AC 4368 PoP 44 Metropolitan Borough of Poplar Annual Report for the YEAR 1938 on The Sanitary Condition and Vital Statistics of the Metropolitan Borough of Poplar by 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 Greesn. Metropolitan Borough of Poplar Annual Report for the YEAR 1938 on The Sanitary Condition and Vital Statistics of the Metropolitan Borough of Poplar BY W. ALLAN YOUNG, d.s.o., m.d., ch.b., d.p.h. Medical Officer of Health. 3 PUBLIC HEALTH COMMITTEE (November, 1937). Councillor Mrs. E. M. Lambert, J.P., L.C.C., Mayor (ex-officio). Chairman: Councillor J. A. Ashley. Vice-Chairman : Mrs. N. F. Cressall. Cllr. Andrews, W. Cllr. Ashley, J. A. (Ch.) Cllr. Butchins, S. Aid. Cressall, G. J., (from June, 1938) J.P. Cllr. Cressall, Mrs. N. F. (V.Ch.) Cllr. Edgett, G. E. Cllr. Fisher, J. Cllr. Goodway, T.J. Cllr. Hammond, J. A. (died June, 1938) Aid. Jones, J. H. Cllr. Pidwell, C. J. Cllr. Philp, F. C. Cllr. Stone, G. Cllr. Tremain, F. C. Cllr. Wooster, J. T. MATERNITY AND CHILD WELFARE COMMITTEE (November, 1937). Councillor Mrs. E. M. Lambert, J.P. L.C.C., Mayor (ex-officio). Chairman: Cllr. Mrs. A. I.. Harris. Vice-Chairman: Cllr. Mrs. L. M. Sadler. Cllr. Cressall, Mrs. N. F. Cllr. Fisher, J. Cllr. Harris, Mrs. A. L. (Ch.) Cllr. Hubbart, P. Cllr. Sadler, Mrs. L. M. (V.Ch.) Cllr. Sargent, A. R. Cllr. Shepherd, Mrs. A. I. Cllr. Sims, Mrs. E. Cllr. Stavers, Mrs. E. Cllr. Tanner, C. A. 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. 0. 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 Analysts (Part-time): ALBERT E. PARKES, F.I.C., F.C.S. H. A. PARKES, B.Sc., F.I.C. GENERAL PUBLIC HEALTH SECTION, PUBLIC HEALTH OFFICE. Chief Administrative Assistant: HAROLD DYER.f (a) H. A. Tibbatts.* (a) W. J. colborneff (a) H. J. Langley.*† (a) c. S. West brook. "J (a) Wm. J ohnson.*‡ (retired 4-7-38) (a) S. Kelly.* Sanitary Inspectors: (a) F. A. Smith.*‡ (a) A. L. Dove.††‡ (a) N. L. Brown. (from 11-4-38) (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.†‡ (e) I. M. G. FARRiES.†† (e) C. H. MEDLAND.††‡ Miss D. A. E. landray.¶*‡‡║ (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, F. S. Jolliffe (resigned 30-4-38), N. L. Brown (appointed Sanitary Inspector), C. J. Cooley (resigned 17-12-38), R. P. May, R. C. Parr and J. W. Dale (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. R. G. Anderson (Office Boy) Caretalcer 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 District Dr. M. Blasker. The Medical Superintendents of St. Andrew s Hospital, St. Clements Hospital 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: Dr. G. 0. Mitchell. Assistant Medical Officer of Health and Assistant Tuberculosis Officer : Dr. L. I). 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: MiiS. E. Tomuns (temporary). Caretaker: \V. J. Parker (retired 1st Aug. 1938) A on-resident Porter: I. Saint (from 3rd December, 1938.) DISINFECTING STATION, YEO STREET. Disinfectors: W. HodoeJ (Chief). F. Farrow. There are also two Apparatus Attendants and one Motor Driver. Four other men are employed in disinfestation work. Manufacture and Distribution of Electrolytic Disinfecting Fluid. Manufacturing: T. Kelleiier 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. Hooan. Belief Mortuary Keeper: C. Haoon. 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). Mrs. D. F. Egan, M.R.C.S., L.R.C.P., D.P.H. *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., R.C.S. (Eng.). Anaesthetist: S. Hutchinson, M.R.C.S. (Eng.), L.R.C.P. (Lond.). Chief Health Visitor: Miss J. M. Cardozo, JJ.iJ.C.'Utt Health Visitors: Miss E. A. Foskett.*¶ Mrs. M. J. Edqell.§¶ Miss M. Mallktt.* Mrs. E. K. Haythornthwaite.*¶ (c) Miss G. I. Hill*¶ (c) Miss E. D. Howlett*¶ (c) Miss B. E. Letts*¶ (e) Miss M. H. Sutcliffe*¶† (c) Miss E. A. H. Williams.*¶ Miss A. Eaton*¶ Sister-in-Charge Artificial Light Treatment. Miss J. Harris, Unqualified Assistant (Artificial Sunlight). Clerk: Miss K. D. Evans. Hon-Resident Porter at Old Ford Clinic; G. F. Geach. Observation Wards. Wellington Road, Bow, E.3. Consulting Physician: H. St. H. Vertbe, M.A., M.D., Ch.B. (Oxford.) Emergency Medical Officer: D. G. Macrae, M.R.C.S. (Eng.), L.R.C.P. (Lond.) Alatron-in-Charge: Miss A. C. Andrews.*¶ Sister: Miss K. Walker (resigned). Miss E. Johnson (from 1st March, 1938). Two Staff Nurses, three Probationers, one Cook, one Maid and a Porter. Free Milk Scheme. Clerks: Miss K. Phklan. 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) Now H.V. Certificate. 7 Public Health Department, Poplar Town Hall, Bow Road, E.3. 7th June, 1939. To the Mayor, Aldermen and Councillors of the Metropolitan Borough of Poplar. Sir, Ladies and Gentlemen, In submitting this report upon the health of the Metropolitan Borough of Poplar for the year 1938 I would remind the Council that the extra duties in connection with Air Raid Precautions and the Council's general instruction that such work is to take precedence over the ordinary work of the Department have resulted in considerable disturbance of the routine work during the last nine months. A special investigation which was being carried out at the request of the Minister of Health, concerning wells in the Borough and their association with London's underground water supply, has been unavoidably delayed. Statistics. It will be seen from the report that the rates for births, deaths and infantile mortality are slightly lower than the corresponding rates for the previous year, but, apart from the fact that the birth rate is the lowest recorded, there is nothing which calls for special comment. Maternity and Child Welfare. The new clinic at Old Ford is referred to on page 111 of this report and plans and photographs are shown. Conferences. The Council was represented at various Conferences during the year and reports of delegates have been submitted to the appropriate Committees. 8 Staff. A re-arrangement of the Inspectorial Staff was necessary as a result of Air Raid Precautions work. Once again I record my appreciation of the co-operation of members of the Council and Officers of other Departments and the loyal support of my staff. I am, Sir, Ladies and Gentlemen, Your obedient Servant, W. ALLAN YOUNG, Medical Officer of Health. 9 Section A. STATISTICS AND SOCIAL CONDITIONS OF THE BOROUGH. Area of Borough (excluding water) 2,136 acres Population (Census, 1931) 155,089 Registrar-General's estimate of resident population— mid-1938 134,400 Number of Inhabited Houses (end of 1938) according to Rate Books 23,958 Rateable Value (October, 1938) £785,611 Sum represented by a Penny Rate (April, 1938) £3,068 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. EXTRACTS FROM VITAL STATISTICS. (Registrar-General's Figures.) Total M. F. Live Births Legitimate 1,959 960 999 Birth Rate 14.9 per 1,000 of the estimated resident population. Ilegitimate 42 17 25 Totals 2,001 977 1,024 Still Births 66 32 34 Rate per 1,000 total (live and still) births 31.9. Total M. F. Deaths 1.537 872 665 Crude Death Rate 11.4 per 1,000 estimated resident population. Adjusted Death Rate 12.7. 10 Deaths from Puerperal causes (Headings 29 and 30 of the Registrar General's Short List):— Deaths. Rate per 1,000 total (live and still) births. No. 29 Puerperal sepsis 3 1.45 No. 30 Other puerperal causes 2 0.97 Total 5 2.42 (A list of deaths from puerperal causes or otherwise associated with pregnancy, etc., is given on page 123.) Death Rate of Infants under one year of age:— All infants, per 1,000 live births 60 Legitimate infants, per 1,000 legitimate live births 58 Illegitimate infants, per 1,000 illegitimate live births 190 Deaths from Cancer (all ages) 244 „ Measles (all ages) 13 „ Whooping Cough (all ages) 3 „ Diarrhoea (under 2 years of age) 17 Marriages. During the year the marriages of 2,804 persons were registered, giving a rate of 20.9 as against 17.9, 20.1, 21.2 21.4, and 21.3 in the five years 1933-1937- Natural Increase. The natural increase of population represented by excess of births over deaths was 464. The principal causes of death are shown in the chart facing page 10. Heart disease, diseases of the Respiratory System (includingTuberculosis) account for the majority of the deaths, but in placing Heart disease first it should be noted that nearly 76 per cent. of the deaths ascribed to this condition were of persons of 65 years or more. TABLE I. Figures for the following table were compiled and furnished by the Registrar-General. Causes of Death. Sex. All Ages 0— 1 — 2— 5— 15— 25- 35- 45— 55- 65— 75— All Causes M 872 70 12 5 16 33 34 32 93 174 215 184 F 665 51 5 6 13 18 24 27 56 106 163 196 1 Typhoid and paratyphoid fevers M — — — — - - - - F - - - - - - - - - - - - 2 Measles M 6 3 2 1 - - - - - - - - F 7 4 2 1 - - - - - - - - 3 Scarlet fever M 1 - - - - - - - 1 - - - F - - - - - - - - - - - - 4 Whooping cough M 2 1 1 - - - - - - - - - F 1 1 - - - - - - - - - - 5 Diphtheria M 6 1 2 2 1 - - - - - - F 4 — — 2 2 - - - - - - - 6 Influenza M 4 1 1 - 1 1 - F 6 1 - - - 1 1 2 1 7 Encephalitis lethargica M 2 - - - - 1 - - - 1 - - F - - - - - - 8 Cerebro-spinal fever M 1 - - - - - - 1 - - - - F 2 1 - 1 - - 9 Tuberculosis of respiratory system M 53 - - 11 8 6 12 11 5 - F 45 1 2 12 15 4 6 3 1 1 10 Other tuberculous diseases M 7 1 1 1 2 1 - 1 - - - F 4 - _ 1 - 1 1 1 - - 11 Syphilis M 4 - - - - - - - 2 1 1 - F 1 - - - - - - - 1 - - - 12 General paralysis of the insane, tabes dorsalis M 4 - 2 1 - 1 - F — — — — — — — - — - — 13 Cancer, malignant disease M 142 — - 1 3 5 15 45 49 24 F 102 - - - - - 1 3 22 30 29 17 14 Diabetes M 5 - - - - - - - 1 2 - 2 F 17 - - - - - - - 1 8 7 1 15 Cerebral haemorrhage, etc. M 22 - - - - - - - 3 6 5 8 F 23 - - - - - - - 1 7 9 6 16 Heart disease M 255 - - - - - 3 5 17 47 96 87 F 229 — - — 3 1 3 5 10 23 71 113 17 Aneurysm M 5 - - - - - - - 2 1 1 1 F 3 - - - - - - - 1 1 1 18 Other circulatory diseases M 31 - - - - - - - 2 - 12 12 F 25 - - - - - - - 2 7 8 8 19 Bronchitis M 36 10 1 1 1 4 11 8 F 23 6 - - - - - - 2 5 10 20 Pneumonia (all forms) M 71 16 3 2 2 3 3 2 9 15 9 7 F 27 8 1 - - - 4 1 5 4 4 21 Other respiratory diseases M 5 - - - - - - - 2 3 - - F 7 1 - - - - - - 1 - 3 2 22 Peptic ulcer M 17 - - - - - 1 1 4 6 3 2 F 2 - - - - - 1 - - - 1 - 23 Diarrhoea, etc. M 9 9 - - - - - - - - - - F 10 8 - - - - 1 - - - 1 - 24 Appendicitis M 4 1 1 - - 1 - - - 1 - F 2 - - - 1 - - - - - 1 - 26 Cirrhosis of liver M 2 - - - - - - - 2 - - - F - - - - - - - - - - - - 26 Other diseases of liver, etc. M - - - - - - - - - - - - F 3 - - - - - - - - 1 1 1 27 Other digestive diseases M 19 - 1 - - - 3 3 2 5 5 F 7 1 - 1 - - - 1 1 - 3 28 Acute and chronic nephritis M 16 - - - 1 1 1 3 3 4 3 F 14 - - - - - 1 - 3 3 7 - 29 Puerperal sepsis F 3 - - - - 3 - - - - 30 Other puerperal causes F 2 - - 1 - 1 - - - - 31 Congenital debility, premature birth, malformations, etc. M 29 27 1 - - - - - - - 1 - F 19 19 - - - - - - - - - - 32 Senility M 1 - - - - - - - - - 1 - F 12 - - - - - - - - - 2 10 33 Suicide M 12 - - - - 1 2 1 2 2 3 1 F 4 - - - - - - 1 1 1 - 1 34 Other violence M 36 7 6 5 2 4 1 - 1 F 22 1 1 - 1 1 - 3 4 11 35 Other defined diseases M 65 1 3 1 3 6 6 2 6 18 6 13 F 38 2 1 2 1 3 2 4 3 9 6 5 36 Causes ill-defined or unknown M - - - - - - - - - - - - F 1 — — — — — - — — — 1 Legit. lllegit. M 66 4 Deaths under 1 year F. 47 4 Totals 113 8 TABLE II.—CAUSES OF, AND AGES AT DEATH DURING 1938. Causes of Death. (Manual of the International List of Causes of Death, 1931.) Total Deaths. Sex. Ages at Death—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  Poplar Institution. St. Andrew's Hospital. St. Clement's Hospital. Bromley House Institution. Poplar Hospital. See Footnotes. Outlying Institutions. Total All Ages Under 5 years. 5- 10- 15- 20- 25- 35- 45- 55- 65- 75 and over Bow. BRomley 0- 1- 2- Total under 5years North. West. Central. South. Northwest. NorthEast. SouthWest. SouthEast. Central. Northwest. West. East. Millwall. Cubitt Town. F 651 47 4 6 57 7 5 10 8 23 29 56 102 161 193 .. Uncertified M .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. F .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 12 13 2 Measles 2 Measles 14 M 7 3 3 1 7 .. .. .. .. .. .. .. .. .. .. .. F 7 4 2 1 7 .. .. .. .. .. .. .. .. .. .. 1 1 3 Scarlet Fever 3 Scarlet Fever 1 M 1 .. .. .. .. .. .. .. .. .. .. 1 .. .. .. F .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 2 2 4 Whooping Cough 4 Whooping Cough 3 M 2 1 1 .. 2 .. .. .. .. .. .. .. .. .. .. F 1 .. .. .. 1 .. .. .. .. .. .. .. .. .. .. 8 10 5 Diphtheria 5 Diphtheria 10 M 6 1 .. 2 3 2 .. .. .. .. .. .. .. .. .. F 4 .. .. 2 2 2 .. .. .. .. .. .. .. .. .. 2 4 6 Influenza 6 Influenza 110 M 4 1 .. .. 1 .. 1 .. .. .. .. .. 1 1 .. F 6 .. .. .. .. .. 1 .. .. .. .. 1 1 2 1 1 2 7 Encephalitis lethargica 7 Encephalitis lethargica 2 M 2 .. .. .. .. .. .. .. 1 .. .. .. 1 .. .. F .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 3 8 Cerebro-spinal Fever 8 Cerebro-spinal Fever 3 M 1 .. .. .. .. .. .. .. .. .. 1 .. .. .. .. .. .. .. .. .. F 2 1 .. .. 1 .. .. .. .. .. .. .. 1 .. .. 9 68 9 Tuberculosis of Respiratory 0 Tuberculosis of Itespirator system 98 M 53 .. 1 .. 1 .. .. 5 5 8 6 12 11 5 .. 11 5 4 3 8 7 10 5 5 13 F 45 .. .. 1 1 1 1 6 6 15 4 7 3 .. 1 K 5 10 10 Other Tuberculous Diseases 10 Other Tuberculous Diseases 11 M 7 .. 1 1 2 .. i 2 .. 1 .. 1 .. .. .. 1 .. .1 1 .. 1 1 .. 1 1 F 4 .. .. .. .. l .. .. .. .. 1 1 1 .. .. 1 .. 2 11 Syphilis 11 Syphilis 5 M 5 .. .. .. .. .. .. .. .. .. .. 3 1 1 .. .. .. .. 1 .. .. .. 1 .. 2 • • (a) F .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. _ 1 4 12 General Paralysis of the Insane, tabes dorsalis 12 General Paralysis of the Insane 4 M 4 .. .. .. .. .. .. .. .. .. 2 1 .. 1 .. .. .. .. .. .. .. .. .. .. 2 F1 .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. _ . 45 172 13 Cancer, malignant disease 13 Cancer, malignant disease 247 M 145 .. .. .. .. .. 2 .. 1 3 5 13 45 49 27 13 20 18 18 14 21 18 13 27 21 F 102 .. .. .. .. .. .. .. .. 1 3 22 30 29 17 2 16 14 Diabetes 14 Diabetes 22 M 4 .. .. .. .. .. .. .. .. .. .. .. 2 .. 2 .. .. 2 2 3 3 .. 5 1 .. 3 2 F 18 .. .. .. .. .. .. .. .. .. .. 2 8 7 1/ 2 34 15 Cerebral haemorrhage, etc. 16 Cerebral haemorrhage, etc. 41 M 23 .. .. .. .. .. .. .. .. .. .. 3 7 6 7 3 3 2 3 2 5 4 1 2 3 h' 18 .. .. .. .. .. .. .. .. .. .. 2 3 7 6 rr 46 333 16 Heart Disease 16 Heart Disease 483 M 256 .. .. .. .. .. .. 2 .. 3 5 19 47 96 84 27 38 22 36 42 34 23 40 41 47 43 33 30 F 227 .. .. .. .. .. 2 .. .. 3 7 10 22 71 112 1 4 17 Aneurysm 17 Aneurysm 7 M 4 .. .. .. .. .. .. .. .. .. .. 1 1 1 1 1 1 1 .. 1 .. .. .. .. .. F 3 .. .. .. .. .. .. .. .. .. .. 1 .. 1 1 i 8 38 18 Other circulatory diseases 18 Other circulatory diseases 58 M 32 .. .. .. .. .. .. .. .. .. .. 1 6 12 13 3 2 7 4 6 2 2 2 3 5 F 26 .. .. .. .. .. .. .. .. .. .. 1 9 8 8 _ „ 2 3 37 19 Bronchitis 19 Bronchitis 60 M 36 10 1 .. 11 .. .. .. .. .. 1 1 4 11 8 2 5 2 1 3 1 3 8 8 7 F 24 5 .. .. 5 .. .. .. .. .. .. 1 2 6 10 17 76 20 Pneumonia (all forms) 20 Pneumonia (all forms) 100 M 72 17 5 1 23 l 1 .. .. 2 3 10 14 11 5 8 2 10 9 8 4 8 4 8 8 F 28 7 .. .. 7 .. .. .. .. .. 4 1 4 8 4 1 4. 21 Other Respiratory Diseases 21 Other Respiratory Diseases 6 M 4 .. .. 1 1 .. .. .. .. .. .. 1 2 .. .. .. 1 1 .. 2 .. .. 1 1 .. F 2 1 .. .. 1 .. .. .. .. .. .. .. .. .. 1 1 2 15 22 Peptic Ulcer 22 Peptic Ulcer 18 M 16 .. .. .. .. .. .. .. .. 1 1 4 5 3 2 1 1 2 2 .. 4 2 .. .. 1 2 F 2 .. .. .. .. .. .. .. .. 1 .. .. .. 1 .. 14 17 23 Diarrhoea, etc. 23 Diarrhoea, etc. 17 M 9 9 .. .. 9 .. .. .. .. .. .. .. .. .. .. 1 .. 2 .. 3 1 3 .. .. ..8 F 8 7 .. .. 7 .. .. .. 1 .. .. .. .. .. .. 1 2 7 24 Appendicitis 24 Appendicitis 7 M 5 1 .. 1 2 .. .. .. .. 1 .. 1 .. 1 .. .. .. .. .. 2 .. .. .. .. 11 F 2 .. .. .. .. 1 .. .. .. .. .. .. .. 1 .. .. .. 25 Cirrhosis of Liver 26 Cirrhosis of Liver 1 M 1 .. .. .. .. .. .. .. .. .. .. 1 .. .. .. .. .. 1 .. .. .. .. .. .. F .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 3 26 Other diseases of liver, etc. 26 Other diseases of liver, etc. 3 M .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 1 .. 1 .. .. .. .. .. .. F 3 .. .. .. .. .. .. .. .. .. .. .. 1 1 1 7 15 27 Other Digestive diseases 27 Other Digestive diseases 24 M 19 .. .. 1 1 .. .. .. .. 1 3 2 2 4 6 .. .. 2 3 2 3 1 .. 3 2 2 4 F 5 .. 1 .. 1 .. .. .. .. .. .. 1 1 .. 2 8 25 28 Acute and Chronic Nephritis 28 Acute and Chronic Nephritis 33 M 21 .. .. .. .. .. .. .. 1 2 1 4 3 1 6 2 3 2 .. 2 1 2 .. 2 2 F 12 .. .. .. .. .. .. .. .. 1 .. 2 1 7 1 .. 2 29 Puerperal Sepsis 3 F 3 .. .. .. .. .. .. .. .. .. 3 .. .. .. .. .. .. .. .. .. .. .. 1 .. .. 1 30 Other 2 F 2 .. .. .. .. .. .. 1 .. .. 1 .. .. .. .. .. .. .. .. .. .. .. .. .. 1 1 1 1 2 30 Other Puerperal causes .. 31 Congenital Debility, Prematur Birth, Malformations, etc. 49 M 30 28 1 .. 29 .. .. .. .. .. .. .. .. 1 .. 3 2 2 .. 5 7 7 5 4 6 1 2 (c) 12 40 31 Congenital Debility, Premature F 19 19 .. .. 19 .. .. .. .. .. .. .. .. .. 8 .. 10 32 Senility 32 Senility 15 M 3 .. .. .. .. .. .. .. .. .. .. 1 .. 1 l 1 2 .. .. .. .. .. 1 3 2 F 12 .. .. .. .. .. .. .. .. .. .. .. .. 2 10 4 9 33 Suicide 33 Suicide 16 M 12 .. .. .. .. .. .. .. 1 2 1 2 2 3 1 2 2 3 1 1 2 .. .. .. 1 3 (d) F 4 .. .. .. .. .. .. .. .. .. 1 1 1 .. 1 9 13 53 34 Other violence 34 Other violence 58 M 36 .. .. .. .. 5 2 1 5 5 1 5 2 .. 11 4 3 2 1 2 12 2 4 4 7 (e) F 22 1 .. .. 1 1 .. .. .. 1 1 .. 5 3 10 30 87 35 Other defined causes 36 Other defined causes 101 M 62 2 2 1 6 2 1 3 3 6 3 6 17 4 12 7 5 4 6 3 5 5 6 19 11 i 11 F 39 1 1 2 4 1 1 3 1 1 4 3 9 7 1 5 1 1 36 Causes ill-defined, or unknown .. 36 Causes ill-defined, or unknown 1 M .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 1 .. F 1 .. .. .. .. .. .. .. .. .. .. .. .. 1 All Causes 1533 M 882 73 15 9 97 10 8 14 19 35 33 92 173 215 186 All Causes F 651 47 4 6 57 7 5 10 8 23 29 56 102 161 193 92 97 94 95 115 115 94 102 142 147 132 88 95 125 76 705 32 28 17 261 1119 Totals 1533 120 19 15 154 17 13 24 27 58 62 148 275 376 379 II Principal causes of death 19j8. (Registrar-General s Classification) Total Deaths during the year 1537 — Males $72 ■ Fema.Us665. 12 TABLE III. Infantile Mortality. Nett Deaths from stated Causes in Weeks and Months under One Year of Age. ^ Causes of Death o V (£ 1—1 M d) "O a P 75 J* o 0 E* <N 1 m O 0 * co 1 <N m 0 03 * 1 co u <D . c w P s . O 5 a O rH Eh m +3 c 0 a co 1 CO -a -4-3 e 0 a CO 1 co m "S 0 a o> 1 CO w C O a 1 C5 Nett total Deaths under 1 year. *r„ 01 Dea<\9 in e»c n„„Ae{' "E O fc -a x G 0) o S ca cq Ji "So ° 3 £ ° « 1 2 3 Measles 5 2 6 1 7 fl 1 y* Whooping Cough — — — — 2 1 1 2 1 — \s Diphtheria — — — — — — 1 1 I 1 — Influenza — — — 1 1 1 1 — Tuberculosis of Nervous System / Tuberculosis of Intestines and Peritoneum .— / Other Tuberculous Diseases / Syphilis - Meningitis 1 1 / Convulsions 1 Bronchitis — — — 3 6 5 1 12 3 15 7 ! 0 Pneumonia — 1 1 2 5 7 6 4 12 12 24 11 3 1 Other Respiratory Diseases 1 1 1 1 / Inflammation of the / Diarrhoea and Enteritis 1 i 4 6 o 2 6 10 16 1 5 6 Hernia, Intestinal Obstruction ___ / Congenital malformations •> s 4 4 1 1 7 6 n 3 4 4 * Congenital Debility and Sclerema 2 1 3 2 1 3 2 i / Icterus — ? Premature Birth 20 3 23 3 11 15 26 5 9 1 Injury at Birth 2 1 — 3 1 2 3 •i / Disease of Umbilicus .. } Atelectasis 1 — — 1 1 — 2 2 — Suffocation—in bed or not stated how , / / Other causes 2 — — 2 — 2 — 1 3 2 5 4 1 / All causes.. 29 5 2 2 38 20 28 21 13 67 53 120 43 26 Lire Births / Legitimate .. 1,959* in the year I Illegitimate .. 42* Nett Deaths /Legitimate .. .. in the year (Illegitimate .. .. ^ Kegistrar-Ueneral s figures. Neo-Natal Death Rate. 1933. 1934. 1935. 1936. 1937. Average 19331937. 1938. Nett Births (Registrar-General) 2,295 2,267 2,215 2,110 2,115 2,200 2,001 Deaths under 1 month.. 67 43 52 39 35 47 38 Neo-Natal death rate per 1,000 nett Births 29.2 19.0 23.5 18.5 16.5 21.4 19.0 13 Births, Maternal Mortality and Infantile Mortality during the twenty years 1919 to 1938. The following Table shows the Birth rate, Maternal Mortality rate and the number and rate per 1 ,ooo 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). V^r. V Live Births. Birth rate per 1,000 population Maternal Mortality. Deaths of Infant s: 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. . oIQ 3,949 24.6 2.78 106 26.8 222 56.2 328 83 243 69 »8l 5,457 34.1 3.48 121 22.2 326 59.7 447 82 213 48 4,478 27.2 3.57 ___ 92 20.5 282 62.9 374 83 243 66 \hl 4,417 26.6 3.17 108 24.5 241 54.5 349 79 147 38 \hl 4,256 25.6 3.29 101 23.7 154 36.1 255 60 163 44 3,831 22.9 1.30 __ 75 19.5 202 52.7 277 72 128 38 3,831 22.7 3.13 73 19.0 215 56.1 288 75 174 50 TO 3,658 21.6 3.97 75 20.5 183 50.0 258 70 136 39 "28 3,309 19.8 2.72 68 20.6 150 45.3 218 66 138 42 TO 3,228 19.9 2.47 64 19.8 166 51.4 230 71 152 49 K 3,064 19.1 3.26 ___ 77 25.1 153 49.9 230 75 123 40 - N 3,056 19.3 1.31 1.26 66 21.6 101 33.5 167 55 102 34 1^2 2,739 17.5 2.55 2.47 60 21.8 151 55.1 211 77 139 50 2,616 17.2 4.20 4.07 57 21.8 109 41.6 166 63 74 28 \% 2,295 15.4 1.74 1.70 59 25.7 64 27.9 123 54 81 34 St 2,267 15.5 3.53 3.40 37 16.3 103 45.4 140 62 72 31 2,215 15.4 3.16 3.06 47 21.2 55 24-8 102 46 95 41 I3' 2,110 15.0 1.89 1.84 35 16.6 118 55.9 153 72 99 44 \ 2,115 15.5 0.94 0.92 32 15.1 97 45.9 129 61 77 35 2,001 14.9 2.50 2.42 34 17.0 86 43.0 120 60 — (Tables showing the causes of death are given as follows:— Deaths under 1 year, page 12. Deaths from puerperal causes, page 123. TABLE IV. Birth-rates, Death-bates, and Analysis of Mortality in the Year 1938. Rate per 1,000 Population Annual Death-rate per 1,000 Population. Rate per 1,000 Live Births. Percentage of Total Deaths. Live Births Stillbirths- All Causes. Typhoid and Paratyphoid Fevers. Smallpox. Measles. Scarlet Fever. Whooping Cough. Diphtheria. Influenza. Violence. Diarrhoea 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. *England and Wales 15.1 0.60 11.6 0.00 0.00 0.04 0.01 0.03 0.07 0.11 0.55 5.5 53 Not available. *126 County Boroughs and Great Towns, including London 15.0 0.65 11.7 0.00 . 0.05 0.01 0.03 0.07 0.10 0.53 7.8 57 *148 Smaller Towns (Populations 25,00060,000 at Census 1931) 15.4 0.60 11.0 0.00 0.00 0.03 0.01 0.02 0.06 0.11 0.54 3.6 51 *London Administrative County 13.4 0.48 11.4 0.00 . 0.06 0.01 0.03 0.05 0.06 0.52 13.1 57 Poplar Borough 14.9 0.49 11.4† . . 0.10 0.01 0.02 0.07 0.07 0.55 8.5 60 85.3 6.9 7.8 . † Crude rate. The adjusted rate is 12.7. Puerperal Sepsis. Others. Tota l . *The Maternal Mortality Rates for England and Wales are as follows:. Per 1,000 total births 0.86 2.11 2.97 The Maternal Mortality Rates for Poplar are as follows:. Per 1,000 total births 1.45 0.97 2.42 *Provisional figures furnished by the Registrar-General. 15 TABLE V. (1938). Cities and Boroughs. Estimated Resident population (Mid-1938) Live Births, Annual rate per 1,000 population. Deathrate per 1,000 population. Deaths of Infants under one year to 1,000 births. LONDON 4,062,800 13.4 11.4 57 West District. Crude Adjusted Paddington 137,400 13.74 11.33 11.21 66 Kensington 174,100 12.8 11.7 10.9 78 Hammersmith 125,100 15.5 11.3 11.6 61 Fulham 137,700 14.2 11.6 11.7 51 Chelsea 56,050 10.2 13.5 11.5 80 City of Westminster 124,400 8.3 10.4 10.7 54.9 North Districts. St. Marylebone 90,680 8.84 11.12 11.0 60 Hampstead 90,480 11.7 11.4 10.7 57 St. Pancras 179,400 13.5 11.5 11.7 64 Islington 292,300 15.32 11.90 12.02 65 Stoke Newington 50,480 13.8 11.0 10.5 43.2 Hackney 205,200 13.4 10.7 11.2 56.46 Central Districts. Holborn 34,350 7.28 10.51 11.25 84 Finsbury 56,960 13.0 12.9 14.1 73 City of London 8,780 6.6 10.7 11.8 51.8 East Districts. Shoreditch 80,360 14. 7 11.4 12.5 64 Bethnal Green 92,910 14.2 11.3 12.8 59.3 Stepney 200,500 13.06 11.05 12.92 60.7 Poplar 134,400 14.9 11.4 12.7 60 South Districts. Southwark 145,300 14.0 12.5 13.4 57 Bermondsey 97,420 14.8 11.0 12.54 45 Lambeth 272,800 14.09 11.9 11.7 51 Battersea 141,700 14.92 11.82 11.70 53.45 Wandsworth 340,100 11.92 11.17 10.38 46 Camberwell 222,400 13.97 12.27 12.27 61 Deptford 95,460 14.4 11.8 ? 54 Greenwich 95,770 13.64 10.89 11.1 42 Lewisham 229,000 13.9 10.49 10.5 47 Woolwich 150,900 13.6 10.4 11.0 50 Note.—The information relating to London supplied by the Registrar-General and that for individual Boroughs by the Medical Officers of Health. 16 (This summary is inserted for comparison with those shown in previous reports.) 1933. 1934. 1935. 1936. 1937. 1938. Population, estimated by Registrar-General:— 149,300 146,370 143,700 140,300 136,800 134,400 Births, Live, rate per 1,000 population 15.4 15.5 15.4 15.0 15.5 14.9 Death rate from all causes, per 1,000 population Crude 12.4 12.3 11.0 12.5 12.6 11.4 Adjusted 13.8 13.7 12.3 13.8 14.0 12.8 Deaths under 1 year of age, rate per 1,000 nett births 54 62 46 72 61 60 Deaths over 65 years of age, rate per 1,000 total population 5.4 5.3 5.2 5.7 6.1 5.6 *Zymotic diseases:— Death rate per 1,000 population 0.4 0.7 0.2 0.8 0.5 0.3 Proportion of 1,000 deaths 29.0 58.3 21.4 67.0 35.9 29.9 Tuberculosis:— Death rate per 1,000 population:— (i) of respiratory system 0.89 0.76 0.81 0.71 0.79 0.73 (ii) other forms 0.09 0.14 0.09 0.12 0.08 0.08 (iii) all forms 1.0 0.9 0.9 0.8 1.87 0.81 All forms: proportion of 1,000 deaths 79.1 73.8 81.9 67.0 69.0 70.9 Respiratory diseases (excluding phthisis and influenzal pneumonia):— Death rate per 1,000 population 1.1 1.7 1.0 1.6 1.5 1.3 Proportion of 1,000 deaths 87.7 142.2 93.8 126.5 122.7 110.0 * Smallpox, Measles, Scarlet Fever, Whooping Cough, Diphtheria and Mem. Croup, Typhoid Fever and Diarrhoeal Diseases. 17 Modernisation of Mortuary and Installation of Refrigerating Chamber. The Public Health Committee considered alternative schemes prepared by the Borough Engineer and Surveyor. Plans were prepared and a rebuilding scheme was approved, at an estimated cost of £4,918. The Minister of Health and the London County Council conferred as to their respective parts of the loan for which sanction was necessary and approval was obtained (1) from the Minister of Health in respect of £2,244 for the post-mortem examination room, and (2) from the London County Council in respect of £2,674 for the mortuary. Temporary arrangements. Arrangements have been made with the London County Council for the temporary use of the mortuary accommodation at the Poplar Institution during the rebuilding of the Council's Mortuary. The Council's Mortuary Keeper will be responsible for the reception of bodies and attendance at post-mortem examinations. The number of bodies deposited in the Council's Mortuary, Cottage Street, Poplar, during the year was 485:— Residents Non-Residents* Totals Males Females Males Females Age not stated (i.e. unknown, newly born) 3 3 11 12 29 Stillborn 1 — — 1 2 Under 1 year 2 5 2 — 9 1 to 5 years 3 3 2 — 8 5 to 15 years 8 3 9 2 22 15 to 25 years 8 1 4 4 17 25 to 45 years 18 11 22 8 59 45 to 65 years 41 17 56 35 149 65 years and upwards 51 38 59 42 190 Totals 135 81 165 104 485 *Brought from outside the Borough for the convenience of the Coroner. Inquests were held on 265 (post-mortem examinations, 175), and 213 other post-mortem examinations were made by order of the Coroner. The total number of post-mortem examinations made was 388. Seven bodies were brought from Fever Hospitals to the Mortuary for custody. In several instances post-mortem examinations were made at the Poplar Mortuary and inquests held at either the Stepney or Shored itch Coroner's Court. 18 Section B. GENERAL PROVISION OF HEALTH SERVICES FOR THE BOROUGH. (i) Public Health Officers of the Authority. A list of the Staff is shown at the commencement of the Report, page 4-6. (ii) (a) Laboratory Facilities. (a) Chemical Analysis. Arrangements are made with analytical chemists who are approved by the Minister of Health. All examinations are carried out at the Public Analysts' own laboratory which is situate at Bank Buildings, 161, Bow Road, E.3. The report of the Public Analysts is given on page 78. (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. (ii) (b) Ambulance facilities. The ambulance services are provided by the London County Council. 19 (ii) (c) Nursing in the Home. New agreements with local nursing associations have been entered into and are referred to on page 120. (ii) (d) Treatment Centres and Clinics. Maternity and Child Welfare Centres, Ante-Natal Clinics and Day Nurseries. (See Maternity and Child Welfare Section, page 107.) Tuberculosis Dispensary. (See page 92, 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. (ii) (e) Hospitals: Public and Voluntary. (i) Fever and Smallpox. Hospitals for patients suffering from these diseases are provided by the London County Council. (ii) Tuberculosis. 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. 20 There are two General Hospitals, Poplar Hospital (supported voluntarily), and St. Andrew's Hospital (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. (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 125.) The Royal College of St. Katharine also have accommodation for 12 cots for children suffering from malnutrition, etc. During the months April to October, six of the cots are used for tonsillectomy cases. 2 (ii) 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 1st January, 1938 5.032 £2,218 43 2nd July, 1938 4,721 £1,921 44 3 (i) Midwifery and Maternity Services. These are referred to in the Maternity and Child Welfare section of this report. Maternal Mortality. All maternal deaths and all cases of Puerperal Fever and Puerperal Pyrexia are specially investigated. (See Maternity and Child Welfare section. page 123.) 21 3 (ii) Institutional Provision for Mothers and, Children. There is one 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. 3 (iii) Health Visitors. 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. 3 (iv) Child Life Protection, see page 124. New Legislation. Factories Act, 1937. The Council delegated their powers to the Public Health Committee and authorised the Medical Officer of Health and all the Sanitary Inspectors to execute the provisions of the Act which have to be administered by the Council. London County Council (General Powers) Act, 1938. Section 3 empowers a Sanitary Authority to provide temporary shelter or house accommodation for occupants of houses where action is being taken under Section 123 of the Public Health (London) Act, 1936, for the destruction or removal of vermin. Public Health (Aircraft) Regulations, 1938, came into operation 1st July, 1938. These were primarily designed to prevent the introduction of infectious diseases into this country through the medium of air-borne traffic. Generally they resembled the Port Sanitary Regulations, 1933, which were made to secure a similar object in regard to waterborne traffic. The County of London Measles and Whooping Cough Regulations, 1938. These regulations, requiring the notification by medical practitioners of certain cases of Measles and Whooping Cough, were issued by the Minister of Health under date 9th September, 1938. 22 Notice of these regulations was given by advertisement in the Press and copies were sent to the medical practitioners practising in the Borough. Increase of Rent and Mortgage Interest (Restrictions) Act, 1938. The Increase of Rent and Mortgage Interest (Restrictions) Act, 1938, received Royal Assent on 26th May, 1938, and made certain changes in the law relating to rent control. Prior to the passing of this Act, certificates of disrepair issued by local authorities (enabling the tenant to withhold the permitted increase of rent) had to specify the works needed to render the house fit for habitation. Certificates are no longer required to specify works needed. The Public Health Committee agreed that when applications with the fee of is. were received from controlled tenants and the District Sanitary Inspector was of opinion the house was not in a reasonable state of repair, the certificate be issued immediately and the action reported to the Committee at their next meeting for ratification. The certificate issued under this Act is in addition to any action which can be taken under the Public Health Act. Agriculture Act, 1937, Part IV, Milk and Dairies Acts and Orders. A Circular letter (No. 1685) was received from the Ministry of Health stating that the provisions of the Agriculture Act, 1937, relating to the transfer of the functions of veterinary inspectors of local authorities to veterinary inspectors appointed by the Minister of Agriculture and Fisheries (which transfer took effect on 1st April, 1938), had made certain amendments necessary in the Milk (Special Designations) Order, 1936, and the Milk and Dairies Order, 1938, and enclosed copies of Amending Orders which came into operation on 1st April. The purpose of the Milk (Special Designations) Amendment Order, 1938, was more particularly to distinguish between cases in which clinical examinations and tuberculin tests were made and certificates thereof given by veterinary inspectors of the Ministry of Agriculture and Fisheries and by private veterinary surgeons respectively, but the opportunity had been taken to make certain further amendments in the Order which experience had shown to be desirable. The definition of "dealer" was extended so as to include a person who used milk for manufacturing purposes. The conditions for a licence authorising the use of the designation "Pasteurised" had been extended to enable a Licensing Authority to require the provisions of "such indicating thermometers and recording thermometers as the licensing authority shall consider requisite.'' 23 Section C. SANITARY CIRCUMSTANCES OF THE BOROUGH. Public Cleansing Services. Included under this heading is the collection, removal and disposal of household, trade and market refuse; street cleansing and watering, gully and cesspool emptying; and snow removal. I am indebted to Mr. S. A. Findlay, A.M.Inst.C.E., the Borough Engineer and Surveyor, for the following particulars:— House Refuse. A minimum bi-weekly collection service is in operation, most bins being placed on the kerb by the householder. The container system is in operation in connection with flats and institutions, and the growth of this system is maintained from year to year. Number of petrol vehicles engaged in the work 21 Number of horse-drawn vans engaged in the work 1 Number of men engaged in the work 80 Trade Refuse. This is collected and/or disposed of when requested by the trader, at his expense. Market Refuse. The container system, augmented by the use of horse-drawn vans, is in operation in the Street Markets. Number of men permanently engaged in the work 16 (Additional men are engaged in this work at week-ends.) 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. The cumbersome and noisy wooden orderly trucks have been replaced by rubber tyred trucks of the two-bin type, and mechanical vehicles fitted with an all-steel body and dustless loading covers are used in conjunction with them. 24 The contents of the bins are collected by motor vehicles which patrol to a scheduled time-table. Motor sweeping machines engaged on street cleansing 2 Motor vehicles employed on the collection of street sweepings 5 Number of men engaged 124 Street Watering. Three motor street watering tanks supplemented by six horse-drawn vans constitute the street watering service. 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 2,600 Pot gullies 599 3,199 Number of gully cleansings:. Brick (170 gallons) 11,226 Pot (30 gallons) 3,352 14,578 Refuse Disposal. Refuse is discharged into barge at Northumberland Wharf, where three hydraulic hoists render possible the discharge of loads at all states of the tide. It is then tipped at Bowers Gifford, near Pitsea, in strict Sanitary Inspectors' Work. Tabulated Statement of Inspections, Insanitary Conditions found existing, and Re-inspections during the year 1938. 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 507 226 899 369 407 780 580 321 4,089 - - - 4,089 Number of Inspections Dwelling Houses House-to-House - - - - . . . . 2 103 122 . 227 On Complaint 521 234 852 367 452 784 579 225 4,014 . . . 4,014 After Infectious Disease 143 50 103 109 112 142 71 103 833 . . . 833 Factories, including Factory Laundries 13 24 25 12 26 1 9 . 110 . . . 110 Workshops, including Workshop Laundries 40 15 2 3 8 3 3 . 74 . . . 74 Workplaces, other than outworkers 43 6 6 24 4 2 17 . 102 . . . 102 Outworkers 4 . . . . . 1 . 5 . . . 5 Stables 3 2 10 23 25 5 46 8 122 . . . 122 Smoke observations 5 7 . 2 15 2 . . 31 . . . 31 Miscellaneous visits and inspections (including visits to Infectious Disease contacts, school inspections, etc.) 434 387 455 213 261 671 234 387 3,042 450 711 . 4,203 Re-inspections 2,214 2,210 1,906 2,087 3,159 1,948 2,678 2,487 18,689 159 49 . 18,897 Premises requiring amendment (a) Dwelling-houses 498 250 819 358 436 716 530 138 3,745 . . . 3,745 (b) Other premises 2 8 24 29 41 5 13 2 124 . . . 124 Service of Intimations, etc.: Intimations served 463 240 684 397 438 809 540 127 3,698 . - . 3,698 ,, complied with 308 122 432 275 335 510 273 139 2,394 - . . 2,394 Notices served 225 88 221 161 138 277 270 27 1,407 . . . 1,407 ,, complied with 127 53 173 70 109 179 143 30 884 - . . 884 Final Notices served 70 13 63 46 17 81 117 2 409 - . . 409 ,, complied with 76 4 56 29 14 70 122 - 371 - . . 371 Summonses applied for . 1 6 2 1 11 1U 31 - - - 31 Work done, number of instances not included above: (a) After legal proceedings 2 1 4 1 . 15 9 . 32 . . 32 (b) Voluntarily 17 12 64 7 133 34 21 - 288 - - - Nuisances, etc., found. Works completed. Defects, etc., found in Dwelling Houses: Drainage: Drains defective 18 15 52 4 124 32 39 13 297 . . . 297 394 ,, obstructed 11 23 78 11 37 51 13 13 237 . . . 237 223 Waste pipes defective, etc. 26 13 56 54 40 27 47 1 264 . . . 264 279 Rainwater pipes not disconnected . . - - 6 - - 1 7 - . . 7 24 W.Cs. and flushing apparatus defective 29 14 85 83 21 91 78 25 426 . . . 426 445 Dampness (not due to defects shown elsewhere) 65 23 182 125 162 436 217 26 1,236 . . . 1,236 1,109 Water: Supply cut off . 7 3 4 2 1 - 5 22 . . . 22 35 Dust Receptacles: Insufficient or defective 95 32 102 82 82 118 73 53 638 - - - 638 687 Miscellaneous: Rooms, etc., dirty and/or verminous 264 123 755 451 504 877 807 224 4,005 . . . 4,005 3,714 Cases of overcrowding . . 3 1 9 1 10 3 27 - - . 27 4 Yards, etc., not properly paved or drained 33 10 97 74 92 81 58 18 463 - - - 463 415 Roofs defective 212 69 479 207 221 406 247 115 1,956 . . . 1,956 1,698 Rainwater pipes and gutters defective 31 34 194 38 264 191 80 54 886 . . 886 848 Public House Urinals requiring cleansing 1 2 1 9 6 1 - 6 26 . . 26 28 Other nuisances or defects 346 158 2,567 943 1,013 2,281 1,625 300 9,233 - - - 9,233 8,210 Defects found in Factories, Workshops, etc.: Sanitary defects 2 12 12 19 3 2 50 . . . 50 35 W.C. accommodation, insufficient or unsuitable - - 2 1 . - 4 - 7 . . 7 5 Overcrowding - - - 1 - - - - 1 - - - 1 - Stables: Manure receptacles defective, etc. - - - 3 1 - - 3 7 - - - 7 11 Accumulations found - - - 1 2 3 - 4 10 - - - - - Number of visits by Assistants (not included above) 2,298 2,148 5,577 2,577 3,520 3,624 3,362 - 23,106 - - - - - •The Housing Inspectors were engaged in inspections, etc., in connection Mr. Belshaw also deputised for a District Inspector on 6 days. Mr. Rose was transferred to other duties (Houses-let-in-lodgings, Common and Seamen's Lodging Houres, etc.) 25 accordance with the Ministry of Health's suggested precautions for "controlled" tipping. Free shoots were found for 614 tons of street sweepings and boiler ashes. Summary for the Year 1938. House refuse 27,481 tons Trade refuse 1,117 „ Street sweepings 4,393 „ Solid gully detritus 804 „ Market refuse 1,892 „ 35,687 ,, Combined Drainage..The following drainage works were approved by the Public Health Committee:. 32, Glengarnock Avenue £15 57/59, £20 12 etc, Rothbury Road £100 12-22, Duff Street and 50, Grundy Street £75 92-94, Kerbey Street £45 11, Augusta Street £80 Plans of Drainage Systems. 85 drainage plans were approved by the Public Health Committee. 4 other plans were submitted without prejudice. 3 (iii) Sanitary Inspection of the Borough.see summarised statement facing this page. 20 The Work of Lady Sanitary Inspector. Tabulated statement of Inspections, of Insanitary Conditions found existing, and of Reinspections, etc., during the year. Factories and Workshops newly discovered and Registered 15 Number of Inspections of:. Factories, including Factory Laundries 111 Workshops, including Workshop Laundries 54 Workplaces 14 Workrooms . Homeworkers' premises 561 Reinspections of above 14 Premises requiring amendment 21 Dejects Found:. 1. Nuisances under Public Health (London) Act:. Found. Remedied. Referred to D.S.I. Referred to H.M. Insp. Want of cleanliness 4 2 2 . Want of ventilation . . . . Overcrowding . . . . Want of drainage of floors . . . . Other nuisances 4 2 2 . Sanitary accommodation Insufficient . . . . Unsuitable or defective 8 8 1 . Not separate for sexes . . . . Want of cleanliness 16 14 2 . 2. Offences under Factory and Workshop Acts . . . . Action Taken Regarding Above:. Intimations served 13 ,, complied with 13 Notices served . ,, complied with . Final Notices served . Legal Proceedings taken . Nuisances remedied without service of Intimations, etc. 7 Other Matters:. Visits re cases of Scabies 462 ,, Verminous children 35 44 ,, Infectious Disease on Homeworkers' premises 1 ,, School Exclusions, etc. 661 cases of Whooping Cough 38 ,, aged and infirm persons 9 Other visits and inquiries 26 Inspections of Schools re Sanitary accommodation 37 Ineffective calls 424 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 1937 347 ,, ,, removed from Register during 1938 . ,, ,, registered during 1938 1 ,, ,, on Register at end of 1938 348 Visits for registration purposes 49 Declarations, for information, sent out . ,, with information, returned . Rooms measured, etc. . Houses registered 1 Notices of registration sent out . Inspections: (a) Night inspections 1 (b) First annual inspections 184 (c) Other routine inspections 5 (d) On complaints 37 (e) On account of re-housing 1 Re-inspections 884 Miscellaneous visits, enquiries, etc. 342 Number of informal notices served 106 ,, ,, complied with 107 ,, Notices served 45 ,, ,, complied with 15 Final Notices served 13 cases in which legal proceedings were taken 3 Work done as a result of Final Notice or legal proceedings number of cases 11 Number of rooms cleansed and freed from vermin 56 Overcrowding, cases discovered . ,, ,, abated . Mixed sleeping, cases discovered . ,, ,, abated . 28 Number of nuisances referred to District Inspectors: (a) Defective or obstructed drains 2 (b) Defective roofs, guttering, etc. . (c) Water supply in tenement houses . (d) Miscellaneous . Remarks: During the year Mr. Luke was engaged on supervision of out-door temporary staff during overcrowding survey 10 weeks and deputised for District Inspector nine days. He was transferred to District Sanitary Inspector's duty, vice Mr. Colborne, and Mr. Rose took over Houses-letin-Lodgings, etc., from 25th April. (b) Common Lodging Houses. The following 4 Common Lodging Houses were licensed to 30th June, 1939. (0 H ? & <f (x) 65, Bazeley Street.Sidney Moore (40 men). (2) East London Hostel, Garford Street (Salvation Army). Evangeline Booth (294 men). (3) 378, Old Ford Road.Mrs. Elizabeth Moore (18 men). (4) 38, Pennyfields.Thomas Alfred Felton (46 men). # 109 inspections of Common Lodging Houses, including 8 night inspections, were made during the year. 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, j 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 nth February. The total of licensed beds was 398 and beds occupied 316. The number of men known to be in receipt of Public Assistance was 26, and 26 beds were paid for by charitable organisations. 29 (c) Stamen's Lodging Houses. The Public Health Committee licensed the following Seamen's Lodging Houses to 30th June, 1939:. Premises. Licensee. No. of Men. The Queen Victoria Seamen's Rest, Jeremiah Street, Poplar Rev. Thomas Athey Embleton (The Seamen's Mission) 115 48 Pennyfields Ah Chow 7 26 inspections of Seamen's Lodging Houses, including 3 night inspects, were made during the year. Shops Act, 1934. No exemption certificates or notices under this Act have been issued during the year. Smoke Abatement. 19 observations were made and 8 nuisances recorded. 11 complaints were received from the London County Council. 4 intimations were served. In addition, 4 works managers were interviewed. 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. Methods of observation and standards in use since 1927 are similar to those of the National Smoke Abatement Society. At the Smoke Abatement Conference of Greater London Local Authorities held in the County Hall, on 25th February, 1938, the following resolution was approved:. "That this meeting is of opinion that steps should be taken to Promote the formation of an Advisory Regional Smoke Abatement Committee for London and Greater London and requests the National 30 Smoke Abatement Society to report to the Authorities concerned, asking them to agree in principle to the proposal and to be represented at a further meeting to be convened for the purpose of establishing such a Committee.'' The Council agreed they would be prepared to become a member of the proposed Committee and appointed two delegates to a further meeting of representatives of Local Authorities at the Ministry of Health on 16th June. Swimming Baths and Pools. As mentioned in previous Annual Reports, following upon the issue of the Ministry of Health Circular 1503, arrangements were 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, 17 samples of bath water were taken and examined as follows:. East India Dock Road.1st class Bath 2 samples. East India Dock Road.2nd class Bath 4 samples. Roman Road.1st class Bath 2 samples. Roman Road.2nd class Bath 4 samples. Glengall Road Bath 2 samples. Millwall Open Air Bath (London County Council) 3 samples. The Bacteriologist reported that from the bacteriological point of view the results were very satisfactory. 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. Houses Let in Lodgings. The report of the Inspector is given on page 27. 31 Offensive Trades. The following are the offensive trade premises in the Borough:. Address. Proprietors. Business. 80, Whitepost Lane Sheppy Glue & Chemical Co. Fat melters. East London Soap Works E. R. Cook & Co., Ltd. Soap boilers. 10-16, Aberfeldy Street Nathan Cohen & Sons 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 „ „ For number of inspections see Table A page 35. Illegal Establishment of Offensive Trade. Legal proceedings were taken against two persons, see page 40. Rag and Bone Dealers. No infringements of the byelaws made by the London County Council under Section 9 of the London County Council (General Powers) Act, 1908, were reported. Licensed Premises Urinals. 26 urinals on licensed premises were found to be insanitary, and were subsequently cleansed. Water Certificates. 11 certificates regarding 243 flats and tenements were issued under the provisions of the Public Health (London) Act. Increase of Rent and Mortgage Interest (Restrictions) Acts. 78 certificates were issued to tenants, and at the request of owners 43 certificates that the work had been done were also issued. 32 Stables. 144 stables were inspected and reported upon, the total number of inspections being 167. The following infringements of the Bye-laws were dealt with:. Accumulations of manure, or premises otherwise not clean 15 Floors not properly drained 1 Dung receptacles:. (a) Not provided 3 (b) Defective 1 (c) Not covered . Other defects 6 11 intimations, 3 notices and 1 final notice 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 in. No notices were served under the Rats and Mice (Destruction) Act, 1919. 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. 33 (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 — — — — — — — Private 1,058 30,636 21,586 225 407 238 870 Totals 1,058 30,636 21,586 225 407 238 870 (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 66 3,140 1,858 — — Conveniences, etc. — — — — — — — Totals 66 3,140 1,858 — — — — Inspection of Schools. The sanitary accommodation at each of the public elementary schools was 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 accommoda. tion was satisfactory and the sanitary arrangements sufficient and kept in a cleanly state. 34 Rag Flock Act, 1911. 15 samples were taken. 13 samples were satisfactory, and 2 did not comply with the prescribed standard of cleanliness. Legal proceedings were taken in one case, and a letter of caution was sent in the other case. The firm which was summoned was ordered to pay £3 3s. od. costs. Hairdressers' Premises. The number of inspections of hairdressers' premises was 93. Nuisances found numbered 6. Four intimations, two notices and one final notice were served. The requirements of these documents were complied with. Canal Boats. During the year visits were paid to the canals and locks, but only non-registered craft (dumb barges) were seen. At no time was there evidence of the vessels being used for residential purposes. Exhumations. No notices of exhumation were received. Factories Act, 1937—Supply of Drinking Water. A request was received from the Gas Light and Coke Company for the issue of a certificate under Section 41 of this Act, regarding the water supply for drinking purposes from the well at their Bow Common Works. The water was examined by the Public Analyst and a certificate approving of this source of supply was granted. In order to keep strict control over supplies from wells the Committee agreed that the Medical Officer of Health should decide in each case whether or not he would accept reports of the chemical and bacteriological examinations carried out by the Analyst making the examination for the owner of the well, or whether it would be necessary to ask the Public Analyst to carry out quarterly examinations. In either case the Medical Officer of Health was of opinion quarterly bacteriological and chemical examinations should be carried out and submitted to him. 35 Factory and Workshop Act 1901 and the Factories Act 1937. Premises. On Register during year. Number of Inspections. Number of Intimations. Number of Notices. Number of Final Notices. Number of Prosecutions. Male. Female. Total. Bakehouses (Factories) 39 — 39 216 81 Bakehouses (Workshops) 6 — 6 21 13 — — — Bakehouses (Domestic Workshops) 3 — 3 14 6 — — — Factories (Laundries and Miscellaneous Factories) 139 112 251 247 20 2 1 — Laundries (Workshops) — 2 2 2 — — — — Laundries (Domestic Workshops) — — — — — — — — Workshops 210 47 257 219 16 2 1 — Workplaces 236 18 254 237 20 5 2 — Places where food is sold or prepared* 1098 — 1098 1701 303 — — — Milk Premises 81 — 81 296 1 — — — Cowsheds 1 — 1 12 — — — — Slaughterhouses 4 — 4 14 17 — — — Poultry Slaughterhouses 2 — 2 13 9 — — — Other offensive trade premises 4 — 4 26 1 — — — Ice Cream premises! 240 — 240 263 1 — — — Home workers' premises 13 392 405 566 In this Table and in Table C on next page "reminders" that periodical cleansing was due are included as "Intimations." * Power is used in 84 of these premises. ‡ ,, ,, 20 ,, ,, (Lists of Slaughterhouses and other offensive trade premises are given on pages 68 and 31.) 36 Table C. Factories, Workshops, Laundries, Workplaces and Homeworkers. I.—INSPECTION. Premises. Number of Inspections. Written Notices. Prosecutions. Intimation. Statutory. Final Factories (Including Factory Bakehouses and Laundries) 463 101 2 1 — Workshopsf 256 35 2 1 — Workplaces 237 20 5 2 — Places where food is sold or prepared! 1701 303 Homeworkers'Premises 566 — — — Total 3223 459 9 4 — t Including Workshop Bakehouses and Laundries. § The inspections of factories where food is prepared areincluded. Power is used in 81 of the premises. 2.-—DEFECTS FOUND * (Corresponding figures for 1937 are shown in brackets). Particulars. Number of Defects. Number of Proseou tions. Found. Remedied. Referred to H.M. Inspector. (1) (2) (3) (4) (5) Nuisances under the Public Health Act: Want of cleanliness 108 (123) 108 (122) — — Want of ventilation — — — — Overcrowding — — — — Want of drainage of floors 1 (2) 1 (2) — — Other nuisances 45 (69) 45 (69) — — Sanitary accommodation 'insufficient 3 (3) 3 (3) — — unsuitable or tive 35 (28) 35 (28) — — not separate for sexes — — — — Offences under the Factory and Workshop Act:— Illegal occupation of underground bakehouse(s. 101) — — — — Breach of special sanitary ments for bakehouses (ss. 97 to 100) — — — — Other offences — — — — (Excluding offences relating to work which are included in Table D of this Report.) Total 192(225) 192 (221) — — * These defects refer to premises mentioned above under table of Inspection. 37 Nature of Work, Outworkers' List (Section 107) / Outwork in un— / wholesome premises, j (Section 108). / Outwork in infected / premises, / (Sections 109, 110). Lists received from Empioyers. Notice served on Occupation as to keeping or or sending lists. Prosecutions. Instances. Notices served Prosecutions Instances. Orders made (S. 110}. Prosecutions 'Sections 109, no,. Twice in the year. Once in the year. Failing to keep or per mit inspec. tion 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) (11) (12) (13) (14) (15) (16) Wearing Apparel— Table D.—Home Work. Making, etc. 54 36 436 2 1 — 29 — 10 Cleaning and Washing Household Linen Laoe, laoe ourtains and nets Curtains and furniture hangings Furniture and Upholstery Eleotro-plate File Making Brass and Brass Artioles Fur pulling Cables and Chains Anchors and Grapnels Cart Gear Locks, Latches and Keys Umbrellas, etc. Artificial Flowers Nets, other than wire nets Tents Sacks Racquet and Tennis Balls Paper,eto.,Boxes, Paper Bags 10 — 127 1 — 1 4 Brush Making Pea Picking Feather Sorting Carding,etc.,of buttons,etc. Stuffed Toys Basket Making Chocolates and Sweetmeats Cosaques, ChristmasCrackers Christmas Stockings, etc. Textile Weaving Lampshades Miscellaneous* 2 — 9 2 1 12 — — Totals 66 36 602 5 2 13 33 — — — — — 10 — • Flags and bunting. 38 List of Outworkers, Factory and Workshop Act, 1901 (S. 107). Class of Homework. Number of Lists received. Number of Addresses of Outworkers. Due Feb. 1st. j 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 36 334 35 319 223 223 220 194 Wearing apparel 29 269 28 249 191 180 176 157 Paper bags, boxes, etc. 6 67 5 61 32 35 8 15 Miscellaneous 1 - 2 9 - 8 36 22 Table E. Registered Workshops and Workplaces. Workshops and Workplaces, etc., on the Register (s. 131) at the end of the year. Number. (1) (2) Bakehouse Workshops 6 Important classes Bakehouse Domestic Workshops 3 of workshops, such as Laundries Workshops 2 workshop bakehouses, Laundries Domestic Workshops — may be enumerated Workshops 257 here. Workplaces 254 Places where food is sold or prepared 1098* Total number of workshops and workplaces, etc., on Register 1620 * Power is used in 84 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).. — Action taken in matters referred Notified by H.M. Inspector Reports (of action taken) sent to H. M. Inspector by H.M. Inspector as 3 able under the Public Health Acts, but not under the 2 tory and Workshop Act (s. 5) Other (Communications) 6 Underground Bakehouses (s. 101):— Certificates granted during the year — In use at the end of the year 11 39 Legal Proceedings. Public Health (London) Act, 1936, Metropolis Management Acts, etc. Address. Nature of Complaint. Result, Inspector. 60, Hobday Street 32a, Ship Street Various defects Yard paving defective; walls and ceilings of store room and workshop dirty 7 days' order; £2 8s. costs Summons withdrawn; £2 5s. costs Colborne, W.J. Dove, A. L. 57, Giraud Street Main roof defective and other defects Work done; £2 penalty; £2 5s. costs Colborne, W.J. 104, Kerbey Street Main roof defective and other defects Work done; £1 penalty; £2 5s. costs do. 21, Ellesmere Street Failed to comply with Magistrate's Abatement Order 10s. penalty; £2 2s. costs do. 27, Ellesmere Street Failed to comply with Magistrate's Abatement Order 10s. penalty; £2 2s. costs do. 44, Sussex Street W.C. obstructed and water service pipe defective Work done; £2 5s. costs do. 66, Quickett Street Main roof defective and other defects Work done; £2 5s. costs West brook, C. S. 172, Brunswick Road Various defects 14 days' order; £2 8s. costs Johnson, W. 174, Brunswick Road Roof and front bay window defective and other defects 14 days' order; £2 8s. costs do. 28, Stewart Street Various defects Work done; summons withdrawn; £2 5s. costs Dove, A. L. 245, Manchester Road No proper and sufficient water supply Work done; £2 5s. costs do. 239, Manchester Road Various defects Work done; £2 5s. costs do. 289, Manchester Road Various defects 7 days' order; £2 8s. costs do. 28, Stebondale Street Various defects Work done; £2 5s. costs do. 166-176, Poplar High Street Trade and business carried on a nuisance and causes effluvia which are a nuisance Summons dismissed; Magistrate satisfied Defendants had taken all practicable means to prevent nuisance do. 166-176, Poplar High Street Nuisance from noise Forthwith abatement order; £10 10s. costs do. 87, Usher Road Various defects Summons dismissed (Magistrate asked to state a case for Smith, F. A. appeal.) 2, Wyke Road Various defects 7 days' order; £5 penalty; £2 8s. costs Smith, F. A. 39, Chipka Street Refuse receptacle, yard paving and window sashes defective 7 days' order; £2 8s. costs Dove, A. L. 100, Stewart Street Refuse receptacle defective Work done; £2 5s. costs ,, 56, Stewart Street Various defects and top floor front rooms verminous 7 days' order; £2 8s. costs do. 41, Chipka Street Various defects 14 days' order; £2 8s. costs do. 40 Address. Nature of Complaint. Result. Inspector. 329, Roman Road Failed to give notice of intention to fit a pipe to a W.(!. Summonses dismissed under Probation of Offenders Act; £5 5s. costs Smith, F. A. 329, Roman Road Drain not laid with suitable fall nor on bed of ooncrete 329, Roman Road Drains repaired so as to be a nuisance 67, Sussex Street .. No proper and sufficient water supply to top floor Work done; Summons withdrawn; £2 5s. costs Luke, H. W. 13, Clifton Street Various defects 7 days' order; £2 8s. costs do. 28, Stratfield Road Main and back addition roofs defective and other defects Closing order; £2 8s. costs.. Westbrook, C. S. 87, Usher Road Appeal heard and remitted to Magistrate for him to hear further evidence and further to consider paragraphs of special case as stated. (Case reheard in January, 1939, when summons adjourned sine die and Defendant ordered to pay £20 costs.) - Smith, F. A. 4, Coborn Road Business of slaughterer of poultry carried on without consent of local authority Summonses dismissed under Probation of Offenders Act; £3 3s. costs Pearce, H. A. 4, Coborn Road Aiding and abetting above 45, Alfred Street Main roof defective and top floor front room ceiling damp Work done; Summons withdrawn; £2 5s. costs Kelly, S. 76, Stainsby Road Walls and ceilings defective and dirty Work done; £2 penalty; £2 5s. costs Luke, H. W. 45, Southill Street Various defects Work done; £2 penalty; £2 5s. do. 62, Guildford Road Various defects uuais Work done; £2 penalty; £2 5s. do. 13, East Ferry Road Main roof leaky and other defects costs 14 days' order; £2 penalty; £2 8s. Dove, A. L. 79, Stebondale Street Various defects costs 14 days' order; £3 penalty; £2 8s. do. 45, East Ferry Road Main and W.C. roofs defective and other defects costs 14 days' order; £2 8s. costs do. Hanbury Buildings No water supply to W.C.'s on first, second and top floors Work done; £2 5s. costs Luke, H. W. 42, Broomfield Street Main roof, back addition roof defective and other defects Work done; £1 penalty; £2 5s. costs Luke, H. W. 226, Devons Road Main roof defective and other defects 14 days' order; £2 8s. costs WeBtbrook, C. S. 169, Fairfoot Road Main roof defective and other defects 14 days' order; £2 8s. costs do. 250, Devons Road Main roof, W.C. roof defective and other defects 14 days' order; £2 8s. costs do. 41 Address. Nature of Complaint. Result. ctor. 77, Blackthorn Street Main roof defective and other defects 14 davs' order; £2 8s. costs do. 22, Stebondale Street Main roof defectivo and other defects 10 (lavs' order; £2 8s. costs Dove, A. L. 66, Mellish Street Main roof defectivo and other defects 14 days' order; £3 penalty; £2 8s. costs Langley, H.J. London County Council Byelaws with Respect to Houses Divided into Separate Tenements. Address. Nature of Complaint. Result. Inspector. 9, Coldharbour Top floor front room defective and other defects 7 davs' order; £2 8s. costs.. Rose, T. C. B. 63, Pennyfields Main roof defective Work done; £2 5s. costs do. 63, Pennyfields Various defects Work done; £2 5s. costs do. Public Health (London) Act, 1936, and the Rao Flock Regulations, 1912. Address. Nature of Complaint. Result. Inspector. Thos. Kirby & Co., 78, Malmesbury Road In possession of rag flock which contained chlorine 227 parts per 100,000 £5 5s. costs Kelly, S. Poplar Flock Mills, Athol Street In possession of rag flock which contained chlorine 100 parts per 100,000 £5 penalty; £4 4s. costs Tibbatts, H. A. H. E. Kershaw, Ltd., 37, Holywell Lane, E.C. At 551, Old Kord Road, in possession of rag flock which contained chlorino 95 parts per 100,000 £3 3s. costs Kelly, S. 42 Food and Drugs (Adulteration) Act, 1928. Address. Nature of Complaint. Result. ctor. Keens (Watford), Ltd., Marlborough Road, Watford Sold at 2, Archibald Street, sausages which contained sulphur dioxide 160 parts per million £2 2s. costs Grabham, C. A. Ascotts' Phaimacies, Ltd., 1-2, Trump Street, E.C.2 Sold at 89, Upper North Street, lime water deficient in calcium hydroxido 40 per cent. Dismissed under Probation of Offenders Act; £2 2s. costs Pearce, H. A. Albert Mayes, 24, Leopold Street, Stepney Sold at 363, West Ferry Road, minced meat which contained sulphur dioxide 44 parts per million £1 penalty; £1 Is. costs Grabham, C. A. Chas. L. Noakcs, 111, West Ferry Road Sold strawberry flavour jam which contained not more than 2.5 per cent, of strawberry matter and had no taste or odour of strawberry Summons dismissed; "warranty" proved do. S. Lewis, Orchard Company, Grange Works, 4, Rockingham Street, S.E.I Gave a label which falsely described strawberry jam (referred to above) Summons dismissed; Magistrate held case to be a "border line" case do. Note.—Letters of caution were sent to 11 vendors in respect of other unsatisfactory samples, etc. 43 Public Health (Condensed Milk) Regulations. Defendant. Offence. Result. ctor. Reginald Bach, 92-94, Chrisp Street Sold condensed milk not labelled as prescribed £2 penalty; £2 2s. costs Pearce, H. A. George Knight, 35, Upper North Street Sold condensed milk not labelled as prescribed Summons dismissed under Probation of Offenders Act do. Merchandise Marks Act and Orders. Defendant. Offence. Result. Inspector. Albert Batiste, 70a, Chrisp Street Exposed for sale imported beef not bearing indication of origin £10 penalty; £2 2s. costs Grabham, C. A. Arthur Willmore, 12, CovenCross Exposed for sale in Roman Road imported rawtomatoes which did not bear indication of origin £3 penalty; £2 2s. costs Pearce, H. A. 44 Summary of Penalties and Costs. Penalties. Costs. £ 8. d. £ 8. d. Public Health (London) Act, 1936 21 0 0 106 19 0 L. C. C. Byelaws—Houses divided into separate Tenements — 6 18 0 Rag Flock Regulations 5 0 0 12 12 0 Food and Drugs (Adulteration) Act, 1928 1 0 0 5 5 0 Public Health (Condensed Milk) Regulations 2 0 0 2 2 0 Merchandise Marks Acts and Orders 13 0 0 4 4 0 Totals £45 0 0 £138 0 0 £183 0 0 London County Council (General Powers) Act, 1928, sec. 28, and Public Health (London) Act, 1936, sec. 224. Removal of infirm persons. It was not necessary to obtain Magistrates' Orders for the removal of infirm persons to institutions. Three 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, 1938. No. of Inspections. No. of Prosecutions. Common Lodging Houses 4 109 — Seamen's Lodging Houses 2 26 — Cowsheds (Licensed) 1 12 — Slaughterhouses (Licensed) 4 14* — Poultry Slaughterhouses 3 13 2‡ Other Offensive Trades 4 26 Milkshops 81 296 — Ice Cream Premises 240 263 — Restaurants and Eating Houses 1,098 1,701 — Registered Foster-Mothers 17 17 by Sanitary Inspectors. Nurse Children kept 17 197 by Chief Health Visitor. •In addition, 810 visits were made in connection with the examination of carcases. persons were summoned for carrying on the business which had been established without the consent of the local authority. Smoke Nuisances. (1) No. of observations 19 (4) No. of Statutory Notices served — (2) No. of intimations served 4 (5) No. of legal proceedings — (6) No. of convictions ,, — (3) No. of complaints received (7) Amount of penalty and (from L.C.C.) 11 costs imposed in each case — Cleansing and Disinfection. No. of adults cleansed 285 No. of children cleansed 4907 No. of rooms cleansed (a) After infectious diseases 1470 (6) for vermin 1211 Water Supply to Tenement Houses. No. of premises supplied 6 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., 10; Tuberculosis, 3. ,, ,, ,, (part-time)—Nil. ,, ,, ,, (Voluntary Association)—M. & C.W., 9. 46 Housing. 1. Total No. of inhabited houses in the Borough 23,958 9. No. of houses (wholly or in part) the subject of Closing Orders (excluding underground rooms) — Public Health Act— 2. No. of houses inspected on account of complaints or illness 5,478 3. No. of Intimations served 4,332 No. of statutory notices served 1,657 10. No. of Closing Orders determined (i.e., houses made fit) — 4. No. of houses repaired or nuisances remedied 4,081 11. Overcrowding (Housing Act, 1936)— Housing Act (1936)— 5. No. of houses inspected— house to house (Housing Consolidated Regs., 1925) JNo. ot tamilies tound to be living in overcrowded conditions — No. of overcrowded families who have obtained alternative accommodation .. 468 353 6. (a) No. of houses included in representations by the Borough Medical Officer under Sec. 25 of H.A., 1936 (6) No. of houses demolished following representation by Borough Medical Officer under Sec. 25 of H.A., 1936 SI 17 12. No. of houses erected by the Borough Council for working classes during year 58 13. Underground Rooms— No. occupied but unfit* 58 No. closed, or modified occupation approved .. 58t 7. No. of houses repaired under Sections 9 and 10 of H. A., 1936:— (а) By owners (б) By L.A. in default of owners 8. No. of houses demolished:— (а) In pursuance of orders under Sec. 11 of the H. A., 1936 (б) Voluntarily 14. Houses Let in Lodgings— — No. in Borough 343 No. of inspections 1.503 No. of prosecutions 3 No. of complaints remedied under the By-laws (not 81 included under any other 9 heading) 37 t Specifications of remedial works accepted in respect of 17 premises. Remedial works completed in 8 premises. Closing orders determined in respect of 5 rooms. Infectious Diseases. Infectious diseases—cases notified under local orders (excluding cases coming to knowledge otherwise than by notification). Disease. Cases notified. Period. Measles 8 1.10.38-31.12.38 German Measles Not notifiable — — Whooping Cough 80 1.10.38-31.12.38 Rheumatic Fever (0-16) Not — — Chicken Pox notifiable — — Zymotic Enteritis 99 15.3.38-31.12.38 47 Section D. HOUSING. The following section on Housing has been prepared in accordance with Circular 1,728 (England) of the Ministry of Health, 1938:— 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) 4,705 (b) Number of inspections made for the purpose 23,626 (2) (a) Number of dwelling-houses (included under head (1) above) which were inspected and recorded under the Housing Consolidated Regulations, 1925 and 1932 — (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 188 (4) Number of dwelling-houses (exclusive of those referred to under the preceding sub-head) found not to be in all respects reasonably fit for human habitation 3,362 2.—Remedy of Defects during the Year without Service of Formal Notices— Number of defective dwelling-houses rendered fit in consequence of informal action by the Local Authority or their officers .. .. .. .. .. .. .. .. 2,044 3.—Action under Statutory Powers during the Year. (a) Proceedings under Sections 9, 10 and 16 of the Housing Act, 1936— (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:— (а) By owners — (б) By local authority in default of owners — 48 (b) Proceedings under Public Health Acts— (1) Number of dwelling-houses in respect of which notices were served requiring defects to be remedied 1,274 (2) Number of dwelling-houses in which defects were remedied after service of formal notices:— (a) By owners 1 209 (5) By local authority in default of owners — (c) Proceedings under Sections 11 and 13 of the Housing Act, 1936— (1) Number of dwelling-houses in respect of which Demolition Orders were made — (2) Number of dwelling-houses demolished in pursuance of Demolition Orders — (d) Proceedings under Section 12 of the Housing Act, 1936— (1) Number of separate tenements or underground rooms in respect of which Closing Orders were made 57* (2) Number of separate tenements or underground rooms in respect of which Closing Orders were determined, the tenement or room having been rendered fit 5 * Specifications approved in iespect of 17 other premises. 4.—Housing Act, 1936, Part IV.—Overcrowding. (a) (i) Number of dwellings overcrowded at the end of the year 3,367 (ii) Number of families dwelling therein 3,367 (iii) Number of persons dwelling therein 21,490 (b) Number of new cases of overcrowding reported during the year 468* *Approximately one-half were due to the increased ages of children, but 238 were discovered in the course of the overcrowding survey (measurement of houses not previously measured) in the early months of 1938. 49 (c) (i) Number of cases of overcrowding relieved during the year 353† (ii) Number of persons concerned in such cases 2,076 t (a) Rehoused by London County Council 179 (6) Rehoused by Poplar Borough Council 39 (c) Rehoused by Housing Association 1 (d) Obtained other alternative accommodation 59 (e) Vacated accommodation taken over 29 (d) Others 46 353 (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 (e) Any other particulars with respect to overcrowding conditions upon which the Medical Officer of Health may consider it desirable to report Number of new houses and tenements erected during 1938:— (a) Total (including numbers given separately under (b))318 (i) By the Local Authority 58 (ii) By other Local Authorities 260 (iii) By other bodies or persons — (b) With State assistance under the Housing Acts:— (i) By the Local Authority (a) For the purposes of the 1936 Act (Slum Clearance) 56 (b) For the purposes of the 1936 Act (Overcrowding) 2 (c) For other purposes Nil. See notes on page 56. 50 Number of Houses owned by the Local Authority [at 31-12-38) (a) Held under the Housing Acts:— (1) With State assistance:— Under the 1919 Act—New Housing 150 Rehousing 36 186 ,, ,, 1923 Act—New Housing 61 Rehousing 24 85 „ ,, 1924 Act 544 ,, ,, 1930/1936 Acts (Slum Clearance) (including 67 built during the last 2 years) 248 ,, 19351*936 Acts (Overcrowding) (including 37 built during last 2 years) 37 1,100 (2) Without State assistance:— Houses converted to tenements (tenements) 24 1,124 (3) Purchase for eventual demolition 4 (b) Held under other powers (1) Purchased for alternative accommodation 2 (2) Other properties 6 8 51 Housing Act, 1936. The progress of areas during 1938 has been as follows:— (/) Represented, in 1938. 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:— 67 Saltwell Street 0.244 10 13 40 — 24.3.38 Clearance only. Inquiry 25.5.38. Order confirmed 19.8.38. 84a Maddains Street, 1—4 0.0653 4 4 13 — 24.3.38 Inquiry 25.5.38. Compulsory Purchase Order confirmed 19.8.38. 84b Maddams Street, 5—24 0.343 20 21 84 — 24.3.38 Inquiry 25.5.38, Compulsory Purchase Order confirmed 19.8.38. 85 Arrow Road 0.1055 6 7 40 —— 24.3.38 Clearance only. Inquiry 25.5.38. Order confirmed 19.8.38. 86 Watts Grove 0.167 7 12 49 — 24.3.38 Inquiry 25.5.38. Compulsory Purchase Order confirmed 19.8.38. 87 Eliza Place (6) London County Council:— 0.080 4 4 17 — 24.3.38 Clearance only. Council property. 23 Elizabeth Place (3 areas) 4.38 178 669 136 26.7.38 2 shops, etc. 52 (11) Represented, prior lo 1938. No. Area. Clearance Area. Whether additional lands acquired. No. of persons in added lands. Acreage of total area. Remarks and position at 31st December, 1938. Title. No. of houses. No. of persons. Dato of resolution. (a) Poplar Borough Council: 16 Old Ford Road (Taylor's Buildings) 5 24 20.12.34 No — 0.07 Premises unoccupied. 34a Sarah Cottages (Lindale Street) 5 14 7.1.37 No 0.04 Premises demolished. 34b Lindale Street 3 15 25.2.37 No — 0.03 Premises demolished. 46 Ford Road (No. 2) 3 14 24.1.35 No — 0.055 Premises unoccupied. 62 Milton Place 9 35 25.5.38 No — 0.097 Premises demolished. 80 Glaueus Street 7 35 25.5.38 No — 0.2304 Inquiry 25.5.38. Order confirmed 19.8.38. 4 houses excluded, but may be purchased under Section 27 of Housing Act, 1936. (6) London County Council: 12 Phoebe Street 140 1118 9.2.37 Yes 176 6.661 Rehousing in progress. 20 Vesey Street (2 areas) 44 250 30.7.35 Yes 46 1.04 Rehousing in progress. 22 Hinks Place 26 94 4.5.37 No — 0.403 Order confirmed May, 1938. Re-housing in progress. 26 Cottage Place 10 30 4.5.37 No — 0.102 Premises demolished. 28 Bow Road (8 areas) 39 110 31.3.36 Yes 115 4.26 Demolition in progress. 38 Dock Cottages (2 areas) 71 322 19.11.35 Yes 143 2.7 Site cleared. 53 Grace Street 69 288 2.2.37 Yes 20 1.48 Rehousing in progress. 56 Devas Street Areas 1—5 305 2164 14.7.36 Yes — 11.299 Rehousing in progress. (inc. added lands) 53 Underground Rooms.—Orders were made prohibiting the use of the following underground rooms for any purpose other than the storage of non-edible articles, except where otherwise stated:— 3, Blackwall Way, E.14 57, Sussex Street, E.14 26, Bruce Road, E.3 63, Three Mill Lane, E.3 22, Sussex Street, E.14 22, Stebondale Street, E .14 14, Glengall Grove, E.14 22, Blackwall Way, E.14 86, Northumberland Street, E.14 10, Stafford Road, E.3 69, Guildford Road, E.14 23, Harley Street, E.3 3, Tomlins Grove, E.3 hi, Hind Grove, E.14 32, Gough Grove, E.14 32, Woodstock Terrace, E.14 65, East India Dock Road, E.14 26, Canton Street, E.14 119, Cadogan Terrace, E.9 88, Fairfield Road, E.3 51, Upper North Street, E.14 7, Abbott Road, E.14 9, Glengarnock Avenue, E.14 43, Saunders Ness Road, E.14 3, Addington Road, E.3 6, Driffield Road, E.3 5, Mornington Road, E.3 10, Bazely Street, E.14 91, Ellerman Street, E.14 28, Bruce Road, E.3 15, Brig Street, E.14 Basement front and back rooms. Basement front and back and scullery. Basement front and back rooms. Basement back room. Basement front room. Basement front and back rooms. Basement front, back, scullery and passage. Basement front room. Basement front and back rooms. Basement front and back rooms. Basement front and back rooms. Basement front, middle and back. Basement front, back and scullery. Basement front and back rooms. Basement front and back rooms. Basement front room. Basement front and back rooms. Basement front room. Basement front room. Basement front room. Basement back room. Basement front and back rooms. Basement front room. Basement front and back rooms. Basement front and back rooms. Basement front room. Basement front, back and scullery. Basement front and back rooms. Basement front and back rooms. Basement front and back rooms. Basement front and back rooms. 54 Undertakings to carry out works accepted. 551, Manchester Road, E.14. 8, Stafford Road, E.3. 183, Stebondale Street, E.14. 171, Stebondale Street, E.14. 74, Stebondale Street, E.14. 34, Merchant Street, E.3. 497, Manchester Road, E.14. 347, East India Dock Road, E.14. 20, Campbell Road, E.3. 603, Manchester Road, E.14. 113, Cadogan Terrace, E.9. 2, Beale Road, E.3. 10, Stafford Road, E .3. 93, 154, 403 and 472, Grosvenor Buildings, E.14. Undertakings cancelled consequent upon specified works being carried out. 50, Saxon Road, E .3. 109, Cadogan Terrace, E.9. 551, Manchester Road, E.14. 93, Campbell Road, E.3. 74, Stebondale Street, E.14. 171, Stebondale Street, E.14. 603, Manchester Road, E .14. 34, Merchant Street, E.3. Closing Orders determined. 76, Sussex Street, E.14 Basement front and back. 3, Tomlins Grove, E.3 Basement front, back and scullery. Works carried out voluntarily. 2a, Oriental Street, E.14. Undertakings not to use rooms for human habitation accepted. 4, Woodstock Terrace ,E .14 Basement front, back and scullery. 55 Contraventions of Closing Orders. Premises. Remarks. 30, Bruce Road, E.3 26th May, 1938, the Town Clerk wrote owner regarding contravention of the Closing Order. In April, 1938, the owner wrote stating occupants had accepted accommodation offer of London County Council and were waiting to hear from them. Owner promised to communicate with Town Clerk when applicant was rehoused. 57, Sussex Street, E.14 1st June, 1938, Housing Inspector reported that premises were not now used for living purposes although still partially furnished. 7, Stafford Road, E.3 18th August, 1938, Housing Inspector reported that Order was now being complied with. 22, Stebondale Street, E.14 Housing and Town Planning Committee allowed basement front room to be used as a boot repairing business for benefit of present occupier. 56 Overcrowding. (Also see pages 48-49.) Special circumstances led to the investigation of 9 new instances of overcrowding, and seven of the more serious cases were reported to the Public Health Committee. Ten 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. No intimations were served. In all 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 measurement of houses which had not been measured during the overcrowding survey of 1935-36 was carried out in the early months of the year. Of the 14,211 houses measured overcrowding was found in 231 (1.11 per cent.). Licence for temporary use by persons in excess of permitted number. One licence was granted in December, 1938, for a period of one year. Since that time one member of the family has died and another has left home after her marriage. There is now no overcrowding at the premises concerned. Verminous Premises and Rooms. The service of notices regarding 311 premises and the contents of rooms at 10 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. 57 Eradication of Red Bugs. Summary of the Work done by the Special Inspectors for Disinfestation. Council Properties. Private Properties. Premises Inspected. Number of premises reported to Public Health Committee (P. H. (L.) A., 1936).. — 310 Number of premises found to be infested . 58 567 Number of premises disinfested 55 451 Inspections Made. Number of premises inspected 237 884 Number of premises re-inspected after disinfestation 5 897 Miscellaneous visits and calls 2,140 833 Total numbers of visits 2,482 2,614 Treatments Applied. Fumigations to 55 Council tenements 186 — ,, to 300 private tenements — 579 Sprayings to Council tenements — — ,, to 151 private tenements — 378 Total treatments 186 957 Number of rooms to which treatments were applied 462 749 Articles Treated. Beds, bedding, etc., by steam disinfection 20,786 3,201 ,, ,, by spraying with insecticide — 6,014 Furniture, by HCN in transit to Council tenements 3.772 – ,, by spraying with insecticide or by blowlamp 293 4,086 Miscellaneous articles (includes pictures, leather goods, crockery, wireless sets, etc.) — 14,686 Totals of articles treated 24.851 27,987 58 Verminous Articles Destroyed. Council Properties. Private Properties. Bedding — 125 Clothing — 121 Furniture — 52 Miscellaneous articles — 292 Totals of articles destroyed . 590 Removal of Families to L.C.C. Tenements. In 23 cases the household effects of such families were treated before they were allowed to move into L.C.C. flats or houses. Bedding—steam treatment 419 Furniture—spraying or blowlamp 375 Sundries—spraying or blowlamp 781 Total of articles treated i,575 Removal of Families to Poplar Borough Council Tenements. In 78 cases the household effects of such families were treated by HCN in transit. Bedding 20,786 Furniture 3.772 In no cases were the household effects of such families treated with vermicide. In 39 cases the household effects were clean and free from vermin and required no treatment Council Private Re-inspections of Tenements Previously Disinfested. Properties. Properties. Number of premises re-inspected 5 301 Number of premises found satisfactory 5 214 Number of premises found satisfactory after further treatment – 27 Number of premises found re-infested — 60 Percentage re-infestation — 20% 59 The following report was submitted by the Inspectors, Messrs. I. M. G. Farries and C. H. Medland:— The completion of re-flooring work in Council premises in the early part of the year resulted in fewer vacancies occurring in Council tenements throughout the rest of the year, as many premises were previously vacated for re-flooring work to be carried out. In consequence, less opportunities occurred for thorough inspections to be made and fewer premises were found to be infested as compared with previous years. Of the vacant premises inspected, there was, however, an increase in the proportion of those found to be free from infestation, and, even among those premises found to be infested, the degree of infestation tended to be less severe. This general tendency towards improvement is probably due, not only to actual fumigation work carried out, but also to the abolition of unnecessary woodwork, the replacement of wooden casing for electric wiring with metal tubing, and the comparatively bug-Proof nature of the more modern flats. Nevertheless, even the most up-to-date flats can easily become infested by the importation of bug-infested furniture, and, for this reason, the furniture all prospective Council tenants, or of tenants transferring from one Council tenement to another, is inspected a few days prior to the date of removal in order to ascertain if any treatment is necessary. Slight infestations are dealt with by spraying the furniture, with or without steam disinfestation of bedding, and severe infestations by HCN fumigation of the furniture in vans during transit to Council houses and team disinfestation of bedding. A danger less easily overcome is the importation of bug-infested second-hand furniture some time after the date of removal to Council tenements, and little can be done to prevent this happening beyond warning Council tenants of the possible consequences of such a practice. Fortunately, the majority of tenants seem to appreciate the freedom from bugs experienced following HCN fumigation of their furniture and apparently exercise more care in buying second-hand furniture after becoming Council tenants. Many of the Council removals carried out were transfers for the purpose of abating overcrowding in Council property, and the proportion removals is increasing as this work is proceeded with. Naturally, 60 these families are usually larger than those from clearance areas, etc., so that there is a tendency for the average amount of furniture fumigated at such removals to become greater. This has resulted in an increased use of hired motor pantechnicons, as the horse-drawn Council vans, which were originally bought for slum clearance work, are usually found to be too small to cope with Council transfers. It may be added that the undoubted prejudice that existed among Council tenants against what they considered the disgrace of HCN fumigation has largely disappeared, and, if HCN fumigation of their furniture is necessary, the majority of tenants are now quite agreeable to such treatment being carried out. 62 Section E. INSPECTION AND SUPERVISION OF FOOD. Cowshed. The following cowshed was licensed to 30th June, 1939:— 17-19, Morville Street—Mr. John Henry Chandler—licensed to keep 19 cows. This cowshed in the Borough was inspected on 12 occasions during ; the year. Dairies and. Milkshops. At the end of the year there were in the Borough 81 registered premises where raw milk is sold. These premises were kept under strict observation, 296 inspections being made. 1 intimation was served in respect of cleansing and various defects. The necessary work was done without need for further action by the department. 3 persons (including 1 itinerant vendor) were registered as retail purveyors of milk, 2 being on account of change of ownership of premises. In addition to the above the following retail purveyors also were registered during the year:— 18 for sale of sterilized milk in sealed bottles (14 on account of change of ownership). 4 for sale of raw milk in sealed cartons (1 on account of change of ownership). 13 for sale of raw milk in sealed bottles (9 on account of change of ownership). Note.—One wholesale purveyor of raw milk was registered on account of change of ownership. 63 Milk (Special Designations) Orders 1936 and 1938. Licences Issued during the Year. Designation. Bottlers. Pasteurisers. Dealers in Sealed Bottles only. Supplementary Licences. Tuberculin Tested 6 18 8 Pasteurised — 2 26 12 Totals 6 2 44 20 The bottling establishments have been under constant supervision and, for the purpose of renewal of licences, special inspections were made and reports submitted. 64 Bacteriological Examination of Milk. Number of Samples Examined for Bacteria (Total Count and B. Coli and Methylene Blue Test)—108. Designated Milk. Where taken: Number satisfactory. Number unsatisfactory. Action taken. On delivery at— From Dealers— Railway Stations. L.C.C. Hospitals and Schools Before bottling. After bottling. Tuberculin Tested 3 — 13 (2) 29 (5) 38** 7 10 letters to dealers and 6 letters to Medical Officers of Health of other Authorities. Pasteurised – 25(1) 15* 19 58 1 One letter to producer and 1 letter to Medical Officer of Health of another Authority. Tuberculin Tested Pasteurised.. — — — 4 4 — Tuberculin Tested (Certifiod) — — — — — — Totals 3 25 28 52 100 8 The figures in parentheses denote number of unsatisfactory samples and are included in the totals. *8 for B. Coli count only. **5 not subjected to B. Coli test. Note.—Of the Seven samples of Tuberculin Tested milk which did not pass the B. Coli test, three also did not paas the Methylene Blue test. 65 Examination of Milk for Tubercle Bacilli (Biological Examination). Number of Samples Examined—35. (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 66.) Number reported: Remarks. Tubercle bacilli absent. Tubercle bacilli present. Examination incomplete. Designated Milks:— 4 of these were taken at L. C. C. schools. Tuberculin Tested 8 — — Tuberculin Tested Pasteurised 2 — — Tuberculin Tested Certified — — — Pasteurised 14 — — Other Milks:— Sterilised 2 — — Bottled (from Dairies) 8 — — „ (from Cowsheds) 1 — — Totals 35 — — 66 In addition to the samples shown in the table on page 65, the London County Council took samples of milk for biological examination for the presence of tubercle bacillus, as follows:— Premises. Grade. No. of samples taken No. Tuberculous. 3 Dairies Ungraded 21 — Accredited 27 2 Tuberculin Tested 2 — 50 2 Where samples were found to be tuberculous, as a result of consequent inspection, cows believed to be the source of infection were slaughtered under the Tuberculosis Order. Inspection by L.C.C. Veterinary Officers in cowsheds: — Premises. Date Inspected. No. of Cows. Cows suffering with Mastitis. *17 and 19, Morville Street 18.2.38 6 1 *One bulk sample was taken at these premises on 10th March, 1938, for examination for tubercle and proved to be negative. (On 1st April, 1938, the duty of inspecting cows in cowsheds in London was transferred to the Ministry of Agriculture and Fisheries.) 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 64.) Meat Inspection. (1.) Retail Meat. The Meat and Food Inspectors, during the course of their inspections of retail butchers' 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 3,767 Number of cases in which meat has been found unsound One (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. Carcases inspected and condemned:— Cattle excluding Cows. Cows. Calves. Sheep and Lambs Pigs. Number killed 54 535 458 3,763 1,229 Number inspected 54 535 458 3,763 1,229 All Diseases except Tuberculosis. Whole carcases condemned — — — 2 2 Carcases of which some part or organ was condemned 2 71 — 302 161 Percentage of the number inspected affected with disease other than Tuberculosis 3.7% 13.3% – 8.1% 13.2% Tuberculosis Only. Whole carcases condemned — 7 — — 4 Carcases of which some part or organ was condemned 2 228 68 Percentage of the number inspected affected with Tuberculosis 3.7% 43.9% – 5.9% ^ Both Tuberculosis and Other Diseases. Carcases of which some part or organ was condemned _ 61 – – 11 Percentage of the number inspected affected with both Tuberculosis and other diseases — 11.4% — — 0.9% The following table shows the total number of organs condemned and is inserted for comparison with previous tables. Class of Animal. All Diseases Except Tuberculosis. Organs, etc. Lungs. Livers Mesenteries. Omenta. Pancreas Spleens. Tripes. Hearts. Kidneys. Intestines. Udders. Heads. Tongues. Cattle – 1 – — 1 — — — 5 — — — — Cows 10 64 8 7 6 6 5 2 7 2 68 10 10 Calves – – – – – – – – – – – — — Sheep and Lambs 316 52 – — — 3 — 5 — 1 — — — Pigs 163 21 1 2 — 3 — 20 — — – 3 3 Class of Animal. Tuberculosis Only. Organs, etc. Lungs. Livers. Mesenteries. Omenta. Pancreas. Spleens. Tripes. Hearts. Kidneys. Intestines. Udders. Heads. Tongues. Cattle 3 1 1 — – – – – – – – – – Cows 225 32 60 10 29 7 12 12 13 6 9 98 98 Calves – – – – – – – – – – – – – Sheep and Lambs – – – – – – – – – – – – – Pigs 21 17 38 4 1 4 1 16 1 — — 37 37 67 During the year 21 samples were taken at 17 elementary schools and two dairies. All the samples were genuine. Ice Cream. During the year, 38 owners or occupiers were registered for the storage or sale of ice cream. Of these 2 were on account of change of ownership. The number of Ice Cream vendors now on register is 240. 263 Inspections were made during the year and one intimation was served in respect of various defects. Meat Inspection — see table facing this page. 68 Slaughterhouses. The following 4 slaughterhouses were licensed to 30th June, 1939:— 1. Bazeley Street.—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.) 14 inspections of slaughterhouses were made. One intimation regarding defects and 16 "reminders" that periodical cleansing was due were served. The defects were remedied and 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. No licences were issued or renewed during the year. 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. 16 licences were issued during the year. Slaughterer of Poultry. The business of a slaughterer of poultry is carried on at two premises in the Borough (see p. 31). Inspections of these premises numbered 13 and 9 "reminders" that periodical cleansing was due were served. The cleansing was carried out without need for further action. 69 Legal proceedings were taken against two persons for carrying on the business which had been established without the consent of the local authority. Bakehouses. At the end of the year there were 48 bakehouses in use, of which 11 are underground. In 39 bakehouses machinery is used. Each bakehouse in the Borough was inspected at least twice during the year, the total inspections numbering 251. 98 "reminders" that periodical cleansing was due were sent out. 2 intimations were served in respect of want of cleanliness and other defects, and the work was done without need for further action by the department. 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 1,098—Eating Houses, 186; Fruiterers, etc., 123; Fish Shops, 72; Butchers' Shops, 53; other premises (mainly "general" shops), 664. 1,701 visits were paid to these premises during the year. Want of cleanliness was found in 23 instances, and 35 other defects existed. In addition to 286 "reminders" that cleansing of fish shops was due, 7 intimations were served. The necessary works were carried out without need for further action by the department. 70 Reports of Food Inspectors. (i) Mr. C. A. Grabham. Totals. Inspections. Intimations. Reminders. Notices served. Stat. Final. Bakehouses:— Factories 110 2 43 — — Workshops 8 — 7 — — Dom. Workshops 13 — 10 — — Slaughterhouses 14 1 9 — — Cowhouses — — — — — Milkshops 51 1 — — — Restaurants and Eating Houses 105 4 — — — Fried Fish Vendors and Fish Curers— Where power is used 103 3 69 — — Others 160 1 84 — — Stalls 1,778 — — — — Other places where food is sold, etc.— Where Power is used 34 — — — — Others 225 5 — — — Ice Cream Premises— Where Power is used 16 — — — — Others 93 1 — — — Wharves, etc., where food is prepared or stored, etc.— Where Power is used Others 92 — — — — Markets— Morning 153 — — — — Evening 68 — — — — Infant Life Protection— Visits 6 — — — Food Poisoning— Visits 6 — — — — Miscellaneous 66 — — — — 3,101 18 218 — — Mr. Grabham also made 10 inspections under the Shops Act (figures are included in above table). 71 Slaughterhouses: Number of Visits 490 Number of Carcases Inspected:— Oxen 38 Bulls — Cows 279 Calves 225 Sheep 2,212 Lambs 254 Pigs 610 Organs condemned and destroyed consequent on slaughterhouse visits Heads and Tongues condemned and destroyed See table facing page 67. Number of Samples procured: (a) Under Food and Drugs (Adulteration) Act 391 (b) Under other Acts, Orders, etc. 61 (including 7 for T.B. only.) (i) Number satisfactory 58 (ii) Number not satisfactory 3 *Action taken in respect of unsatisfactory samples: (a) Legal proceedings (b) Letters sent to Vendors, Bottlers, etc. 5 (c) Reported to appropriate Government Department, or Local Authority 2 Public Health (Foreign Meat) Regulations— Certificates issued 74 Visits to Factories 172 Assistant's Time—Hours 471½ 72 (2) Mr. H. A. Pearce. Totals. Inspections. Intimations. Reminders. Notices served Stat. Final Bakehouses:— Factories 106 — 36 — — Workshops 13 — 6 — — Dom. Workshops 1 — — — — Slaughterhouses 13 — 16 — — Cowhouses 12 — — — — Milkshops 245 — — — — Restaurants and Eating Houses 172 3 — — — Fried Fish Vendors and Fish Curers— Where Power is used 56 — 37 — — Others 204 — 96 — — Stalls 2,691 — — — — Other places where food is sold, etc.— Where Power is used 160 — — — — Others 388 1 — — — Ice Cream Premises— Where Power is used 38 — — — — Others 116 — — — Wharves, etc., where food is prepared or stored, etc.:— Where Power is used — — — — — Others 2 — — — — Markets— Morning 214 — — — Evening 77 — — — Miscellaneous 115 — — — — Infant Life Protection—Visits 11 — — — Food Poisoning—Visits 2 — — — — 4,636 4 191 — — Mr. Pearce also made 3 inspections under the Shops Act (figures are included in above table.) 73 Slaughterhouses : Number of Visits 320 Number of Carcases Inspected:— Oxen 16 Bulls Cows 256 Calves 233 Sheep 862 Lambs 435 Pigs 619 Organs condemned and destroyed consequent on slaughterhouse visits See table facing page 67 Heads and Tongues condemned and destroyed Number of sample procured: (a) Under Food and Drugs (Adulteration) Act 376 (b) Under other Acts, Orders, etc. 91‡ (i) Number satisfactory 84 (ii) Number not satisfactory 7 *Action taken in respect of unsatisfactory samples: (a) Legal proceedings 2 (b) Letters sent to Vendors, Bottlers, etc. 6 (c) Reported to appropriate Local Authority 5 Public Health (Foreign Meat) Regulations— Certificates issued 6 Visits to Factories 6 Assistant's Time—Hours 406 ‡Including 9 for phosphatase test; 6 for T.B 74 The following were condemned by Mr. C. A. Grabham and destroyed:- 244 casks Grape Fruit Juice comprising 7,040 gallons. 17 tins Tongue. 40 jars Tongue. 75 casks Lemon Juice comprising 4,490 gallons. 72 bottles Tongue. 5 tins Caviare. 8 casks Orange Juice comprising 460 gallons. 5 jars Caviare. 1 6-lb. tin Beef. 2 carboys Orange Juice comprising 40 gallons. 127 tins Pineapple. 1 tin Asparagus. 28 casks Lime Juice comprising 2,240 gallons. 93 tins Sardines. 1 jar Cocktail. 5 casks Apricot Pulp comprising 250 gallons. 338 1-lb. tins Assorted Fruits. 282 2-lb. tins Assorted Fruits. 12 tins Apricot Pulp. 23 2½-lb. tins Assorted Fruits. 19 tins Orange Juice. 1 tin Damsons. 5 cwt. Lemon Peel. 39 bags Brown Sugar. 4 tins Prawns. 16 tins Corned Beef. 18 tins Tomatoes. 1 tin Haricot Beans. 60 lbs. Tomatoes. 7 tins Pears. 13 Chickens. 3 tins Petit Pois. 82 Turkeys. 4 tins Sheep Tongues. 1 tin Turkey. 54 31 -lb. tins Anchovies. 35 tins Mushrooms. 8 tins Oysters. 1 jar Mushrooms. 16 tins Tomato Puree. 1 tin Kippered Herrings. 96 tins Figs. 31 tins Kippers. 5 tins Hams. 179 tins Sprats. 1 jar Truffles. 116 tins Peas. 1 tin Mustard. 17 tins Golden Berries. 62 tins Raspberries and Blackcurrants 372 tins Strawberries and Blackberries. 1 tin Pate de Foie Gras. 324 tins Salmon. 42 10-lb. tins Black Currant Pulp. 183 tins Lobster. 5½ stone Rock Salmon. 24 tins Herrings. 20 Scotch Lamb Carcases. 12 tins Celery. The following were condemned by Mr. H. A. Pearce and destroyed:— 2 casks Orange Juice comprising 100 gallons. 8 lbs. Plums. 100 cases Oranges. 2 casks Lemon Juice comprising 100 gallons. 204 portions Cheese. 7 lbs. Bacon. 3 bags Orange Peel. 6 stone Dog Fish. 14 tins Tomatoes. 29 Wild Rabbits. 2 tins Plums. 75 The following unsound foodstuffs were released on condition that they were not used for human consumption:— 30 150/196 qrs. Wheat For animal food. 1 36/48 qrs. Wheat ,, ,, ,, 21 145/496 qrs. Wheat ,, ,, ,, 2 452/496 qrs. Wheat ,, ,, ,, 1 64/496 qrs .Wheat ,, ,, ,, 2 200/400 qrs. Barley For poultry food. 200 lbs. Barley ,, ,, 3 casks Tallow Grease manufacture. 1 ,, ,, ,, ,, 3 ,, ,, ,, ,, 2 ,, ,, ,, Soap manufacture. Released to other Authorities for purposes of Grease making:— 19 casks Tallow. 18 casks Tallow. 13 casks Tallow. 128 cases Anchovies were placed under stop and subsequently released. Certain foodstuffs were damaged aboard a vessel in collision in the River Thames. In addition to those foodstuffs previously reported, the following were released to other Authorities for technical and other purposes:— 7 bales Hops 65 packages Confectionery 49 cases Ground Almonds 39 cases Shelled Almonds 38 cases Dates 22 baskets Cheese 4 packages Raisins 2 skips Bovril Quantity of Tea 23 chests Tea 2 cases Canned Tomatoes 18 cartons of 144 packets Suet 5 ,, ,, ,, 1 carton containing 28/1 packets Suet 2 cartons of 28/1 packets Suet 3 cases Canned Dressed Crab 10 cases Canned Pineapples 15 cases Canned Salmon 18 cases Lambs' Tongues 10 cases Canned Salmon 9 cartons Cereals 2 cartons Marcaroni/Vermicelli For animal food. For sorting purposes. ,, ,, To be dealt with under supervision of other Authority. 76 (c) Food and Drugs (Adulteration) Act, 1928. The results of the analyses of 793 samples were reported to the Public Health Committee during the year:— Sample. Number examined. Number Adulterated. Action taken. Legal Proceedings. (See page 42 ) Letters of caution sent. 1. Drugs, etc. Glycerine of Thymol 2 — — — Lime Water 4 1 1 — Malt Extract 2 Oil, Camphorated 4 — — — Oil, Olive 2 — — Ointments: Blue 2 — — Boracic 4 — — Sulphur 2 — — — Zinc 8 — — — 2. Spirits. Rum 4 — — — Whisky 2 — — — 3. Other Articles. Baking Powder 2 — — — Barley, Pearl 6 — — — Biscuits 2 — — — Blanc Mange Powder 2 — — — Brawn 4 — — — Bread and Butter 12 — — — Butter 28 1 — 1 Cake 6 — — — Cheese 4 — — — Chocolate Bolls 6 1 — — Cocoa 2 — — — Coffee 2 — — — Cooking Fat 4 — — — Cordials 6 — — — Cornflour 2 — — — Cream 1 — — — Cream, Canned 1 — — — Custard Powder 2 — — — Dripping 8 — — — Egg Powder 2 — — — Fish Paste 4 — — — Flour 3 — — — Flour, Self-raising 2 — — — Fruits, Canned and Dried 4 — — — Ground Ginger 2 — — — Herrings in Tomato Sauce 2 — — — Ice Cream 2 — — — Jams 15 2 2 — Carried forward 170 5 3 1 77 Sample. Number examined. Number Adulterated. Action taken. Legal Proceedings. (See page 42.) Letters of caution sent. Brought forward 170 5 3 1 Lard 2 — — — Lemon Curd 4 — Lemonade 2 — Lemonade Crystals 2 — — — Lamb's Liver 2 — Margarine 37 — Meat, Fresh 11 — — — ,, Minced 8 1 1 — ,, Paste 6 — — — ,, Cooked 2 — — — Milk 393 13 — 3 ,, Condensed 23 — — — Hot 6 3 1 2 Mincemeat 6 — — — Mustard 2 — — — Oatmeal 2 — — Pea Flour 2 — — — Peas, Canned 4 — — — Peel, Preserved 2 — — — Pepper 4 — — — Rice 4 — — — Sago 4 — — — Sardines 8 — — — Sauce 2 — — — Sausages 17 3 1 — Shredded Suet 2 — — — Spice, Mixed 2 — — — Suger 4 — — Sweets 12 — — — Table Jelly 12 — — — Tapioca 2 — — — Tea 4 — — — Tripe 4 — — Vinegar 26 2 — 2 Vinegar, Malt — — — — Totals, 1938 793 27* 6 8 Totals, 1937 794 13** 1 8 * Including 4 informal samples. ** Including 3 informal samples. Of the samples of milk, 152 were procured from itinerant vendors, 81 on Sundays and 71 on weekdays. All these samples were genuine. 78 Milk; and Cream not Sold as Preserved Cream. (1) Number of Samples examined for the presence of preservative. (B) r in which preservative was reported to be present, and percentage of preservative found in each case. Milk 393 Nil. Cream 1 Nil. Annual Report of the Public Analysts. During the year 1938, 793 samples were examined under the Food and Drugs (Adulteration) Act. 10 samples were submitted by a neighbouring Authority, the remainder by the Inspectors. No samples were submitted by the Public under the Act. 207 of the samples were purchased informally. 27 samples were found to be adulterated, 23 formal and 4 informal. The adulteration was at the rate of 3.4 per cent. as compared with 3.46 per cent. for the whole of London and 5.5 per cent. for the whole of England and Wales in 1937. The rate of adulteration in the Borough for the past 10 years was as follows:— Year. No. of Samples examined. Percentage of adulteration. 1938 793 3.4 1937 794 1.6 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 Average 810 5.2 79 The number of samples examined was at the rate of 5.79 per 1,000 of the estimated population as compared with 9.91 per 1,000 for the whole of London and 3.79 per 1,000 for the whole of England and Wales in 1937. 393 samples of milk were examined of which 13, or 3.3 per cent. were reported as adulterated, as compared with 3.26 per cent. for the whole of London and 7.4 per cent. for the whole of England and Wales in 1937. The milk adulteration in the Borough for the past 10 years was as follows:— Year. No. of Milks examined. ntage of adulteration. 1938 393 3.3 1937 362 1.1 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 Average 383 3.9 Condensed, Milks. 23 samples of Condensed and Evaporated Milk were examined, all of which complied with the provisions of the Condensed Milk Regulations. Preservatives. There were 4 contraventions of the Preservatives Regulations, 1 Minced Meat and 3 fresh Sausages contained Sulphur Dioxide preservative. 80 Other samples examined during the year, all for the Public Health Department were:— 1 Effluent. 1 Well Water. 2 Spirits. 9 Pasteurised Milks, all of which were satisfactory. 15 Rag Flocks, 2 of which did not comply with the Regulations for cleanliness. ALBERT E. PARKES, H. A. PARKES, Public Analysts. 81 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. 15 — 2 — Agricultural Produce (Grading and Marking) Act, 1928. Premises registered under section 4, for storage of eggs: Bow Cold Storage Company, Limited, Payne Road, Bow. 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. Legal proceedings were taken in two instances, see page 42. Manufacture of Preserved Foods. No applications for the manufacture of preserved food were submitted, The number of premises now on the register is 46. Food Poisoning. During the year 5 notifications were received and one suspected I case was found during enquiries. Investigations into the 6 cases resulted in them being classified as follows:— Possible cases 2 Personal susceptibility 1 Not true food poisoning 3 82 The 2 possible cases were members of the same family and the cause of the illness was unsound chocolate roll, the vendor of which was cautioned. All patients 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. 178 visits were paid to factories and 22 tons 7 cwts. 3 qrs. 1st. 3lbs. of foodstuffs were inspected and passed for export. 4 Turkeys were also certified for export. Certificates were issued in connection with 80 consignments of foodstuffs: Canada (3), Australia (51), United States of America and Dependencies (11), India (9), other countries (6). Other foodstuffs certified for export; 100 cases each 48 cartons of dates 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. During 1938 the Committee approved 45 re-entries and 1 new entry in the Council's list. TABLE VII A.. Notifiable diseases, cases and deaths by wards, 1938. Notifiable Disease. Cases Notified. Deaths. Whole Borough. Bow. Bromley. ____Poplar. Whole. Borough. Bow. Bromley. Poplar. North. West. Cent. South. NorthWest. NorthEast. SouthWest. South East. 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) 440 35 32 30 31 22 36 47 18 62 38 25 20 27 17 10 1 — 1 1 — 2 1 — 1 — 1 1 — 1 Erysipelas 60 5 1 2 1 8 6 7 — 2 6 7 4 9 8 2 — 1 — — — — — — — — 1 — — — Scarlet Fever 310 20 19 24 28 25 11 30 11 18 38 20 19 14 33 1 — — — — — — — — — 1 — — — — Typhus Fever — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — Enteric Fever (including Paratyphoid) 3 — 1 — — — — — — — — 1 — — 1 — — — — — — — — — — — — — — — Relapsing Fever — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — Continued Fever — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — Puerperal Fever 6 — — 1 1 — — 2 1 1 3 — — — — — — — 1 — — — 2 — — Puerperal Pyrexia 45 3 4 3 2 3 2 3 5 4 4 5 1 1 5 — — — — — — — — — — — — — — — Cerebro-Spinal Fever 6 — — — — — 2 1 1 — — 1 1 — 3 — — — — — — 1 — 1 — — 1 — — Acute Poliomyelitis 4 1 — —— 1 — 1 — — — — — — 1 — — — — — — — — — — — — — — — — Acute Encephalitis Lethargica — — — — — — — — — — — — — 2 — — — — — — — — 1 — — 1 — — Ophthalmia Neonatorum 9 — 1 1 — — — — — — 4 — — 2 1 — — — — — — — — — — — — — — — *Zymotic Enteritis 99 2 3 1 2 7 6 12 2 6 7 27 3 6 15 17 1 — 2 1 3 1 3 — 1 1 2 — — 2 Pneumonia, Acute Primary 290 16 17 15 12 14 18 35 16 12 27 24 20 39 25 44† 3 2 4 3 5 1 4 4 3 4 5 — — 3 ,, Acute Influenzal 13 — 2 1 — 1 1 1 1 2 — —- — 3 1 1† — — — — — — — — — 1 — — — — Dysentery 14 — — — 1 5 1 — 2 3 — — — 1 1 1 — — — — — 1 — — — — — — — — †Measles 8 — 1 1 — 1 — — — — 1 3 1 — — 14 — 1 — — 2 — 1 1 3 1 2 1 2 — †Whooping Cough 80 2 10 16 4 10 2 3 4 12 6 1 9 1 — 3 — — 1 — 2 — — — — — — — — — Totals 1393 84 91 94 82 97 85 140 60 122 131 113 80 106 108 101 5 4 8 5 12 5 10 6 10 8 11 7 4 6 * †See notes at foot of Table VII. TABLE VII. Notifiable diseases during the Year 1938. (52 Weeks.) Notifiable Disease. Cases Notified in Whole Borouqh. Total Deaths in Age-Periods. At all Ages. At Ages—Years. Number of Cases admitted to Hospital. At all Ages. At Ages—Years. Under 1. 1 to 2. 2 to 3. 3 to 4. 4 to 6. 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 Membraneous Croup) 440 9 16 37 37 53 196 60 15 11 4 1 1 439 10 1 — 1 2 1 4 1 — — — — — Erysipelas 66 1 1 2 1 — 2 2 3 10 10 21 13 45 2 — — — — — — — — — — 1 1 Scarlet Fever 310 3 17 25 31 23 135 39 14 18 4 1 — 297 1 — — — — — — — — — — 1 — Typhus Fever — — — — — — — — — — — — — — — — — — — — — — — — — — Enteric Fever(including Paratyphoid) 3 — — — — — — — 1 1 — 1 — 3 — — — — — — — — — — — — — Relapsing Fever — — — — — — — — — — — — — — — — — — — — — — — — — — — Continued Fever — — — — — — — — — — — — — — — — — — — — — — — — — — — Puerperal Fever 6 — — — — — — — 1 3 2 — — 6 3 — — — — — — — — — 3 — — Puerperal Pyrexia 45 — — — — — — — 4 35 5 1 — 43 — — — — — — — — — — — — — Cerebro-Spinal Fever 6 2 — 1 — — — 1 — — 1 1 — 6 3 1 — — — — — — — — 1 1 — Acute Poliomyelitis 4 — 2 1 — 1 — — — — — — — 4 — — — — — — — — — — — — — Acute Encephalitis Lethargica — — — — — — — — — — — — — — 2 — — — — — — — — 1 — 1¶ ¶ Ophthalmia Neonatorum 9 9 — — — — — — — — — — — 2 — — — — — — — — — — — — — *Zymotic Enteritis 99 52 30 8 4 3 2 — — — — — — 67 17 16 — — — — — — — 1 — — — Pneumonia, Acute Primary 290 49 38 27 23 20 33 5 7 25 16 31 16 125 44† 14 3 — — — — — — 1 3 16 7 ,, Acute Influenzal 13 1 — — — — 1 1 — 4 2 4 — 1 1† — — — — — — — — — — — 1 Dysentery 14 2 3 — 1 2 3 2 — 1 — — — 7 1 — — — — — — — — — — 1 — §Measles 8 4 1 2 — — — — — 1 — — — 1 14 7 5 1 — 1 — — — — — — — §Whooping Cough 80 6 13 7 14 11 28 1 — — — — — 9 3 2 1 — — — — — — — — — — Totals 1393 138 121 110 111 113 400 111 45 109 44 61 30 1055 101 41 9 2 2 2 4 1 — 3 7 21 9 This table does not include cases in which the original diagnosis was not confirmed. * See notes on pages 90 and 119. The number of deaths relates to the whole year. §§ Notifiable from 1st October, 1938. † Notified patients only. ¶ Not notified; inmate of Institution for some years. (An analysis of cases and deaths by Wards is given in a separate Table on next page.) 83 Section F. PREVALENCE OF, AND CONTROL OVER, INFECTIOUS AND OTHER DISEASES. Tables showing the incidence of and deaths from infectious diseases face this page, and there is nothing which calls for special comment. The notification rate was 10.4, compared with 9.8 in 1937. Mortality from Diphtheria, Scarlet Fever and Enteric Fever. Diphtheria. Scarlet Fever Enteric and Paratyphoid Fevers. Cases 440 310 3 Deaths 10 1 — Fatality Rate 2.3 0.3 — 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 understanding that the Poplar children do not require a special clinic. The number dealt with during the year was as follows:— Cases referred to Hackney 86 Certificates of immunisation received during 1938 76 Certificates of natural immunity received during 1938 12 Re-Schick only 2 Treatment incomplete owing to removal 3 Cost £40 15s. od. The immunising agent used is TAM. 84 Diphtheria Anti-toxin. 180,000 units of diphtheria anti-toxin were issued to medical practitioners 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. 156,000 units were issued from St. Andrew's Hospital during the year. Care is taken to see that old stock is replaced periodically. Enteric Fever. Five 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 leaving 3 cases, the attack rate being 0.02. There were no deaths. Smallpox. No cases of Smallpox were notified during the year. A revised memorandum on the steps to be taken by Sanitary Authorities on the occurrence of Smallpox was issued by the Ministry of Health. Copies of the memorandum were supplied to each Public Vaccinator in the Borough and the Vaccination Officer. Vaccination. The following particulars regarding vaccination have been taken from the Vaccination Officer's reports:— 85 Extract from the Report of the Vaccination Officer, respecting tho Vaccination of Children whose Births were registered from 1 st January to 31st December, 1937, inclusive: — Registration Sub-Districts. Number of Births registered 1st Jan. to 31st Dec., 1937. Number of Births entered by 31st January, 1939, in "Vaccination Register." Number of Births which on 31st January, 1939, 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 1938. Number of Statutory Declarations of Conscientious Objection actually received during the calendar year 1938. Col. 1 Successfully vaccinated . Col. 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) (5) (6) (7) (8) (9) (10) (11) (12) (13) Bow and Bromley 1246 129 — — 823 55 — 28 36 175 336 1115 Poplar 408 62 — — 276 22 — 1 11 40 Total 1654 181 — — 1099 77 — 29 47 221 336 1115 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) Ihe figures in Columns 2 to 11 should not include re-registered births. The total number of copies of certificates for the year 1937 sent to other Vaccination Officers was 103, M. 379. 86 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, 1938. 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 213 75 288 33 Bromley Dr. C. Cotter 55 20 75 11 Poplar Dr. H. J. O'Brien 47 31 78 11 Bow Dr. D. G. Macrae 77 11 88 6 Millwall Dr. M. Blanker 34 13 47 5 St. Andrew's Hospital Dr. J. R. M. Whigham — — — — Poplar Institution Dr. J. R. M. Whigham — — — — St. Clement's Hospital Dr. E. T. Pinhey — — — — Col. 1 2 3 4 5 6 7 M. 379s. 87 The following analysis of the Report of the Vaccination Officer reveals the fact that nearly 88 per cent. of the children whose births were registered in 1937 were not protected by successful vaccination:— Births registered 1.654 Deduct:— Died unvaccinated 77 Removals to other districts 29 Removals to places unknown, etc. 47 153 Surviving residents 1,501 Successful vaccinations numbered .. 181 ' 181=12.1 per cent. Insusceptible of Vaccination Had Smallpox . Conscientious Objections declared .. 1,099 Vaccinations postponed on Medical Certificates Number not accounted for 221 Total unvaccinated children 1,320=87.9 per cent. 1,501 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 Anthrax, Glanders or Hydrophobia in Man occurred. 88 Erysipelas. 66 cases of Erysipelas were notified, and there were two deaths from this disease. 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 vear:— Puerperal Fever. Puerperal Pyrexia. Cases notified 6* 45* Removed to L .C .C. Fever Hospitals 4 16 Treated in other Hospitals 2 27 Treated at home — 2 Consultant called in — — Deaths 3** — * Corrected figures (after adjustment for altered diagnosis). ** Including two cases which were not notified. A list of deaths from puerperal causes or associated with pregnancy is given on page 123. Continued and Typhus Fevers. No cases of continued and typhus fevers were notified. Cerebro-Spinal Fever. Six cases of Cerebro-Spinal Fever were notified and were treated in hospital. Four patients received serum treatment (two with Prontosil also) and three recovered. Deaths numbered three (including one patient who had been treated with Prontosil only. In three other cases diagnosis was not confirmed. Acute Poliomyelitis. Four cases were notified and removed to hospital. Acute Polio-Encephalitis. No cases of Acute Polio-Encephalitis were notified. Acute Encephalitis Lethargica. No cases were notified. Two deaths were certified as being due to Encephalitis Lethargica. One was of a patient who was notified in 1928 and the other of a patient who had not been notified. Both had been in institutions for a number of years, 89 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. 90 Post-Vaccinal Encephalitis, etc. No case of Post-Vaccinal infection was reported. Measles. The County of London Measles and Whooping Cough Regulations came into operation 1st October, 1938. 1,802 cases of Measles and German Measles (of which 8 were notified) were reported to the Medical Officer of Health from various sources (principally from L.C.C. schools). This figure is corrected for altered diagnosis cases. 268 of the cases were treated in hospitals. Fourteen deaths were attributed to Measles. Zymotic Enteritis. Regulations dated 4th March, 1938, were issued by the Ministry of Health require the notification of cases of Zymotic Enteritis in children under 5 years of age. Notice of the regulations was given by advertisement in the local press and by posters. (A summary of the notified cases which were visited by the Health Visitors is given in the Maternity and Child Welfare Section, page 120.) Pneumonia. 290 cases of Acute Primary Pneumonia and 13 cases of Acute Influenzal Pneumonia were notified during the year, 126 of the patients being treated in hospitals. 45 notified patients died—44 Acute Primary Pneumonia and 1 Acute Influenzal Pneumonia. Malaria. No cases of Malaria were notified during the year. 91 Dysentery. 17 cases were notified and were treated in hospital. In 3 instances the diagnosis was not confirmed. One death was recorded—bacillary dysentery; bacillus pyocyaneus; diabetes mellitus. 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 119. Cancer. The number of deaths from Cancer for the last ten years is shown below: - Year. Males. Females. Total 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 1937 134 107 241 1938 142 102 244 92 Tuberculosis. Tuberculosis Officer's Report. The London County Council continued from 1st April, 1938, the arrangements whereby Tuberculosis Officers of the Metropolitan Boroughs are deemed to be honorary consultants for tuberculosis in the general hospitals under the London County Council's control. The Council's Tuberculosis Dispensary is at No. 1, Wellington Way (late 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 Porter. Tuesday 11 a.m. and 2 p.m. Any person not at work or not attending School. Thursday Friday X-Ray Apparatus, Tuberculosis Dispensary. Early in 1938 a letter was received from the London County Council approving the proposal to renew the X-Ray screening apparatus at the Dispensary by the purchase and installation of the Watson "Telestat" screening unit. The plant was installed in June, 1938, and 211 screenings were carried out from that date till the end of the year. 93 Statistics for 1938. The three following tables comprise the annual return for 1938 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, whether lost sight of, recovered or dead. 94 Return for the year 1938. 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):- (a) Definitely Tuberculous 65 44 3 3 3 2 6 3 68 46 9 6 129 520 (b) Diagnosis not completed — — — — — — — 4 4 1 1 10 (c) Non-Tuberculous — — — — — — — — 133 121 59 68 381 B.-Contacts examined during the year:— (a) Definitely Tuberculous 1 2 — 1 — 1 1 2 1 4 349 (b) Diagnosis not completed — — — — — — 2 1 2 5 (c) Non-Tuberculous — — — — — — — — 76 118 70 76 340 C.-Cases written off the Dispensary Register as:— (a) Recovered 19 11 2 3 4 7 8 9 23 18 10 12 63 797 (b) Non-Tuberculous (including any such cases previously diagnosed and entered on the Dispensary Register as Tuberculous) – – – – – – – – 215 245 129 145 734 D.—Number of Cases on Dispensary Register on December 31st:- (a) Definitely Tuberculous 248 207 13 25 32 33 44 34 280 240 57 59 636 651 (b) Diagnosis not completed — – – — — — — — 4 6 2 3 15 1. Number of cases on Dispensary Register on January 1st, 1938 716 2. Number of cases transferred from other areas, and cases returned after discharge under Head 3 in previous years 45 3. Number of cases transferred to other areas, cases not desiring further assistance under the scheme, and cases "lost sight of" 90 4. Cases written off during the year as Dead (ail causes) 92 5. Number of attendances at the Dispensary (including Contacts) 5,030 6. Number of Insured Persons under Domiciliary Treatment on December 31st 234 7. Number of consultations with Medical Practitioners:— (a) Personal 6 8. Number of visits by Tuberculosis Officers to homes (including personal consultations) 552 (b) Other 299 9. Number of visits by Nurses or Health Visitors to homes for Dispensary purposes 6,461 10. Number of:— (a) Specimens of Sputum, etc., examined * P.H. 210 Dispensary 525 (b) X-RAY examinations made in connection with Dispensary work Screenings at Dispensary 211 Films at St. Andrews Hosp. 350 11. Number of "Recovered" cases restored to Dispensary Register, and included A. (a) and A.(b) above 2 12. Number of "T.B. plus" cases on Dispensary Register on December 31st 356 2. PULMONARY TUBERCULOSIS. Showing in summary form (a) the condition at the end of 1938 of all Patients remaining on the Dispensary Register; and (b) the reason for 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 the 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 1938. Previous to 1928. 1928. 1929. 1930. 1931. 1932. Class T.B.—. Class T.B.+ . Class T.B.—. Class T.B.+. Class T.B.—. 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. + ). Group I. Group II. Group III. Total (T.B. + ). Group I. Group II. Group III Total (T.B.+ ). Group I. Group II. Group III. Total (T.B. + ). Group I. Group II. Group III. Total (T.B.+). Group I. Group II. Group III. Total (T.B.+). (a) Remaining on Dispensary Register on December 31st. Disease Arrested Adults M. - 1 6 - 7 - - — — — — 1 1 — 2 — — 1 — 1 — 2 — — 2 3 3 2 — 5 F. 1 — 2 — 2 — — 1 — 1 — 1 — — 1 1 — 1 1 2 1 1 — 1 2 2 1 3 — 4 Children 2 — — — - — — — — — — — — — — 1 — — — — — — — — — — — — — — Disease not Arrested Adults M. - 1 3 - 4 1 - 3 — 3 — 4 — 4 — 3 1 — 4 — 1 2 — 3 1 4 3 — 7 F. 1 — 3 - 3 — 1 1 — 2 — 1 — — 1 — 1 — 1 — 1 2 — — — 3 2 — 5 Children - — 1 1 2 — — — — — — — — — — — — 1 — 1 — — — — — — — — — — Condition not ascertained during the year 1 2 - 2 - - — — — — — — — — 1 — 1 2 — — — — 1 — 2 — 2 Total on Dispensary Register at Dec. 31st 5 2 17 1 20 1 1 5 — 6 3 5 — 8 2 4 5 1 10 3 5 4 1 10 7 11 12 — 23 (b) Not now on Dispensary Register and reasons for removal therefrom. Discharged as Recovered Adults M. 46 28 44 — 72 5 5 1 — 6 1 1 — — 1 6 2 2 — 4 4 4 2 6 — 5 — — 5 F. 80 28 34 — 62 1 4 3 — 7 4 6 1 — 7 3 3 1 — 4 3 1 2 — 3 3 — — — — Children 96 8 13 — 21 3 1 — — 1 2 — — 2 5 — — — — 5 1 — — 1 1 — — — — Lost sight of or otherwise removed from Dispensary Register 82 56 111 4 171 22 6 16 — 22 7 11 23 2 36 23 16 21 3 40 13 12 12 3 27 8 20 12 — 32 Dead Adults M. 21 35 120 29 184 10 11 25 5 41 4 14 24 9 47 5 9 40 14 63 4 14 28 13 16 55 — 14 16 9 39 F. 10 29 99 17 145 2 2 27 3 32 7 13 29 6 48 4 7 25 7 39 1 5 15 1 36 3 6 22 16 44 Children 2 — 7 2 9 4 — 2 — 2 1 — 1 — 1 1 2 2 — 4 — 1 1 3 1 — 1 — 1 Total written off Dispensary Register 337 184 428 52 664 47 29 74 8 111 26 47 78 17 142 47 39 91 24 154 30 38 60 131 16 45 51 25 121 Grand Totals 342 186 445 53 684 48 30 79 8 117 26 50 83 17 150 49 43 96 25 164 33 43 64 141 23 56 63 25 144 1933. 1934. 1935- 1936. 1937. 1938 | (a) Remaining on Dispensary Register on December 31st. Disease Arrested Adults M. 1 5 2 — 7 4 6 4 — 10 2 — 1 — 1 2 — — — — — — — — — — — — — F. 2 1 2 — 3 5 4 3 — 7 2 3 1 — 4 3 — — — — — — — — — — — — Children — 2 — — 2 5 2 — — 2 — — — — — 1 — — — — — — — — — — — — — — Disease not Arrested Adults M. — 6 2 — 8 1 3 6 — 9 3 6 10 — 16 6 5 16 — 21 14 5 24 — 29 14 8 31 17 2 41 F. 1 5 3 — 8 1 3 2 — 5 — 5 11 1 17 3 6 8 1 15 10 8 22 3 33 16 5 1 2 24 Children — — — — — — 2 1 — 3 1 — — — — 3 1 3 — 4 3 1 — — 1 5 — — — 1 Condition not ascertained during the year 3 2 — — 2 — — — — — 2 — — 1 — 1 2 2 — 4 2 2 — — 2 — — 49 — — Total on Dispensary Register at Dec. 31st 7 21 9 — 30 16 20 16 — 36 12 — 23 — 38 19 14 29 1 44 30 16 46 3 65 35 13 — 4 66 (b) Not now on Dispensary Register and reasons for removal therefrom. Discharged as Recovered Adults M. 1 2 — 2 — — — — — — — — — — — — — — — — — — — — _ — — — F. — 1 — — 1 — — — — — — — — — — — — — — — — — — — — — — — — — Children 2 — — — — — — — — — — — — — — — — — — — — — — — — — — — — — Lost sight of or otherwise removed from Dispensary Register 13 19 13 1 33 23 14 15 — 29 17 10 14 — 24 11 7 19 — 26 6 6 11 1 18 — 1 1 — 2 Dead Adults M. 4 18 25 16 59 5 9 17 9 35 2 3 22 6 31 4 5 21 7 33 — 1 14 6 21 8 3 1 6 5 12 F. 2 13 23 11 47 5 6 20 3 29 2 4 10 6 20 1 1 9 2 12 1 — 6 2 1 _ 2 3 5 Children — 1 3 1 5 1 — 1 — 1 — — — — — 2 — — — — — — 1 — 48 — - — 1 20 Total written off Dispensary Register 22 54 64 29 147 34 29 53 12 94 21 17 46 12 75 18 13 49 9 71 7 7 32 9 113 3 2 9 9 86 Grand Totals 29 75 73 29 177 50 49 69 12 130 33 31 69 13 113 37 27 78 10 115 37 23 78 12 113 38 15 58 13 3. NON-PULMONARY TUBERCULOSIS. Showing in summary form (a) the condition at the end of 1938 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 1938. Previous to 1928. 1928. 1929. 1930. 1931. 1932. 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. Total. Bones & Joints. Abdominal . Other Organs. Periph'al Glands. Total. Bones & Joints. Abdominal. Other Organs. Periph'al Glands. Total. (a) Remaining on Dispensary Register on December 31st. Disease Arrested Adults M. — - 1 - 1 - - - - - - - - - - - - - - - - - 1 - 1 1 — 2 — 3 F. 1 - — - 1 - - - - - - - - - - - - - — 1 — — — 1 — — — — — Children 1 - — - 1 — — — — — 2 — — — 2 2 — — — 2 3 — 1 4 - - — - - Disease not Arrested Adults M. 1 - - - 1 1 - - - 1 - - - - - - - 2 - 2 1 - 1 - 2 1 — 1 — 2 F. 1 - 3 1 5 - - - - - - - - 1 1 - - - - - 1 — 2 — 3 1 — — — 1 Children - - — - — — — — — — 1 — — - 1 — — — 2 2 1 — — 1 2 2 — 1 — 3 Condition not ascertained during the year — — — — — — — — — — — — — — — — — 1 — 1 — — — — — — — 1 — 1 Total on Dispensary Register, December 31st 4 — 4 1 9 1 — — — 1 3 — — 1 4 2 — 3 2 7 7 - 4 2 13 5 — 5 — 10 Transferred to Pulmonary — — — 3 3 — — — — — — — 1 1 2 — — — — — 2 — - — 2 — — — 1 1 (b) Not now on Dispensary Register and reasons for removal therefrom. Discharged as Recovered Adults M. 9 4 4 6 23 - - - 2 2 5 1 1 - 7 1 1 2 1 5 3 — 1 1 5 - — — — — F. 8 — 8 11 27 2 - - - 2 1 - - 3 4 2 — 2 — 4 2 2 1 1 6 1 — — — 1 Children 28 12 13 78 131 4 3 — 4 11 6 2 2 5 15 7 5 2 7 21 3 1 1 6 11 - 2 1 7 10 Lost sight of or otherwise removed from Dispensary Register 19 3 10 31 63 6 3 2 7 18 6 1 2 3 12 9 1 2 4 16 11 1 2 5 19 5 — — 5 10 Dead Adults M. 7 — — — 7 - - 1 - 1 1 - - - 1 - - - - - 2 — — — 2 1 — — — 1 F. 1 — — — 1 1 - - 1 1 - - - 1 - - - - - 1 1 — — 2 — — — — — Children 5 — — 1 6 — — — 1 1 1 — — — 1 - - — — — 1 — — — 1 — — — — — Total written off Dispensary Register 77 19 35 127 258 13 6 3 14 36 21 4 5 11 41 19 7 8 12 46 23 5 5 13 46 7 2 1 12 22 Grand Totals of (a) and (b) (excluding those transferred to Pulmonary) 81 19 39 128 267 14 6 3 14 37 24 4 5 12 45 21 7 11 14 53 30 5 9 15 59 12 2 6 12 32 1933. 1934. 1935. 1936. 1937. 1938. (a) Remaining on Dispensary Register on December 31st. Disease Arrested Adults M. — - - - - - - 2 1 3 - - - 2 2 - - - - - - - - - - - - - - F. — - - - - - - 1 1 2 - - - - - - - - - - - - - 1 1 - - - - - Children 1 1 — 3 5 - - - 8 8 2 1 - 5 8 — 1 — 3 4 - — — - - — — — — Disease not Arrested Adults M. 1 - 1 - 2 - - - - - - - - - - 3 - 2 - 5 1 - - 1 2 - - - 2 2 F. — — - - - - - - 1 1 - 1 - - 1 - - 1 5 6 2 - 2 2 6 - — 1 1 2 Children 2 - — 2 4 1 - — 1 2 3 1 — 1 5 5 - 1 3 9 4 - — 2 6 7 1 — 1 9 Condition not ascertained during the year — — — — — — - — 2 2 1 — — — 1 — - — — — — — — 1 1 — — — — — Total on Dispensary Register, December 31st 4 1 1 5 11 1 — 3 14 18 6 3 — 8 17 8 1 4 11 24 7 — 2 7 16 7 1 1 4 13 Transferred to Pulmonary — - — 1 1 — — — - — — — — - - 1 — — — 1 — — — - — — — — — — Not now on Dispensary Register and reasons for removal therefrom. Discharged as Recovered Adults M. 1 — — - 1 - - - 1 1 - - - - - - - - - - - — - - — — — — — — F. - 1 1 1 3 1 1 1 - 3 - - - - - - - - - - - — — — — — — — — — Children 1 1 — 4 6 1 1 - 1 3 — — — — — — - — — — — — — — — — — — — — Lost sight of or otherwise removed from Dispensary Register 2 2 4 3 11 3 - 3 6 12 5 1 1 4 11 4 1 4 2 11 — — — 1 1 — 1 1 — 2 Dead Adults M. 1 — — 1 2 - - 1 - 1 - - 1 1 1 - 1 - 2 1 - — - 1 — — — — — F. - — — — - - - - - - 1 - 1 1 - - - 1 - - 1 — 1 — — — — — children - - — — — — — — - — - — — — - - — — 1 1 — - 1 — 1 — — — — — Total written off Dispensary Register 5 4 5 9 23 5 2 5 8 20 6 1 1 5 13 6 1 5 3 15 1 — 2 1 4 — 1 1 — 2 Grand Totals of (a) and (b) (excluding those transferred to (Pulmonary) 9 5 6 14 34 6 2 8 22 38 12 4 1 13 30 14 2 9 14 39 8 - 4 8 20 7 2 2 4 15 95 Comments on Table I. Items A and. B.—The total new cases and contacts examined during the year shows a decrease of 44 as compared with 1937. The 520 new cases of Item A is a composite figure made up as follows:—375 cases (excluding contacts) attending for the first time during 1938, and 145 cases (including contacts) examined during preceding years and discharged as non-tuberculous, who presented themselves for re-examination during 1938. Of these 520 new cases, 129 were found to be suffering from tuberculosis. 349 new contacts (Item B) were examined during the year, and of these 4 were found to be suffering from tuberculosis. Item 5.—The number of attendances during the year shows a decrease of 291 as compared with 1937. Item 9.—In addition to the 6,461 visits paid by the Health Visitors for Dispensary purposes, 162 "non-dispensary" visits were paid under the Public Health (Tuberculosis) Regulations, 1930. Comments on Tables II and III. These returns continue to remain optional. During the year 63 cases were removed from the Dispensary Register as "Recovered" (there were 45 in 1937), and are analysed in Item C on Table I. These have been added to those similarly removed in former years in the appropriate columns of Tables II and III. Additional Statistics. Patients sent away for institutional treatment 119 Patients in receipt of extra nourishment from Dispensary during the year 128 Patients in receipt of extra nourishment from Dispensary on December 31st 50 Reports on child contacts to Divisional School Medical Officer 104 Letters to General Practitioners concerning patients 401 Reports to General Practitioners on official forms 117 Progress reports received from General Practitioners 24 Clinical reports to London County Council 461 Reports to Ministry of Pensions — Shelters on loan during year 2 Shelters on loan on December 31st 1 Beds and bedding on loan during year Cases 15 Beds and bedding on loan on December 31st 8 96 During the year 21 new cases and 31 old cases have attended Colindale, Grove Park, Brompton, Royal Chest, St. Andrew's and Victoria Park Hospitals for 744 refills; an increase of 268 over the number for 1937. 2 new cases and 5 old cases of Lupus have attended the London Hospital during the year for 148 applications of Finsen Light and 631 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 one tuberculous child was recommended for admission to Open Air School, and seven children were boarded out under the London County Council Contact Scheme. 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 7 patients were seen by the Dental Officer who reports as follows on the work done:— Number of patients attending 7 ,, attendances 7 ,, general anaesthetics 3 ,, local anaesthetics 3 ,, extractions 15 Report of the Secretary to the Tuberculosis Care Committee. The Tuberculosis Care Committee continues to meet monthly at the Dispensary to deal with matters affecting the social welfare of persons suffering from tuberculosis. The primary work of the Committee is the consideration of the home circumstances of each new case of tuberculosis as it occurs, with a view to arranging for the provision of any assistance which the occurrence of the disease may render necessary. Old cases in which any special need arises are also reported. No case is brought 97 forward unless the consent of the patient, or person responsible, has first been obtained, but that this is seldom refused is shown by the fact that out of 133 new cases notified during the year 115 were reported to the Tuberculosis Care Committee. The total number of cases dealt with by the Committee during the year was 175. About one-third of these were found to be in need of some kind of practical help. This was obtained, when possible, from other agencies, e.g., the London County Council, the Unemployment Assistance Board or from voluntary societies, but in the majority of cases the patients' needs were met by the Tuberculosis Care Committee's voluntary fund, the Poplar Tuberculosis Fund. 143 grants were made by the Committee of the Poplar Tuberculosis Fund during the year. These may be summarised as follows:— Clothing and Boots 69 Fares 38 Pocket-money Allowances 13 Removals and Rent 8 Dentures 5 Bedding 5 Holidays 2 Insurance arrears 1 Laundry Allowances 1 Wireless 1 143 The income of the Poplar Tuberculosis Fund has been well maintained throughout the year. The Committee has been fortunate in continuing to receive regular contributions in respect of Sunday opening of Cinemas from the Poplar Pavilion and the Poplar Hippodrome. The 1938 Christmas Seal Sale, organised by the Tuberculosis Care Committee under the auspices of the National Association for the Prevention of Tuberculosis, was more successful than that of the previous year, over £60 being raised in the Borough of Poplar by this means, and the Christmas Sale, held at the Dispensary in December, brought in another £52. Other efforts by means of which useful sums have been raised were an Entertainment by the Elyssa School of Dancing and a Saturday night collection at the Clapton Stadium. Grants have again been received from the Alexandra Rose Day Committee, the National Deposit Friendly Society 98 and the Prudential Societies, as well as donations from the Poplar Benevolent Society, the London Co-operative Society, the Hackney Wick Stadium and a number of private subscribers. Full particulars of the activities of the Poplar Tuberculosis Fund are to be found in the Annual Report of the Fund which is published, together with the Balance Sheet, at the end of the financial year. The Handicraft Class, an occupation centre for patients who are unable to do ordinary work, continues to meet weekly at the Dispensary under an instructress provided by the London County Council. The occupation provided by the Class, which can also be carried on during the week at home, appears to be much appreciated by those who belong. There were 14 names on the register at the end of 1938. 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 at Kensington Town Hall in March, at the Ex-Servicemen's Exhibition at the Imperial Institute in November, and at the Christmas Sale at the Dispensary. The Poplar Tuberculosis Care Committee is an affiliated society to the National Association for the Prevention of Tuberculosis and, as such, was able to send a delegate to the Annual Conference of that Association, which was held in London from June 30th to July 1st. The Committee is also represented on the Standing Conference of Metropolitan Borough Tuberculosis Care Committees. Two meetings of this Conference were attended during the year and under its auspices a visit was paid to Highwood Hospital. 99 PUBLIC HEALTH (TUBERCULOSIS) REGULATIONS, 1930] Part I.—Summary of Notifications during the period from the 1st January, 1933, to the 31st December, 1938, in the area of the County, County Borough, or Metropolitan Borough of Poplar (to which this Return relates). Age Periods Formal Notifications. Number of Primary Notifications of New Cases of Tuberculosis. Total Notifications. 0- 1- 5- 10- 15- 20- 25- 35- 45- 55- 65- Total (all ages). Pulmonary—Males — — 2 2 12 9 12 12 18 11 5 83 130 ,, Females — 1 1 2 15 14 16 8 3 1 1 62 94 Non-Pulmonary—Males — 2 1 3 2 4 2 — 1 1 — 16 21 ,, Females — — 2 1 2 — 1 1 1 — — 8 9 Col. (1) (2) (3) (4) (5) (3) (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 - - — - 5 2 2 7 1 18 ,, Females — 1 — — — 3 3 — 1 — 2 10 Non-Pulmonary—Males — 2 1 1 1 - 2 1 1 — 1 10 ,, Females — - 2 — — 1 3 — — 2 — 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 1 transferable death from Register-General 2 1 Posthumous notifications 7 4 "Transfers" from other areas (other than transferable deaths) 13 10 Other Sources, if any (specify) Forms 1 & 2 3 2 Part III.—NOTIFICATION REGISTER Pulmonary. Non-Pulmonary. Total Cases. Males. Females Total. Males. Females Total. Number of cases of Tuberculosis remaining at the 31st December, 1938, on the Registers of Notifications kept by the District Medical Officers of Health in the County, the Medical Officer of Health of the County Borough, or Metropolitan Borough 333 270 603 11l 98 209 812 Number of cases removed from the Register(s) during the year by reason of:— 1. Withdrawal of notification - - - - - - - 2. Recovery from the disease 24 14 38 9 20 29 67 3. Death (all causes) 60 48 108 8 5 13 121 4. Otherwise 43 35 78 15 17 32 110 100 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 887 877 879 885 Number of New Cases notified 52 46 33 33 Number of Cases restored to Register, etc. 15 18 15 11 Number of Cases removed from Register 77 62 42 117 Number of Cases on Register at end of quarter. Pulmonary 641 647 651 603 Non-Pulmonary 236 232 234 209 Totals 877 879 885 812 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 2 4 — — 1 2 — 5 — 2 1 2 4 - 2 1 1 10— 2 2 4 1 15— 12 15 3 2 11 12 2 — 20— 9 17 4 1 25— 17 19 4 4 8 15 1 — 35— 14 8 1 1 6 4 — 1 45— 20 4 2 1 12 6 1 1 55— 18 1 1 2 11 3 - 1 65 and upwards 6 3 1 — 5 2 - — Totals 101 72 26 16 53 45 7 4 The ratio of non-notified Tuberculosis deaths to total Tuberculosis deaths was 6.4%. Death rates per 1,000 population Tuberculosis of respiratory system 0.73 Other forms of Tuberculosis 0.08 All forms 0.81 Death rates per 1,000 population:— Tuberculosis of respiratory system 0.73 Other forms of Tuberculosis 0.08 All forms 0.81 101 Disinfecting Department. Totals. Rooms Disinfected 1,470 Premises visited re Disinfection 1,722 Articles Disinfected. Smallpox. Other Infectious Diseases. Tuberculosis. Scabies and Verminous. Miscellaneous. Totals (a) From Infected Premises – 9,838 297 2,174* 430 12,739 (4) From Cleansing Station – 71,379† 71,379 (c) From Contacts — 25 — — – 25 Totals — 9,863 297 73,553 430 84,143 * Scabies only. † Verminous and Scabies. Articles destroyed by request, 43. Vermicide—Quantity issued from Depots, nil. Cleansing Station. M. F. Totals. Verminous persons cleansed 15 4 19 ,, children ,, 486 141 1,627 Scabies cases, cleansed, adults 125 141 266 „ ,, children 1,490 1,790 3,280 Total cleansings 2,116 3,076 5,192 All verminous children are treated with special comb. 102 Motor Vehicles. Vehicle. Speedometer register (miles). Petrol consumption (gallons). Average m.p.g. Blue Van 4,470 2$9 15.4 Brown Van 5,325 347 15.3 Lorry 5,657 366 15.4 Medical Officer of Health's Car 7,005 517 13.5 Special Vehicle for Contacts 6,274 590½ 10.6 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 56,229 gallons were manufactured and broken down to 136,431 gallons of weaker solution for distribution. The production of the solution at a strength of 4 grammes of available chlorine per litre has averaged 124,857 gallons per annum for three years at an average annual cost of £2,053, the cost per gallon thus being nearly 4d. 103 Quantity Produced. As Manufactured. Gallons. As Issued. (v.e., Weaker Solution.) Gallons. Electricity Consumed. Units. No. 1 Apparatus 28,415 63,040 9,807½ No. 2 Apparatus 27,814 73,391 10,768 Totals 56,229 136,431 20,575½ 1,025 gallons were supplied to London County Council Elementary Schools for spraying and cleansing floors of classrooms. 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. 1938. £ s. d. March 450 1,539 90 19 0 June 477 1,133 76 19 0 September 443 859 62 7 0 December 508 1,314 85 6 0 Totals 1,878 4,845 £315 11 0 Miss Landray made 35 visits in connection with verminous schoolchildren and 462 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, 285 persons—including 15 from common and seamen's lodging houses (see next page)—applied for baths and for their clothes to be disinfested. 104 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. 65, Bazely Street – – – 378, Old Ford Road — — – 38, Pennyfields 2 — 2 East London Hostel, Garford Street 13 — 13 15 15 From Common Lodging Houses without the Borough of Poplar (by agreement with L.C.C. at a charge of is. per person cleansed) – – – Totals — — — For cleansing of verminous rooms see page 56. Public Health Education. Report by Mr. T. Wigley, M.A. (Cantab). The story of public health administration in our country is a very creditable one. Since the Government assumed responsibility for the physical well-being of the people, as it did in the Public Health Act of the seventies, progress has been rapid. From the Ministry of Health downwards, under the spirited guidance of Public Health Committees and Medical Officers, pure water, efficient drainage, disposal of refuse, wholesome milk, untainted food, are only some of the advantages conferred 105 by progressive administrators. As a result of the labours of research workers and the practical application of their results we can point to a diminution of many serious diseases, and we have only to look at the lowered death-rate, especially among children, and the increased general longevity, to realise that the conditions of life have in the past fifty years improved out of all recognition. Much, however, remains to be done in the way of personal hygiene and education, if these are to keep pace with the advances in Public Health. This work of education of the public in matters of health and disease has gone on vigorously during the past year. All too many people are still very ignorant and conservative in matters of self-care, and large numbers still cling to the erroneous theories of their forefathers in such matters as diet, clothing, fresh air and exercise, and the task of persuading them to reform is not an easy one. On the other hand, a keen enthusiasm for health and a desire to be instructed have been manifested in a large number of centres of opinion, where regular series of lectures are in constant demand. One example of this eagerness will illustrate the general tendency: out of a large meeting for women, which has a monthly lecture, a number of young mothers asked for a series on "The Child" to be arranged specially for them; the pleasure in giving such lectures is equalled only by the keenness with which the instruction is received. The work is succeeding in an amazing way and grows with every year. The Poplar Borough Council may be congratulated on the adventurous and far-sighted spirit with which it began such educational work, the success which has attended its efforts, and the hopes which it may legitimately entertain for its development in the future. The health of the citizen cannot be improved so rapidly as the output of aeroplanes, since it is something that depends on a long glimpse into the future, on much thought and the conviction that health is supremely valuable, but expenditure with a view to health of body and mind brings ample return in the present, and creates the conditions which will determine the future. 106 summary. Number of Centres at which lectures were given 20 Number of lectures given (January-December) 208 To men and boys 64 (Attendances 1,806) To women and girls 135 ( ,, 8,459) To mixed audiences 9 ( ,, 329) 208 (Total attendances 10,594) expenditure year ending 3IST march, 1939. £ s. d. Grant to Central Council for Health Education 5 0 0 Printing, Stationery and Postage 1 8 2 Fees to Lecturers 447 6 0 Total £453 14 2 In addition to the grant to the Central Council for Health Education, the following grants were made:— To the Industrial Health Education Society, £2 2s. National Society for the Prevention of Venereal Disease, £2 2s. MATERNITY AND CHILD WELFARE CLINICS ON DECEMBER 31st, 1938. Situation. Nature of 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: Tuesdays, 2 to 4 p.m. ; Wednesdays, 10.30 a.m. to 12.30 p.m. and 2 to 4 p. m. Ante-Natal-. Mondays, 10.30 a.m. to 12.30 p.m. (except first and third in each month), and 2 to 4 p. m. Post-Natal: First and third Mondays in each month, 10.30 a.m. to 12.30 p.m. Artificial Light Treatment: (By appointment only) Tuesdays and Saturdays, 9.30 a.m. to 12.30 p.m.; Thursdays, 9.30 a.m. to 12.30 p.m. and 2.30 to 4.30 p.m. Sewing Class and Cookery Class: Thursdays, 2 to 4 p.m. Old Ford Clinic, Ruston Street Medical Officer's Room and Weighing and Waiting Rooms Infant Consultations: Tuesdays, 2 to 4 p.m.; Fridays, 10.30 a.m. to 12.30 p.m. and 2 to 4 p.m. Ante-Natal: Tuesdays, 10.30 a.m. to 12.30 p.m. (except first Tuesday in the month); Thursdays, 10.30 a.m. to 12.30 p.m. Post-Natal: First Tuesday in month, 10.30 a.m. to 12.30 p.m. Sewing Class: Thursdays, 2 to 4 p.m. 54, West Ferry Road Ditto Ditto Ditto Infant Consultations: Fridays, 10.30 a.m. to 12.30 p.m. and 2 to 4 p.m. Ante-Natal: Tuesdays, 2 to 4 p.m. (except first, third and fifth Tuesdays in each month); Thursdays, 2 to 4 p.m. Post-Natal: First, third and fifth Tuesdays in each month, 2 to 4 p.m. Methodist Chapel, Manchester Road .. Wellington Road Medical Officer's, Weighing and Waiting Rooms Medical Officer's, Weighing and Waiting Rooms, Dispensary Dentist's Room, Recovery Room, Artificial Light Room Sewing Class: Mondays, 2 to 4 p.m. Infant Consultations: Wednesdays, 10.30 a.m. to 12.30 p.m. and 2 to 4 p.m. Infant Consultations: Thursdays, 10.30 a.m. to 12.30 p.m. and 2 to 4 p.m. Ante-Natal: Wednesdays (except first in the month), 2 to 4 p.m. Post-Natal: First Wednesday in the month, 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 p.m. to 4.30 p.m. Dental : (By appointment only) Tuesdays and Wednesdays, 10 a.m. to 12 noon. Special Clinic: (By appointment only) Fridays, 2 to 4 p. m. 6) Provided by the Royal College of St. Katharine:— 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. Cookery Class: Wednesdays, 2 to 4 p.m. Dental Clinic: Alternate Tuesdays, 2 p.m.; Thursdays, 10 a.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., Wednesdays and Thursdays, 10 a.m. Post-Natal Clinic: Wednesdays, 9.30 a.m. to 12.30 p. m. 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. 107 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. Extensions of Maternity and, Child Welfare Services. The following additional sessions have been established during the year:— Old Ford Clinic.—Ante-natal session on Thursday mornings, commenced at the beginning of October. Wellington Road.—Ante-natal clinic held weekly in place of fortnightly from beginning of October. Midwives Act, 1936. The London County Council's Scheme for Domiciliary Midwifery was referred to in the report for 1937. 1. At the request of the London County Council a circular letter, prepared by the County Medical Officer of Health, giving particulars of the new domiciliary midwifery service was sent to all medical practitioners practising in the Borough. A letter was also sent to the practitioners giving particulars of the Borough Council's Ante-Natal and Post-Natal Clinics, Ante-Natal Consulting Clinic and the arrangements with the Consulting Obstetricians. 2. Consulting Obstetricians.—It was arranged that the whole of the Consultants for Area "A" should be formed into one panel for the Area and the fee payable an inclusive one of five guineas. 108 The Council's Consultants, Mr. A. Brews and Mr. R. Dodds, both agreed to act as Consultants for the whole area and the Council agreed that the arrangements with these two Consultants be continued until determined by either side after giving three months' notice. During the year (1938) the services of a consultant were utilised on two occasions. 3. Emergency Obstetric Service.—Consultations have taken place with the London County Council regarding the establishment of an emergency obstetric service ("Flying Squad"). The County Council intimated that it was prepared to establish an emergency obstetrical service for domiciliary use in connection with its hospitals for the purpose of dealing with acute obstetrical emergencies in cases in which patients cannot be moved to hospital without undue risk. The service includes blood transfusions. The Borough Council informed the London County Council that it was prepared to make use of this service when necessary and to pay the sum of five guineas in respect of each person attended. It was intimated that this service would come into operation early in 1939. 4. Prohibition of unqualified persons.—In an Order dated 30th August, 1938, the Minister applied the provisions of Section 6 of the Midwives Act, 1936, to the Administrative County of London. The "County of London (Midwifery—Prohibition of Unqualified Persons) Order, 1938," came into operation on 1st November, 1938. As requested by the County Council, copies of a memorandum and an advertisement were sent to the local practitioners. Co-operation with Voluntary Organisations and London County Council, (a) Royal College of St. Katharine. The Minister of Health's Maternity and Child Welfare Contributions (London) Scheme, 1937, made under Section 101 (6) of the Local Government Act, 1929, for the grant period 1st April, 1937, to 31st March, 1942, required the Borough Council to make an annual contribution to the Royal College of St. Katharine of £4,442, 109 (b) Co-operation between London County Council Hospitals and Clinic Medical Officers. (i) A letter was received from the London County Council stating that the Council felt that a closer link could, with advantage to the maternity services of London be established between the maternity and child welfare clinics of the City Corporation and the Metropolitan Borough Councils and the Council's general hospitals if the medical officers in charge of the maternity and child welfare clinics were permitted to be associated in an honorary capacity with the maternity departments and ante-natal clinics at the Council's hospitals. For some time past there had been co-operation between the Clinic Medical Officers of this Borough and St. Andrew's Hospital. With the co-operation of the Medical Superintendent of St. Andrew's one Conference had already been held between the Medical Superintendent, the Consulting Obstetrician, the Borough Council Clinic Medical Officers and Medical Officers of the Royal College of St. Katharine. As the Clinic Medical Officers were only part-time Officers, the Council adopted a recommendation of the Maternity and Child Welfare Committee:— "That in order to maintain complete co-operation between medical officers of the Borough Council, the Royal College of St. Katharine Ante-Natal Clinics and the officers in charge of Maternity and Ante-Natal Departments of St. Andrew's Hospital, the Council agrees to the suggestion that the Medical Officer of Health be associated in an honorary capacity with the Maternity and AnteNatal Departments of St. Andrew's Hospital to ensure this cooperation, and through him, the Clinic Medical Officers to have meetings with the staff of St. Andrew's Hospital when desired by either party, a definite meeting to be held every six months, and that the London County Council be so informed.'' (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 the work carried on at Infant Consultation. 20 nurse-midwives attended our clinics during the year. 110 (c) The Queen Mary Day Nursery and Social Settlement. The Minister of Health has approved an annual contribution of £500 for the five years 1st April, 1937, to 31st March, 1942, to 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 by Her Royal Highness the Duchess of Gloucester. It is reported that during 1938 the attendances numbered 7,800. (d) Co-operation with the General Hospitals. As reported last year it had been 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, and with the willing co-operation of the hospital officials 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. 736 reports were received:— from St. Andrew's Hospital 619 from Voluntary Hospitals 117 (In addition to the above the London County Council sent 356 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) 32 of the senior girls attending Domestic Science classes visited Wellington Road Maternity and Child Welfare Centre for instruction in mothercraft. (b) 1,578 case sheets relating to the children who reached the age of 5 years were forwarded to the Education Department. 240 special reports were also forwarded regarding children attending school, not yet 5 years of age. 111 (f) Co-operation with the Invalid Children's Aid Association. The Council makes a grant of £10 per annum towards the cost of providing surgical appliances for children under 5 years of age. The Association assisted 12 children in obtaining surgical appliances and provided convalescent treatment in 16 cases during 1938. Old Ford Clinic. After prolonged discussion with the London County Council as to the provision in a Maternity and Child Welfare Clinic of a School Treatment Centre, the erection of the new Clinic at Old Ford, commenced in December, 1937, was completed in the late summer. The work was carried out by direct labour and the cost of demolishing the old buildings and erecting the Clinic was £9,609. The Maternity and Child Welfare Centre on the ground floor comprises a waiting hall, in which there is a raised platform which is fitted out as a model kitchen, where talks and demonstrations can be given; weighing room with undressing cubicles; doctor's room; health visitors' room; perambulator shelter, store cupboards, etc. In addition, a grass plot has been provided where children may play while waiting for their mothers and a lean-to shelter for the protection of perambulators during inclement weather will be provided. Plans and photographs of the Clinic are included in this report. The first floor, with a separate entrance, has been rented to the London County Council for use as a School Treatment Centre. Owing to the international crisis there was no official opening of the building. Centres. In the table facing page 110 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. 112 The number of attendances at the Centres during the last 10 years is shown below:— Borough Council. Royal College. 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 1937 41,530 28,335 1938 47,240 29,180 Ante-Natal Clinic, Public Health Department. 1,102 live births and 35 stillbirths were notified in the area served by the Public Health Department during the year 1938. The following table shows the distribution of these births:— Live Births. Stillbirths. Doctors'patients .. .. .. 60 — Midwives'patients .. .. .. 276 6 St. Andrew's Hospital .. .. .. 509 18 East End Maternity Hospital .. .. 143 6 Other Institutions .. .. .. 114 4 Per Registration Returns .. .. — 1 (information not ascertainable) - — 1,102 35 Of this number the following attended our Ante-Natal Clinics:- Doctors' patients 5 (8.3%) Midwives' patients 245 (86.9%) St. Andrew's Hospital 371 (7°-4%) East End Maternity Hospital 19 (12.8%) Other Institutions 5 (4-2%) 645 (56.7%) Old Ford Clinic—Exterior (1). Old Ford Clinic—Exterior (2). Old Ford Clinic—Main Hall. Old Ford Clinic—Weighing Room. Old Ford Clinic—Vestibule. Old Ford Clinic-Ground Floor Plan. Old Ford Clinic—Plan of First Floor which is used by the London County Council as a School Treatment Centre. 113 Clinic Attendances. Number of individual patients 978 New Cases 910 Total attendances 3,295 Average attendance per session 15.1 (compared with 35.1 at R. Coll. —3 Doctors) Home Visitation by Health Visitors. First visits 879 Revisits 1,855 114 STATISTICAL SUMMARY OF HOME VISITING FOR 1938. Public Health Department. The Royal College of St. Katharine. Total 1938. Total 1937. Cases. Visits. Cases. Visits. Cases. Visits. Cases. Visits. Ante-Natal:— No. of Cases 879 — 539 — 1,418 — 1,611 — Primary visits — 879 — 539 1,418 — 1,611 Re-visits — 1,855 — 1,592 3,447 — 3,888 Infant Child Welfare visits:— Primary visits (Infants) .. — 995 — 879 1,874 — 1,991 Removed before visit — 35 — 62 97 — 64 Died before visit — 8 26 34 33 Stillbirths — 26 — 33 59 — 57 Re-visits— Under 1 — 7,643 — 8,632 19,150 16,275 — 17,807 1—5 — 18,105 — 37,255 — 42,873 Removed — 741 — 615 1,356 — 1,427 Died — 56 — 36 92 — 108 fOphthalmia Neonatorum:— No. of Cases notified 9 — — — 9 — 5 — Primary visits — 9 — — 9 — 5 Re-visits — 13 — — 13 — 7 Removed to Hospital 2 — — — 2 — 4 — Enteritis:— (a) No. of Cases reported.. — — — — 21 — (a) Primary visits — — — — — 21 Re-visits — — — 6 Removed to Hospital — — — — 15 — Died — — — 2 (6) No. of Cases notified (Z.E.) 71 — 33 — 104 — 45 — (6) Primary visits.. — 71 — 33 104 — 45 Re-visits — 50 — 73 123 — 62 Removed to Hospital 77 — — — 77 — 81 — Died — 7 — 3 10 — 15 Measles:— No of Cases under 5 years 636 — 496 — 1,132 — 222 — Primary visits — 636 — 496 1,132 — 222 Re-visits — 169 — 235 404 — 125 Removed to Hospital 222 — — — 222 — 89 — Died — 6 — 4 10 — 4 Primary visitsiover 5 years — 435 — 229 664 — 219 Re-visits — 49 — 14 63 — 35 Whooping Cough:— No. of Cases 103 — 134 — 237 — 534 — Primary visits — 103 — 134 237 — 534 Re-visits — 24 — 58 82 — 320 Removed to Hospital 29 — — — 29 — 57 — Died — 1 — — 1 — 7 f Puerperal Fever:— No. of Cases notified 6 — — — 6 — 5 — Primary visits — 6 — — — 6 — 5 Re-visits — 8 — — — 8 — 10 Removed to Hospital 6 — — — 6 — 5 — Died:— (a) Notified Cases.. 1 — — — 1 — — — (6) Non-notified Cases i — — — 1 — 1 — fPuerperal Pyrexia:— No. of Cases notified 45 — — — 45 — 31 -— Primary visits — 45 — — — 45 — 31 Re-visits — 39 — — — 39 — 53 Removed to Hospital 43 — — — 43 — 28 — Died — — — — — 1 — Maternal Deaths:— Maternal Deaths (number) 5 — — — 5 — 5 — Primary visits — 5 — — — 5 — 5 Re-visits — 17 — — — 17 — 6 Miscellaneous Visits.. — 962 — 477 1,439 1,131 Total Visits:— Primary — 3,253 — 2,428 — 5,681 — 4,843 Re-visits — 29,745 — 30,892 — 60,637 — — Total Visits paid, 1938 32,998 33,320 66,318 — — Total Visits paid, 1937 — 34,257 — 38,472 — — — 72,729 * Zymotic Enteritis is notifiable t All cases are visited by Health Visitors of the Public Health Department Enquiries re Maternal Deaths are made by the Public Health Department. 115 The following table shows the attendances at each of the Clinics during the year 1938:— Old Ford. West Ferry Road. Manchester Road. Simpsons Road. Weilington Road. P.H. Dept. Total. Royal College of St. Katharine Total. Ante-Natal Clinics: — Attendances 898 964 — 929 504 3,295 1,720 Average per session 18.0 15.3 — 12.2 17.4 15.0 35.1 Infant Consultations:— (3 doctors) First attendances 309 234 177 279 334 1,333 875 Total attendances 7,475 5,659 5,489 6,537 7,190 32,550 18,156 Average per session 50.0 56.6 53.8 43.0 70.5 53.4 74.1 Average attendance of (2 doctors) each child 10.9 10.0 11.2 10.0 9.2 10.1 — Light Clinics:— Attendances — — — 2,692 5,062 7,754 4,510 Average per session — — — 14.0 17.7 16.2 18.4 Dental Clinics:— Attendances 1,386 1,386 1,292 Average per session — — — — 13.9 13.9 11.0 Sewing Class 63 312 — 819 — 1,194 1,285 Garden attendances 90 820 910 660 Mothers' Clinic (Post- Natal) 67 105 171 8 351 653 Remedial Clinic — — — — 904 Total attendances at all Clinics:— 1938. 1937- P .H. Department 47,240 41.530 Royal College of St. Katharine 29,180 28,335 Total 76,420 69,865 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 .. 3 (4 consultations) (b) Referred by clinic medical officers .. 20 (21 consultations) 23 (25 consultations) 116 Post-Natal Consultative Clinic at St. Andrew's Hospital. With the approval of the London County Council arrangements have been made with the Consulting Obstetrician at St. Andrew's Hospital to see post-natal cases at the Special Ante-Natal Consultative Clinic, held at St. Andrew's Hospital. Should the number of ante-natal patients become too great for this Clinic, arrangements will be made to hold another clinic. 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, 11,535 lbs 817 1 3 Special Milk, 342 lbs. 24 4 6 Dried Milk, Humanised, 75 lbs 7 10 0 Aberdeen Emulsion 4 0 0 Dusting Powder 1 5 0 Medicinal Paraffin 8 11 4 Medical Sundries 18 12 4 Dentures 144 1 10 Materials at Sewing Class 30 18 11 Convalescent Treatment 11 2 6 Virol 19 1 0 Oil and Malt 67 12 9 Concentrated Food 88 15 2 Payments for Gas (Dental Clinic) 5 13 0 Accouchement Sets 2 17 0 Cod Liver Oil 27 17 4 Total £1.279 3 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. 775 such vouchers were issued during the year. 117 Convalescent Treatment, etc. Convalescent Treatment (mothers with babies) .. 29 cases. ,, ,, (mothers alone) .. 2 " ,, ,, (children under 5 years) .. 39 Loan of maternity bag, containing clothing, etc... 13 Grants by Maternity and Child Welfare Committee during the Calendar Year, 1938. Maternity Outfits at half-price 12 ,, ,, free to Nursing Sisters of St. John the Divine 274 The Committee provided dentures to five necessitous mothers who were unable to complete their payments, the cost to the Committee being £7 2s . od. {The following tables refer to the whole Borough.) Statistics Respecting Infants Born in 1937. All births, including those occurring in outlying districts, but belonging to the Borough 2,230 Doctors in attendance 178 Midwives in attendance 560 Delivered in institutions 1,492 Not stated — Moved into Borough 147 2.3 77 Stillborn (Stillbirths per 1,000 births) 60 Died before visit 31 Not requiring or desiring visits 56 -- 147 Visited 2,230 Removed within the year ... 39i Died during visitation 77 468 Remaining under supervision end of first year „ 1,762 Mortality per 1,000 visited 34-5 118 The 1,762 children visited during 1937 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 67.8 percent. Mixed feeding 22.6 ,, Hand-fed 9.6 ,, The 77 children who died during the first year of life, were fed during the first six months of life as follows:— Breast-fed 19.5 per cent. Mixed feeding 44.0 „ Hand-fed 3.64 „ Below is a statement comparing the mortality rates per 1,000 visited of children fed by the various methods:— (a) Babies breast-fed 12 (b) ,, who received mixed food (breast and hand) 79 (c) ,, hand-fed 142 S tillbirths. (This refers to the whole Borough.) 67 Stillbirths were investigated during the year 1938. Number of Stillbirths 67 Doctors in attendance 2 Midwives in attendance 11 Delivered in Institutions 52 B.B.A 1 (Hospital case) Unknown 1 119 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 hoapital. 1929 56 51 5 56 1930 42 38 4 42 — — — 1931 37 36 1 37 — — — 1932 27 18 9 27 — — 1 1933 23 15 8 23 — — — 1934 21 10 11 21 — — — 1935 10 5 5 10 — — — 1936 5 1 4 5 — — — 1937 5 1 4 5 — — 1938 9 7 2 9 — — Cases Notified and Visited. Number of notifications received 9 Very slight cases 3 Sight of one eye damaged Recovered 9 Occurred in Institutions 4 Occurred in the practice of medical practitioners Occurred in the practice of midwives 5 Admitted to hospital as in-patients 2 Treated as hospital out-patients Treated privately 2 Visited by nurse . 4 Zymotic Enteritis. Notifications received (patients under 5 years) 104 Under 1 year (see feeding below) 57 1 to 2 years 31 2 to 3 years 7 3 to 4 years 6 4 to 5 years 3 Died before notification received 4 Visited 83 Treated in hospitals.. 77 Of the 57 cases of Zymotic Enteritis under 1 year of age which were notified, 9 died. These were fed as follows:— Breast fed 1; mixed feeding 1; hand-fed 7. 120 Home Nursing Arrangements. Following upon negotiations, revised agreements were entered into with the three following Nursing Associations:— (a) East London Nursing Society; (b) The Nursing Sisters of St. John the Divine; (c) St. John's (Isle of Dogs) Nursing Association. The agreements with the East London Nursing Society and the Nursing Sisters of St. John the Divine provided for the nursing of the following cases:— (a) Measles, German Measles, Whooping Cough, Zymotic Enteritis (epidemic Diarrhoea), when occurring in children under the age of 10 years; (b) Nursing during pregnancy; Puerperal Fever, Pyrexia and other complications where the Midwife has been advised to discontinue attendance; Ophthalmia Neonatorum; (c) Pneumonia, Influenza, Malaria, Dysentery, Poliomyelitis, Encephalitis Lethargica; (d) Pemphigus, Conjunctivitis, etc., in children under the age of 5 years. The agreement with the St. John's (Isle of Dogs) Nursing Association provided for the nursing of cases (a), (c) and (d), together with Ophthalmia Neonatorum. During the negotiations with the Nursing Associations it was apparent that much nursing work for children under 5 years of age had been carried out for which the nursing societies had not claimed payment. Agreements were entered into from 1st January, 1938, and the Council agreed to pay the following block grants for the calendar year 1938, such grants to be reviewed, in the light of the experience gained, at the end of the year:— East London Nursing Society £160 Nursing Sisters of St. John the Divine £40 St. John's (Isle of Dogs) Nursing Association £10 At the end of the year the work of the three Nursing Associations was reviewed and for the calendar year 1939 the block grants were revised as follows:— East London Nursing Society £140 Nursing Sisters of St. John the Divine £50 St. John's (Isle of Dogs) Nursing Association £12 121 The following is a summary of visits paid by Nurses during 1938:— (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 1 3 4 — Visits 23 147 — — 170 Slight Inflamma tion of Eyes* Cases 7 9 2 18 Visits 103 128 30 261 Measles Cases Under 5 97 7 13 117 5-10 32 1 3 36 — Visits Under 5 614 89 111 — 814 5-10 367 11 24 — 402 Pneumonia Cases Under 5 41 7 2 50 5-10 9 — — 9 — Visits Under 5 558 131 38 — 727 5-10 102 — — — 102 Pemphigus Cases 1 1 _ Visits — 15 — — 15 WhoopingCough Cases Under 5 1 — — 1 — Visits Under 5 9 — — — 9 Zymotic Enteritis Cases 1 1 — Visits — 6 — — 6 Puerperal Pyrexia Cases 1 1 — Visits — 11 — — 11 Maternity Nursing Cases 4 28 32 — Visits 122 423 — — 545 Totals Cases 192 58 20 270 Visits 1,898 961 203 — 3,062 *Reported by L.C. C. 122 The following table relates to visited children ot ages 1 to 5 years:- Year of Birth. 1933. 1934. 1935. 1936. Remaining under supervision: End of first year — — — 1.737 ,, second year — 1.643 — ,, third year — 1,618 — — ,, fourth year 1,566 — — — Inward Transfers 184 204 132 119 Visits discontinued — — — — Outward Transfers 167 235 206 246 Died 5 4 4 20 Remaining under supervision: End of second year — — — 1,590 ,, third year — — 1.565 — ,, fourth year — 1.583 — — ,, fifth year 1.578 — — — Mortality per 1,000 visited: Second year — — — 10.8(15.2) Third year — — 2.3 (8.1) — Fourth year — 2.2 (6.2) — — Fifth year 2.9 (1.0) 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 6 deaths associated with pregnancy, etc., investigated and the maternal mortality rate was 2.90 per 1,000 total births (live and still.) See list, page 123. 123 List of Maternal Deaths and Deaths Associated with Pregnancy. Cause of Death. Attended at Institution. Attended at home by Treated in Institution subsequently. No. of prev ious pregnancies. Received Ante-natal care or Treatment at M.C.W. Clinic. Elsewhere. Puerperal Sepsis (3 cases). Rupture of uterus. Obstructed labour. Shock, haemorrhage and sepsis. P.M. No. Doctor. Yes. 3 No. No. Septicaemia. Septic endometritis. Natural abortion. P.M. No. Doctor. Yes. 8 No. No. Cerebellar abscess. Abscess of peritoneum following old suppurative peritonitis. Coroner's P.M (On enquiry by the Registrar-General it was ascertained that the peritonitis was due to miscarriage.) No. Doctor. Yes. 3 No. No. Other Puerperal Causes (2 cases). Uraemia. Toxaemia of pregnancy. Premature confinement. Ante-partum haemorrhage. Suppurative mast itis Yes. — Yes. Nil. No. Yes at int. Accidental haemorrhage. Toxaemia of pregnancy. Anuria No. Midwife. Yes. 6 Yes. No. Other Death associated with Pregnancy (1 case). Pulmonary tuberculosis. Pregnancy Yes. — Yes. — No. In Hospital since 17.12.37. 124 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 88). 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. (During 1938, Consulting Obstetricians were called in to two cases.) Infantile Mortality. The infantile mortality rate was 60. Child Life Protection. Number of Foster Mothers under supervision at 31st December, 1938 17 Number of Foster Children under supervision at 31st December, 1938 17 Number of new Foster Mothers registered during 1938 6 Number of children legally adopted during 1938 — Number of children who attained the age of 9 years during 1938 1 Under Supervision during some part of 1938:— Foster Mothers 21 Foster Children 28 Number of visits:— Chief Health Visitor, or Deputy 197 Male Inspectors 17 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. 125 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. Out-patients. Total number of attendances 334 Attendances for test-feeding 322 Number of new cases 159 Help over difficulty in breast-feeding continues to be one of the most important features of out-patient treatment. Altogether 35 mothers who had difficulty in feeding their infants attended. The results were complete restoration of normal feeding in a little over half the number, preservation of partial breast-feeding in nearly all the remainder, and failure in only a few. Breast-fed only 17 Partially breast-fed 13 Bottle-fed only 3 Failed to complete attendances 2 The remaining cases were difficulties in bottle-feeding, suitably dealt with, consultations with the clinic medical officers, or cases for admission. 126 In-patients. Admitted 92 Recovered 78 Improved 11 Transferred to Hospital 1 Removed by parents 1 Died 1 Classification of cases. Malnutrition 30 Difficulty in Artificial Feeding 25 Neuroses (food refusal, insomnia, etc.) 16 Rickets 9 Debility after illness 4 Pyloric stenosis 4 Miscellaneous 4 92 Points of Interest. Successful treatment of pyloric stenosis by medical measures was continued this year. In this disease the nervous control of the stomach is defective and the child becomes gravely ill from vomiting of a severe type and dies unless relieved by medical or surgical treatment. Until recently all treatment of any value has been surgical. The use of the drug atropine methyl nitrate has enabled one now to dispense with the knife. Welfare centres are ideal places for the application of the new remedy, because there cases can be seen early and treated promptly, matters of much importance. All our little patients did remarkably well. We were much helped by the many virtues of the mothers, who were punctual, regular and enthusiastic in applying the remedy and also in feeding and tending the baby, proud of being pioneers, I think. The popularity of the wards continues, I am thankful to say, to be high. There are always more children awaiting admission than we can deal with. Indeed we could easily fill a third ward. We regret the death of one child which occurred quite unexpectedly from convulsions not long after admission. A child was transferred to hospital who developed whooping cough. He was isolated in good time and no one else caught it. We look back upon the last as a year of successful results and good progress. H. ST. H. VERTUE, M.D. 127 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 1938. 311 children and 57 mothers are reported on. The children are classified as follows, and I have analysed the results of treatment in the table below:— Rickets 25 cases (12 severe, 13 mild) Disturbed Dentition 78 ,, Malnutrition 34 ,, Debility 37 ,, After Illness 70 ,, Prematurity 14 ,, Prophylactic 12 ,, Various Disorders 41 ,, Analysis of Results. Marked Success Success Moderate Success Failure Rickets 9 15 1 — Disturbed Dentition 40 29 8 1 Malnutrition 21 7 4 2 Debility 14 17 5 1 After Illness 30 33 7 — Prematurity 6 7 1 — Prophylaxis 8 3 1 — Various Disorders 22 14 2 3 Totals 150 125 29 7 Notes. Premature children, always anaemic, are particularly good subjects for U.V.R., as they need more sunshine than the rest. I now invite all the prematures I meet at welfare clinics to take a course. 128 Prophylactic treatment of infants is a developing line, and well worth the mothers' effort in town conditions. A few mothers have proposed it themselves and I hope more who can will seek us out. The remaining group (various disorders) is an important one, a good response has been obtained in otitis, catarrh, anaemia and various nervous troubles in elder children. A few have been sent by their own doctors to our great pleasure. We are all glad to have a garden at both centres. During really hot weather, when U.V.R. is undesirable, the gardens have been enjoyed, with benefit, by toddlers. Mothers are classified as follows:— Ante-Natal 20 57 Post-Natal 9 Debility and Anaemia 13 Rheumatism 6 Various 9 Results:— Marked Success. Success. Moderate Success. Failure 33 14 9 i The one failure had severe nervous depression. This increased, and I sent her for mental treatment. We had a few striking cures among the "various disorders." Several mothers, also, come regularly every year, having proved the tonic effect on themselves. Again, as in previous years, I wish to express my deep appreciation of the work of the Sister in Charge and of her thoughtful care for mothers and children; and also to thank Miss Harris for her kindness, patience and efficiency in assisting. E. M. LAYMAN. Statistical Summary. January 1st to December 31st, 1938. Bow. Poplar. Totals. Number of attendances 5,062 2,692 7.754 ,, ,, sessions 286 193 479 ,, ,, patients 342 200 542 129 The 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, 3is< December, 1938. (Figures for the same period last year are included for comparison). Number of Visits. 1937. 1938. First visits to Expectant Mothers 729 539 Re-visits to Expectant Mothers 2,092 1,592 First visits to children 1,036 1,000 Re-visits to children 34,615 29,946 38,472 33,077 Measles. Visits to children over five 243 33,320 New births 1,068 1,014 Total number of children on register 4,028 3,911 Attendances at Clinics. Infant Clinics. New cases 936 875 Attendances—Under 1 year 8,764 9,108 1—3 years 6,163 6,477 3—5 years 2,900 2,571 17,827 18,156 Average attendance per clinic 71.6 74.1 Number of individual children 2,116 2,113 Number of individual mothers 1,761 1,751 Ante-Natal Clinics. New cases 538 531 Total attendances 1,691 1,720 Average attendance per clinic 33.8 35.1 Number of individual mothers 605 592 130 Post-Natal Clinics. 1937. 1938. New cases 198 253 Total attendances 530 653 Average attendance per clinic 10.8 13.6 Number of individual mothers 229 284 Dental Clinics. Mothers. New cases 165 164 Total attendances 613 683 Average attendance per clinic 8.6 9.9 Number of individual mothers 265 276 Children. New cases 180 217 Total attendances 468 609 Average attendance per clinic 9-7 12.9 Number of individual children 236 289 Artificial Sunlight Clinics. New cases 200 246 Total attendances 3,512 4,510 Average attendance per clinic 18.4 18.4 Number of individual children 222 305 Number of individual mothers 12 11 Garden attendances for open-air treatment 1,825 660 Remedial Exercises and Massage Clinics. Mothers. New Cases — 59 Total Attendances — 87 Average attendance per clinic — 8.7 Number of individual mothers — 59 Children and Expectant Mothers. New cases 66 67 Total attendances 648 817 Average attendance per clinic 7.4 9.4 Number of individual children 78 73 Number of individual mothers 6 8 131 Sewing Class. 1937. 1938. New cases 50 47 Total attendances 1,221 1,285 Average attendance per class 27.7 29.2 Cookery Class. New Cases.. — 19 Total attendances.. — 70 Average attendance per class — 4.4 Observation Ward. Number of children admitted 64 60 Average duration of stay days 31.6 40.2 Tonsil Clinic. Number of children admitted 113 82 Average duration of stay days 5.1 5.1 Tonsil Enquiry. Special Visits - 299 Out-Patients ' Departments . Test-Feeding Department. Total attendances 1,291 1,415 Number of mothers who attended with their babies for test feeds.. 221 212 Treatments. Mothers. Total treatments given to mothers 270 253 Number of individual mothers treated 51 46 Children. Total treatments given to children 2,388 2,652 Number of individual children treated 362 417 Ante-Natal Department. Births. In the area allotted to St. Katharine's there were 982 (1937—1,036) live and 32 (32) stillbirths during the year, making a total of 1,014 (1,068). 132 Live Births Attended St. Katharine's Ante-Natal Clinic 1938 1937 1938 1937 Doctor's patients 59 98 2 (3.4%) 8 (8.2%) Midwives' patients 200 242 127 (63.5%) 168 (69.4%) St. Andrew's Hospital 500 454 311 (62.0%) 294 (64.8%) East End Maternity Hospital 161 186 11 (6.8%) 15 (8.1%) Other Institutions 62 56 4 (6.4%) 0 (0.0%) In all 592 (1937—605) women have attended this department during the year, making 1,720 visits (1,691), or 2.9 (2.8) visits apiece. The average attendance has been 35.1 (33.8) per Clinic. There were 531 new cases during the year. Post-Natal Department. 284 women (1937—229), or nearly a third (1937 a quarter) of "the number confined, have been examined. There were 253 (198) new cases. They have averaged 2.3 (2.3) visits apiece. Total attendances 653 (530). Observation Ward. 60 infants (1937—64) were admitted during the year and made an -average stay of 40.2 days (31.6) each. The reasons for admission were as follows:— Illness of Mother 19 Nutritional disorders 15 Recovery from tonsillectomy 11 Preparation for tonsillectomy 2 Nervous disorders 3 Otitis Media 3 Atelectasis, Rickets, Pyloric Obstruction Skin Lesions 7 60 133 Results of admission:— Fully recovered 34 Improved 23 Not improved 1 Transferred to Hospital 2 60 In addition 82 (113) children were admitted for the surgical removal of adenoids and unhealthy tonsils. 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. H. K. WALLER, M.D. 134 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 work carried out in the Dental Clinic of the Maternity and Child Welfare Department, at Wellington Road. The following is a summary:— 100 Sessions have been held. 1,386 Total Attendances. 88 Permanent teeth filled. 171 Temporary teeth filled. 28 Permanent teeth extracted with local anaesthesia. 1,925 Permanent teeth extracted under Nitrous Oxide Gas. 976 Temporary teeth extracted under Ethyl Chloride. 214 Scalings. In addition, dressings, minor treatment and the fitting of dentures. 421 new patients have attended during the year, which is a considerable increase over the previous year, whilst the average attendance per session has risen to 13.8 as compared with 12.4 in 1937. In most respects the work compares favourably with previous years, in spite of the temporary cancellation of sessions during the September crisis. A decrease in the number of temporary teeth extracted will be noted. It is difficult to say whether this decrease is due to a lower number of children attending, or whether it is due to the fact that fewer teeth have to be extracted. My impression, however, is that there are fewer teeth to be extracted, the number of children for total clearance definitely seems to be small nowadays, compared with only a few years ago. This, with other signs, must point to the fact of stronger and healthier children. I should like to take this opportunity again of thanking those who assist me in the Clinic, and those in any way connected with it, for their essential help and support. C. HAMMOND WILLIAMS. 135 Free Milk Scheme. Milk is supplied to expectant and nursing mothers and to children under 3 years of age (in special circumstances 5 years). In 1937 the scheme was extended and details are given in the report for that year. Dried milk is supplied under the scheme, with the exception that Pasteurised 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. During the 52 weeks ended 31st December, 1938, 9,434 applications for free milk were received, of which 7,599 were granted. (The number of persons granted milk was 11,559.) Orders were issued for 159,684 pints of Pasteurised milk, and 26,966 pounds of dried milk, the total commitments amounting to approximately £3,843. In addition, orders were issued for 1,491 bottles (40Z.) of iron solution and 12,808 bottles (40Z.) of cod liver oil. 428 cases were investigated by the Enquiry Officer. All cases were found satisfactory. Distribution from ist January, 1938, to 31ST December, 1938 C.L.O. Iron Solution. (40Z. bottles.) "A." "G." "S." (40Z. Double lbs. lbs. lbs. bottles.) strength 16,977 7,426 770 11.363 578 369 The following table shows in comparative form the applications, etc., during the last ten years:— 136 Year. Applications. Applications granted. Cost (approx:) £ Orders issued. Cases investigated by I. O. Unsatisfactory cases. Fresh. (Pints) Dried. (lbs.) 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 — 1937 7,547 6,133 3,476 105,6.">8 25,430 461 1938 9,434 7,599 3,843 159,684 26,966 428 — 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 1938 was approximately £558. APPENDIX I. A Brief Outline of the Air Raid Precautions Work carried out by the Public Health Department since Middle of September, 1938. Prior to the 26th September, 1938, general approval had been given bv the Home Office to Poplar's scheme for dealing with Air Raid casualties. Letters from the Home Office dated 9th and 13th August, 1938, gave general approval to the establishment of four large and two medium First Aid Posts and eight First Aid Party Depots. The four large First Aid Posts were to have been established at three of the Borough Council's Public Baths (Roman Road, East India Dock Road and Glengall Grove), and Marner Street School, and the two medium First Aid Posts at St. Saviour's Church School and Cubitt Town School. Plans for adapting these premises had already been prepared by the Borough Surveyor and were in process of being submitted to the Home Office for approval when the crisis occurred. 137 During the crisis week members of the Staff were "standing by" night and day and beds and bedding were supplied for use in various Departments. The bedding used was taken from our stocks at the Infectious Disease Shelter. On the morning of Monday, September 26th, permission was obtained from the Town Clerk to proceed as rapidly as possible with the erection and equipping of the First Aid Posts. The only Posts which could be readily adapted were those which the Council owned, namely, the three Baths. The Borough Surveyor's Department in conjunction with the Baths Department proceeded with all possible speed working day and night, to accomplish this. Meanwhile since no medical supplies were forthcoming, as promised, we proceeded to order what we considered to be essential for equipping the First Aid Posts and supplying the First Aid (Stretcher) Parties with first aid pouches. As no stretchers were available the then Borough Surveyor agreed to make a sample stretcher to a specification which was given him and within three days the Works Department had produced one hundred stretchers with trestles. One of the Borough Council's disinfecting vans was converted to carry two stretcher cases and six secondhand motor vehicles were purchased, two of which were converted to carry stretchers. If the International situation had not cleared there would have been two fully equipped First Aid Posts by the end of the week, one at Roman Road Baths and the other at Glengall Grove Baths, while the Post at East India Dock Road Baths would have been ready by the following Monday. Arrangements were made for telephones to be installed in the First Aid Posts and First Aid Party Depots which were not at that time on the telephone. The method of construction adopted in erecting the three First Aid Posts on the floors of the three Baths was as follows:— Partition walls consisted of double-faced armoured plywood panels set in deal sectional framing, the roofs of similar panels supported on joists, the wider spans being carried by rolled steel angles. This method of construction allows of marking each section for storage and rapid re-erection. The floor space of each Bath was divided up into various rooms—undressing rooms; decontamination rooms with sprays, hot and cold water and sinks; first aid rooms; 138 dressing rooms; storage rooms and an adequate supply of chemical closets provided. As the First Aid Unit formed really a building within a building the Electricity Department lit the whole Unit by electricity from a separate meter; secondary means of lighting was provided by means of hurricane lamps. The Electricity Department also supplied for the First Aid rooms electric cookers which served a dual purpose, namely, heating the rooms when necessary and boiling hot water for sterilizing and washing purposes. The General Purposes Committee of the Council at a meeting on 5th October, agreed that the fitting out of the East India Dock Road Baths be completed and then dismantled and that the fitting out of the Roman Road Baths and Glengall Grove Baths as First Aid Posts be completed and used for training purposes for First Aid personnel. The Baths were used by the few members of St. John Ambulance Brigade and other persons who had volunteered for First Aid duty. By the 25th November both these Posts were dismantled and stored ready for re-erect ion. The following equipment was purchased:—The usual drugs and dressings, sterilisers, splints, sufficient surgical and medical instruments to carry out minor surgery, blankets, hot water bottles, dressing gowns, etc. The fact that these First Aid Posts were produced and equipped within a week was entirely due to the loyalty and whole-hearted cooperation of members of the staff of my own department and of the staffs of the Borough Surveyor's, Baths and Electricity Departments. The Borough Treasurer's Department supplied an officer who made a most efficient quarter-master and took charge of all supplies. The photographs give some idea of the method of construction and final appearances of some of the rooms at the First Aid Posts at Roman Read and Glengall Grove Baths. Although the Home Office had not envisaged the presence of Doctors at First Aid Posts it was felt strongly that Doctors should be available and accordingly on Sunday, 25th September, the President of the Tower Hamlets Division of the British Medical Association was approached and as a result a rota of local general practitioners who volunteered for work at First Aid Posts was prepared within a short time. First Aid Post—Roman Road Baths:' Entrance for Wounded. First Aid Post—Roman Road Baths:- Undressing Room for contaminated wounded males. First Aid Post—Glengall Grove Baths:- Decontamination Room for unwounded males. First Aid Post—Roman Road Baths:- Decontamination Room for wounded females. First Aid Post- Glen gall Grove BathsFirst Aid Room for males. First Aid Post—Roman Road Baths:- First Aid Room for females. 139 The question of the disposal of the civilian dead was also considered. Four huts were purchased for erection as temporary mortuaries and a representative of the local undertakers was interviewed regarding a scheme for staffing the mortuaries and the burial of the civilian dead. Steps were taken to augment the training in First Aid and Anti-Gas measures of such volunteers as were available. Since the crisis the Public Health Department has been continuously engaged in Air Raid Precautions work and has taken over the arrangements for the training of all First Aid personnel and also the arrangements for short courses in First Aid for Air Raid Wardens. Mr. W. J. Colborne, one of the Sanitary Inspectors who is an Instructor (C.A.G.S. Special) has given the course of instruction in anti-gas measures to members of the staffs of the Town Clerk's, Borough Treasurer's, Baths, Libraries and Public Health Departments in addition to lecturing to classes of "key" men in industry, local clergy and school keepers. Since February, 1939, the Sanitary Inspectors have been engaged in the survey preliminary to the erection of steel shelters and other important matters arising out of Air Raid Precautions measures. 140 INDEX. Sections of the Report:— Page A. Statistics and Social Conditions 9 B. General Provision of Health Services 18 C. Sanitary Circumstances of the Area 23 D. Housing 47 E. Inspection and Supervision of Food 62 F. Infectious Disease 83 G. Maternity and Child Welfare 107 Appendix—Air Raid Precautions Work 136 Age Mortality 16 Agricultural Produce (Grading and Marking) Act, 1928 81 Air Raid Precautions Appendix 136 Analysts' Report 78 Ante-natal Clinics, Attendances:— (a) Public Health Department 112 (b) Royal College of St. Katharine 129 Ante-natal Consultant Clinic at St. Andrew's Hospital 115 Anthrax 87 Antitoxin, quantity issued 84 Area, Population, etc. 9 Artificial Sunlight Treatment 127, 130 Bacteriological Examination of Milk 64 Bakehouses 69 Bed-bug Eradication 57 Births and Birth Rates 9,13-16 Butter and Margarine Factories 81 Canal Boats 34 Cancer, Deaths from 91 Cerebro-spinal Fever 88 Child Life Protection 124 Cleansing Station 101 Clearance Areas 51, 52 Clinics, M. & C.W. Facing 107 Clinics, Tuberculosis 92 Combined Drainage. 25 Committees 3 Common Lodging Houses 28 Consultants:— 1. Puerperal Fever, etc. 88 2. Obstetric107, 124 Continued and Typhus Fevers 88 Convalescent Treatment 117 Co-operation with Voluntary Organisations, etc 108 Coroner's Court 17 Cowsheds 62 Customs and Inland Revenue Acts, Certificates 32 Day Nursery 110 Deaths and Death Rates 9-16 Deaths, Classified Causes, Table Facing 11 ,, Infantile, Table 12 Dentisto' Reports 96, 134 Diarrhoea and Enteritis, Deaths 10 Diphtheria 83 141 INDEX—(continued). Page Diphtheria Immunisation 83 Disinfectant, Electrolytic 102 Disinfecting Department 101 Disinfestation 57 Dysentery 80 Electrolytic Disinfecting Fluid 102 Encephalitis Lethargica 88 Enteric Fever 84 Erysipelas 88 Exhumations 34 Export of Meat Foods 82 Factories Acts 35-38 Food, Supervision of 62 Food and Drugs Acts, etc. 76 Food Inspectors'Reports 70-76 Food Poisoning 81 Free Milk Scheme 135 Fumigation by HCN 58 Glanders 87 Hairdressers'Premises 34 Health Education 104 ,, Services 18 Home Nursing 120 Home Visiting Summary 114 Homeless Persons, Census 28 Houses Let in Lodgings 27 Housing 47 Hydrophobia in Man 87 IceCream 67 Infant Life Protection 124 Infantile Mortality 10,12,13 Infectious Diseases, Table of Notifications Facing 83 Infirm Persans, Removal 44 Inhabited Houses 9 Inquests 17 Invalid Children's Aid Association 111 Lady Sanitary Inspector, Report 26 Lectures on Health Subjects 104 Legal Proceedings, etc. 39 Legislation 21 Malaria 90 Marriages 10 Maternal Mortality 10,13,122 Maternity and Child Welfare 107 Measles 90 Meat Food Products, Certification 82 Meat Inspection Facing 67 Merchandise Marks Act 81 Milk, Bacteriological and Biological Examinations 64, 65 Milkshops, etc.62 Mortuary 17 Motor Vehicles 102 142 INDEX—(continued) Page Neo-Natal Deaths 12, 13 Notifications of Infections Diseases, Table Facing 83 Observation Wards 125 Offensive Trades 31 Old Ford Clinic 1ll Ophthalmia Neonatorum 93-124 Overcrowding 48, 56 Parliamentary Wards, Statistics Map Facing 8 Pharmacy and Poisons Act 82 Plague 88 Pneumonia 90 Poliomyelitis, etc. 88 Poor Law Belief, etc. 20 Population 9 Post-Natal Consultative Clinic 116 Post-vaccinal Encephalitis, etc. 90 Preserved Foods, Manufacture 81 Public Cleansing Services, etc. 23 Public Education in Health 104 Puerperal Fever and Puerperal Pyrexia 88 Queen Mary Day Nursery, etc. 110 Rag and Bone Dealers 31 Rag Flock Act 34 rats and Mice Destruction Act 32 Refuse Disposal 23 Removal of Infirm Persons 44 Rent Bestriction Acts, Certificates 31 reports:— Artificial Sunlight Clinics, Medical Officer 127 Dental Surgeon (M. & G.W.) 134 Dental Surgeon (Tuberculosis) 96 Lecturer on Health Subjects.104 Observation Wards, Consulting Physician 125 Public Analyst 78 Boyal College of St. Katharine, Senior Medical Officer 129 Tuberculosis Officer 92 Royal Collage of St. Katharine 108, 129 Samples under Food and Drugs Act 76 Sanitary Inspectors'Work, Summaries 26-29 Scarlet Fever 83 Scavenging, Street Cleansing, etc. 23 Schools, Inspection of 33 ,, Use of Electrolytic Fluid in 103 Seamen's Lodging Houses.29 Shops Act 29 Slaughterer of Poultry 68 Slaughterhouses 68 Smallpox 84 Smoke Nuisances 21 Stables 32 Staff 4 143 INDEX—(continued.). Page Stillbirths 9, 118 Street Cleansing, etc. 23 Street Trading 32 Swimming Baths, etc. 30 Tables of Deaths 11-16 ,, of Infectious Diseases Facing 83 Tubercle bacilli in Milk, Examinations for 65 Tuberculosis Care Committee 96 ,, Death Rate 16 and 100 ,, Deaths 100 ,, Notifications, etc. 99, 100 ,, Officer's Report 92 Typhoid and Paratyphoid Fevers. 84 Underground Rooms 53 Unhealthy Areas 51,52 Urinals on Licensed Premises 31 Vaccination 84-87 Verminous Children and Persons 103, 104 ,, Rooms 56 Vital Statistics, Summary 9 ,, ,. Tables 11-16 Wards Statistics, Map Facing 8 Water Certificates 31 ,, from Wells 34 Whooping Cough, Deaths 10 Workshops, Workplaces, etc. (Tables) 35-38 Zymotic Diseases, Death Rate 16 ,, Enteritis 90 and 119