice Cream 66 Infant Life Protection 125 Infantile Mortality 10,13, 14 Infectious Diseases, Table of Notifications Facing 82 Infirm Persons, Removal 44 Inhabited Houses 9 Inquests 18 Lady Sanitary Inspector, Report 26 Lectures on Health Subjects 105 Legal Proceedings, etc. 40-44 Legislation 20 Malaria 93 Marriages 11 Maternal Mortality 10,14, 123 Maternity and Child Welfare 108 Measles 90 Meat Food Products, Certification 80 Merchandise Marks Act 79 Midwives' Fees and Compensations 118 Milk, Bacteriological and Biological Examinations 63, 64 Milkshops, etc. 61 Mortuary 18 Motor Vehicles 102 Neo-Natal Deaths 13, 14 Notifications of Infectious Diseases, Table Facing 82 Observation Wards 126 Offensive Trades 36 142 INDEX-(continued). Page Ophthalmia Neonatorum 120 Overcrowding 54 Overcrowding Survey 54 Parliamentary Wards, Statistics Map Facing 10 Pharmacy and Poisons Act 80 Plague 86 Pneumonia 92 Poliomyelitis, etc. 87 Poor Law Relief, etc. 19 Population 9 Post-vaccinal Encephalitis, etc. 90 Preserved Foods, Manufacture 79 Public Cleansing Services, etc. 24 Public Education in Health 105 Puerperal Fever and Puerperal Pyrexia 87 Rag and Bone Dealers 36 Rag Flock Act 39 Rags for Export 39 Rats and Mice Destruction Act 37 Refuse Disposal 24 Removal of Infirm Persons 44 Rent Restriction Acts, Certificates 36 Reports:— Artificial Sunlight Clinics, Medical Officer 128 Chief Health Visitor 112 Dental Surgeon (M. & C.W.) 137 Dental Surgeon (Tuberculosis) 98 Lecturer on Health Subjects 105 Observation Wards, Consulting Physician 126 Public Analyst 77 Royal College of St. Katharine, Senior Medical Officer 131 Tuberculosis Officer 94 Royal College of St. Katharine 131 Samples under Food and Drugs Act 75 Sanitary Inspectors' Work, Summaries 25-28 Scarlet Fever 82 Scavenging, Street Cleansing, etc. 22 Schools, Inspection of 39 ,, Use of Electrolytic Fluid in 103 Seamen's Lodging Houses 29 Shops Act 34 Slaughterer of Poultry 67 Slaughterhouses 67 Smallpox 83 Smoke Nuisances 34 Stables 37 Staff 4 Stillbirths 10, 120 Street Cleansing, etc. 22 Street Trading 37 Swimming Baths, etc. 35 Tables of Deaths 12-17 ,, of Infectious Diseases Facing 82 Tubercle bacilli in Milk, Examinations for 64 143 INDEX—(continued). Page Tuberculosis, Death Rate 17 ,, Deaths 101 ,, Notifications, etc. 100 ,, Officer's Report 94 Typhoid and Paratyphoid Fevers 83 Underground Rooms 53 Unhealthy Areas 51 Urinals on Licensed Premises 36 Vaccination 83-86 Verminous Children and Persons 102, 104 ,, Rooms 56 Vital Statistics, Summary 10 ,, ,, Tables 10-17 Wards Statistics, Map Facing 10 Water Certificates 36 Workshops. Workplaces, etc. (Tables) 30-33 Zymotic Diseases, Death Rate 17 ,, Enteritis 92 and 121