32. SANITARY. REPORT, PORT OF LONDON SANITARY COMMITTEE, WITH THE HALF-YEARLY REPORT OF THE MEDICAL OFFICER OF HEALTH FOR THE PORT OF LONDON, To 30th Jun.e, 1889. Presented 3rd October, 1889. 32. SANITARY. REPORT. PORT OF LONDON SANITARY COMMITTEE, WITH THE HALF-YEARLY REPORT OF THE MEDICAL OFFICER OF HEALTH FOR THE PORT OF LONDON, To 30th June, 1889. Presented 3rd October, 1889. b PLON 15 WHITEHEAD, Mayor. A Common Council holden in the Chamber of the Guildhall of the City of London, on Thursday, the 3rd day of October, 1889. THE Port of London Sanitary Committee did this day deliver into this Court a Report in writing, under their hands, with the Half-yearly Report of the Medical Officer of Health to the 30th June, 1889; which was read. Resolved, That the consideration thereof be adjourned, and it is Ordered, That the same be printed and a copy sent to every Member of this Court. MONCKTON. To the Right Honourable the Lord Mayor, Aldermen, and Commons of the City of London, in Common Council assembled. WE whose names are hereunto subscribed, of your Port of London Sanitary Committee, to whom it has been referred to carry into execution the Public Health Acts, 1872 and 1875, beg to submit for the consideration of your Honourable Court the Report of Dr. William Collingridge, the Medical Officer of Health of the Port of London, for the Half-year ending 30th June, 1889, which Report contains a full and detailed account of the work done during that period in the Port of London by the Medical Officer of Health and the Inspectors. b 2 4 The Report also contains information in connection with:— (1) Small-Pox. (2) Enteric and Scarlet Fever. (3) Other Diseases. (4) Chicken-Pox. (5) Infected Clothing. (6) Unsound Meat. (7) The Launch. (8) The Hospital. (9) Canvey Island. (10) Canal Boats. Your Committee again have great satisfaction in drawing attention to the continued healthy condition of the Port, an unusually small number of cases of infectious disease having been recorded during the past half-year. As stated in the Medical Officer's Report, application was made to the Local Government Board by your Committee in April last for the Board's approval to the inclusion of chicken-pox among the dangerous infectious disorders specified in the regulations made by the Committee in 1885, under section 125 of the Public Health Act, 1875. Bearing in mind the difficulty of distinguishing chicken-pox from smallpox at certain stages of the disease we considered it extremely desirable that our proposal should be adopted. We have recently, however, received a letter from the Local Government Board, in which they state that one effect of carrying out the proposal would be that every ship arriving in the Port with a case of chicken-pox on board would be subject to detention under the Committee's regulations, a result which, as the Board understood, was not contemplated by your Committee. If, however, any such ship were not detained until the arrival of the Medical Officer of Health the master would be liable to the penalty of 5l. imposed by Article 7 of the regulations. The Board did not think it expedient to place masters under this liability, and, having regard to the fact that the number of cases of chicken-pox met with on board ship in the Port was very small, the Board were not at present prepared to assent to the proposed amendment of the regulations. All which we submit to the judgment of this Honourable Court. Dated this first day of October, 1889. J. E. Walford. Daniel Greenaway. Frank Tayler. W. G. Howard. Henry H. Thompson. Wm. Courtney, Junr. J. N. Pimm. David Burnett. William Creasey. Cornelius Barham. INDEX. Page Introduction Small-Pox 9 Enteric Fever 11 Scarlet Fever 13 Other Diseases 13 Memorandum on the subject of Chicken-Pox 16 Cases of Chicken-Pox within the Port of London 17 Infected Clothing 19 Unsound Meat 19 The Launch 19 The Hospital 20 Canvey Island 20 The Canal Boats Acts 21 Index to Appendices 23 PORT OF LONDON SANITARY OFFICES KING WILLIAM STREET, GREENWICH, 1st July, 1889. TO THE WORSHIPFUL THE PORT OF LONDON SANITARY COMMITTEE. Gentlemen, I have the honour to present herewith a brief record of the work carried out in the Port of London by your officers during the first six months of the present year. This period has happily been an exceptionally healthy one, but little infectious disease of any kind having come under the notice of your officers. Advantage has been taken of this to concentrate attention on the general sanitary work of the district, such as in the face of epidemic-work it is well-nigh impossible to give with our extremely limited staff. The whole system of sanitary inspection has been carefully revised, and, accordingly, a somewhat higher standard of efficiency required. This to a certain extent will account for the larger number of vessels in which sanitary defects have been pointed out and rectified. It is satisfactory to note that this greater care of detail thus possible has been thoroughly appreciated by masters and owners, and that with but few exceptions the same steady support has been given to this Authority as heretofore. During the six months 9,713 vessels of all classes have been visited and examined, with the result that in 288 cases cleansing orders were given and complied with, being in the proportion 2.9 per cent. of the total number. Of the whole number no less than 8,583, or 88.3 per cent. were of British nationality, the next places in point of number being taken by the Germans and Scandinavians, with the percentages of 4.1 and 4 respectively. Thirteen vessels were fumigated on account of infectious disease, viz.:— 5 for measles, 4 for small-pox, 1 for scarlet fever, 1 for enteric fever, 1 for chicken-pox, and 1 for fever and ague. 8 One of these vessels was the Metropolitan Asylums Board's Hospital Ship "Atlas." Although this vessel is under the authority of the Asylums Board, and your Worshipful Committee has no jurisdiction whatever over her management, she nevertheless is a ship within your district, and when it became necessary to remove her into dry dock for purposes of repair it clearly became the duty of your Medical Officer to guard against the possibility of infection in dock. The Managers took this obvious view of the case, and accordingly applied to have her fumigated, which was therefore carried out by your officers. The operation occupied a whole day and required for its due performance 1½ cwt. of sulphur. The number of structural alterations necessary for the hygienic improvement of vessels still continues to increase. During the half-year no fewer than 389 such improvements, affecting 354 vessels, have been carried out. The majority of these, while important, involve comparatively trifling expense, though it is found in practice that where any objection is raised to the execution of an order, it is invariably one of the smallest and least difficult to effect. Of these alterations 130 affected ventilation, 28 water tanks, and 231 lighting and heating of forecastles. Perhaps one of the most difficult and at the same time most important sanitary questions in connection with small vessels is the storage of water. Wooden casks are so cheap and so readily obtained that the temptation to use them as receptacles for water is very great. They are, however, very difficult to keep clean, even when new, and moreover rapidly decay, causing the water to deteriorate and become foul. For some time past it has been our policy on all occasions to endeavour to discountenance their use, and to substitute either slate or iron tanks. The result has been satisfactory, and proper storage is now becoming far more usual. I lay stress upon this result inasmuch as it shows the value of steady and continuous pressure in sanitary work. There can be no question as to the enormous influence of sanitary surroundings upon the well-being of seamen as of others, nor as to the certainty of restraining the spread of infectious disease by maintaining the public health at the highest possible standard. The main object of a sanitary authority should be the prevention rather than the treatment of disease. It is now generally conceded that, while too great stress cannot be laid upon the importance of supervision of all vessels arriving in a port, yet, after all, the main protection of a country 9 from the risk of importation of infectious disorders must always be the keeping of our ports, harbours, rivers, docks and surroundings in a thoroughly healthful condition. It is clearly not reasonable to expect that we can always avoid the arrival of infection from abroad, but it is without doubt possible to prevent its spread by so having our ports in such sanitary condition that the infection will be unable to find a congenial resting-place. Infection is a distinct entity with a definite vitality, but it must always be borne in mind that the vitality depends very largely upon the conditions of its surroundings. In a dirty, dark, ill-ventilated, and ill-drained district where disease is once introduced it has a far greater chance of working havoc than in one where the opposite conditions prevail. Even in the case of cholera, the most dreaded of all plagues, it has been shown to demonstration that with pure air, pure water, good drainage, and thorough cleanliness, in every sense of the word, a population has but little to fear, and on this fact our modern ideas of the futility of quarantine and the substitution for it of a rational system of medical inspection have been based. SMALL-POX. The history of small-pox in London during the half-year is soon written— practically, there has been none. But, inasmuch as with the absence of this disease there is as usual a marked tendency for the only safe precaution, viz., vaccination, to become neglected, it is precisely during such non-epidemic times that the necessity for guarding against its introduction from abroad is apparent. Hence, the responsibility of guarding the entrance of our port increases in inverse ratio to the amount of the disease in London. Fortunately we have had but few importations. Of these I give brief particulars:— On the 25th January notice was received from the Seamen's Hospital that a fireman who had applied at that institution for relief had been sent to the Asylums Board's Hospital with small-pox. He belonged to the steam ship "Raven," which arrived in the West India Docks on 13th, the patient being at that time to all appearance in perfect health. The vessel had left Oporto on 8th, where she had lain two days. She left London on 15th for Newcastle, arriving on 16th, leaving again for London on 18th. c 10 The patient lived at his own house in Greenwich, and worked on board during the day. On the 21st (13 days after leaving Oporto) he was "unwell," and on 23rd went to the Seamen's Hospital, where he was found to be suffering from small-pox. The vessel was at once fumigated, re-vaccination offered to the crew, and notice sent to the Medical Officers of Health for Newcastle and Greenwich. The case is an interesting and instructive one as it shows how easily a disease might be spread by a person who at the time was apparently in good health and certainly not suspected of small-pox. The infection was obviously derived from Oporto, where small-pox was prevalent. On the 8th February the steam ship "Clyde" on arrival in dock reported having had a case of small-pox on board. The crew were shipped at Bombay on the 18th January, and were inspected by a medical officer on the following day. The patient had just left a Hadji ship, which had suffered severely from small-pox, and was no doubt infected at the time of joining. On the 19th he was taken "ill," and on 22nd (12 days after joining) the case was diagnosed and the patient at once isolated in boat on upper deck. On arrival at Brindisi on 24th he was sent to hospital and the boat disinfected. Thanks to the prompt treatment no further cases occurred on board. On 27th the steam ship "Lisbon" came into the London Dock with a case of small-pox on board. The patient had been in hospital at Lisbon for asthma from February 2nd to 20th, and stated that in the next bed was a man suffering from what he considered was small-pox. On arrival in London he went to his home in the East End, suffering from what was believed to be cold. At the Seamen's Hospital, where he applied, he was found to have small-pox, and sent at once to the Asylums Board's Hospital. On the 7th May the steam ship "Jason" reported at Gravesend with a case of small-pox. 11 She had touched at Port Said on 20th April, leaving the following day The patient who was taken ill on 30th April was at once removed to the Port Sanitary Hospital with all his effects. The bed and bedding were burned on board and the vessel fumigated. He was probably infected at Port Said. On 30th May the steam ship "Nestor" came in having had a death from small-pox on the voyage. She left Singapore on 8th April and Penang on 14th, taking in pilgrims at both ports. On the 20th a child was taken ill, and died six days later. The vessel was quarantined for five days at Kamaran and fumigated. All being well on arrival no further action was deemed necessary. On 4th January a report was received that a vessel which had come into the Port of London had imported a case of small-pox into Dundee, thus causing a small outbreak. On enquiry it was found that the "Edmund Kaye," the vessel in question, had not put into London at all, but that Wm. Carter, A.B., was paid off from her at Dundee on 6th December, 1888, and on 8th of same month took a ticket as passenger in the passenger steamer which trades between Dundee and London. His reason for coming to London was in order to go to the Seamen's Hospital as he was suffering from rupture. He eventually found his way to Camberwell, and on communicating with the Medical Officer of Health for the district it was found that he had not suffered from small-pox. ENTERIC FEVER. On the 28th May the Danish sailing ship "Excelsior" arrived in the Commercial Dock. A seaman went on to the Seamen's Hospital on arrival as being unwell. The vessel was at once fumigated as the case appeared to be suspicious. On the 4th a definite diagnosis of enteric fever was made by the hospital authorities. He had been poorly since 22nd May, 11 days after leaving Memel. c 2 12 As no report of the illness had been made to Her Majesty's Customs at Gravesend on arrival a letter was sent to the authorities informing them of the facts. On 1st June the steam ship "Clan Macpherson," from Calcutta, came into Tilbury Dock. On 2nd a seaman was taken ill. He was attended by a medical man, treated as a case of lung disease, and sent to Seamen's Hospital, where he was found to have enteric fever, and the fact reported to Port Sanitary Authority. As' the vessel had already left for Glasgow notice was at once sent to the Medical Officer of Health of that port. June 18th.—The captain-superintendent of the Training Ship "Arethusa" reported that a boy had died on board from blood-poisoning, following what was afterwards diagnosed as enteric fever. There was no suspicion of the nature of the illness during its course and no other cases occurred on board. I have repeatedly brought before your Worshipful Committee the serious position in which training ships without some means of isolation of infectious disease would be placed in the event of an outbreak. Two of these institutions only are in this dangerous position, viz., the School Board Ship "Shaftesbury," off Grays, and the "Arethusa," off Greenhithe. During the early part of 1888 the "Shaftesbury" had a severe lesson in the shape of an outbreak of scarlet fever, which, fortunately, was controlled at an early stage by the means of isolation in your hospital at Gravesend. This is no longer available, and to cope with a like outbreak would now be a most difficult matter—very costly even if successful. It was hoped that, as a result of this warning, arrangements would have been made for the provision of what your medical officer has so often urged upon the authorities, viz., a small, perfectly isolated building, fitted with say, eight or ten beds for cases of infectious disease. The simplest plan which I suggested was that an arrangement should be made with the Port Sanitary Authority whereby a certain number of beds at Gravesend would be kept available for the ship in return for an annual payment for a certain term of years. Your Authority has land in excess of present requirements, and also a medical officer and administrative staff upon the spot. The distance is but small, and either the launch or ambulance boat would be at the service of the ship. Thus, for an annual payment far below the cost of an independent hospital, however small it might be, the ship would have the use of a staff and beds, while the Port Sanitary Authority, by the agreement being made for a certain term, could erect a small pavilion for the treatment of small-pox only. 13 The "Arethusa," off Greenhithe, is so much farther up the river that such an arrangement would hardly be satisfactory. The matter has repeatedly been urged upon the Committee by your officers, but the maintenance of the vessel is a work of charity and dependent upon public subscriptions. While, therefore, the Committee are extremely anxious to do whatever they can in the matter, they are naturally bound to exercise the strictest economy. At the present time an attempt is being made to obtain a suitable isolated house which can be adapted for the purpose. SCARLET FEVER. On 8th May a boy was removed to Seamen's Hospital, from "Arethusa," suffering from scarlet fever. The patient was taken ill on 1st and was at once removed to the "Chichester" and thence to a boathouse on shore, this last removal being necessary on account cf the "Chichester" being given up by the Society. The case was diagnosed as scarlet fever on 7th, and removed in the launch to the Seamen's Hospital. The boathouse and all effects were fumigated. At first the nature of the illness was very doubtful. No source of infection was traced and the lad had not been on leave. There were no cases in Greenhithe. On 22nd May a case of scarlet fever was removed from steam ship "Rose." The vessel arrived from Seaham on 18th; on 19th patient went to hospital for simple sore throat and was seen daily. On 22nd it was reported as scarlet fever and moved to Port Sanitary Hospital in the ambulance boat and the vessel fumigated. The master reported that there had been many cases of scarlet fever in Hartlepool. OTHER DISEASES. On 16th January steam ship "Ballaarat" on arrival at Gravesend reported case of measles. A Lieutenant, R.N., came on board at Gibraltar on 9th inst. and was taken ill same day, the rash appearing on 10th. As he was convalescent on arrival he was allowed to leave, his cabin and goods having been disinfected. 14 On 17th January a case of measles occurred at the Coast Guard Station, Canvey Island. The patient, a married woman, aged 22, went to Portsmouth on 21st December, and returned to Canvey on 7th January. On 17th she was taken ill and the eruption appeared. The patient was at once isolated and the husband put "off duty" in order to attend upon her. Measles were prevalent at Portsmouth, and the patient was there exposed to infection. No other cases occurred. On 21st May steam ship "Colorado" on arrival at Gravesend reported a case of measles. The patient's sister had had measles in New York. The case reported ill on 20th May to ship's surgeon, and was isolated on board. On arrival she was convalescent. The cabin and effects were fumigated and the vessel at once went on to Hull. On 21st May steam ship "Nepaul" arrived in the Royal Albert Dock with a doubtful case of measles on board. The child on 16th developed a rash like measles without any premonitory symptoms. This lasted two days and cleared up without any other definite symptoms. Surgeon reported it as "measles" in order to be on the safe side. The family embarked at Madras, where measles were prevalent. On 31st May steam ship "Vega" arrived in Tilbury Dock with a case of measles. Vessel left Suez 16th May, 1889, „ „ Port Said 17th May, 1889, „ „ Malta 21st May, 1889. The patient (deck lad) was taken ill on 24th May, and was convalescent on arrival. Cabin fumigated. 15 On 2nd February steam ship "Clan McArthur" on arrival in Tilbury Dock reported case of malarial fever. Vessel left Calcutta 12th December, 1888, Called at Madras 27th December, 1888, „ Colombo 30th December, 1888, „ Suez 12th January, 1889, „ Port Said 13th January, 1889, Taken ill 30th January, 1889. The patient was treated on board and went round to Glasgow in the ship. The master of the vessel was served with a fumigation order, which was duly complied with. On 27th February the steam ship "Clan Sinclair" came into Tilbury Dock with a convalescent case of "fever and ague" on board. She left Bombay on 24th January, 1889, and the patient was taken ill two days later. The fumigation of quartermaster's cabin and effects was carried out. On 15th March a case of chicken-pox was removed in the launch to the Port Sanitary Hospital from the steam ship "Navari.no," lying in Royal Albert Dock. She sailed from Calcutta on 24th January and touched at Port Said on the 18th February. The day after leaving Port Said a case of chicken-pox appeared and was isolated for two days only, when the patient is reported to have recovered, and was said to be safe on arrival. No report was made of the case on arrival either at Gravesend or to your Inspector on visiting the ship in dock. The so-called convalescent was seen on 12th on account of information received, and as he still had an eruption visible was at once isolated. As he had been among the rest of the crew without any restriction for three weeks other cases were naturally expected. A second case appeared on 15th, two others on 29th, a fifth on 31st, and a sixth on 2nd April. They were all removed to the Port Sanitary Hospital and the vessel fumigated after each removal. 16 A fortnight after the last removal, before the vessel sailed, the whole crew was mustered, and after being stripped and bathed each man was provided with a new suit of clothes, the old ones being afterwards thoroughly disinfected. The Company moreover wisely decided to notify the fact of the disease having occurred to each intending passenger, a prudent foresight which would certainly be amply repaid by the confidence it would naturally inspire. As the first patient had been decided by the medical officer of the ship to be convalescent on arrival the master could not be held responsible for the omission to report under your Worshipful Committee's regulations, but was obviously in fault in not notifying to Her Majesty's Customs that there had been illness on board, and was unwise in not stating the fact to your Inspector, when the first case would have been at once isolated and, possibly, the subsequent attacks avoided. On my representation it was at once decided to apply to the Local Government Board to approve of the addition of chicken-pox to the list of diseases mentioned in the regulations. A deputation, consisting of the Chairman, the Town Clerk, and your Medical Officer, waited upon the Secretary and Medical Officer of the Board by appointment and explained their views. By request your Medical Officer embodied these in the following memorandum:— MEMORANDUM. It appears to me to be highly desirable from various points of view that chicken-pox should be included in the list of those dangerous infectious disorders for which special regulations may be made by the Port Sanitary Authority and confirmed by the Local Government Board, under section 125 of the Public Health Act of 1875, mainly because there is always a close and dangerous similarity between chicken-pox at a certain stage and cases of modified small-pox, a similarity which it is within the knowledge of the Board has on more than one occasion led to disastrous results, and, as the Board are aware, is so close that for some statistical purposes the RegistrarGeneral has found it necessary to include chicken-pox with small-pox. Another point is that, inasmuch as Lascars and other natives who are especially subject to infantile diseases of a severe type form a considerable percentage of the crews of the large ocean-going passenger steamers, this notification becomes of great moment when the importance and character of our ocean passenger traffic is taken into consideration. It has happened that chicken-pox has spread on board these vessels and given rise to much trouble. A memorandum of cases of chicken-pox occurring within the Port of London has already been submitted to the Local Government Board, and a copy is hereto appended. From this it will be seen that the number of cases occurring is extremely small and not likely to interfere to 17 any extent with the commercial interests of the port, and, moreover, it must be distinctly understood that if powers of notification and removal such as we seek were granted to the Port Sanitary Authority the Medical Officer would of course have a discretionary power to carry out removal, &c. I would farther call the attention of the Board to the fact that the arrangements of the Authority are such that no delay or detention of any kind occurs in removal of cases of infectious disease from vessels in the port. The Medical Officer and proper officers remove cases immediately on notification at Gravesend, and the vessel is fumigated on her way up the river, if possible, to avoid the loss of a tide, and I am able to state as a fact, that in no single instance has detention occurred. It may be urged of course that chicken-pox is not a "dangerous infectious disorder" within the meaning of the Act, and this of course is open to argument. It certainly appears to your Medical Officers that a disease which may at any moment be spread from crews of vessels to passengers and children of passengers in a severe form must be considered dangerous in the commonsense meaning of the word, although not in the large majority of cases dangerous to life. CASES OF CHICKEN-POX WITHIN THE PORT OF LONDON. 4th May, 1882.—Nineteen cases of chicken-pox were removed from "Assam" by road to Gravesend and taken on board " Rhin." One contracted small-pox on board. One case on 17th and one case on 23rd, removed to Homerton. Vessel fumigated after each removal. 21st May, 1882.—Case of chicken-pox removed to Homerton from "Rome." 8th June, 1882.—Case chicken-pox (emigrant) removed from "Persian Monarch" at Gravesend and brought back to London. 25th July, 1883.—One case chicken-pox (child) removed from "Grecian Monarch" to "Rhin." By misunderstanding allowed to leave the ship and returned to London. 2nd December, 1884.—One case on "Cornwall." Isolated. No history of infection. 16th June, 1885.—Case removed to hospital from steam ship "New Guinea" by Board of Trade Medical Officer. d 18 17th June, 1885.— Case removed to hospital from steam ship "Tainui" by Board of Trade Medical Officer. 25th October, 1887.—Steam ship "Britannia," Royal Albert Dock, two cases. Both patients were part of crew of 154 natives, embarked at Bombay in steam ship "Valetta" on 23rd September. Vessel called at Aden 29th September, „ „ Port Said 5th October, „ „ Malta 8th „ „ „ Gibraltar 12 th „ „ „ Plymouth 16th „ „ „ London 17th „ One case taken ill 24th „ First case removed on 25th to Gravesend in launch. Second case removed 29th. Firemen's quarters and steerage hospital fumigated after each removal. 11th April, 1888.—Steam ship " Rome," two cases. Vessel left Sydney 20th February, „ Malta 1st April, Second class passenger taken ill 4th „ Well 8th „ Boy attacked 7th ,, The case not removed at Gravesend. Patient allowed to travel to Liverpool, chicken-pox not being on list in u regulations." 3rd July, 1888.—Steam ship " Oceano," Royal Albert Dock. Small-pox ( ?) Vessel arrived 11th June. Patient taken ill 29th, pains in head, back, and sore throat ; doubtful rash on 3rd July. Removed to Gravesend. Fumigation. Crew mustered daily for inspection by ship's surgeon. 15th March, 1889.—Steam ship " Navarino," Royal Albert Dock, six cases. Vessel left Calcutta 24th January, „ Madras 29th ,, „ Colombo 2nd February, ,, Suez 17th ,, „ Port Said 18th ,, 19 The day after leaving Port Said a case of chicken-pox appeared. Isolated two days only. Said to be safe on arrival. Not reported anywhere. On 12th, from information of chief engineer, Dr. Finlay saw him and isolated him. Second case found on 14th and removed to Gravesend following day. Third and fourth removed on 29th, Fifth „ 31st, Sixth „ 2nd April. Fumigation after each removal. INFECTED CLOTHING. On the 22nd January the steam ship "City of Edinburgh" arrived in Victoria Dock having four packages of cholera-infected clothing on board, the property of two persons who had died from cholera on 19th December, 1888, at Calcutta. It appeared that these goods were consigned in the usual way as cargo, and that none of the officers of the ship knew of their nature. They were removed to the Port Sanitary Hospital and there fumigated, all the expenses being paid by the shipowners, who have moreover undertaken to give strict injunctions to their officers to take precautions to prevent the recurrence of such a dangerous proceeding. UNSOUND MEAT. In Appendix H (pages 29-30) will be found particulars of all seizures of unsound meat, &c., during the half-year. As usual there have been no considerable quantities condemned at one time. The list includes Beef, Mutton, Venison, Salt Meat, and Fruit. In nearly all cases the consent of the owners to the destruction was obtained, thereby avoiding the necessity of applying for a magisterial order. THE LAUNCH. The "Clotho" continues to perform her work satisfactorily in spite of the great strain at times put upon her machinery. Up to the present time a very small amount has been expended upon keeping her in repair, the wear and tear being less than might reasonably be expected. After nearly five years' work it was deemed advisable to have d 2 20 her carefully overhauled and any obvious defects remedied. This was done by a consulting engineer and the result was satisfactory. At the same time the old paint was all removed from her sides and bottom, the deck-houses were scraped and revarnished, and the funnel was cut off at a higher level so that it can be lowered with much lighter weights, thus adding to the steadiness of the vessel in a seaway. In about twelve months' time it will probably be necessary to open her up, and lift the boiler for further careful examination. THE HOSPITAL. The Hospital has accommodated during the six months cases of small-pox on two occasions, one case of scarlet fever, and three cases of chicken-pox, in all six cases. The inside blinds have been removed and wooden louvred outside shutters ordered to be fitted to the windows. These will be an improvement, being more durable and unlikely to retain infection. It is again my duty to urge upon the Committee the necessity of providing a distinct pavilion of, say, six or eight beds for small-pox. It is not safe to attempt to treat small-pox in the present building at the same time with cases of other disease, and a grave responsibility is incurred by the present arrangement. A small building erected at comparatively little cost, at a proper distance from the present block, would meet the case. CANVEY ISLAND. The health of the island has been good. But one case of infectious disease has occurred. This was measles contracted at Portsmouth. The artesian well at Waterside has been re-bored by the Ecclesiastical Commissioners and is now in a satisfactory condition. All the houses have been periodically inspected and numerous sanitary defects have been remedied. The long-needed public well in the village is now in a fair way towards completion. The amount required, by no means large, has been raised by the exertions of the principal owners and inhabitants, aided greatly by liberal donations from the Court of Common Council and the Ecclesiastical Commissioners on the understanding that the well when completed should be free for public use. 21 A contract was entered into with a firm which has had considerable experience in the neighbourhood, and the work is now being carried out as rapidly as possible. It is expected that the formal opening will take place about the end of September next. THE CANAL BOATS ACTS. The Canal Boats Acts have been steadily worked in the course of the ordinary routine, no special arrangements having been made. During the half-year 323 boats have been inspected, having on board a population of 786 persons. In eight cases the boats were without certificates on board at the time of inspection. These were, however, all registered, and as the omission was accounted for the masters and owners were simply warned. On the 26th February the master of the "Dee" was summoned at the West Ham Police Court for indecent occupation, and was fined 20s. and 7s. costs. The boat was registered for man, wife and four children, and at the time of inspection was occupied by the master, his wife, a lad of 17 and a boy of five. No infectious disease was discovered on any canal boat within the district. Twenty-five of the ordinary Thames lighters, not under the Shipping Act, were registered for the first time under the Canal Boats Acts. This registration is slowly but steadily being carried out. In conclusion I have much pleasure in expressing my keen appreciation of the uniformly steady and valuable support given by your Worshipful Committee to the Medical Officers and staff* generally, and have the honour to be, Gentlemen, Your obedient Servant, WILLIAM COLLINGRIDGE, M.D., Medical Officer of Health, Port of London. 23 INDEX TO APPENDICES. Appendix Page A Number of Vessels inspected in Docks and on the River, from January 1st to June 30th, 1889 24 B Number and Nationality of Vessels inspected, from January 1st to June 30th, 1889 25 C List of Effects Disinfected 26 D List of Vessels Fumigated, with Causes 27 E Number of Structural Alterations carried out 28 F Number of Vessels in which Structural Alterations have been ordered, but not yet completed 28 G Cases of Infectious Diseases in the Port of London 29 H Particulars of Unsound Meat condemned by Port Sanitary Authority 31 I Particulars of Inspection of Canal Boats 33 J Number of Water Barges inspected 34 24 APPENDIX A. Number of Vessels Inspected in each Dock and on the River, from January 1st to June 30th, 1889. Docks. Number. Number to be Cleansed or Whitewashed. No. of Foul Cargoes. No. of Outward Bound. No. of Sick referred to Hospital. St. Katharine 233 3 — 16 — London 366 10 — 27 1 Regent's Canal 200 4 — 4 — Millwall 747 29 — 89 — West India 740 43 — 92 10 East India 308 14 — 40 — Victoria 438 30 — 42 1 Royal Albert 627 25 — 25 2 Commercial 513 12 — 20 2 Gravesend District 2,434 21 — 72 2 River 3,107 97 — 156 5 Total 9,713 288 — 583 23 Number. No. to be Cleansed, &c. Total to end of 1888 289,395 17,874 From January 1st to June 30th, 1889 9,713 288 Total since commencement 299,108 18,162 25 APPENDIX B. Number and Nationality of Vessels Inspected, from January 1st to June 30th, 1889. Nationality. Number. Proportion per cent, of the Total Number. American 1 Austrian 1 — Belgian 2 •02 British 8,583 88.36 Danish 92 •94 Dutch 122 1.24 Finnish 4 •04 French 42 •43 German 399 4.10 Greek 1 — Italian 6 •06 Russian 14 •14 Spanish 51 •52 Swedish and Norwegian 395 4.06 Total 9,713 E 26 APPENDIX C. Effects Disinfected, from January 1st to June 30th, 1889. Date. Ship's Name. Where from. Date and Cause of Death. Where Disinfected. Date. Cause. Jan. 1 City of Edinburgh Calcutta Dec. 19,'88 Cholera Port Sanitary Hospital. ,, 15 Gem Demarara Nov. 1, '88 Yellow Fever London Dock. Mar. 29 Rodney Sydney Unknown Unknown ,, ,, April 9 Mid Lothian Sourabaya Oct. 11,'88 Malarial Fever West India Dock. ,, 30 Clyde Bank Pisagua Unknown Unknown Millwall Dock. May 11 Clan Gordon Madras Aug. 14,'87 ,, Tilbury Dock. June 6 Vega Calcutta Aug. 14,'87 ,, ,, ,, ,, 17 Quathlamba Natal Dec. 16,'88 Cholera St, Katharine Dock. ,, 28 Fiery Cross Aruba Feb. 21,'89 „ 22,'89 Yellow Fever River, Charlton. Number. Total to end of 1888 641 From January 1st to June 30th, 1889 9 Total since commencement 650 27 APPENDIX D. Vessels Fumigated, from January 1st to June 30th, 1889. Date. Ship's Name. Steam or Sailing. Where from. Cause of Fumigation. Jan. 16 Ballaarat Steam Gibraltar Measles ,, 17 Coast Guard Station - Canvey Island ,, 25 Raven Steam Oporto Small-pox Feb. 27 Clan Sinclair ,, Bombay Fever and Ague ,, 28 Lisbon ,, Lisbon Small-pox Mar. 15 Navarino ,, Calcutta Chicken-pox May 17 Jason ,, Yokohama Small-pox ,, 21 Colorado ,, New York Measles ,, 21 Nepaul ,, Madras ,, ,, 21 Atlas Hospital Ship Long Reach Small-pox ,, 22 Rose Steam Seaham Scarlet Fever ,, 31 Vega ,, Calcutta Measles June 3 Excelsior Sailing (Danish) Memel Enteric Fever Number. Total to end of 1888 258 From January 1st to June 30th, 1889 13 Total since commencement 271 e 2 28 APPENDIX E. Alterations made, from January 1st to June 30th, 1889. Month. No. of Vessels in which Alterations have been made. Ventilation. Water tanks. Lighting, heating, cleansing, &c. Total No. of Alterations. January 61 23 5 39 67 February 71 22 6 52 80 March 80 27 9 54 90 April 47 18 3 31 52 May 61 24 4 37 65 June 34 16 1 18 35 Total 354 130 28 231 389 APPENDIX F. Alterations ordered, from January 1st to June 30th, 1889. Month. No. of Vessels in which Alterations have been ordered. Ventilation. Water tanks. Lighting, heating, cleansing, &c. Total No. of Alterations. January 9 1 2 6 9 February 12 5 3 8 16 March 11 3 6 5 14 April 15 4 4 11 19 May 10 3 2 5 10 June 19 6 5 14 25 Total 76 22 22 49 93 29 APPENDIX G. Cases of Infectious Disease in the Port of London, from January 1st to June 30th, 1889. Date. Name of Vessel. Description. Official No. Owners or Brokers. Where lying. Disease. Source of Infection. Where case removed to. Jan. 16 Ballaarat Str. 81,838 Peninsular and Oriental S. N. Co., Leadenhall-st. Royal Albert Dock Measles Gibraltar Convalescent on board. „ 17 Canvey Island Coast Guard Station - - - - - - - - - - Measles Portsmouth Treated at Station. „ 25 Raven Str. 87,144 General S. N. Co., Great Tower-street. South West India Dock Small-pox Oporto Metropol. Asylums' Board Hospital. Feb. 2 Clan McArthur Str 87,657 Cayzer, Irvine & Co., Gracechurch-street. Tilbury Dock Malarial Fever Treated on Board. „ 8 Clyde Str. 84,345 Peninsular and Oriental S. N. Co., Leadenhall-st. Royal Albert Dock Small-pox Bombay Brindisi Hospital. „ 27 Clan Sinclair Str. 86,705 Cayzer, Irvine & Co., Gracechurch-street. Tilbury Dock Fever and Ague Bombay Convalescent on board. „ 28 Lisbon Str. 65,609 J. Hall & Co., 1, New London-street. London Dock Small-pox Lisbon Small-pox Hospital Mar. 15 Navarino Str. 68,894 British India S. N. Co., 13, Austin-friars. Royal Albert Dock Chicken-pox (6) Calcutta Port Sanitary and Seamen's Hospitals. May 7 Jason Str. 81,400 J. Swire & Sons, 19, Billiter-street. Gravesend Small-pox Port Said Port Sanitary Hospital. „ 8 Arethusa Traing. Ship. National Refuges for Homeless and Destitute Children Greenhithe Scarlet Fever (?) Seamen'sHospital. „ 21 Colorado Str. 93,119 Wilson & Sons, Hull Gravesend Measles New York Convalescent on board. „ 21 Nepaul Str. 73,821 Peninsular and Oriental S. N. Co., Leadenhall-st. Royal Albert Dock Measles (?) Madras Ditto. „ 22 Rose Sail 23,322 W. Steveson, East Hartlepool. Gravesend Scarlet Fever Hartlepool Port Sanitary Hospital. 30 APPENDIX G.—continued. Date. Name of "Vessel. Description. Official No. Owners or Brokers. Where lying. Disease. Source of Infection. Where case removed to. May 31 Vega Str. 81,306 J. B. Westray & Co., 112, Fenchurch - street. Tilbury Dock Measles - - - Convalescent on board. „ 31 Nestor Str. 60,078 Ocean S. S. Co., Liverpool Royal Albert Dock Small-pox Singapore Died at Sea. June 3 Excelsior Sail Danish Tegner, Price & Co., 107, Fenchurch-street. Commercial Dock Enteric Fever Memel Seamen'sHospital. „ 13 Clan Macpherson Str. 87,709 Cayzer, Irvine & Co., Leadenhall-buildings, Gracechurch-street. Tilbury Dock Enteric Fever - - - Ditto. „ 18 Arethusa Traing. Ship. National Refuges for Homeless and Destitute Children Greenhithe Enteric Fever (?) 31 APPENDIX H. Unsound Meat, &o., during the Half-year ending June 30th, 1889. Date. Ship's Name. Official Number. Where lying. Where from. Amount condemned. Jan. 8 Arawa 89,953 Royal Albert Dock New Zealand 1 carcase Mutton. ,, 18 Ormuz 93,341 Tilbury Dock Sydney 14 carcases Mutton. „ 21 Tula Danish Mill-wall Dock Copenhagen 1 case Venison. Feb. 6 Ionic 86,299 Royal Albert Dock New Zealand 1 carcase Mutton. „ 12 Selembria 86,288 Ditto Ditto 4 carcases Mutton, 2 quarters Beef. „ 19 Rimutaka 89,652 Ditto Ditto 18 carcases Mutton, and 33 parts carcases. March 1 Fifeshire 73,740 West India Dock Ditto 2 carcases Mutton, 4 legs. „ 19 Ruapehu 76,069 Royal Albert Dock Ditto 16 carcases Mutton, 25 legs. „ 29 Tainui 90,001 Ditto Ditto 39 carcases Mutton, 32 parts carcases. April 18 Kaikoura 89,627 Ditto Ditto 326 carcases Mutton, 11 quarters Beef. „ 18 Zeta 95,416 West India Dock River Plate 21 carcases Mutton. May 7 Bayley 91,983 Royal Albert Dock New Zealand 41 carcases Mutton, 45 parts carcases. „ 7 Doric 87,847 Ditto Ditto 2 carcases Mutton. 32 APPENDIX H.—continued. Date. Ship's Name. Official Number. Where lying. Where from. Amount condemned. May 8 Cygnet 87,183 Blackwall Antwerp 2 crates Plucks. ,, 10 Tongariro 76,067 Royal Albert Dock New Zealand 20 carcases Mutton, 96 legs. ,, 10 Marlborough 73,858 East India Dock Ditto 2 carcases Mutton. ,, 13 Iberia 69,336 Tilbury Dock Sydney 2 boxes Tomatoes, 2 boxes Passion Fruit. ,, 16 Cameo 75,329 Millwall Dock Christiania 1 cask Salted Meat. ,, 21 Britannia 93,196 Royal Albert Dock Melbourne 14 cases Apples, 3 cases Pears. ,, 30 Arawa 89,953 Ditto New Zealand 110 carcases Mutton, 120 legs, 3 quarters Beef. ,, 30 Ormuz 93,341 Tilbury Dock Sydney 43 carcases Mutton, 1 box Passion Fruit. ,, 30 Invercargill 84,489 East India Dock New Zealand 4 carcases Mutton, 2 legs. June 6 Cuzco 65,901 Tilbury Dock Sydney 41 carcases Mutton, 19 boxes Tomatoes, 6 boxes Passion Fruit. ,, 7 Aorangi 76,068 Royal Albert Dock New Zealand 27 boxes Kidneys, 2 boxes Quinces, 2 boxes Tomatoes. 33 APPENDIX I. V\ Particulars of Canal Boats Inspected under the Canal Boats Acts, 1877 and 1884, froir January 1st to June 30th, 1889. Months. No. of Canal Boats Inspected. Registered No. of Persons to live on board. No. of Persons living on board. No. of Canal Boats without Certificates on board. No. of Prosecutions against Masters and Owners. No. of Cases of Infectious Disease on board. No. of Barges Registered by the Port of London Sanitary Authority. January 42 152 99 2 — — 3 February 58 236 159 1 I — l March 62 226 151 — — — 17 April 37 133 84 — — — — May 75 268 174 3 — — l June 49 213 119 2 — — 3 Total 323 1,228 786 8 1 — 25 34 APPENDIX J. Number of Water Barges Inspected, from January 1st to June 30th, 1889. No. of Water Barges in District. No. Inspected. In Good Condition. Repaired as Ordered. Condemned. Laid up, &c. 28 28 8 12 3 5 Charles Skipper and East, Printers, St. Dunstan's Hill, E.C 33. SANITARY. REPORT PORT OF LONDON SANITARY COMMITTEE, with the HALF-YEARLY REPORT of the MEDICAL OFFICER OF HEALTH FOR THE PORT OF LONDON, To 31st December, 1889. Presented 13th February, 1890. PLON 15 33. SANITARY. REPORT. POUT OF LONDON SANITARY COMMITTEE, WITH THE HALF-YEARLY REPORT OF THE MEDICAL OFFICER OF HEALTH FOR THE PORT OF LONDON, To 31st December, 1889. Presented 13th, February, 1890, B ISAACS, Mayor. A Common Council holden in the Chamber of the Guildhall of the City of London? on Thursday, the 13th day of February, 1890. THE Port of London Sanitary Committee did this day deliver into this Court a Report in writing, under their hands, of proceedings of the Committee, and submitting the Report of the Medical Officer of Health of the Port of London for the Half-year ending 31st December, 1889, and recommending the following reappointments for One year from Lady Day, 1890, viz.:— William Collingridee, Esq., M.D., as Medical Officer of Health, William Henry Lewis Henry Spadaccini William Baillie William Anderson as Sanitary Inspectors; also for authority to re-appoint Philip Whitcombe, Esq., Medical Officer of the Hospital at Gravesend, at his present rate of remuneration, viz., Two hundred Guineas per annum, and to reconsider the terms of Dr. Collingridge's appointment; which was read. Resolved, that the consideration thereof be adjourned, and it is Ordered, that the Report be printed and a copy sent to every Member of this Court. MONCKTON. B 2 4 To the Right Honourable the Lord Mayor, Aldermen, and Commons of the City of London, in Common Council assembled. WE whose names are hereunto subscribed, of your Port of London Sanitary Committee, to whom it has been referred to carry into execution the Public Health Acts, 1872 and 1875, beg to submit for the consideration of your Honourable Court the Report of Dr. William Collingridge, the Medical Officer of Health of the Port of London, for the Half-year ending 31st December, 1889, which Report contains a full and detailed account of the work done during that period in the Port of London by the Medical Officer and the Inspectors. The Report also contains much interesting matter respecting: i. Infectious and other diseases. ii. Training Ships. iii. Unsound Meat, &c. iv. Nuisances. v. Infected Clothing. vi. The Launch. vii. Canal Boats. Your Honourable Court having, as the Port of London Sanitary Authority, adopted the Infectious Disease (Notification) Act within the Port, the Resolution adopting the same has been advertised as required by the Act and a copy thereof sent to the Local Government Board. In accordance with the instructions of the Court your Committee will now take such steps as will secure the efficacious working of this valuable Act within the Port. We beg further to report that it becomes necessary that the Medical Officer and the Inspectors of Nuisances of the Port of London should be re-appointed for a period of twelve months from the 25th March, 1890; we accordingly recommend that William Collingridge, M.D., should be re-appointed for that period as the Medical Officer of Health for the Port of London, and that William Henry Lewis, at 175/. per annum, Henry Spadaccini, at 55s. per week, William Baillie, at 45s. per week, and William Anderson, at 40s. per week, be re-appointed Inspectors. With regard to the salary at present paid to Dr. Collingridge, viz.: 700/. per annum, we beg to report that we have received a communication from him with reference to a reconsideration of the terms of his appointment. Your Committee find that nearly six years have elapsed since Dr. Collingridge's salary was last reviewed, and as additional duties have been conferred upon and undertaken by your Honourable Court in respect of the Port during such period, casting increased responsibilities and work upon your Medical Officer, we are of opinion, looking to the able and satisfactory 5 manner in which he carries out his duties, that we should be authorized to take the said communication into our consideration and we accordingly recommend the same to your Honourable Court. As stated in our Reports, agreed to by your Honourable Court, great advantage has been found from having a Medical Officer to take charge of the Hospital at Gravesend, and as Mr. Philip Whitcombe continues to perform his duties in a most satisfactory manner we are of opinion that his services should be retained for the same period as the other officers, and that we should be authorized to re-appoint him accordingly at his present rate of remuneration, viz. : Two hundred Guineas for one year. All which we submit to the judgment of this Honourable Court. Dated this fourth day of February, 1890. Geo. T. Thornes. J. E. Walford. Henry H. Thompson. Frank Tayler. W. G. Howard. Wm. Courtney, .Junr. F. Dadswell. Cornelius Barham. Daniel Greenaway. INDEX Page Introduction 9 Small-Pox14 Scarlet Fever 15 Diphtheria16 The Influenza 17 Other Diseases 18 The Training Ships 18 Unsound Meat, &c. 19 Nuisances19 Infected Clothing 20 The Launch 21 The Canal Boats Acts, 1877 and 1884 21 Index to Appendices 25 PORT OF LONDON SANITARY OFFICES, KING WILLIAM STREET, GREENWICH, January. 1890. TO THE WORSHIPFUL THE PORT OF LONDON SANITARY COMMITTEE. Gentlemen I have the honour of submitting to you herewith a Half-yearly Report on the sanitary work done by your officers during the latter six months of 1889, being the twentieth to which I have signed my name as your Medical Officer. During the half-year 9,683 vessels of all classes were visited, inspected, and reported upon as to their sanitary condition, being for your whole staff an average of 62 on every working-day. Of these 318 required cleansing in some form, and in all these cases the orders given were duly attended to. Of the total number no fewer than 8,356 (equal 86.29 per cent.) carried the British flag, the Scandinavian with 521 (equal 5.38 per cent.) being next in order of frequency. Six vessels only have been fumigated on account of infectious disease, and details of these are given in Appendix D. One hundred and forty structural alterations, involving 131 different vessels, have been ordered and carried out during the half-year, and all without any difficulty or objection on the part of the owners. It sometimes occurs that objections are raised to structural alterations by masters of vessels simply because they think that to incur any expense, unless they can show great necessity, would tend to discredit them with their employers. In order to support these officers, and at the same time to ensure the carrying out of both orders and suggestions, I have arranged that in all cases an official letter should be sent to each owner briefly stating our requirements. The result has been most encouraging. At the present time only 56 alterations in vessels are outstanding, and in the majority of these the works have been carried out though not inspected. I would take this opportunity of urging the extreme importance, both in maintenance of health and also in the avoidance of expense, of a sanitary supervision of vessels while building. c 10 There is no reason why forecastles at the present day should be constructed i n such a manner as to be dark and ill-ventilated. Owners are always ready to see defects when pointed out, and to do their best to remedy them, but it would seem much more reasonable to construct vessels with good, light and well-ventilated forecastles than to be obliged to pull them to pieces afterwards. No question of economy of space nor of money is concerned, it is simply a matter of utilising material to the best advantage. The easiest way would be for all plans of vessels to be submitted to the Sanitary Authorities of the Ports where built, in order that their Medical Officers of Health might be able to advise as to the best arrangements. There should be no bye-laws, and no hard and fast rules, but the most would then be made of the space reserved for the crew's quarters, which is certainly not the case at the present time. Of the 204 alterations ordered during the half-year 65 related to improvement of ventilation, 38 to storage of water (mainly the substitution of iron tanks for wooden casks), and 101 to lighting and heating. Two very important Acts have been passed during the last Session which have an important bearing upon the work of your Worshipful Committee in common with that of all other Sanitary Authorities. By the Poor Law Act, 1889, Section 3 (1), it is enacted "that the Managers of the Metropolitan "Asylums District, subject to such regulations and restrictions as the Local "Government Board from time to time make, may admit any person who is "not a pauper, and who is reasonably believed to be suffering from a fever or "small-pox or diphtheria into an asylum provided by the Managers and "(2) The expenses incurred by the Asylum Managers for the maintenance of "any such person shall be paid by the Guardians of the Union from which "he is received, and those Guardians may recover the amount of those "expenses as a simple contract debt from the said person or from any person "liable by law to maintain him;'' and "(3) The said expenses so far as the "same are not so recovered by the Guardians shall be repaid to them out of "the Metropolitan Common Poor Fund." The following section legalises the admission ot cases of diphtheria into the Managers' Fever Hospital. The 1st Section legalises the admission of all cases into the Asylums Board's Hospital who are suitable on account of their illness without regard to their station in life. The Managers therefore will receive any cases arising in the port within the limits of their jurisdiction, and will charge the authority for maintenance. This arrangement, which has been carried out for several years, becomes now a legal one. 11 The 2nd Section is clearly a repetition of Section 132 of the Public Health, 1875, with the addition that the debt may be recovered from any person legally bound to maintain the patient if he be not able himself to pay. The 3rd Section is one which might materially affect your Worshipful Committee as, if strictly carried out, no expense for maintenance in hospital would ever fall upon the Corporation for cases of disease occurring within the limits of the Metropolis. It certainly seems a sound principle that the expense of dealing with diseases should be borne equally by all the Metropolitan Authorities, inasmuch as isolation is for the common good. By Section 6 of the same Act " the Asylum Managers may allow their " carriages to be used for the conveyance of persons suffering from any " dangerous infectious disorder to and from hospitals and places other than " Asylums provided by the Managers, and may make reasonable charges for " their use." Originally every Sanitary Authority in the Metropolis had some kind of an ambulance for infectious cases, but these having been all taken over by the Asylums Board there remained no provision except for their own service. The Managers, in pursuance of the power granted by the above section, have issued the following regulations:— METROPOLITAN ASYLUMS BOARD. AMBULANCE SERVICE. REMOVAL OF PERSON'S SUFFERING FROM INFECTIOUS DISEASES. 1. Apply on week days, between 8 a.m. and 8 p.m., To the Chief Offices: Postal Address: Norfolk House, Norfolk Street, Strand, W.C. Telegraphic Address : Asylums Board,London. Telephone Number, 2587. N.B.—Applications in the latter part of the day must be dispatched in time to reach the Offices before 8 p.m. c 2 12 At night, between 8.0 p.m. and 8.0 a.m., and on Sundays, Christmas Day, and Good Friday, To the Ambulance Stations: Eastern Ambulance Station: Brooksby's Walk, Homerton, N.E. Soutli-Eastern Ambulance Station: New Cross Road (near Old Kent Road Railway Station), S.E. Western Ambulance Station: Seagrave Road, Fulham, S.W. 2. Removal to the Board's Hospitals— (a) Only persons suffering from small-pox, fevers, or diphtheria are admitted into the Board's Hospitals. (b) Every application must state the name, age, and full address of the patient, from what disease suffering, and in cases of fever the particular kind of fever ; and also the name of the person making the application. (c) Unless a Medical Certificate be handed to the Ambulance Nurse the patient will not be removed. (d) Patients should leave all valuables, money, &c., and all outside clothing at home, should wear body linen only, and be wrapped in the blankets provided for the purpose. (e) The Ambulance Nurse will leave, at the house from which the patient is removed, a notice stating the Hospital to which the patient is to be taken, and a copy of the regulations as to visiting, &c. 3. Conveyance to other places— (a) Persons suffering from any dangerous infectious disorder may be conveyance by Ambulance to places other than the Board's Hospitals. N.B.—Dangerous Infectious Disorders includes the following: Smallpox, Cholera, Diphtheria, Membranous Croup, Erysipelas, Scarlatina or Scarlet Fever, Typhus, Typhoid, Enteric, Relapsing, Continued and Puerperal Fevers, and Measles. (i.) Name, sex, and age of patient. (ii.) Description of disease, and, in the case of fever, the particular kind of fever. (iii.) Full address from which the patient is to be conveyed, (iv.) Full address to which the patient is to be conveyed. (c) The patient must be provided with a Medical Certificate of the nature of the disease, to be handed to the Driver of the Ambulance. (b) Every application for an Ambulance must state:— 13 (d) The charge for the hire of the Ambulance, including (when the patient is over ten years of age) the services of a male attendant, is 5s. This amount must be paid to the Driver, who will give an official receipt for the same. (e) One person only will be allowed to accompany the patient, and such person may be conveyed back to the place from which the patient was conveyed. (f) The Ambulances may be sent outside the Metropolitan district only by special sanction of the Ambulance Committee or of the Clerk to the Board, and in such cases an extra charge will be made of Is. for every mile outside the Metropolitan area. 4. The Drivers of the Board's Ambulances are not allowed to loiter on their journeys or to stop for refreshments on pain of instant dismissal. It is particularly requested that any breach of this regulation, or any neglect or incivility on the part of the Drivers, Nurses, or Attendants may be immediately reported to the undersigned. The Servants of the Board are forbidden to accept any gratuities or refreshments. (By Order), W. F. JEBB, Clerk to the Board. Dated 16th December, 1889. Another important measure of the past Session is the Infectious Disease (Notification) Act, 1889, which requires notification of every case of certain diseases specified in the Act to be notified to the Medical Officer of Health, both by the householder and the practitioner in attendance on the patient. The Act came into force in every London District on 1st November, 1889, and may be voluntarily adopted by any Sanitary Authority provided that a resolution to this effect be passed at a meeting of such Authority, and fourteen clear days at least before such meeting special notice of the meeting and of the intention to propose such resolution shall be given to every member of the Local Authority. This resolution when passed shall also be published at least one month before the Act comes into operation. Your Worshipful Committee has always so keenly urged the compulsory notification of disease, and so strongly recommended the extension of our imperfect regulations, that a resolution was at once passed to recommend the Corporation, as the Port Sanitary Authority, to adopt the Act, and this report is now before the Court of Common Council, the date fixed being the first of March. By this Act for the first time the master of every vessel will be compelled to notify any case of infectious disease. Hitherto, as you are aware, a very large number of craft, to wit: sailing barges trading wholly within the Port, and which therefore can never be said to arrive within the Port, have been 14 under no obligation to report, although they are precisely the class of vessel likely to further the spread of infection. Your Committee have on several occasions tried to induce the Local Government Board to class them as Canal Boats under Section 10 of Canal Boats Act, 1884, which provides that " if it shall at any time appear " to the Local Government Board, on the representation of any Registration or " Sanitary Authority, or of any Inspector appointed under this Act, that the " principal Act and this Act ought to apply to any vessel or class of vessels " which would be within the definition of Canal Boat contained in Section " 14 of the principal Act if such vessel or class of vessels were not registered " under the Merchant Shipping Act, 1854, and the Acts amending the same, " the Local Government Board may declare that the principal Act and this " Act shall apply to such vessel or class of vessels, although the same may be " registered as aforesaid, and thereupon the same shall be deemed to be a Canal '' Boat or Canal Boats within the meaning of the principal Act and this Act, " and the definition contained in Section 14 of the principal Act shall be " amended accordingly ; " but the Board has not seen its way to include this class of vessel. Obviously the carrying out of this Act will entail a considerable amount of extra work for your Medical Officers, but its value from a public health point of view is so great that no difficulty could possibly be 'raised on that score. It is interesting to note that, although the adoption of the Act outside the Metropolis is voluntary, already 700 sanitary districts have availed themselves of it, which means (including London and 59 towns with local Acts) that more than 18,000,000, or two-thirds of the total population of England and Wales, are under an obligation to notify. The fee to be paid to a medical practitioner is 2s. 6d., which amount will be repaid by the Metropolitan Asylum District Managers for ail cases within their jurisdiction. By Section 13 the provisions of the Act apply to every ship, vessel, boat, &c., and in the definitions the expression "Port Sanitary District" is stated to mean the Port Sanitary District of London, and any port or part of a port for which a Port Sanitary Authority has been constituted under the Public Health Acts, and any such Port Sanitary District shall form no part for the purposes of this Act: The "occupier'' in the case of a ship, vessel or boat is defined to be the master or other person in charge thereof. SMALL-POX. The fact that London has been entirely free from small-pox naturally makes the early isolation and treatment of cases brought into London of the utmost importance. 15 On the 12th October the s.s. " Dunbar Castle " on arrival at Gravesend reported having had a case of small-pox on the voyage. The vessel left Mauritius where the patient embarked on 8th August, and he was taken ill on 12th and removed to Saldanho Quarantine Station on 25th. Here the vessel was fumigated and detained in quarantine until 13th September. On the 27th December the Medical Officer of Health for Whitechapel reported that a man who had arrived in s.s. " Sarpedon " was about to be taken from the Sailors' Home to the Small-pox Hospital at Homerton. The vessel left Algiers (where he joined from hospital) on 18th and arrived in London on 27th. r He at once left the ship in apparently good health and went to the Sailors' Home, where he developed the disease. Though to all appearance in good health on arrival in the port he was obviously infected in Algiers. The vessel was fumigated and notice sent to the Port Sanitary Authority of Liverpool whither she was bound. SCARLET FEVER. On the 6th Auo-ust the s.s. " Hawarden Castle " on her arrival at Gravesend reported a case of scarlet fever. The vessel left Natal on 7 th July and the patient was taken ill on 2nd August. The case was reported at Plymouth but allowed to come into Gravesend, where he was removed to the Port Sanitary Hospital and the vessel fumigated. On the 15th the Tyne Shipping Co. notified that a patient with scarlet fever had come up the river on the s.s. " Tynesider." The vessel left Newcastle on 14th, and the patient was only found to be unwell on the way up the Thames. On landing the Company sent for a medical man who diagnosed it as scarlet fever, but had of course no power to detain it. It was removed to a house in Poplar, which was traced after a day's search and reported to the Medical Officer of Health, the vessel being at once fumigated. The Company have undertaken in future to register the names and addresses of all passengers who leave their vessels ill from any cause. 16 On 19tli August a case of scarlet fever was reported on the barge " Ifield " lying at Charing Cross. The master had brought his wife and two children from Stroud on loth. On the 17th one child was taken ill, and the case reported in error to the Lambeth Yestry, by whose officers the patient was removed to Hospital, but the barge left without fumigation. This was carried out on 19th by the Port Sanitary Authority as soon as reported. On the 22nd the child's mother was found to be suffering from the same disease and was therefore removed and the barge again fumigated. The second child, who was removed on loth, escaped the infection altogether. On the 2nd October a case of the same disease was found in the barge " Ernest," lying off Temple Pier. The patient (a lad) left Stroud on 23rd September and was taken ill on 28th, but his father did not think there was anything serious the matter with him. He was taken to the Fulham Hospital and the barge fumigated. Both these barges clearly brought the infection from Stroud, where scarlet fever was prevalent. On the 17th October a patient suffering from scarlet fever was landed at Tilbury from s.s. '' Tongariro," outward bound, and brought up to London by rail. On the following day the case was reported, and he was sent to the Metropolitan Asylums District Hospital. DIPHTHERIA. On the 23rd, 27th, and 28th August respectively, three boys on the " Arethusa " Training Ship, lying off Greenhithe, were attacked with a mild form of diphtheria, which happily did not spread, and for which there was no ascertained cause. They were isolated in a boat-house on shore, which does duty as an infectious disease hospital. The "Arethusa" Committee have for some time been anxious to furnish Hospital accommodation in accordance with the strong and oft-repeated recommendations of your Medical Officers, but have not yet been able to do so. 17 Naturally, no house in the village can he obtained for the purpose, nor can any suitable land be procured to erect an adequate building. Apart from these difficulties there is also the very serious question of expense, which cannot be lost sight of by a charitable institution. The " Worcester" Training Ship, off Greenhithe, will also have to face the same difficulty when the lease of their present Sanitorium expires in a few months. The owner refuses to renew on any terms, and the Committee are not prepared to accept the enormous responsibility of conducting such an institution without the means of isolation of a few cases of infectious disease. The School Board " Shaftesbury," off Grays, is also in the same predicament. Both these vessels have decided, wisely, I think, to approach your Worshipful Committee with the request that you will consider an application to provide accommodation at the Gravesend Hospital on mutual terms. If such be arranged, with proper safeguard, it would seem a reasonable way of meeting what at present is a serious difficulty and an undoubted danger. Every institution without means of early and prompt isolation of infectious disease is in constant danger of a serious outbreak, especially where the inmates are of tender years. THE INFLUENZA. During the last ten days of the year an epidemic febrile catarrh, probably the so-called Russian Influenza, has attacked a large number of persons in the Port of London. The symptoms of this disease, as observed, are, in the majority of cases, high temperature, pains in limbs, and severe frontal headache, lasting for three or four days, and followed by extreme prostration and debility. In some persons catarrhal, and in others abdominal symptoms mainly characterise the malady. Happily all the cases are mild, and no deaths occur from the uncomplicated disease. It is, nevertheless, a real and definite illness, though one which a Sanitary Authority can do nothing for in the direction of prevention. The only necessary treatment is to keep the patients in a uniform temperature, and carefully guard against the complications so likely to arise, such as pneumonia and bronchitis, to which already many deaths have been attributed. D 18 OTHER DISEASES. On 1st October the s.s. "Garonne" came in with a convalescent from chicken-pox on board. The patient embarked at Sydney on 18th August, and was taken ill on 23rd September. He was isolated on the voyage and the bedding destroyed by ship's surgeon. No farther action was required. On 4th October the s.s. " Parthian " reported two cases of intermittent fever on the voyage. She left Mobile on 16th August. The first patient was attacked on 19th and the second on 21st. Both being convalescent on arrival no action was taken. On 1st October the s.s. "Inventor" came into the Tilbury Docks. On the following day the engineer was taken ill, and supposed to be suffering from " inflammation of the lungs." On the 8th, the case proving to be one of enteric fever, he was removed to the Port Sanitary Hospital, where, after a lengthy illness, he eventually recovered. On 24th a case of erysipelas was reported on Canvey Island. The patient was isolated in her own house, and the room afterwards fumigated, etc. On 13th November the s.s. "Navarra" arrived at Gravesend and passed up river. The crew left her at Erith, and one man who went to the Sailors' Home was thence removed to the Asylum Board's Hospital with "West Coast fever." The vessel had been trading up Niger, and all the crew had suffered, with one death only. THE TRAINING SHIPS. The health of these vessels has been extremely good notwithstanding the great disadvantages, under which they labour. The " Arethusa," off Greenhithe, as already reported, had three cases of diphtheria during August, attributed to the boys having been wet through, and allowing their clothes to dry on them. On 23rd September, on the same ship, a boy was attacked with enteric or typhoid fever, for which no cause could be assigned. He was treated in the ship's boat-house on shore. 19 On 15 th August one case of enteric fever, and on 7th September a second, occurred on the School Board Ship " Shaftesbury," and were admitted into the Ship's Infirmary. Inasmuch as this same building serves as a quarantine station for the new boys to be kept under observation before being taken on board the ship, the system of admitting infectious cases is a most dangerous one, and certainly should be discontinued. In consequence of the reports of your Medical Officer the School Board appointed an expert to inquire into and report upon the sanitary condition of the vessel. This has since been submitted to the School Ship Committee, and practically confirms every objection already made and brought before your Worshipful Committee, although the recommendations go far beyond what in my opinion is absolutely necessary, and if carried out would involve the expenditure of a large sum of money. What is really of most importance is that the ventilation of the vessel generally should be greatly improved, and that the exposed surface of the iron sides should be coated with cork or other similar preparation in order to prevent the condensation which cannot fail to be hurtful to the health of the boys. UNSOUND MEAT, &c. Although there have been a considerable number of seizures during the six months, still happily the total quantity is small, amounting only to 8,749 stones of mutton, 165 stones of beef, 16 tons 15 cwt. of onions, 7 cases of apples, 260 boxes of kippered herrings, and 19 cases of potted meat. One large seizure has been made of about 14,950 boxes of dates, for which a magistrate's order was obtained at the Thames Police Court. These had become rotten on account of saturation with fresh and salt water used for the purpose of extinguishing a fire which broke out on board. They were sold for the purpose of distillation under a proper and sufficient guarantee and the amount received will be paid to the owners after deduction of expenses in accordance with the Resolution of your Worshipful Committee. Full details of all seizures are given in Appendix. NUISANCES. . The majority of nuisances injurious to health occurring in the Port come under other headings, such as Ventilation, Cleanliness, etc., and have already been dealt with, but few cases requiring special mention here. D2 20 On 25th July the Chief Officer of the Coast Guard at Shoeburyness reported a serious nuisance, caused by the deposit of refuse from London dust bins for use in the brick fields at South church. This was being shot on the foreshore and there sifted, causing an undoubted danger to the health of the station. The Brick Company were called upon to remove the existing heap forthwith, and for the future to cart the refuse direct into their own premises, and by dealing with it there to minimise the nuisance. This was at once agreed to, and no complaint has been since received. Several tug-owners have been cautioned as to the emission of black smoke from their funnels, and in all cases a marked improvement has been observed. INFECTED CLOTHING. The practice of sending home the effects of persons who have died from infectious disease abroad is such a dangerous one that your officers have endeavoured in every way to stop it altogether. Urged by your Committee, the Board of Trade issued a circular letter to all Consuls and Shipping Masters, calling upon them to destroy all infected clothing where practicable, and in other cases to certify that proper fumigation had been carried out. Notwithstanding this circular letter, instances still occur of clothing—the property of persons who have died from infectious disease—being sent to this country without any evidence of fumigation, and also the property of deceased persons without information as to cause of death. It is our rule to fumigate in both the above classes, and to notify the facts to the Board of Trade, with a view to discouraging the practice. The Board always assist your Medical Officer by calling upon the official concerned for an explanation of the circumstances. In all eight consignments of infected or suspected clothing have been thus dealt with during the half-year, the causes being Yellow Fever (1), Typhoid (1), Cholera (1), West Coast Fever (1), Typhus Fever (1), and Unknown (3), a sufficiently formidable list to justify attention being paid to the subject. In one instance the patient had died from typhoid fever ; it was stated by the forwarding Officer abroad that although the patient had died from this disease, still it had only developed after his admission to Hospital, and that therefore the clothing could not have become infected. This is such a refinement, depending upon theories of incubation period, habits, and spread of infection, that practically the only safe course to adopt was to consider the goods as dangerous. 21 In another instance, where three of the crew of a vessel had died from Cholera—one at Bussorah and two at sea—the effects were brought straight home without any pretence at disinfection. Under these circumstances the vessel was boarded on her arrival, and the infected clothing destroyed in the furnace fires on her way up the river. A letter was then sent to the owners, in consequence of which instructions were issued to all their officers to in future destroy such clothing at the time of death. The most extraordinary point in the question is the extremely small value of the clothes, in the majority of cases merely a few shillings. THE LAUNCH. The Launch " Clotho " continues to serve usefully the double purpose of means of locomotion for your officers and the conveyance of patients to Hospital in the after-cabin. Her four years under Lloyd's Yacht Register having expired, notice was received in October last that the time had arrived when she must be submitted to the Special Survey No. 1, according to the Society's rule. As at the time she had just been thoroughly overhauled, it was arranged that the survey should be postponed until March. It will then be necessary, in order to retain her registry, to lay her ashore, and have her thoroughly inspected by the surveyor of Lloyd's. The expense will be small, but the advantage in the way of value and insurance is great. CANAL BOATS ACTS, 1877 and 1884. I have to report briefly upon the working of the above Acts in the Port of London during the year 1889. The number of boats inspected is by no means large, the total number being only 624 during the twelve months, or 25 less than during 1888. This is mainly due to the fact that no special Canal Boat Inspector has been appointed owing to the enormous area of the district and the uncertainty of finding canal boats in any definite position. 22 I have hitherto advised your Worshipful Committee to allow the inspection to be made by the Inspectors in their daily round of the Docks and district generally. This has the great advantage of not wasting valuable time in looking for the boats, and at the same time ensures a regular and systematic visiting of the district, which under any other plan would be difficult if not impossible. Your officers find that the Acts are now thoroughly well understood, and there are but few owners or masters who have not had some experience of the power of the law. No difficulty is ever experienced in obtaining entry at any reasonable hour, and papers are freely shown and information readily given. Overcrowding exists to a very limited extent, though where present being due to poverty and impossibility of providing a house on shore, it unfortunately affects for the worse the young children, who are most seriously injured thereby. The 624 boats inspected were registered for 2,293, and were occupied by only 1,531. I have pointed out in a previous Report one great reason for this wide difference, viz., the practice of some Authorities to register according to the cubic space only, and to altogether neglect the accommodation provided. Thus it is no uncommon thing to find a boat registered for eight persons, which is only fitted for three, and which never requires to carry more than the smaller number. There can be no question that the policy of gradually enforcing the Acts, cautioning owners and masters, and only proceeding to extremities in those cases where other means have failed, has disarmed much of the opposition at first shown to their provisions, and has greatly assisted in carrying them into effect. The boats as a general rule are well kept, and the masters are inclined to look upon the Inspectors as coming between them and the owners, and obtaining structural alterations and improvements which, unaided, they would be unable to get carried out. Gradually, I am happy to report, the "family" boat is beginning to disappear, and instances are becoming more common where the craft is worked by men alone. This is an improvement fraught with the most important results as regards the proper rearing and education of children and the moral elevation of the women, for whom canal boats cannot supply proper accommodation. In 18 cases during the year the boats were found to be without certificates on board. In all these instances the owners were communicated with and the defect remedied. With the exception of the wide river barges, where the difficulty of proving habitation before a magistrate is great, and where 23 owners are slow to register without being absolutely compelled to do so, there are but few canal boats now unregistered within the Port of London. During the year 36 boats have been registered with the Port Sanitary Authority, three of these being re-registrations on account of change of ownership. At the present moment 181 boats are on our register, and with one exception these are all "wide" boats. If it be considered advisable by the Local Government Board to press the registration of wide craft so as to include all those which are only irregularly used as dwellings, then it will be absolutely necessary to so amend the Acts as to give some more definite meaning to the words "used as a dwelling." The Port Sanitary Authority have expended a great amount of time, labour, and expense without being able to get any real decision on the point, and it can hardly be wondered at that owners knowing this fact should take advantage of the uncertainty to evade compliance with the provisions of the law. No notification of change of master has been made, though it is known that this constantly occurs. The name of the master is not mentioned on the official certificate of registration, and it seems unreasonable to look upon this change as a violation of the Act. In many instances it would be utterly impossible for owners to carry on their business if the notification were insisted upon. No case of infectious disease has been met with during the year in the Port, nor have any been reported by the Authorities. One prosecution only has been undertaken. On 4th February the master of the barge "Dee" was summoned at the West Ham Police Court for indecent occupation. There were living on the boat, in the same eabin, the master, his wife, and a lad of 17. He was fined 20s. and 7s. costs, a sufficiently heavy fine when the loss of time and expenses of travelling are taken into consideration. In four other cases one child too many was carried, but a communication to the owners proved sufficient to at once remedy this. I would very strongly urge upon Registration Authorities the advisability of putting every possible obstacle in the way of registering fore-cabins especially to allow of carrying females on board, who, without such forecabins, would be excluded. They are always low, damp, and ill-ventilated, and, in addition, on a river like the Thames, exposed to great danger. I am, moreover, of opinion that in the majority of cases they are simply registered to evade the law, and are not used for the purpose of sleeping. 24 An Inspector visiting a barge by day is told that the after-cabin is registered for a man, wife, and children under 12, and that the fore-cabin is registered for one girl over age, and the certificate bears this out. Whereas, a night visit would, I am convinced, often show the whole family in one cabin. On the whole, the experience of the Canal Boats Acts in the Port of London is a favourable and encouraging one. Much remains to be done, but I am certain that there is due to their working a steady though necessarily a slow improvement in the morality and condition of our boatmen. The district has been repeatedly visited by the Canal Boat Inspector of the Local Government Board, Mr. J. L. Brydone, with whom I am in frequent communication, and to whom I am indebted for many valuable suggestions and much kindly assistance. A summary of the figures referred to is given in the appendix. I have the honour to be, Gentlemen, Your obedient Servant, WILLIAM COLLINGRIDGE, M.D., Medical Officer of Health, Port of London. 25 INDEX TO APPENDICES. Appendix Page A Number of Vessels inspected in each Dock and on the River, from July 1st to December 31st, 1889 26 B Number and Nationality of Vessels inspected, from July 1st to December 31st, 1889 27 C List of Effects Disinfected 28 D List of Vessels Fumigated, with Causes 29 E Number of Structural Alterations carried out 30 F Number of Vessels in which Structural Alterations have been ordered, but not yet completed 30 G Cases of Infectious Diseases in the Port of London 31 H Particulars of Unsound Meat condemned by Port Sanitary Authority 33 I Particulars of Inspection of Canal Boats 35 Number of Water Barges inspected 36 E 26 APPENDIX A. Number of Vessels Inspected in each 'Dock and on the River, from July 1st to December 31st, 1889. Docks. Number. Number to be Cleansed or Whitewashed. No. of Foul Cargoes. No. of Outward Bound. No. of Sick referred to Hospital. St. Katharine 201 1 — 4 — London 347 16 — 14 2 Regent's Canal 235 8 — — 1 Millwall 621 13 — 51 1 West India 748 64 2 94 2 East India 257 13 — 27 2 Victoria 462 22 1 26 3 Royal Albert 664 27 — 31 3 Commercial 781 33 — 6 6 Gravesend District 606 39 — 59 1 River 4,761 82 — 9 9 Total 9,683 318 3 321 30 Number. No. to be Cleansed, &c. Total to 30th June, 1889 299,108 17,874 From 1st July to 31st December, 1889 9,683 318 Total since commencement 308,791 18,192 27 APPENDIX B. Number and Nationality of Vessels Inspected, from July 1st to December 31st, 1889. Nationality. Number. Proportion per cent, of the Total Number. American 1 — Austrian 2 — Belgian 1 — British 8,356 86.29 Danish 162 1.67 Dutch 122 1.26 Finnish 17 .18 French 37 .38 German 362 3.74 Greek 2 — Italian 14 .14 Russian 21 .22 Spanish 65 .67 Swedish and Norwegian 521 5.33 Total 9,683 E2 28 APPENDIX C. Effects Disinfected, from July 1st to December 31st, 1889. Date. Ship's Name. Where from. Date and Cause of Death. Where Disinfected. Date. Cause. July 4 s.s. De Bay Santos June30,'89 Yellow Fever Millwall Dock. Sep. 25 s.s. Hong Kong Penang Unknown Unknown Royal Albert Dock. Oct. 7 s.s. Oanfa - Shanghai „ „ Port Sanitary Hospital. „ 15 s.s. Loch Etive - Cochin- „ Typhoid Fever London Dock. „ 25 s.s. Clan Mackay Madras Oct. 5,'89 Ague Mercantile Marine Office, Tilbury. „ 31 s.s. Baghdadi Bussorah Sep.12,'89 Cholera On Board, at Gravesend. Nov. 18 s.s. Navarra Akassa „ 1,'89 West Coast Fever Mercantile Marine Office, Tower Hill. Number. Total to June 30th, 1889 650 From July 1st to December 31st, 1889 7 Total since commencement 657 29 APPENDIX D. Vessels Fumigated, from July 1st to December 31st, 1889. Date. Ship's Name. Steam or Sailing. Where from. Cause of Fumigation. 1889. July 16 - Garth Castle Steam Cape Town Chicken-pox. Aug. 15 Tynesider „ Newcastle Scarlet Fever. „ 19 I field Barge Bochester „ Oct. 2 Ernest William Stroud „ Nov. 13 Navarra Steam Akassa West Coast Fever. Dec. 31 Sarpedon „ Algiers Small-pox. Number. Total to June 30th, 1889 271 From July 1st to December 31st, 1889 6 Total since commencement 277 30 APPENDIX E. Alterations made, from July 1st to December 31st, 1889. Month. No. of Vessels in which Alterations have been made. Ventilation. Water tanks. Lighting, heating, cleansing, &c. Total No. of Alterations. July 28 12 4 14 30 August 21 14 1 9 24 September 18 9 1 8 18 October 26 11 — 18 29 November 19 5 3 12 20 December 19 4 3 12 19 Total - 131 55 12 73 140 APPENDIX F. Alterations ordered, but not yet carried out, from July 1st to December 31st, 1889. Month No. of Vessels in which Alterations have been ordered. Ventilation. Water tanks. Lighting, heating, cleansing, &c. Total No. of Alterations. July 6 2 4 1 7 August- 9 2 4 4 10 September - 9 2 5 2 9 October 11 2 4 10 16 N ovember 8 2 1 6 9 December 13 — 8 5 13 Total - 56 10 26 28 64 APPENDIX G. Cases of Infectious Disease in the Port of London, from .Tuly 1st to December 31st, 1889. Date. Name of Yessel. Description. Official No. Owners or Brokers. Where lying. Disease. Source of Infection. Where case removed to. 1889. Aug. 6 Hawarden Castle Str. 87,076 Donald Currie and Co., 4, F enchurch-street. Gravesend Scarlet Fever. Natal Port Sanitary Hospital. „ 15 Tynesider Str. 95,240 Tyne Shipping Co., Newcastle. Free Trade Wharf Scarlet Fever. Newcastle „ 19 Ifield Barge 74,822 John Wood, Gravesend Eastwood and Co., Charing Cross. Scarlet Fever. Stroud. Deptford Hospital. Sept. 2 Arethusa Traing Ship. - National Refuge Greenhithe Diphtheria - Treated on Shore. Oct. 1 Garonne Str. 65,855 Anderson and Anderson, F enchurch-a venue. Tilbury Dock Chicken-pox Sydney. Convalescent on arrival. „ 2 Ernest William Barge 50,167 John Wood, Gravesend. Temple Bar Scarlet Fever. Stroud. Fulham Metropolitan Asylums „ 4 Parthian Str. 87,715 James McFarlane. Commercial Dock Intermittent Fever. Mobile. Board Hospital. Convalescent on arrival. „ 8 Inventor Str. 78,801 Charente S. S. Co., Liverpool. Tilbury Dock Enteric Fever. Calcutta Port Sanitary Hospital. „ 12 Dunbar Castle Str. 87,166 Donald Currie and Co., F enchurch-street. Gravesend Small-pox Mauritius Saldanho Quarantine Station. 31 APPENDIX G.—continued. Date. Name of Vessel. Description. Official No. Owners or Brokers. Where lying. Disease. Source of Infection. Where case removed to. Oct, 17 Tongariro Str. 86,067 New Zealand S. S. Co., Auckland, New Zealand. Gravesend - Scarlet Fever - - Whitechapel, Metropolitan Asylums Board „ „ Canvey Island - - - Erysipelas _ Hospital. Treated on Island. „ 28 Oriental Str. 93,210 Peninsular and Oriental S. N. Co. Royal Albert Dock Scarlet Fever Bombay Aden. „ 13 Navarra Str. 86,675 Holman and Sons, Lime street. Nelson's Dry Dock West Coast Fever Akassa Metropolitan Asylums Board Hospital. Dec. 31 Sarpedon Str. 76,533 J. Swire and Son - Royal Albert Dock Small-pox Algiers - Metropolitan Asylums Board Hospital. 32 APPENDIX H. Unsound Meat, Ac., from July 1st to December 31st, 1889. Date. Ship's Name. Official Number. Where lying. Where from. Amount condemned. 1889. J uly 5 Lusitania 65,888 Tilbury Dock Sydney 1 halfcarcase Mutton. „ 8 . Ionic 86,299 Royal Albert Dock New Zealand 7 cases Apples. „ 6 . Coptic 84,164 Ditto - 5 carcases one part carcase Mutton. „ 16 . Rimutaka 89,652 Ditto New Zealand 18 carcases 24 part carcases Mutton. „ 17 . Dunedin 68,085 East India Dock Ditto 1 carcase 1 part carcase Mutton, 1 quarter Beef. „ 22 . Canterbury 68,106 - Ditto 81 carcases 49 part carcases Mutton, 28 carcases 1 part carcase Lamb. „ 26 Ionic 86,299 Royal Albert Dock Ditto 252 stone Mutton, 103 stone Beef. Aug. 14 Oamaru 71,682 East India Dock Ditto 164 carcases 88 part carcases Mutton. „ 20 Tanui 90,001 Royal Albert Dock Ditto 6 carcases 1 part carcase Mutton, 1 piece Beef. Sept. 2 Austral 85,923 Tilbury Dock Australia 8 part carcases Mutton. „ 14 . Kaikoura 89,627 Royal Albert Dock New Zealand 5 carcases Mutton. „ 16 . Bona — Millwall Dock Fiume • 192 packages Onions. „ 16 . Cameo 75,329 Ditto Christiana 9 bags (18 cwt.) Onions. 33 APPENDIX H.—continued. Date. Ship's Name. Official Number. Where lying. Where from. Amount condemned. Sept. 19 Selembria 86,288 London Dock Buenos Ayres 1,349 carcases 46 part carcases Mutton. „ 28 Orpington 87,032 Millwall Dock Mediterranean 65 packages (4 tons) Onions. Oct. 14 Arawa 89,953 Royal Albert Dock New Zealand 2 carcases 4 half carcases Mutton. Nov. 22 Thorsten Swedish Millwall Dock Gothenburg 260 boxes Kippered Herrings. „ 25 Bayley 91,983 Royal Albert Dock New Zealand 9 carcases 6 part carcases Mutton. „ 25 Rimutaka 89,652 Ditto Ditto 5 carcases 5 part carcases Mutton, 1 piece Beef. „ 29 Coptic 84,164 Ditto Ditto 5 carcases 12 part carcases Mutton, 1 quarter Beef. „ 30 Opawa 73,740 West India Dock Ditto 2 part carcases Mutton, 5 quarters Beef. Dec. 6 James Watt 81,810 London Dock Bussorah 18,000 boxes Dates. „ 10 Ionic 86,299 Royal Albert Dock New Zealand 4 carcases 9 part carcases Mutton. „ 11 Greece 45,170 Ditto New York 19 cases Potted Meat. „ 20 Ruapeliu 86,069 Ditto New Zealand 1 part carcase Mutton. 34 35 APPENDIX I. Particulars of Canal Boats Inspected under the Canal Boats Acts, 1877 and 1884, from July 1st to December 31st, 1889. Months. No. of Canal Boats Inspected. Registered No. of Persons to live on board. No. of Persons living on board. No. of Canal Boats without Certificates on board. No. of Prosecutions against Masters or Owners. No. of Cases of Infectious Disease on board. No. of Barges Registered by the Port of London Sanitary Authority. January 42 151 99 2 - — 4 F ebruary 58 236 159 1 l — — March - 62 226 151 1 — — 16 April - 37 133 84 — — — 1 May - 75 261 177 3 — — 1 June - 59 213 119 2 - — 3 July - 45 146 116 1 — — 1 August 57 221 149 3 — - 6 September - 57 205 140 1 — - — October 45 150 113 2 — - November 38 146 107 1 — 3 December 49 205 117 1 — — 1 Total 624 2,293 1,531 18 1 - 36 36 Char!os Skipper and East, Printers, St. Dunstan's Hill. E.(". APPENDIX J. Number of Water Barges Inspected, from July 1st to December 31st, 1889. No. of Water Barges, in District. No. Inspected. In Good Condition. Repaired as Ordered. Condemned. Laid up, &c. 28 28 16 9 1 9