PLON 16 34 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, 1890. Presented 25th September, 1890. PLON 16 34. 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, 1890. Presented 25th September, 1890. ISAACS, Mayor. A Common Council holden in the Chamber of the Guildhall of the City of London, on Thursday, the 25th day of September, 1890. THE Port of London Sanitary Committee did this day deliver into this Court a Report in writing, under their hands, with Half-yearly Report of the Medical Officer of Health to the 30th June, 1890; and recommending that Thomas William Bailey be appointed one of the Inspectors of Nuisances of the Port until Lady Day next, at wages of 30s. per week. And a Motion being made and Question put, That this Court doth agree with the Committee in their said Report, the same was Resolved in the Affirmative and Ordered accordingly. Ordered, That the Report 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 Comm.on Council assembled. TT7"E, 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 the 30th June, 1890, 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 with respect to— (1) Small Pox. (2) Training Ships. (3) Scarlet Fever. (4) Other Diseases. (5) The Hospital. (6) The River and Sewage. (7) Cholera. (8) Unsound Food. (9) Water Barges. (10) Infected Clothing. (11) The Staff. (12) The Canal Boats Act. We again have much satisfaction in being able to report the continued healthy condition of the Port, very few cases of infectious disease having occurred during the past half-year. In connection with that portion of the Report, paragraphs 6 and 7 on page 6, entitled " Unsound Food," we suggest that all expenses out of pocket and the time of the Inspectors should be charged to the Consignees. We have to report that, in consequence of the resignation of Mr. William Henry Lewis, one of the Inspectors of the Port, we took steps to fill the vacancy, and, from a considerable number of applicants, we have selected Thomas William Bailey. He has now been on probation for some time, and, as Dr. Collingridge reports that he does his work in a satisfactory manner, we now beg to recommend his appointment by your Honourable Court until Lady Day next at wages of 30s. a week. All which we submit to the judgment of this Honourable Court. Dated this second day of September, 1890. Geo. T. Thornes. Frank Tayler. J. Siieppard Scott. cornelcus barham. G. W. Pimm. John Akers. W. G. Howard. Thomas Wildash. 1 N D E X Page Introductory 7 Small-Pox 8 Training Ships --------- 9 Scarlet Fever 11 Other Diseases 11 The Hospital 14 The River and Sewage 16 Cholera 17 Unsound Food 18 Water Barges 19 Infected Clothing 19 The Staff 20 Canal Boats Acts 21 PORT OF LONDON SANITARY OFFICES, GREENWICH. July, 1890. TO THE WORSHIPFUL THE PORT OF LONDON SANITARY Gentlemen, I have the honour to submit to you a report giving a brief account of the work of your Officers during the first half of the present year. During this period, 7,532 vessels have been visited and inspected, 1,160 of which were lying in the river, 1,937 in the Gravesend or lower district, and the remainder in the various docks. Owing to the very serious dislocation of the shipping trade of the Port, consequent upon the unhappy disputes with the dock labourers and others, the work of your Officers has been carried on under great disadvantages and with much additional trouble and friction. This is a point of view of the strike question which would probably not be obvious to the onlooker, but which is a real and serious trouble to those who are responsible for the sanitary supervision of shipping. It also has an influence upon the work of your officers from another cause ; dock authorities and ship owners have felt seriously (in common with the labourers) the heavy losses consequent upon the cessation of trade, and, in consequence, are not only unwilling but also unable in some cases to carry out suggestions, involving expense, which, although they are not absolutely necessary, and cannot therefore be legally ordered, -still would tend materially to improve the sanitary condition of vessels and the surroundings of our seamen. Of the total number, 347 required some amount of cleansing to be carried out (= 4\5 per cent.) This is about the usual average proportion. 6554 or 87 per cent, of the vessels thus inspected were of British nationality—the Scandinavian with 394 (= 5-2 per cent.) being next in order of numbers. Sixteen vessels were fumigated on account of infectious disease (see Appendix D.), and in five cases infected clothing sent home from abroad was disinfected (see Appendix C.) COMMITTEE. 8 Appendix E. gives in a tabular form the structural alterations carried out by order of your Officers. It shows that a total of 179 alterations were carried out on 158 vessels. These include 41 alterations for the improvement of ventilation, 100 for additional means of lighting, heating and cleansing, while 38 involved the condemnation and destruction of improper receptacles for water, and the provision of new ones, in the majority of cases of galvanised iron. It is impossible to exaggerate the importance of this particular department of our work in its bearing upon the health of our merchant navy, and its powerful influence in the prevention of disease. Ample powers are given to your Authority by the Public Health Act, 1875, but, as usual, T have to report that the penal clauses of that Act are practically never put into force, and but rarely even alluded to. In appendix F. is a list showing that 85 structural alterations affecting 76 vessels have been ordered, but are not yet carried out. As I have previously explained, many of these alterations are made, but it is a rule not to return them as complete until they have been actually inspected. This will account for there being always a large (though not an increasing) number of outstanding orders. SMALL-POX. Very few cases have come under notice, two only having actually been brought into this country, one to Portland, and one to London. On 29th January, a case was reported from Whitechapel. The patient was admitted into Hospital at Lisbon on 10th (where there were several cases of small-pox), and remained there five days. He came home in the s.s. " London," reaching London on the 20th, and at once left the ship and went to his home in Upper East Smithfield. On the 27th {i.e. 12 to 17 days after he was exposed to the danger of infection at Lisbon) he was taken ill and applied to the Seamen's Hospital, and at once sent on to the Asylum Board's Hospital, and the case reported to your Officers. This man, although obviously infected on arrival, left his vessel in apparently perfect health, and showed no signs of disease until seven days after. The vessel was at once fumigated and thoroughly cleansed. 9 On the 5th February, the s.s. " Irrawaddy " reported a case taken ill the day after leaving Rangoon, and landed at Colombo four days later with all effects, the cabins being at once fumigated. Four other vessels "Thames," "Ganges,'' "Oroya," and "Chusan" also reported having had single cases of this disease on their homeward voyage. In each instance the patient was immediately isolated and landed at the first opportunity with all bedding and clothing, and fumigation carried out. On all these vessels this prompt action was happily successful in preventing any spread of the infection. The s.s. "Capella," which left Calcutta on 2nd March, had a patient attacked with small-pox on 7th April. On arrival at Portland, he was taken to hospital on shore and the vessel fumigated by the Port Sanitary Authority. Re-vaccination was offered gratuitously to the crew, but all refused to submit thereto. TRAINING SHIPS. The general condition of the training ships has been good. It is scarcely possible to conceive that vessels moored in a foul sewagepolluted river like the Thames can be healthy and proper habitations for a large number of young boys, and it certainly reflects very favourably on the management of these institutions that, in spite of this great drawback, the health of their inmates should have been so well preserved. There have been but few cases of infectious disease. Two isolated cases of diphtheria occurred on the " Arethusa," off Greenhithe, one on 19th March, and one on 19th April. These were treated on shore in the hut, which serves as an isolation hospital. The Medical Officer of the ship, in the absence of any definite cause, is inclined to attribute these cases to the general unhealthy condition of the river, and there would appear to your Medical Officer only too good reason to share in this belief. On the 18th February, one of the boys on the training ship "Cornwall" was attacked with scarlet fever. He was immediately removed to the ship's isolation hospital on shore, and every precaution taken to prevent the spread of infection. c 10 On the 25t,h March, a second case occurred, and was treated in the same way, the result being that no others were affected. A slight outbreak of measles has occurred on the " Worcester " training ship, lying off Greenhithe. The first case was that of a lad who joined the vessel on 1st May, after 14 days' leave of absence. He was attacked on 6th, and the disease being diagnosed on 7th, was at once removed to the Port Sanitary Hospital in an ambulance boat specially constructed for the purpose. It is quite clear that this lad was infected during his absence from the ship, though the exact source could not be traced. On the '29th, three other cases were removed, and a fifth on the following day. No other boys were attacked until the fith -Tuly, when a single case occurred. Thus, in all, six were infected, happily all with a mild type of disease. The fact that so infectious a disorder was thus checked is sufficient proof (if any be needed) of the extreme value of isolation accommodation for this and other similar institutions. Since writing my last Half-yearly Report, the only two training ships without any such hospital provision, viz., the " Shaftesbury " and the " Worcester," have petitioned the Court of Common Council to be allowed to make a mutual arrangement with your Worshipful Committee for the reception of their infectious sick. This petition has been duly referred, and is at the present moment under consideration. There would appear to be no question of expense involved, as obviously the only reasonable arrangement is one whereby the whole of the cost would fall upon the authorities of the two vessels, while the advantages are obvious. The Port Sanitary Authority have hitherto treated all the cases from the "Shaftesbury," and have happily been instrumental in checking two or three threatened outbreaks. The only additional responsibility would thus be that due to the "Worcester," and, judging from the experience of the past, I feel confident that your present staff would be ample to cope with the increased work. Beyond the advantage to the ship in having hospital accommodation and staff constantly ready, there would be the great point gained of removing infectious cases to a spot already set apart for this purpose, and avoiding the necessity of establishing small centres of infection in the riparian districts. 11 SCARLET FEYER. On the 27th April, a seaman with the above disease was removed to the Port Sanitary Hospital from the s.s. " Juan." The vessel left Batoum on 2nd April, and the patient was taken ill on the 17th. OTHER DISEASES. On the 19th April, a case of illness was reported on the canal boat " Elizabeth," lying at Silvertown. On visiting the boat it was found to be diphtheria, and, after very great difficulty in obtaining the consent of the parents, was taken to the Asylum Board's Hospital, where it unfortunately died. There were five other children living in the same boat. Soon after, a second case, also fatal, was reported from Bugbrooke, Northampton, on the same boat. It was also stated that the case had probably arisen from exposure to a foul outfall in the neighbourhood of the Tower. A careful investigation was made into this statement, when it was established that no foul outfall or other specially unhealthy condition existed in that district, and that no other cases had been heard of. Moreover, the Medical Officer of Health of the riparian Authority, Dr. Loane, stated that his district had been particularly free from diphtheria for some considerable time. On the 24th January, a native saloon boy was taken with erysipelas to the Port Sanitary Hospital from s.s. " Goorkha," which had been lying in London for nine days previously. On 28th February, a case of enteric fever was removed from s.s. Orient" on arrival. She left Sydney 11th January, and the patient was taken ill on the 25th. The case was at once diagnosed and removed to the ship's hospital, the forecastle being fumigated by the surgeon. On April 2nd, the s.s. " Clan Macintosh," on arriving, reported having had enteric fever and measles on the homeward voyage. c 2 12 The enteric fever patient was isolated in a saloon cabin, and, on convalescence, all his bedding and effects were disinfected. The cabin was fumigated in dock. The case of measles appeared on 25th February, and was convalescent on 3rd March, when all effects were thoroughly fumigated. On the 9th April, the s.s. " Chusan" reported that a child had been attacked with chicken-pox at Aden on 28th March, and had been at once removed from the ship, and all its effects disinfected by exposure to a high temperature for 24 hours. On the 16th April, a saloon passenger was taken to the Port Sanitary Hospital from the s.s. " Hawarden Castle " suffering from enteric fever. The vessel left Cape Town on the 25th March, and the disease appeared immediately afterwards. He stated that he had been living in a house at Johannesburg where other cases had occurred, and the disease is known to have been ripe in that district. The fact was reported to the Plymouth Local Authority, where the vessel touched, but no action was taken there. On the 28th April, the master of s.s. " Diomed," on arrival at Gravesend, failed to report a case of enteric fever on board his vessel to your Medical Officer, and refused to stop his vessel while the case was removed. Your Medical Officer, therefore, met the vessel on her arrival in the Royal Albert Docks, and removed the patient to the Seamen's Hospital the same day. The master then expressed his great regret at having committed so serious a breach of the Port Regulations, but it was felt that the offence was too great to overlook, and a summons was, therefore, taken out against him at the Gravesend Police Court. The evidence against the master »vas unusually complete, the surgeon of the ship having entered the case as " typhoid fever " in the official log on the 11th April. On the hearing of the case, the Bench came to the conclusion that an offence had been committed, but dismissed the summons on the ground that the Port Regulations fixed the penalty at 51. ; whereas, the Public Health Act, under Section 125 of which these Regulations are framed, fixed it at 2/., and that this error made the Regulations bad in law. 13 Apparently, however, to mark their sense of the gravity of the offence, they refused to grant the master his costs, thereby, indirectly, inflicting a fairly heavy fine. These Regulations were drawn up by the City Solicitor, but the penalty was added by the Local Government Board, which is clearly responsible. The City Solicitor, to whom the matter was referred, reported that, without question, if the decision was appealed against, it would be upset, but that the only result of this would be to still further punish the master, who had freely admitted his mistake, without any corresponding advantage to the Authority, and that the simplest plan would be to at once correct the fault in the Regulations and have them again confirmed by the Local Government Board, as required by the Act. Your Worshipful Committee adopted this suggestion, and the Regulations have, accordingly, been amended. The only alteration, besides the amount of penalty, is the omission of cholera from the list. As this disease is specially provided for in the " Cholera " Order of 1883, its presence in the Regulations is unnecessary. On the 29th April, a case of measles was admitted into the Port Sanitary Hospital from the s.s. " Massillia." She left Bombay on the 4th. On the 28th, after leaving Plymouth, a child was taken ill. A previous case had occurred twelve days after leaving Bombay, and had been landed at Brindisi on the 18th. From this patient the infection had been derived. On the 7th May, the s.s. " Nepaul," on arrival, reported having had fifteen cases of measles on the homeward voyage, the first being taken ill three days after leaving Calcutta. Three cases were taken into the Port Sanitary Hospital with their effects, and the vessel fumigated. On the 23rd, the s.s. "City of Khios" came in, having had four cases of measles on the homeward voyage. The patients were all seamen, and were convalescent on arrival. The first was taken ill on the 5th May, and the other three on the 15th. There was no isolation hospital on board, and to this may be attributed the failure to check the infection at the first case. The only reason for the absence of such accommodation being a desire to economise canal dues, I wrote the owners urging upon them the advisability of erecting so necessary a structure on deck. 14 On the 1st May, the s.s. " Mirzapore " took on board a fresh native crew. On the 7th, one of them was attacked with measles. He was at once isolated under a tent on deck, and landed at Aden with all his effects on the following day. No other cases occurred. On the 14th June, the s.s. "Persian Monarch" arrived at Gravesend. when the master reported that his child was suffering from measles, but refused to allow it to be taken to hospital, stating that he would keep it on board until convalescent. At this time the " Regulations " were before the Local Government Board for confirmation, and, therefore, legally did not exist. The previous Regulations had been declared bad in law by the Gravesend Bench, and as any proceedings would have had to be taken before the same authority, it was useless to summon the master. I, therefore, simply reported the matter to the owners, calling attention, not only to the breach of the Regulations, but to the very serious injury likely to be caused to a passenger vessel by so extraordinary a proceeding on the part of an officer. A reply was received stating that the owners were unaware of the master's action, and that they had cautioned him, and ordered him in future to strictly obey all the Port Regulations. I need scarcely add that the child was at once removed from the vessel. It is so clearly in the best interests of shipowners that their vessels should be above suspicion, that no other result could have been reasonably expected. On the 20th, the Poplar Board of Works reported that a case of enteric fever, which had been removed from that district, was traceable to the s.s. " Roslin Castle." On inquiry, it was found that the patient left Cape Town in the vessel on 28th May, and left in London on 9th April, then apparently in good health. He was taken ill on the 20th. It is clear, therefore, that though showing no signs of the disease on arrival, that he was infected before entering the Port. THE HOSPITAL. The Port Hospital has been of great value in the isolation of infectious disease. During the half-year one case of erysipelas, three of enteric or typhoid fever, one of diphtheria, and ten of measles, have been under treatment there. 15 I would again take the opportunity of pointing out the absolute necessity of an additional ward to be used for the treatment of small-pox cases only, when they arise. It is not safe to treat such cases under the same roof as, or in close proximity to, other diseases. The arrangement proposed by the training ships would, if carrried out, provide such extra means of isolation without cost to the authority, and I am, therefore, naturally anxious to see the negotiations brought to a satisfactory termination. The staff of the Hospital would remain the same. During the month of May some cases of whooping cough were sent for admission from the s.s. " Assyrian " by the Board of Trade Medical Officer. Bearing in mind the nature of this malady, and the great danger involved in sending such cases into an infectious disease hospital, your Medical Officer decided to refuse admission, and advised your Worshipful Committee to endorse his action. In intimate connection with the Hospital is the question of payment for accommodation. Hospitals for the reception of cases of infectious disease are maintained primarily for the protection of the public, in order that, by proper and early isolation of the patient, the danger of infection may be as far as possible minimised. To this end the Legislature has decreed that any person suffering from a " dangerous infectious disease " on board any vessel, ship, or boat, shall be removed to hospital. Inasmuch, therefore, as the removal is compulsory, it seems certainly unfair to compel payment for treatment and maintenance while isolated for the public good. And, moreover, the very fact of there being a charge must act as a deterrent;. If it be known to all that no payment would or could be demanded, hospitals would be more popular, isolation more complete, and the prevention of epidemics more feasible. This is recognised as a fact by all Sanitarians, and adopted as a principle by many Local Authorities. Your Committee has already recognised the importance of not putting any obstacles whatever in the way of prompt removal of infectious sick, and has reduced the charge from 35s. to 21s. per week. I would now urge the abolition of payment altogether on these grounds :— Firstly, that it must always act as a deterrent. Secondly, that the amount thus recovered in the course of the year is exceedingly small. And, lastly, that it has led in the past to considerable friction in dealing with shipowners and masters. 16 These remarks, obviously, will not apply to any institutions or public bodies who may desire to make use of your Hospital for their patients. For these it is their bounden duty to provide, a duty which they should certainly be legally forced to fulfil, and if it answers their purpose to arrange with the Port Sanitary Authority to perform their work, they must be prepared to pay liberally for the privilege. They cannot in any way part with their obligations, and cannot demand as a right what the Port Sanitary Authority is prepared to concede as a favour. THE RIVER AND SEWAGE. The condition of the river water during the early summer has naturally greatly exercised the mind of your Medical Officer. The London County Council, inheriting a legacy of a costly and useless sewage scheme, has not yet had any opportunity of investigating the matter and deciding as to its future action. The precipitation works are being proceeded with, and will probably be complete in about twelve months' time. The Barking outfall has been in operation for the last six months. The effect, so far as the condition of the river water is concerned, has been exactly what those who best understand the question predicted, viz., a thorough and complete failure. This precipitation, at enormous cost, is intended as a temporary and palliative measure which having been commenced must be finished. The whole question of the disposal of the sewage of the Metropolis has been referred to eminent engineers, with instructions to report fully as to the best method and its approximate cost. During the last week of May and the early part of June, the whole river from Limehouse to Purfleet was in a fearful condition, certainly as bad as at any time during the last ten years. The precipitation and deodorization appeared not to have the slightest effect. Happily, however, the summer up to the present time has been extremely cold and wet. In consequence of the low temperature, and almost continuous rain, the horrible condition of affairs has gradually improved, and now during the first week of July the water is fairly good. 17 For the comfort and health of those whose business or pleasure takes them on the river it is greatly to be desired that we may be favoured with a continuance of the present weather. CHOLERA. According to published reports the cholera has existed for some months during the past year in Mesopotamia and the valleys of the Tigris and Euphrates. This appears to have become much more active during the latter part of January and February. During the last week of January it was reported that 3,000 fatal cases had occurred at Bussorah, including the English vice-consul and two of his family. Your Medical Officer, therefore, suggested to the Local Government Board to issue an order prohibiting the importation of rags from this district. There can be no doubt as to the danger of importation of disease of other kinds than cholera by means of rags and old clothes, filthy as they always are, and I would take this opportunity of calling attention once more to the advisability of some general scheme for dealing with all imported rags, so as to avoid the necessity for any special and intermittent arrangements, which for obvious reasons must always prove ineffectual. In the absence of such system, however, the only safe plan seems to be to resort to a prohibitory order for a certain period, a plan which has been already adopted by the Local Government Board. The quantity of rags from these parts is not large, but the danger cannot be considered as in proportion to the amount, inasmuch as one bale of infected clothing is quite as likely to introduce disease as a large consignment. The same disease has once again made its appearance in Spain. Although it has shown itself only in one province, and no apparent route of infection has been traced, it is quite possible, as suggested, that the disease has in some manner been lying latent, and that the present outbreak is but a recrudescence of the previous epidemic. It is very difficult at any time to arrive at the truth of cholera returns of Spain, but it would appear that the disease has been confined to a comparatively small part of the province of Valencia, and that the number of cases has not exceeded some 400. At the same time, the mortality has been high, averaging about 60 per cent, of those attacked. D 18 Most of these cases were reported during the latter half of June, and at present the number is reported to be rapidly diminishing. While apparently, therefore, there is no reason to fear an invasion of cholera, it behoves every Sanitary Authority to take the utmost precautions possible without causing any excitement or panic. All vessels arriving from Spanish ports are specially visited, and careful inquiries made as to the health of all on board, during both the voyage, and their stay in the foreign ports. UNSOUND FOOD. The quantity of unsound food dealt with by your Officers has been small, although the number of seizures has been somewhat larger than usual. The total amount of meat condemned and destroyed during the six months has been 1,988 carcases of mutton, and 278 pieces or part carcases, five pieces of beef, and 61 boxes of kidneys. Other miscellaneous seizures of food comprised 6,800 boxes of oranges, 32 cases of apples, 8 cases of pears, 13 cases of pineapples, one case of German sausages, 2 cases of salmon, 2 cases of sardines, and 10 cases of vegetables. Fruit and vegetables are simply destroyed by mixing with refuse, and used as manure. The meat, though unfit for food, has a definite commercial value. By the instructions of your Worshipful Committee it is sold, under arrangement, to a contractor, who boils it down under the supervision of your Officers in order to extract the fat, the residuum being used as a manure. The amount thus obtained, after the deduction of expenses actually paid, is handed to the consignee, together with a certificate of the destruction. The Corporation, therefore, at the present time, is actually paying the consignee the value of the meat (as unsound), and giving the time and services of their Officers for this purpose gratuitously, and [ would submit that is wrong in principle. If a reasonable deduction from the nett value (after deduction of expenses) of say 10 or 20 per cent, were made, this, although it would not amount to a large sum, would practically reimburse the Authority for the sum expended on supervision. In this way, without any hardship whatever, an average income of say 50Z. a year might be assured. I would, therefore, commend this question to your consideration. 19 WATER BARGES. During the half-year the water barges supplying shipping have been constantly under supervision and inspected carefully. At the beginning of the year there were 25 in use in the district, Two new iron ones have been built. Fourteen of the old ones were found to be in fairly good condition. Two have been repaired (such repairs amounting almost to rebuilding). Four which had become unsound and unfit for the purpose have been condemned, and either broken up, or sold for other purposes, while two have been allowed to continue in use for filling boilers only, and have been labelled to this effect. Five are still laid up after condemnation by your Officers, awaiting the decision of their owners as to whether they are worth the expense of repairing to the extent required. One new iron water barge is now being built. As nearly all these vessels are in the hands of small owners, who do not realize the extreme importance of having a drinking water above suspicion, this department of our work is of a most trying and harassing description. Nevertheless, the result of steady constant pressure in the same direction is gradually telling, and the owners are beginning to see that wooden barges perish so quickly, and require such constant repairs, that they are more costly than iron ones. An appeal to the pocket is generally understood, and when a sanitary improvement can be demonstrated as a financial success much of the opposition is dissipated. INFECTED CLOTHING. Although, consequent upon the energetic action of the Board of Trade, on the representation of your Medical Officer, the dangerous practice of sending home the effects of seamen who have died abroad from infectious disease has greatly diminished, still some few cases have occurred. Thus, in January, the clothing of two men who had died from "fever"— one, typhus—was sent home from Rotterdam without any information as to disinfection. d 2 20 Two other consignments were received, the late property of persons who had died from typhoid fever, while one packet was that of a deceased seaman, the cause of death not being stated. In all cases where either the cause of death is known to be an infectious disease without evidence of fumigation, or where the cause of death is unknown, fumigation is carried out, and the facts, so far as ascertainable, reported to the Board of Trade. The Board thereupon calls upon the official responsible, and in due course transmits to your office a copy of the explanation. As this never occurs twice from the same source, there is a fair presumption that eventually the proper regulations will be strictly carried out. THE STAFF. The only change in the constitution of your Inspectorial Staff is that caused by the resignation of Inspector Lewis, who has served your Worshipful Committee for a period of seventeen years, and who, during the last ten years, to my personal knowledge, has worked faithfully and to the best of his ability. His retirement is due simply to the fact that from physical weakness and declining health and vigour he is no longer able to carry out efficiently the duties of an Inspector. I have been authorised to appoint temporarily an Officer to fill his place, and to report thereon at the next meeting. During January, complaints were received of a serious nuisance on the Millwall Dock Companies' property caused by the deposit of dustbin refuse by the Poplar Board of Works. The refuse of the district has been shot here for some years, gradually filling up the low ground. Having reached close to surrounding houses it undoubtedly caused a nuisance, injurious to the Public Health. The Dock Company were, therefore, called upon to abate the nuisance forthwith. A reply was received on the following day stating that the shoot had been permanently closed. 21 CANAL BOATS ACT. During the half-year, 291 canal boats have been inspected, having on board a population of 690 persons. One case only of infectious disease has been met with, on the " Elizabeth," as already reported. The master of one barge, " George," of Warwick, No. 66, was fined 10s. and costs for overcrowding. 18 boats have been registered for the first time. Further details will be given in the Annual Report required by the Canal Boats Act. I 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 each Dock and on the River, from December 31st, 1889, to June 30th, 1890 24 B Number and Nationality of Vessels inspected, from January 1st to June 30th, 1890 25 C List of Effects Disinfected 26 D I Jst 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 and Food 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 December 31st, 1889, to June 30th, 1890. Docks. Number. Number to be Cleansed or Whitewashed. No. of Foul Cargoes. Outward Bound. No. of Sick referred to Hospital. St. Katharine 209 8 — 6 - London 405 40 — 21 5 Regent's Canal 321 3 — 2 1 Millwall 563 21 1 32 2 West India 469 52 — 41 2 East India 252 7 — 29 — Victoria 389 26 — 37 1 Royal Albert 701 30 — 28 1 Commercial 581 45 — 19 3 Gravesend District 1,937 6 — 5 — Tilbury 539 41 — 34 — River 1,166 68 — 2 3 Total 7.532 347 1 256 18 Number. No. to be Cleansed, &c. Total to 31st December, 1890 - 308,791 18,192 From 1st January to 30th June, 1890 - 7,532 347 Total 316,323 18,539 25 APPENDIX B. Number and Nationality of Vessels Inspected, from January 1st to June 30th-, 1890. Nationality. N umber. Proportion per cent, of the Total Number. American 1 - Austrian 6 .79 Belgian 4 .53 British 6,554 87.01 Chilian 1 — Danish 88 1.16 Dutch 82 1.08 Finnish 21 .27 French 30 .39 German 291 3.86 Greek 3 .03 Italian 8 .10 Russian 10 .13 Spanish 39 .51 Swedish and Norwegian 394 5.23 Total 7,532 E 26 APPENDIX C. Effects Disinfected, from January 1st to June 30th, 1890. Date. Ship's Name. Where from. Date and Cause of Death. Where Disinfected. Date. Cause. 1890. Jan. 21 Merlin Rotterdam and Schiedam. Unknown Fever,Typhus Fever. Mercantile Marine Office, Tower Hill. April 5 Diadem Malta - Mar. 8,'90 Enteric Fever Ditto. May 15 Iris Hamburg Oct. 21,'88 Low Fever - St. Katharine's Dock House. „ 23 Iberia Sydney Mar.25,'89 (Unknown Tilbury Dock. June 12 British Sceptre - Cochin China Feb. 1,90 Malarial Fever London Docks. Total to December 31st, 1889- From January 1st to June 30th, 1890 Total since commencement Number. 657 5 662 27 APPENDIXD. Vessels Fumigated, from January 1st to June 30th, 1890. Date. Ship's Name. Steam or Sailing. Where from. Cause of Fumigation. 1890. Jan. 24 Goorkha Steam Calcutta Erysipelas. „ 29 Donati " Lisbon Small-pox. Feb. 5 Thames " Bombay " „ 18 Cornwall Training Ship Purfleet Scarlet Fever. 28 Orient Steam Sydney Enteric Fever. April 2 Clan Macintosh " Calcutta " „ 9 Chusan " " Small-pox. 55 55 55 " " Measles. „ 16 Hawarden Castle " Cape Town Enteric Fever. „ 19 Elizabeth - Canal Boat - Birmingham Diphtheria. 5> V Arethusa - Training Ship Off Greenhithe - " „ 20 Diomed Steam Y okohama Enteric Fever. „ 27 Juan " Batoum Diphtheria. „ 29 Massillia " Bombay Measles. May 3 Clan Grant " Calcutta Malarial Fever. " 7 Nepaul " " Measles. Jone 14 Persian Monarch " New York " Number. Total to December 31st, 1889 277 From January 1st to June 30th, 1890 - 16 Total since commencement 293 E 2 28 APPENDIX E. Alterations made, from January 1st to June 30th, 1890. Month. No. of Vessels in which Alterations have been made. Ventilation. Water Tanks. Lighting, heating, cleansing. &c. Total No. of Alterations. January 21 6 — 20 26 February 10 2 — 11 13 March 17 1 3 15 19 April 15 5 4 7 16 May 28 14 5 11 30 June 67 13 26 36 75 Total 158 41 38 100 179 APPENDIX F. Alterations ordered, but not yet carried out, from January 1st to June 30th, 1890. Month. No. of Vessels in which Alterations have been ordered. Ventilation. Water Tanks. Lighting, heating, cleansing, &c. Total No. of Alterations. January 8 4 — 5 9 February 10 2 3 8 13 March 14 1 3 10 14 April 18 7 4 10 21 May 19 5 3 12 20 June 7 2 2 4 8 Total 76 21 15 49 85 APPENDIX G. Cases of Infectious Disease in the Port of London, from January 1st to June 30th, 1890. Date. Name of Vessel. Description. Official No. Owners or Brokers. Where lying. Disease. Source of Infection. Where case removed to. 1890. Jan. 24 Ghoorkha Str. 85,932 Gray, Dawes & Co., Austin Friars. Royal Albert Dock Erysipelas (?) Port Sanitary Hospital „ 29 London and Str. 45,007" J. Hale & Co. - London Dock Small -pox Lisbon - Met. Asy. Board Ship Donati Str. 55,040 Feb. 5 Irrawaddy Str. 82,264 Galbraith, Pembroke & Co.. Austin Friars. Gravesend Small-pox Rangoon Colombo „ 5 Thames Str. 85,898 P. and O. Stin. Nav. Co., Leadenhall Street. Royal Albert Dock Small-pox Bombay Gibraltar „ 18 Ganges Str. 83,978 Ditto Ditto Small-pox (?) Bombay Suez „ 18 Cornwall Refor matory S hip - Purfleet - Scarlet Fever (?) Isolation Hospital, on shore. „ 28 Orient - Str. 82 254 Anderson, Anderson & Co., Fenchurch Street. Tilbury - Enteric Fever (?) Sydney Port Sanitary Hospital Mar. 19 Arethusa Traini ng Ship National Refuges Greenhithe - Diphtheria (?) Ship's shore Hospital „ 25 Cornwall Refor matory Ship Purfleet - Scarlet Fever See 18th Feb. Ship's shore Hospital „ 25 Oroya Str. 93,712 Anderson, Anderson & Co., Fenchurch Street. Tilbury - Small-pox Ismailia Naples April 2 Clan Macintosh Str. 87,690 Cayzer, Irvine & Co., Leadenhall Buildings. Ditto - Enteric Fever Calcutta — „ 2 Ditto Str. 87,690 Ditto Ditto Measles Calcutta — ,, 9 Chusan Str. 87,414 P. and O. Stin. Nav. Co. Gravesend Small-pox Calcutta Madras „ 9 Ditto Str. 87,414 Ditto Ditto Chicken-pox (?) Aden „ 16 Capella Str. 97,741 T. J. Harrison, Liverpool Tilbury Small-pox (?) Portland 29 APPENDIX G.—continued. Date. Name of "Vessel, Description. Official No. Owners or Brokers. Where lying. Disease. Source of Infection. Where case removed to. 1890. April 16 Hawarden Castle Str. 87,076 Donald Currie & Co., Fenchurch Street. East India Dock Enteric Fever Johannesburg Port Sanitary Hospital „ 19 Elizabeth Canal Boat Fellows, Morton & Clayton Silvertown Diphtheria (?) Met. Asylum, Homerton „ 19 Arethusa Traini ng Ship National Refuges Greenhithe Diphtheria (?) Attributed to general unhealthy state of the river. Isolation Hospital „ 20 Diomed Str. 60,046 Ocean S.S. Co. Royal Albert Dock Enteric Fever Singapore Port Sanitary Hospital „ 27 Juan Str. 49,894 W. S. Westcott, Ingram Court, E.G. Gravesend - Diphtheria Batoum Ditto „ 29 Massillia Str. 87,404 P. and O. Stm. Nav. Co. - Royal Albert Dock Measles (?) Ditto May 3 Clan Grant Str. 87,645 Cayzer, Irvine & Co., Leadenhall Buildings. Tilbury - Malarial Fever Calcutta Died. Buried at Sea. » ^ Nepaul Str. 73,821 P. and O. Stin. Nav. Co. Gravesend - - - Measles (3 cases) Calcutta Port Sanitary Hospital » 8 Worcester Thames Nautical College Greenhithe - Measles (?) Ditto „ 23 City of Khios Str. 78,632 G. Smith, 45, West Nile Street, Glasgow. Victoria Dock Measles (4 cases) (?) Convalescent on arrival „ 27 Mirzapore Str. 65,604 P. and O. Stm. Nav. Co. Royal Albert Dock Measles Bombay Aden „ 29 W orcester Thain es Nautic al College - Greenhithe Measles (3 cases) (see 8th May) Port Sanitary Hospital June 1 Ditto Di tto _____ Ditto Measles (see 8th May) Ditto „ 14 Persian Monarch Str. 82,315 Allen Bros. & Co., 103 Leadenhall Street. Royal Albert Dock Measles New York Own home „ 20 Roslin Castle Str. 87,126 Donald Currie & Co., Fenchurch Street. East India Dock Enteric Fever Cape Town Met. Asylum 30 APPENDIX H. Condemned Meat, Ac., from January 1st to June 30th, 1890. Date. Ship's Name. Official Number. Where lying. Where from. Amount condemned. 1890. January 3 Arcadia 93,172 Royal Albert Dock Sydney 17 carcases and 8 parts of carcases of mutton. „ 4 Lady Jocelyn 11,923 East India Dock New Zealand 2 carcases and 6 parts of carcases of mutton. „ 8 Tainui 90,001 Royal Albert Dock Ditto 1 carcase, 1 half-carcase of mutton, and 3 pieces beef. „ 13 St. Andrew 68,252 West India Dock Valentia 6,800 boxes oranges. „ 15 Kaikoura - 89,627 Royal Albert Dock New Zealand 180 carcases, 9 part carcases, 1 piece beef. „ 29 Brittannia 93,196 Ditto Ditto 4 carcases and 3 part carcases of mutton. March 10 Fredenborg Danish Commercial Dock Riga L case German sausages. " 17 Lusitania - 65,888 Tilbury Dock Sydney 13 carcases, 3 half-carcases, and 1 leg mutton. " 17 Aorangi - 76,068 Royal Albert Dock New Zealand 18 carcases and 9 part carcases of mutton. " 18 Lusitania - 65,888 Tilbury Dock Sydney 2 cases vegetable marrows, 6 cases carrots, 2 cases parsnips. " 24 Orthes 78,563 Royal Victoria Dock San Francisco 2 cases sardines. April 8 Rimutaka - 89,652 Royal Albert Dock New Zealand 1 carcase, 16 parts, 4 legs mutton. " 30 Aslileigh Brook - 86,171 Ditto Ditto 730 carcases, 38 part carcases mutton. 31 APPENDIX H.—continued. Date. Ship's Name. Official Number. Where lying. Where from. Amount condemned. 1890. Orthes 78 563 Royal Victoria Dock Sau Francisco 2 cases salmon. Liguria 69,367 Tilbury Dock Sydney 12 cases pineapples. April 30 Ionic 86,299 Royal Albert Dock New Zealand 165 carcases, 42 part carcases mutton, and 1 piece beef. May 3 Ruapehu - 76,069 Ditto Ditto 8 cases pears. " 14 Invercargill 68,117 East India Dock Ditto 17 carcases. 31 part carcases mutton. " 10 Ruapehu - 76,069 Royal Albert Dock Ditto 2 carcases, 25 part carcases mutton. " 27 Taiuui 90,001 Ditto Ditto 14 carcases, 15 part carcases mutton. June 6 Brittannia 93,196 Ditto Sydney 15 cases apples. " 11 Kaikoura 89,627 Ditto New Zealand - 822 carcases, 67 parts of carcases mutton, and 61 boxes kidneys. " 11 Doric 87,847 Ditto Ditto 17 cases apples. 32 33 APPENDIX I. Particulars of Canal Boats Inspected under Canal Boats Acts, 1877 and 1884, from January 1st to June 30th, 1890. 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. Registered by the Port of London Sanitary Authority. January 38 117 88 4 — — 6 February 51 151 119 7 l - 3 March 42 163 104 1 — — 2 April 60 205 177 5 — l 5 May 74 260 138 8 - - 2 June 26 80 64 2 - — - Total 291 976 690 27 l 1 ' 18 f 34 APPENDIX J. List of Water Barges Inspected in the District, from January 1st to June 30th,1890. No. Inspected, in the District. In Good Condition. Repaired as Ordered. Condemned. Laid up, &c. 27 14 2 6 5 Charles Skipper and East, Printers, St. Dunstan's Hill, E.C 35. SANITARY. REPORT, POET OF LONDON SANITARY COMMITTEE, WITH THE HALF-YEARLY REPORT ok the MEDICAL OFFICER OF HEALTH FOR THE PORT OF LONDON, To 31st December, 1890. Presented 5th February, 1891. 35. 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, 1890. Presented 5th February, 1891. SAVORY, Mayor. A Common Council holden in the Chamber of the Guildhall of the City of London, on Thursday? the 5th day of February, 1891. THE Port of London Sanitary Committee did this day deliver into this Court a Report in Avriting, 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 Halfyear ending 31st December, 1890, and recommending the following re-appointments for One year from Lady Day, 1891, viz. : — William Collingridge, Esq., M.D., as Medical Officer of Health, Henry Spadaccini, William Baillie, William Anderson, as Sanitary Inspectors; Thomas William Bailey, 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 ; which was read. And a Motion being made and Question put, That this Court doth agree with the Committee in their said Report, the same was Resolved in the Affirmative, and it is Ordered, That the Report be printed and a copy sent to every Member of this Court. MONCKTON. 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, 1890, 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. It will be seen that the Port has again been singularly free from small-pox, only three cases having been discovered. The Report also deals at some length with the important subject of cholera. Owing to the serious outbreak of this disease in Spain and Mesopotamia fresh regulations for the treatment of persons suffering from cholera, and the prevention of its spread, were framed and issued by the Local Government Board under the Public Health Act, 1875. A copy of these regulations is appended to the Medical Officer's Report. In the Report will also be found, among other matters, much interesting information regarding various infectious diseases, the administration of the Canal Boats Acts within the Port, the Training Ships, and the River. 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, 1891 ; 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 Henry Spadaccini at 60s. per week, William Baillie at 45s. per week, William Anderson at 45s. per week, and Thomas William Bailey at 30s. per week, be re-appointed Inspectors. 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 authorised to re-appoint him accordingly at his present rate of remuneration, viz. : Two hundred Guineas for one year. Mr. and Mrs. Hicks having retired from the position of Chief Caretakers at the Hospital, as reported to your Honourable Court, we have promoted Mr. and Mrs. Ballard to fill the vacancies, they having been in the service of your Committee for the past few years as Assistant Caretaker and Nurse respectively. 5 Having advertised for Candidates for the latter situations we selected therefrom Mr. and Mrs. Charles Phillips, whom we appointed at 23s. per week. All which we submit to the judgment of this Honourable Court. Dated this third day of February, 1891. Geo. H. Edmonds. Henry H. Thompson. W. G. Howard. Thomas Wild ash. Frank Tayler. A. Holt Barber. T. G. Beatley. c INDEX. Page Introductory 9 Small-Pox 10 Scarlet Fever 11 Other Infectious Diseases 11 The Training Ships 12 Notification of Infectious Disease 14 Cholera 15 Unsound Food 17 Infected Clothing 17 The Hospital 18 Nuisances 18 Canvey Island 19 The River 20 Canal Boats Acts, 1877 and 1884 21 C 2 TO THE WORSHIPFUL THE PORT OF LONDON SANITARY COMMITTEE. Gentlemen, I have to submit herewith a report of work done by your Officers in the Port during the latter half of 1890. On reference to Appendix A it will be seen that the number of vessels inspected during the period, 7,914, was considerably larger than during the previous six months, although still much smaller than usual. This small number of vessels is largely due, as previously stated, to the unfortunate relations between Labour and Capital which have for some time seriously interfered with the trade of the Port, and which still threaten to cause lasting injury. Of these 7,914, 6,611 or 83.53 per cent, were under the British flag, being a falling off of 3.47 per cent., Scandinavian in the meantime having risen from 394 (=5.23 per cent.) to 608 (=7.68 per cent.), and Germans from 291 (=3.86 per cent.) to 333 (=4.2 per cent.) Of the total number, 332 (=4.1 per cent.) required some form of cleansing to be carried out. In all these the requirements of your Officers were complied with, without the necessity of any legal proceedings. In Appendix E it will be seen that no less than 103 structural alterations, affecting 92 vessels, have been carried out for the hygienic improvement of vessels. Of these 103 improvements 35 affected ventilation, 13 the water supply, and 55 lighting and heating. In Appendix F it is shown that in 84 vessels alterations which have been ordered are still for various reasons either still outstanding, or, if completed, have not yet been formally inspected and returned as such. Twenty vessels have been fumigated on account of infectious disease (Appendix D) and in nine cases infected clothing has been stopped and dealt with. PORT OF LOTDON SANITARY OFFICES, GREENWICH. January, 1891. 10 There have been considerable changes in your Staff. The vacancy caused by the resignation of Inspector Lewis has been filled by the appointment of Inspector Bailey. I am pleased to report that Mr. Bailey has already obtained the Certificate of the Sanitary Institute ; this was one of the conditions of his appointment by your Worshipful Committee. The whole of your Inspectorial Staff are now in possession of this Certificate. Mr. and Mrs. Hicks, Chief Caretakers of the Gravesend Hospital, have retired on account of age, and their places have been filled by the promotion of Mr. and Mrs. Ballard. Mr. and Mrs. Phillips have been appointed Assistant Caretakers. SMALL-POX.jj Again I have to record that small-pox has been absent from London. A few cases have been imported, but fortunately arrested before doing much damage. On the 28th August a French sailor, who arrived in steam ship "Gaudiana" on 18th, was found to have small-pox, and was taken to the Asylums Board Hospital, and the vessel fumigated. The vessel left Marseilles on 8th August, and six days previously the second engineer had gone to Hospital with the same disease. On 13th September a suspicious case was taken from steam ship " Rewa" in the Royal Albert Dock to the Port Sanitary Hospital. Three other patients were sent to the Seamen's Hospital from the same ship on 14th, 15th and 16th. These latter cases were clearly chicken-pox, and the first was the only doubtful one. On the 29th September the steam ship "Ocampo," on arrival from Buenos Ayres, reported a patient with small-pox. He was taken to the Port Sanitary Hospital and vessel fumigated. On 19th November a case of sickness was reported on steam ship " Erymanthe." This proved to be small-pox, and was sent to the Asylums' Board Hospital as a dense fog on the river rendered it dangerous to remove him to Gravesend. He was taken ill at Havre on 15th and seen by a medical man, who stated the disease to be "gastric." He became infected at Marseilles. 11 There have been thus three definite importations of this disease, two from Marseilles and one from Buenos Ayres. SCARLET FEVER. On the 3rd July a case of scarlet fever was notified by the medical man in attendance on the "Lady" Mission Ship, lying in the Regent's Dock. On visiting the vessel it was found that a second patient was already infected, and both were sent to the Homerton Hospital. The vessel was fumigated and the services on board suspended for a time. Her sanitary condition not being good, and her position unsuitable for a permanent dwelling, representations were made to the Thames Church Mi ssion and the matter is still receiving consideration. On the 11th August a patient with scarlet fever was removed to the Port Sanitary Hospital from the " Carnegie," lying in the West India Docks. He had joined from Cumberland six days previously, and had been living in a house where the disease had existed. OTHER INFECTIOUS DISEASES. On 18th July, at the request of the Government Surgeon in charge, a case of enteric fever was admitted into the Port Sanitary Hospital from the revenue cutter " Beatrice." This being a vessel under the command of an officer of Her Majesty's Government no further action was taken. On 13th August a case of erysipelas was reported from the London Hospital as having been admitted from the steam ship " Lady Olive." By that time the vessel had sailed for Dublin, and the only precaution taken was to communicate the fact to the Sanitary Authority of that port. On the lfith August a case of chicken pox was taken to the Port Sanitary Hospital from the steam ship " Clyde." The patient had been taken ill three days only before arrival. On 21st August a patient with enteric fever was removed to Port Hospital from steam ship "Clan Macintosh," lying in the Tilbury Dock. The vessel left Calcutta on 3rd July. 12 On the 23rd September a child was reported to be suffering from enteric fever in a watchman's cottage in the Royal Albert Dock. She was at once removed to Hospital and the cottage fumigated. On examination of the sanitary condition of the cottage several defects were found and remedied, though there is no reason to suspect these as having been the cause of the disease. On the 27th, another case of chicken pox, traceable to infection from steam ship " Rewa," was taken to the Port Sanitary Hospital from the steam ship " Ethiopia," to which vessel he had been transferred. On the 1st October the steam ship " Chyebassa," on arrival, reported a case of enteric fever. The vessel was visited and the patient then being convalescent no further action was deemed necessary. The vessel left Calcutta on 22nd August. A passenger was attacked on 7th September and was declared to be convalescent on 25th September. A second (a native) was taken ill a few days later. In the course of the investigation it was found that the master had made no entry in the official log in accordance with the provisions of the Merchant Shipping Act, this fact was therefore communicated to the Board of Trade, who called upon the master for an explanation. It seems rather an anomaly that although the Act requires an entry to be made of the sickness of any member of the crew, it is not compulsory in the case of a passenger; this omission might easily lead to serious consequences. On the 3rd December the steam ship " Clan Buchanan," which left Calcutta on 24th October, reported that a patient who was attacked with erysipelas on 25th October had, during delirium on 28th, jumped overboard and was drowned. On the 19th December a case of measles was taken from schooner " Florence," lying at Gravesend, and the vessel fumigated. The infection was derived from Grimsby, where the lad had been staying with his brother in bed who was suffering from the same disease. THE TRAINING SHIPS. The health of the boys has on the whole been very good, especially when the great drawback of living on a sewage-polluted river is taken into consideration. It seems almost impossible to believe that the advantages from the experience of ship life can be at all commensurate with the danger to health from this source. 13 As previously reported, there was during May and July a slight outbreak of measles on the "Worcester," off Greenhithe, the training ship of the Thames Nautical Training College Committee, when six boys were attacked. Eleven others were attacked during July, when the outbreak was cut short by the breaking up of the School for the Summer Vacation. All these cases were of a mild character, and did well in the Port Hospital to which they were removed. During the Vacation the vessel was fumigated, and afterwards thoroughly washed down with a disinfecting solution, the bedding being heated by super-heated steam. On return of the boys no further cases occurred. On the 29th November a suspicious case was taken to Hospital, as it was believed to be diphtheria. On admission it was found to be a severe case of simple sore throat. On the 8th December two boys with mumps were sent to the Hospital from the same ship. On 11th November a solitary case of enteric fever occurred on " Cornwall " Reformatory Ship off Purfleet. The boy was at once removed to the isolation Hospital on shore, and all possible precautions taken to prevent spread of infection. No source of disease could be traced. A suggestion was made that it might have been due to the deposit of dust-bin refuse on adjoining land by the Kensington Sanitary Authority. This was investigated by your Medical Officer, who could see no reason for adopting it. On 27th November a very mild case of enteric fever was reported from the School Board Training Ship " Shaftesbury," off Grays. The boy was removed to the Infirmary on shore, and was under observation there some little time before the disease could be diagnosed. The application of the Governing Bodies of the two ships "Worcester" and " Shaftesbury" to be allowed to use the Corporation Hospital on equitable terms is still under discussion by your Worshipful Committee, the sanction of the Court of Common Council having been given to the principle. d 14 The scheme hangs fire on account of the position taken up by the London School Board, which, while (as I believe) properly insisting upon the fact that the Port Sanitary Committee is the right authority to provide Hospital accommodation, demurs to any arrangement whereby payment is demanded except when the Hospital is actually used by them. Clearly it is the duty of every public Institution to arrange for isolation of infectious cases. The School Board is unable to provide this on board (as isolation is there impossible), nor can it be obtained on shore. They therefore seek to make an arrangement with the Corporation. The Corporation has already decided to assist them in their difficulty, but it is not reasonable to expect this, unless payment be made to defray the cost of erections, &c. The Committee of the "Worcester" has agreed to such an arrangement, which is only waiting for the final decision of the School Board to be carried into effect. While negotiations are going on, the cases from these two vessels are being received at Gravesend. This, however, is merely provisional, and may at any time be stopped if the strain upon our limited accommodation becomes too great. One important point in considering this question must not be lost sight of, viz. :—that the Corporation of the City of London voluntarily pays all the expenses of the Sanitary administration of the Port out of the City Cash (having no rates or tolls on shipping for the purpose), while the London School Board has unlimited powers of raising money from the ratepayers for the purpose of carrying on its work. NOTIFICATION OF INFECTIOUS DISEASE. This Act, which has now been in force for twelve months, works very satisfactorily and practically without any friction. Beyond this Act, which requires notification simply forthwith without any special limitation as to place and time, notification of disease on board an inward bound ship by the Master on arrival at Gravesend is compulsory under the regulations of the Port Sanitary Authority. These regulations were amended and re-issued during July (see Appendix ). They require the Master to report infectious disease on arrival to the Medical Officer of Health ( Section 3) and to cause his vessel to remain off the Custom House until the Medical Officer of Health has boarded her (Section 4). They further (Section 5) require the Master to remove the patient to the Port Sanitary Hospital if so directed by the Medical Officer of Health, and, finally (Section 6), require notice to be given if the disease appear after leaving Gravesend. 15 In order that these regulations should be known as widely as possible, copies were sent to every owner or broker having officers or agents in London, and an Abstract thereof is printed on the back of the notice left on board every vessel inspected by your Officers. Further copies are given to all vessels arriving from "foreign" by Her Majesty's Customs at Gravesend. CHOLERA. In view of the extensive spread of cholera in Spain and Mesopotamia, the Local Government issued new cholera Regulations, bearing date 28th August. The importance of these orders, which apply equally to all ports in the United Kingdom, is such that I append a copy thereof. Several new additions have been made since last issued, the principal of which is the provision under Article 10 for furnishing the names and addresses of all persons leaving an infected ship to the Local Authority of the district to which such persons are about to proceed. This, if carefully worked, ought to prove a most valuable safeguard by keeping the Authority and its Officers informed of the possibility of danger, and in assisting the early recognition of cases of disease, which otherwise pass unnoticed. Provision is also made for cases where a Sanitary Authority is unable to fix within its own jurisdiction a place for the detention of vessels, giving them power to appoint some suitable spot, if necessary, outside its district with the sanction of the Local Government Board (see Article 6). It is further laid down, for the first time, that on the arrival of any vessel infected with cholera, the Medical Officer of Health shall give information to the Local Government Board. Article 19 compels the hoisting by every cholera infected ship, within three miles of the coast, of the yellow flag, between sunrise and sunset. Although no importation of cholera has occurred, there have been several rumours. During the third week in August much unnecessary alarm was excited in London by a report that a case of A siatic cholera was actually under treatment in the Poplar Hospital. The patient was a man who had been employed on steam ship " Duke of Argyll." He was seen by Dr. W. J. Hill, who was acting as Port Medical Officer, and the case was carefully investigated by him in conjunction with Dr. W. H. Power of the Local Government Board. D 2 16 All precautions were at once taken; the vehicles in which he had travelled were traced, and dealt with by the West Ham Sanitary Authority, while the house in which he had lived and his clothing were fumigated and cleansed by the Whitechapel Board of Works. The conclusion arrived at was that the patient was suffering from a severe attack of so-called "English cholera" or diarrhoea, and this was confirmed by the official statement of the Local Government Board that "he had been suffering from "symptoms which although clinically indistinguishable from true cholera " are from time to time observed in cases of cholera nostias, such as occur "annually in London and other large cities." Although the policy of concealment is dangerous and unjustifiable, the excitement caused by this announcement shows the extreme necessity for caution in publishing cases of cholera until the diagnosis is confirmed, and the heavy responsibility of such diagnosis. Two other alarms have been given. On the 11th September the Local Government Board reported steam ship "Uppingham" to be on her way to London, her whole crew having been attacked with "fever with choleraic symptoms," nine deaths having occurred. The owners of the vessel, on being communicated with as to the date of arrival, stated that there had been one death on board from "Java fever," and that they had decided not to bring the vessel to London. On the same day the steam ship "Tagus," which was stated to have had twelve deaths from cholera on board among the pilgrims two months previously, was reported to be bound for London. She arrived on 23rd, when it was found, according to the Medical Officer's Log that there had been two deaths from dysentery, but none from cholera. Nevertheless she had been detained for 18 days at Suez, and finally, to complete the farce, allowed to leave in strict quarantine. On the 4th September the Local Government Board, acting under the Public Health Acts, issued an order prohibiting the importation into this -country of rags from Spain until the end of the year 1890. In consequence of the decline of cholera in the country the order has not been renewed. Your Worshipful Committee had previously applied for an order to prohibit rags from Mesopotamia and other parts where the cholera was at the time prevailing, but the Local Government Board did not see its way clear to issuing such. 17 As an instance of the extent to which quarantine regulations can be carried may be mentioned the fact that during the months July to October seven clean and healthy vessels trading with Spain were fumigated by this Authority at the request of the owners, who, of course, paid for the accommodation simply because if they returned to Spanish ports infected with cholera they were liable to detention by reason of their haying left the same places and not having since undergone fumigation. UNSOUND FOOD. The quantity of unsound food destroyed has as usual been by no means large, and bears a very small proportion to the total amount received. In all 961 carcases of mutton, 580 packages of fish, 27 cases of fresh fruit, and 25 tons of vegetables have been thus dealt with. One large seizure was that of about 1,000 tons of currants which were sunk in steam ship "Vulcan" on 18th October. These were sold, while underwater, by auction on the understanding that if utilized in France, with the consent of the Sanitary Authority there, they would not be condemned. The Thames Conservancy, however, failing to raise the wreck the currants could not be got out and thus became putrid. They were therefore seized and an order obtained from a magistrate for their complete destruction. They are being carried out to sea and thrown overboard by the Thames Conservancy, the Port Sanitary Authority having agreed to pay one half of the actual cost incurred in moving them in lighters from the ship and destroying them. The Conservancy obviously taking the duty of unloading the vessel. INFECTED CLOTHING. In spite of all that has been done, " infected " clothing is still from time to time sent home either by private individuals or by shipping masters and other Government Officials. Nine instances of this have occurred during the past half-year. Two of the late owners were stated to have died from "fever," and two from " cholera," while in the remaining cases the cause of death was either not stated, or so stated as to be unintelligible. They all, however, agreed in one point, viz. : that there was no evidence of any kind that they had been fumigated or treated in any way. 18 They were, therefore, disinfected before being handed to the owners, and in those instances where they had been sent by Government Officials the facts, so far as ascertained, were reported to the Board of Trade. While the country has the most elaborate arrangements for dealing with epidemic disease on a large scale, it is very readily forgotten how constant and real must the danger of infection be when constantly the clothing of persons who have died abroad from all kinds of disease is being sent home without, in many cases, any precaution or trouble as to consequences. Your Medical Officers have paid special attention to this point, and have reason to know that the practice, though still carried out, is very largely diminished. THE HOSPITAL. The Hospital has received during the six months two cases of small-pox, one case of scarlet fever, two of enteric or typhoid fever, 11 of measles, two of chicken-pox, and three other cases in which diagnosis was uncertain, in all 22 cases. Your Worshipful Committee has not yet thought fit to adopt the suggestion as to the abolition of all fees for maintenance of patients in Hospital, except in the case of Public Institutions ; I trust, however, that the question is not yet finally settled, and that eventually this will be agreed to, as I feel certain that from a public health point of view it is the only reasonable plan to adopt. NUISANCES. Complaints of nuisances arising from various causes are brought to the notice of your Officers daily, and are dealt with as a matter of routine. One or two only call for special mention. On the 8th August a letter was received from the Captain of the Reformatory Ship "Cornwall," off Purfleet, complaining of a serious nuisance arising from the deposit of rubbish by the Kensington Vestry on the shore near the vessel. This was investigated by your Chairman and Dr. Hill, who found that there was really no nuisance that could fairly be considered as in any way injurious to health. The matter was again brought up on 12th November by the medical attendant to the ship suggesting it as a possible cause of a case of enteric fever which had occurred on board. Your Medical Officer inspected the spot in company with the Medical Officer of Health for the Orsett Union, in which district the deposit actually is made. 19 It was found then that the nearest point of the deposit was 280 yards from the ship's isolation hut on shore, and over 400 yards from the vessel. Although the wind at the time was blowing directly from the heap to the vessel, no nuisance was at any time appreciable, and a report to that effect was sent to the Captain of the vessel. During the month of August also a letter was received from the Clerk to the Board of Works for the St. Olave's District complaining of foul smell arising from the mud in St. Saviour's Dock at low water. This nuisance undoubtedly exists, and in hot weather must be distinctly a source of danger. A communication was therefore sent to the Thames Conservancy, calling upon them to take action in the matter, inasmuch as the Port Sanitary Authority had neither the power nor the means to deal with it. The Conservancy, in due course, replied that they could not undertake to dredge the dock further than the entrance, and stated that wharf proprietors were themselves legally responsible for the removal of the trouble of which they made complaint. The difficulty appears to arise from a water-course which formerly entered the head of the dock having been diverted, and your Medical Officer has suggested that if a reservoir were constructed so as to receive a charge at high water and discharge it at low tide, the rush of water would prevent the accumulation of mud. The matter is still, therefore, in the hands of the St. Olave's Board of Works, who it is understood, in their dilemma, have approached the Local Government Board. During the month of November complaints were received as to the gradual fouling of a creek at Grays Thurrock by the dropping of manure while unloading barges. This creek being the property of an individual, he was asked to arrange for the thorough dredging, which was accordingly carried out. During the months of August and September the whole of the closets and dust-bins in the various docks received, as usual, special attention. All were emptied, cleansed, and whitewashed, many were removed from unsuitable places, and some were reconstructed on new lines, suggested by your Officers. CANVEY ISLAND. The only important sanitary work on the island has been the provision of water tanks in some of the outlying farms, by means of which they are enabled to draw their supply from the public pump, which continues to give good water in unlimited quantity. \ 20 During July two cases of erysipelas occurred at Sluice House, for which there appeared to be no obvious cause. The drainage of the houses being defective, fresh arrangements were ordered, and were at once carried out by the owner. In August two cases of measles occurred at Waterside Farm, the infection having been brought from Poplar by children staying on the island, Six other cases occurred during September and October, all clearly traceable to the same source. One other case of the same disease was brought from Southend during December. None of the above were removed to Hospital, but the best possible arrangements made for isolation in their own homes, thorough fumigation being subsequently resorted to. THE RIVER. During the hot weather the condition of the river water gave rise to considerable anxiety on the part of those concerned with the care of the Public Health. The present mode of treatment, applied only in part to the sewage of the Metropolis, does not seem to have affected in any way the state of things. If there has been any benefit from the system adopted, it ha3 at any rate been more than neutralized by the increased quantity which flows into the sewers from year to year. The river water during the past summer was undoubtedly as bad as it has been at any time during the last ten years. It appears to be influenced entirely by temperature, rainfall, and barometric pressure, and to be for all practical purposes unaffected by any addition of chemicals at the outfalls. A report has been issued by the Engineer and Chemist of the London County Council in which it is stated that " below bridge, and as far as Limehouse, the water was as good as we have often seen it in the Thames above Teddington." With reference to this, I would point out that this is no uncommon thing on a falling tide ; and secondly, that this inspection was made on two dates—16th and 22nd September. The temperature during August was almost continuously below the average, and rain fell on 15 days during the month. The first week in September was again cold, while the remainder of the month was above the average. 21 / But as the report in question states, and as your Medical Officer has always . pointed out, the trouble is not due so much to the sewage recently discharged as to that which has been discharged for some time. Therefore, the report as it stands must be considered as a perfectly fair and reasonable one, requiring only a note as to the cold and wet weather during August. CANAL BOATS ACTS, 1877 and 1884. Herewith I beg to submit a few notes on the administration of the Canal Boats Acts, 1877 and 1884, within the limits of the Port of London, for the year 1890. No change has been made in the arrangements for inspection. The Port is divided into certain sections, to each of which an inspector makes a daily visit, and takes under his notice such boats as are thus met with in his daily round. As a general rule it has been found that the provisions of the Act are carried out in their entirety, and the violations thereof are not only few in number, but of a comparatively trifling character, such as non-production of certificate (when boat in order), want of painting, &c. In these minor cases the master of the boat is verbally cautioned at the time, and subsequently a letter is sent to the owner, calling attention to the default, and warning him of the consequence of repetition. Since September a new system has been adopted, which has scarcely yet had sufficient working to prove its value. A book is kept at the office, having a form of complaint in duplicate, and a certificate to be signed by an inspector when the cause of complaint has been remedied. One copy of the plaint with the blank certificate attached is duly filled-up and sent to the owner of the boat. On the face of this plaint it is stated that the defect must be at once remedied, and a certificate that this has been done, signed by the proper authority, returned to the office. A certain time, generally 14 days, is stated on the form, and failure to return within that time will be considered as sufficient reason for taking proceedings if the offence be of such a nature as to call for the same. In the appendix attached hereto it will be seen that 557 boats have been inspected during the 12 months, or about 100 less than during the last year. As the arrangements for inspection have not in any wise been altered, this can only mean that a smaller number of canal boats have passed through the e 22 district. Of this, from actual inspection, I have no doubt, and the cause is simply the disturbance of the shipping trade in the Port, owing to the unhappy relations between labour and capital. Practically all the canal boats coming into our district carry cargo to and from vessels, and any decrease of the shipping industry will naturally be reflected in the canal boat industry, another proof of the far reaching effects of these unfortunate differences, many of which we scarcely realize at present, but which undoubtedly have a wide and lasting influence for evil upon the commerce of the country. On these 557 boats, registered in the aggregate for 1,667 persons, only 1,284 were actually living. Thus in the eye of the law there is practically no overcrowding in these boats, although many of them carry a complement which certainly is the utmost possible consistent with health and decency. This disparity of numbers is, as I have previously pointed out, mainly due to the fact that some registration authorities licence for the full number of persons who can be carried, as calculated by the cubic capacity of the cabin without any reference to the legal requirements as to proper sleeping accommodation. As an instance of this a boat has been recently inspected which, while registered for 17 persons, provided proper accommodation for four or five only. This particular boat could legally have carried in the after cabin a man, wife and 14 children, and in the fore cabin a man, wife and 12 children, in all, four adults and 26 children ! Happily, however, she carried only three adults and three children, for whom there was ample space. Thirteen cases have occurred of boats travelling while unregistered under the Acts, and all these have since been registered under this or some other Authority. Six cases of over-crowding were met with. Five of these were satisfactorily explained and remedied. In two of these the over-crowding was caused by a young child, which was removed from the boat at the first opportunity. In a fourth, the master of the boat was in an advanced stage of consumption, and had taken on help for work which he was obviously unable to perform, while the fourth was a case where the master of the boat having been taken suddenly ill was left behind, and the new hand brought his wife on the trip with him. The sixth case was that of the "George," of Warwick, No. 66, which being registered for a man, wife and three children, was found to have on board a man, wife and five children. The master having refused to remedy the over-crowding, a summons was applied for, and on hearing, he was fined 10s., and 2s. costs. 23 Only one case of Infectious Disease occurred within the Port. On the 19th April, Diphtheria was reported on the " Elizabeth," of Berkhampstead, No. 29, lying at Silvertown. The boat was at once visited, and the patient, a child of four, after much difficulty with the parents, removed to Homerton Hospital, where he unfortunately died. The barge was then fumigated, and certificate thereof handed to the master. Unfortunately, a second case from the same boat (also fatal) was reported from Northampton, and the source of infection attributed to foul outfalls off the Tower of London, where she was said to have been lying. On enquiry it was found that no foul outfalls existed as stated, that no cases of Diphtheria had occurred in any other vessels there, nor on shore in the neighbourhood, and further that the "Elizabeth" had been lying at the Tower Bridge Works in mid-stream, and not therefore within the influence of any outfall. The work of registration proceeds but slowly. Owners no longer care to have men resident in their craft, and offer no inducements for them to remain. In some instances masters have been turned out of their barges and forbidden to permanently occupy them, hence these craft no longer come strictly within the purview of the Acts. Only 30 have been registered by this Authority within the 12 months, and the actual number now on the register is 208. With the exception of this failure to register, and the unfortunate cause, the Acts have been satisfactorily complied with, and their beneficial effects are steadily becoming manifest. There is no evidence of any objections to their provisions on the part of those whom one would most willingly and naturally consult, the inhabitants themselves, and the very small amount of opposition that is manifest comes only from a few owners who. from gross indifference to the comforts and welfare of their employes, or a deliberate intention to avoid any possible source of expense, systematically ignore or evade their legal duties and responsibilities. These happily are but few in number, and are becoming well known by their repeated offences, and the penal clauses of the Acts provide for them a treatment of which they have been sufficiently warned, and which must in the long run prove effectual. In spite of all that has been done I can see no reason for altering my firm conviction that Canal Boats are not (and cannot be made) fit and proper places for young women and children. To say nothing of the education question, the mere size of the cabins utterly precludes the possibility of decency, and it certainly is a standing e 2 24 marvel how the ordinary functions of life can be carried on in so circumscribed a space, and yet not produce more demoralizing effects upon the inhabitants than are now evident. One great difficulty in dealing with these boats is to obtain a " history," and to trace them in their wanderings through the country. This would seem to be a comparatively simple matter if the Central authority, the Local Government Board, were to call upon each local authority to furnish regularly, and at frequent intervals, particulars of every inspection where any fault was found. In this way a thorough and reliable record could easily be kept and referred to. Then the character of each boat would be known, and no mistakes could be made in prosecuting an ignorant owner or master, or (as more frequently occurs) in showing a cunning and wilful offender undue leniency. I have the honour to be, Gentlemen, Your obedient Servant, WILLIAM COLLINGRIDGE, M.D., Medical Officer of Health, Port of London. SUMMARY OF CANAL BOATS FOR THE YEAR ENDING 31st DECEMBER, 1890. January. February. March. April. May. June. July. August. September. October. November. December. TOTAL. Registered for 1,667 persons. Carrying 1,284 persons New boats registered by Port Sanitary Authority 5 3 1 5 2 ... ... 1 ... 4 4 5 30 Re-registered owing to structural alterations ... ... ... ... ... ... ... ... ... ... ... ... ... Re-registered for other reasons ... 1 ... 1 ... ... ... ... ... ... ... 1 ... 3 Total registered at 31st December, 1889 178 ... ... ... ... ... ... ... ... ... ... ... ... Cancelled 1 ... ... ... ... ... ... ... ... ... ... ... ... Actual number on Port Sanitary Register. 181 184 186 191 193 ... ... 194 ... 198 203 208 208 Total inspected in district. 38 50 45 70 80 26 48 58 44 51 26 21 557 Conforming to Acts and Regulations 30 36 44 63 61 22 41 54 37 38 24 20 470 Infringing in respect to:— Registration 1 4 1 ... 3 1 2 ... 1 ... ... ... 13 Notification of change of master Absence of certificate ... 4 5 ... 5 7 3 3 3 3 2 1 L 37 Certificate not identifying owner with boat ... ... ... ... ... ... ... ... ... ... ... ... ... Marking, &c. ... 3 ... ... 3 ... 2 ... 2 1 1 ... 15 Over-crowding . ... 1 1 ... ... ... ... 1 1 1 ... ... 6 Partition separating sexes ... ... ... ... ... ... ... ... ... ... ... ... ... Male over age . ... ... ... ... ... ... ... ... ... 1 ... ... 1 Females over age ... ... ... ... 2 ... ... ... ... ... ... ... 2 Cleanliness ... ... ...... ... ... ... ... ... ... 1 ... ... 1 Painting. ... 1 ... ... ... ... ... ... ... 1 ... ... 2 Ventilation ... ... ...... ... ... ... ... ... ... ... ... ... ... Dilapidation ... ...... ... ... 1 ... ... ... ... ... ... ... 1 Removal of bilge water ... ...... ... ... ... ... ... ... ... ... ... ... ... Without pump ... ... ... ... ... ... ... ... ... ... ... ... ... Refusal to admit inspector ... ... ... ... ... ... ... ... ... ... ...... ... ... No proper water vessel . ... ...... ... ... 3 ... ... ... ... ... ... ... 3 Without double bulkhead ... ...... ... ... ... ... ... ... ... ... ... ... Notification of infectious disease ... ...... ... 1 ... ... ...... ... ... ... ... ... 1 Detained for cleansing ... ... ... ... ... ... ... ... ... ... ... ... ... Proceedings taken. ... 1 ... ... ... ... ... ... ... ... ... ... 1 Cautions given 1 6 1 5 11 ... 4 3 7 5 1 1 45 „ attended to 1 4 1 4 10 ... 3 ... 5 3 1 ... 32 25 Total registered, by Port Sanitary Authority since 1887 211 Cancelled 8 Actual Number on Register, 31st December, 1890 208 26 INDEX TO APPENDICES Appendix Page A Number of Vessels inspected in each Dock and on the River, from June 30th to December 31st, 1890 27 B Number and Nationality of Vessels inspected, from June 30th to December 31st, 1890 28 C List of Effects Disinfected 29 D I jist of Vessels Fumigated, with Causes 30 E Number of Structural Alterations carried out 31 F Number of Vessels in which Structural Alterations have been ordered, but not yet completed 31 G Cases of Infectious Diseases in the Port of London 32 H Particulars of Unsound Meat and Food condemned by Port Sanitary Authority 35 I Regulations, Port Sanitary Authority—Public Health Act, 1875 37 J Regulations, Port Sanitary Authority—Cholera 39 27 APPENDIX A. Number of Vessels Inspected in each Dock and on the River, from June 30th to December 31st, 1890. Dock. Number. Number to be Cleansed or Whitewashed. Number of Foul Cargoes. Outward Bound. Sick referred to Hospital. St. Katharine 261 3 — 4 — London 253 19 — 9 — Regent's Canal 302 3 — 3 2 Mill-wall 658 32 — 27 2 West India 560 45 — 103 5 East India 231 10 — 34 — Victoria 392 18 1 59 2 Royal Albert 740 24 — 52 9 Commercial 969 93 — 17 1 Gravesend District 1,605 18 — 18 - Tilbury 525 39 — 33 — River 1,418 28 — 1 Total 7,914 332 1 359 22 Number. Number to be Cleansed, &c. Total to 30th June, 1890 316,323 18,539 From 30th June to 31st December, 1890 7,914 332 Total 324,237 18,871 28 APPENDIX B. Number and Nationality of Vessels Inspected, from June 30th to December 31st, 1890. Nationality. Number. Proportion per cent. of Total Number. American 12 15 Argentine 2 — Austrian 4 — Belgian 3 — British 6,611 83.53 Danish 111 1.40 Dutch 60 .75 Finnish 15 .18 French 35 •44 German 333 4.20 Greek 3 - Italian 10 •12 Portuguese 2 — Russian 24 •30 Spanish 81 1.02 Swedish and Norwegian 608 7.68 Total 7,914 29 APPENDIX C. Effects Disinfected, from June 30th to December 31st, 1890. Date. Ship's Name. Where from. Date and Cause of Death. Where Disinfected. Date. Cause. 1890. July 21 Lusitania Sydney ? ? Mercantile Marine Office, Tilbury. Aug. 28 Edmondsley Barbadoes May 10,'90 Fever St. Katharine's Dock House. Sept. 8 Montana - Philadelphia June 7,'90 Malignant Malaria. Mercantile Marine Office, Tilbury. Nov. 24 Coromandel Shanghai ? Cholera Port Sanitary Hospital. „ 24 Sutlej Port Said Unknown Unknown „ 24 Patroclus Shanghai ? Cholera „ 24 Oakdale Barbadoes July 26,'90 Malaria Mercantile Marine Office, St. Katharine's Dock. „ 29 Teucer Singapore July 8,'90 Fever Mercantile Marine Office, Tidal Basin. „ 29 Oroya Sydney June21,'90 ? Port Sanitary Hospital. Total to June 30th, 1890 - 662 From June 30th to December 31st, 1890 - 9 Total since commencement - 671 F 30 APPENDIX D. Vessels Fumigated, from June 30th to December 3lst, 1890. Date. Ship's Name. Steam or Sailing. Where from. Cause of Fumigation. 1890. July 4 - Lady Thames Church Mission Ship Scarlet Fever. „ 10 - H.M.S. Beatrice Sailing Southend - Enteric Fever. „ 22 - Juan Cunningham Steam Valencia - By request of Brokers. ,, 23 - Molina 55 ,, ,, ,, 24 - Pinzon 55 ,, ,, ,, 30 - Hen-era - ,, ,, Aug. 7 - Daoiz 55 ,, ,, 13 - Solis ,, ,, ,, ,, 11 - Carnegie - Sailin g, outward bo und for Cape Town Scarlet Fever. „ 16 - Clyde Steam Bombay - Chicken-pox. „ 20 - Duke of Argyll - ,, Calcutta - English Cholera(?) „ 21 - Guadiana - ,, Marseilles - Small-pox. „ 21 - Clan Macintosh- ,, Calcutta - Typhoid Fever. Sept. 13 - Rewa ,, ,, Small-pox. „ 15 - ,, ,, ,, ,, „ 20 - ,, ,, ,, Chicken-pox. , 29 - Ocampo - ,, Buenos Ayres - Small-pox. Oct. 4 - Colon ,, Valencia - By request of Brokers. Nov. 20 - Erymanthe Marseilles - Small-pox. Dec. 18 - Florence - Sailing Grimsby - Measles. Total to June 30th, 1890 - 293 From June 30th to December 31st, 1890 - 20 Total since commencement - 313 31 APPENDIX E. Alterations made, from June 30th to December 31st, 1890. Month. No. of Vessels in which Alterations have been made. Ventilation. Water Tanks. Lighting, heating, cleansing. &c. Total No. of Alterations. July - 20 9 4 13 26 August 25 13 4 11 28 September - 14 3 1 11 15 October 14 5 2 7 14 November - 7 2 2 3 7 December - 12 3 — 10 13 Total - 92 35 13 55 103 APPENDIX F. * Alterations ordered, but not yet carried out, from June 30th to December 31st, 1890. Month. No. of Vessels in which Alterations have been ordered. Ventilation. Water Tanks. Lighting, heating, cleansing, &c. Total No. of Alterations. July - 8 5 1 4 10 August 5 1 — 4 5 September - 13 5 3 10 18 October 19 3 7 11 21 November - 24 7 5 19 31 December - 15 5 — 15 20 Total - 84 26 16 63 105 F 2 APPENDIX G. • Cases of Infectious Disease in thk Port of London, from 30th June to 31st December, 1890. Date. Name of Vessel. Description. Official No. Owners or Brokers. Where lying. Disease. Source of Infection. Where case removed to. 1890. July 3 [.ady - Hulk Thames Church Mission, 31, New Bridge Street. Lock, Regent's Canal - Scarlet Fever (2) (?) Met. Asy. Hospital, Homerton » 6 Worcester Thames Nautical Training College Greenhithe - - - Measles - Previous cases Port Sanitary „ 10 H.M.S. Beatrice - Sail Her Majesty's Customs Gravesend - - Enteric Fever - (?) ±JLU£> U1 bill Ditto „ 16 Worcester Thames Nautical Training College Greenhithe - Measles (9 cases) Previous cases Ditto Aug. 11 Carnegie Sail 70,323 Tomlinson, Hodgett & Co., 8, Drury Lane, Liverpool. S. West India Dock Scarlet Fever - Westmoreland Ditto „ 13 Lady Olive - Str. 77,399 British and Irish Steam Packet Co. River - - - - Erysipelas (?) London Hospital, on the 8th „ 16 Clyde - Str. 84,345 P. and O. Stm. Nav. Co. - Royal Albert Dock Chicken-pox (?) Bombay - Port Sanitary Hospital „ 20 Guadiana Str. F rench Messageries Maritimes de France. Ditto Small-pox Marseilles Met. Asylums Hospital „ 21 Clan Macintosh Str. 87,690 Cayzer, Irvine & Co. Tilbury Dock Enteric Fever - Calcutta Port Sanitary Hospital July 19 Canvey Island — — — Erysipelas (?) Isolated at residence Aug. 6 Ditto — — — — Measles - Poplar - Ditto !) )' Ditto — — — — Ditto - Ditto - Ditto „ 15 Ditto — — — — Erysipelas Previous case Ditto » 24 Ditto — — — — Measles - Previous case Ditto oa to APPENDIX G.—continued. Date. Name of Vessel. Description. Official No. Owners or Brokers. Where lying. Disease. Source of Infection. Where case removed to. 1890. Aug. 28 Canvey Island — — — — Measles - Previous cases Isolated at residence » »> Ditto — — — — Ditto - Ditto - Ditto Sept. 13 Rewa - Str. 85,946 Gray, Dawes & Co. - Gravesend and Royal Albert Dock. Variola (?) (?) Port Sanitary Hospital „ 15 Ditto - - - Str. Ditto Ditto Royal Albert Dock Chicken-pox (?) Branch Seamen's Hospital, Royal Albert Dock „ 16 Ditto - - - Str. Ditto Ditto Ditto Ditto (?) Ditto „ 23 Royal Albert Dock (Cons table's Co ttage), S. side Enteric Fever - (?) Met Asy.Hospital, Homerton „ 27 Ethiopia Str. 68,120 Gray, Dawes & Co. - Koyal Albert Dock Chicken-pox (see s.s. Rewa) Port Sanitary Hospital „ 29 Ocainpo Str. 85,020 Gellatly, Hankey, Sewell & Co. Gravesend and Deptford Small pox Buenos Ayres Ditto Oct. 1 Chyebassa Str. 71,686 Gray, Dawes & Co. - Royal Albert Dock Enteric Fever (2) Calcutta Convalescent on arrival „ 16 Canvey Island — — — Measles (4) Previous cases Isolated „ 20 Ditto — — — — Ditto (2) Above cases - Ditto Nov. 19 Erymanthe - Str. French Messageries Maritimes de o France Hoy a: Albert Dock Small Pox Marseilles Metropolitan Asylums Hospital „ 13 Cornwall Reformatory Ship - Purfleet Enteric Fever - (?) Ships' Infirmary on shore „ 29 W orcester - Thames Nautical Training College - Greenhithe - Diphtheria (?) (?) Port Sanitary Hospital Dec. 3 Clan Buchanan Str. 85,927 Cayzer, Irvine and Co. Tilbury Erysipelas Calcutta Drowned at sea 03 05 APPENDIX G.—continued. Date. Name of Yessel. Description. Official No. Owners or Brokers. Where lying. Disease. Source of Infection. Where case removed to. 1890. Dec. 8 Worcester - Thames Nautical Training College - Greenhithe - Mumps - (?) Fort Sanitary Hospital „ 10 Ditto Di tto Ditto Ditto - Ditto - (?) - Ditto „ 19 Florence Sail 18,753 E. Bannister, Gravesend - Gravesend - Measles - Grimsby Ditto „ 27 Shaftesbury - Training Ship London School Board Grays - Typhoid Fever (?) Ships' Infirmary on shore „ 24 Canvey Island Brick House Cottage, No. 2 - — Measles - Southend Isolated at residence 00 APPENDIX H. Condemned Meat, &c., fbom June 30th to December 31st, 1890. Date. Ship's Name. Official Number. Where lying. Where from. Amount condemned. 1890. July 1 Turakina - 60,352 West India Dock New Zealand - 31 carcases and 124 pieces mutton, 1 quarter beef, 1 piece beef 1 " Canterbury 68,106 East India Dock Ditto 25 carcases and 31 pieces mutton, 4 oxtails. „ 2 - Oamaru - 71,682 Victoria Dock - Ditto 2 half-carcases and 1 piece mutton. » 1 " Orient 82,254 Tilbury Australia - 3 carcases, 10 parts, and 2 legs mutton. „ 16 - Albano 29,316 ( Mill wall Dock, j — 333 packages fish, and 20 packages caviare. » 16 Thurso 65,230 j " Z " warehouse | — 229 packages fish. „ 17 - Lusitania - 65,888 Tilbury Sydney - Half-carcase, 1 leg, and part loin mutton. „ 24 - Maori 62,401 Albert Dock - New Zealand - 2 pieces mutton. August 8 Aorangi - 76,068 Ditto Ditto 38 carcases, 2 pieces mutton, 1 carcase lamb. 9 - Morayshire 97,607 Ditto Ditto 21 cases lemons and limes. 27 - Coptic 84,164 Ditto Ditto 2 carcases, 11 pieces, and 1 haunch mutton. September 5 Maori King 96,689 Ditto Ditto 35 carcases mutton. „ 13 - j Morayshire 97,607 Ditto Ditto 748 carcases and 563 pieces mutton. OS Oi APPENDIX H.—continued. Date. Ship's Name. Official Number. "Where lying. Where from. Amount condemned. 1890. September 22 Victoria Dock, No. 12 shed, ex s.s. " Denmark," New York 678 tins meat. 27 - Ruapehu - 76,069 Albert Dock - New Zealand - 2 pieces mutton, 1 case kidneys. » 3 - Rimutaka - 89,652 Ditto Ditto 4 pieces mutton. 3 - Oceana 93,170 Ditto Sydney 6 cases oranges. October 2 Tamise F rench In barge - — 25 tons onions (in barge at Fresh Wharf). 13 - Tainui 90,001 Albert Dock - New Zealand - 2 carcases, 3 pieces, and 5 legs mutton, .1 piece beef. November 5 Kaikoura - 89,627 Ditto Ditto 43 carcases and 6 pieces mutton. 17 - Lady Jocelyn - 11,923 Ditto Ditto 28 carcases and 34 pieces mutton. 18 - V ulcan German River ( Wreck )- Greece 25,000 cases currants. December 27 A rawa 89,953 Albert Dock - New Zealand - 6 carcases and 19 pieces mutton, 2 sides veal, 2 cases kidneys. OS at 37 APPENDIX I. REGULATIONS made by the Port Sanitary Authority for the Port of London [pursuant to the Public Health Act, 1875, Section 125], and approved by the Local Government Board, for the removal to Hospital of persons brought within the Port by any Ship or Boat who are infected with a dangerous Infectious Disorder. 1. In these Regulations the expression " The Port Sanitary Authority " means the Mayor, Aldermen, and Commons of the City of London, acting as the Port Sanitary Authority of the Port of London ; the expression " Dangerous infectious disorder" means any one of the following diseases : — Diphtheria, Erysipelas, Measles, Scarlatina, Small-Pox, Typhoid or Enteric Fever, Typhus Fever. The expression " Ship" includes a boat, and the expression " Medical Officer of Health" includes any legally-qualified Medical Practitioner acting for such Officer and any assistant to the Medical Officer of Health. 2. These Regulations shall remain in force until they are revoked by the Port Sanitary Authority, or until fresh Regulations, under Section 125 of the Public Health Act, 1875, are made by the Port Sanitary Authority and approved of by the Local Government Board. 3. Every master or other person having charge of a ship arriving in the Port of London, with any person on board, whether a passenger or belonging to the ship's crew, suffering from a dangerous infectious disorder, shall stop on arrival off the Custom House at Gravesend, and forthwith send notice to the Medical Officer of the Port Sanitary Authority stationed at Gravesend, that there is a person on board suffering from such a disorder. 4. The Master or other person in charge of the ship shall cause her to remain off the Custom House until the Medical Officer of Health has boarded her. 5. The Medical Officer of Health to whom notice is given as aforesaid, shall as soon as practicable visit the ship, and ascertain whether the person referred to in the notice is suffering from a dangerous infectious disorder, and if in the opinion of the Medical Officer of Health he is, and can properly be removed, and proper accommodation can be provided for him in the Hospital of the Port Sanitary Authority at Gravesend, or in some other hospital to which the Port Sanitary Authority are entitled to remove patients, the master or other person having charge of the ship shall forthwith cause such person to be removed to such hospital according to the directions of the Medical Officer of Health. G 38 6. If any dangerous infectious disorder shall break out on board any ship arriving in the Port of London, and after she has passed Gravesend, the master or other person having charge of such ship shall give notice to the Medical Officer of Health of the Port Sanitary Authority, at his Office at Greenwich, that there is on board a person suffering from such a disorder, and if, upon examination, the Medical Officer of Health shall find that he is so suffering, the master or other person in charge of such ship shall forthwith cause such person to be removed to a hospital to which the Port Sanitary Authority are entitled to remove patients, as directed by the Medical Officer of Health. 7. Any master or other person having charge of a ship arriving in the Port of London, and failing to perform any duty imposed on him by these Regulations, shall be liable to a penalty not exceeding Forty Shillings. Guildhall, July 10th, 1890. HY. HOMEWOOD CRAWFORD, City Solicitor. Approved of by the Local Government Board this nineteenth day of July, 1890. HUGH OWEN, CHAS. T. RITCHIE, Secretary. President. 39 APPENDIX J. 25,963 (28th August, 1890.) Cholera Regulations : Ports. (General.) Do all Port Sanitary Authorities ;— To all other Sanitary Authorities as herein defined;— To the Queen's Harbour Masters of Dockyard Ports;— To all Officers of Customs;— To all Medical Officers of Health of the Sanitary Authorities aforesaid;— To all Masters of Ships;— To all Pilots;— And to all others whom it may concern. WHEREAS We, the Local Government Board, are empowered by Section 130 of the Public Health Act, 1875, from time to tune, to make, alter, and revoke such Regulations as to us may seem fit, with a view to the treatment of persons affected with Cholera, and preventing the spread of Cholera, as well on the seas, rivers, and waters of the United Kingdom, and on the high seas within three miles of the coasts thereof, as on land; and may declare by what Authority or Authorities such Regulations shall be enforced and executed ; And whereas by Section 2 of the Public Health Act, 1889, it is enacted that Regulations of the Local Government Board made in relation to Cholera and Choleraic Diarrhoea, in pursuance of Section 130 of the Public Health Act, 1875, may provide for such Regulations being enforced and executed by the Officers of Customs, as well as by other Authorities and Officers, and without prejudice to the generality of the powers conferred by the said Section, may provide for the detention of vessels and of persons on board vessels, and for the duties to be performed by Pilots, Masters of Vessels, and other persons on board vessels ; provided that the Regulations, so far as they apply to the Officers of Customs, shall be subject to the consent of the Commissioners of her Majesty's Customs ; g 2 40 And whereas by certain Orders dated the 12th day of July, 1883, and an Order dated the 21st day of April, 1884, We prescribed Rules and Regulations with a view to the treatment of persons affected with Cholera, and for preventing the spread of the disease, and it is expedient that such Orders should be revoked, and that further Regulations should be prescribed as herein-after mentioned, to which the Commissioners of Her Majesty's Customs have signified their consent so far as such Regulations apply to the Officers of Customs : NOW THEREFORE, We, the Local Government Board, do hereby revoke the aforesaid Orders, except in so far as they may apply to any proceedings now pending, and We do, by this Our Order, and in exercise of the power conferred on Us by the Public Health Act, 1875, as amended and extended by the Public Health Act, 1889, and every other power enabling Us in that behalf, make the following Regulations, and Declare that they shall be enforced and executed by the Authorities herein-after named Definitions. Art. 1.—In this Order— The term " Ship " includes vessel or boat; The term "Officer of Customs " includes any person acting under the authority of the Commissioners of Her Majesty's Customs ; The term "Master " includes the officer, pilot, or other person for the time being in charge or command of the ship ; The term "Cholera " includes Choleraic Diarrhoea; The term "Sanitary Authority" means every Port Sanitary Authority and every Urban or Rural Sanitary Authority whose district includes or abuts on any part of a customs port, 'which part is not within the jurisdiction of a Port Sanitary Authority; The term "Medical Officer of Health" includes any duly qualified Medical Practitioner appointed by a Sanitary Authority to act in the execution of this Order; For the purposes of this Order,— (1.) So much of a customs port abutting on an Urban or Rural Sanitary District ns is nearer to such District than to any other, and is not included within the jurisdiction of any Port Sanitary Authority, shall be deemed to be within such District; (2.) Every ship shall be deemed infected with Cholera, in which there is or has been during the voyage or during the stay of such ship in a port in the course of such voyage, any case of Cholera. I.—Regulations as to Detention by Officers of Customs. Art. 2.—If any Officer of Customs, on the arrival of any ship, ascertain from the Master of such ship or otherwise, or have reason to suspect that the ship is infected with 41 Cholera, he shall detain such ship, and order the Master forthwith to moor or anchor the same in such position as such Officer of Customs shall direct ; and thereupon the Master shall forthwith moor or anchor the ship accordingly. Art. 3.—Whilst such ship shall be so detained, no person shall leave the same. Art. 4.—The Officer of Customs detaining any ship as aforesaid shall forthwith give notice thereof, and of the cause of such detention, to the Sanitary Authority of the place to which the ship shall be bound, or where the ship shall be about to call. Art. 5.—Such detention by the Officer of Customs shall cease as soon as the ship shall have been duly visited and examined by the Medical Officer of Health ; or, if the ship shall, upon such examination, be found to be infected with Cholera, as soon as the same shall be moored or anchored in pursuance of Article 10 of this Order. Provided, that if the examination be not commenced within twelve hours after notice given as aforesaid, the ship shall, on the expiration of the said twelve hours, be released from detention. II.—Regulations as to Sanitary Authorities. Art. 6.—Every Port Sanitary Authority and every other Sanitary Authority within whose district persons are likely to be landed from any ship coming foreign shall, as speedily as practicable, with the approval of the Chief Officer of Customs of the port, fix some place where any ship may be moored, or anchored, for the purpose of Article 10; and shall make provision for the reception of Cholera patients and persons suffering from illness removed under Articles 13 and 14. The place to be fixed as aforesaid, where any ship may be moored or anchored for the purpose of Article 10, shall be some place within the jurisdiction or district of the Sanitary Authority, unless the Local Government Board otherwise consent; in which case the place so fixed shall, for the purposes of this Order, be deemed to be within such jurisdiction or district. Provided that in the case of any Dockyard Port for which a Queen's Harbour Master has been appointed the place where any ship shall be moored or anchored for the purpose of this Article shall from time to time be fixed by the Port Sanitary Authority with the approval of the Queen's Harbour Master instead of with that of the Chief Officer of Customs of the Port. Provided also, that where, in pursuance of any of the above-cited Orders, places have been duly fixed for the mooring or anchoring of ships for the like purpose, such places shall be deemed to have been so fixed in pursuance of this Order. Art. 7.—The Sanitary Authority, on notice being given to them by an Officer of Customs, under this Order, shall forthwith cause the ship in regard to which such notice shall have been given, to be visited and examined by their Medical Officer of Health for the purpose of ascertaining whether she is infected with Cholera. Art. 8.—The Medical Officer of Health, if he have reason to believe that any ship coming or being within the jurisdiction or district of the Sanitary Authority, whether examined by the Offier of Customs or not, is infected with Cholera, shall, or if she have 42 come from a place infected with Cholera, may, visit and examine such ship, for the purpose of ascertaining whether she is so infected ; and the Master of such ship shall permit the same to be so visited and examined. Art. 9.—If the Medical Officer of Health on making such examination as aforesaid (whether under Article 7 or under Article 8), shall be of opinion that the ship is infected, he shall forthwith give a certificate in duplicate in the following Form, or to the like effect, and shall deliver one copy to the Master, and retain the other copy or transmit it to the Sanitary Authority. He shall also give to the Local Government Board information as to the arrival of the ship, and such other particulars as that Board may require. Certificate. _day of._189 . Sanitary Authority of I hereby certify that I have examined the ship of , now lying in the Port of [or detained at ] and that I find that she is infected with Cholera. Medical Officer of Health [or Medical Practitioner appointed by the Sanitary Authority.] Art. 10.—The Master of any ship so certified to be infected with Cholera shall thereupon moor or anchor her at the place fixed for that purpose under Article 6, and she shall remain there until the requirements of this Order have been duly fulfilled. Art. 11.—No person shall leave any such ship until the examination herein-after mentioned shall have been made. Art. 12.—The Medical Officer of Health shall, as soon as possible after any such ship has been certified to be infected with Cholera, examine every person on board the same, and in the case of any person suffering from Cholera or from any illness which the Medical Officer of Health suspects may prove to be Cholera, shall certify accordingly; and any person who shall not be so certified by him shall be permitted to land immediately on giving to the Medical Officer of Health his name and place of destination, stating, where practicable, his address at such place. The name and address of any such person shall forthwith be given by the Medical Officer of Health to the Clerk to the Sanitary Authority, and such Clerk shall thereupon transmit the same to the Local Authority of the District in which the place of destination of such person is situate. In this Article the term "Local Authority" means any Urban or Rural Sanitary Authority; and in the Administrative County of London, the Commissioners of Sewers, the Yestry under the Metropolis Management Act, 1855, of a Parish in Schedule A., and the District Board of a District in Schedule B. to that Act, as amended by the Metropolis Management Amendment Act, 1885, and the Metropolis Management (Battersea and Westminster; Act, 1887, and the Woolwich Local Board of Health. 43 Art. 13.—Every person certified by the Medical Officer of Health to be suffering from Cholera shall be removed, if his condition admit of it, to some hospital or other suitable place appointed for that purpose by the Sanitary Authority; and no person so removed shall leave such hospital or place until the Medical Officer of Health shall have certified that such person is free from the said disease. If any person suffering from Cholera cannot be removed, the ship shall remain subject, for the purposes of this Order, to the control of the Medical Officer of Health; and the infected person shall not be removed from or leave the ship, except with the consent in writing of the Medical Officer of Health. Art. 14.—Any person certified by the Medical Officer of Health to be suffering from any illness which such Officer suspects may prove to be Cholera, may either be detained on board the ship for any period not exceeding two days, or be taken to some hospital or other suitable place appointed for that purpose by the Sanitary Authority, and detained there, for a like period, in order that it may be ascertained whether the illness is or is not Cholera. Any such person who, while so detained, shall be certified by the Medical Officer of Health to be suffering from Cholera, shall be dealt with as provided by Article 13 of this Order. Art. 15.—The Medical Officer of Health shall, in the case of every ship certified to be infected, give directions, and take such steps as may appear to him to be necessary, for preventing the spread of infection, and the Master of the said ship shall forthwith carry into execution such directions as shall be so given to him. Art. 16.—In the event of any death from Cholera taking place on board such ship while detained under Article 10, the Master shall, as directed by the Sanitary Authority or the Medical Officer of Health, either cause the dead body to be taken out to sea, and committed to the deep, properly loaded to prevent its rising, or shall deliver it into the charge of the said Authority for interment; and the Authority shall thereupon have the same interred. Art. 17.—The Master shall cause any articles that may have been soiled with Cholera -discharges to be destroyed, and the clothing and bedding and other articles of personal use likely to retain infection which have been used by any person who may have suffered from Cholera on board such ship, or who, having left such ship, shall have suffered from Cholera during the stay of such ship in any Port, to be disinfected or (if necessary) destroyed; and if the Master shall have neglected to do so before the ship arrives in port, he shall forthwith, upon the direction of the Sanitary Authority or the Medical Officer of Health, cause the same to be disinfected or destroyed, as the case may require; and if the said Master neglect to comply with such direction within a reasonable time, the Authority shall cause the same to be carried into execution. Art. 18.—The Master shall cause the ship to be disinfected, and every article therein, other than those last described, which may probably be infected with Cholera, to be disinfected or destroyed, according to the directions of the Medical Officer of Health. 44 III.—Flag to be hoisted by Ships infected with Cholera. Art. 19.—The Master of every ship infected with Cholera shall, when within three miles of the coast of any part of England or Wales, cause to be hoisted the Commercial Code Signal Q, being a yellow flag, under the National Ensign, and shall keep the same displayed during the whole of the time between sunrise and sunset. Given under the Seal of Office of the Local Government Board, this Twenty-eighth day of August, in the year One thousand eight hundred and ninety. HUGH OWEN, CHAS. T. RITCHIE, President. Secretary. Notice.— The Public Health Act, 1875, provides by Section 130 that any person wilfully neglecting, or refusing to obey or carry out, or obstructing the execution of any regulation made under that Section, shall be liable to a penalty not exceeding Fifty Pounds. Date of publication in the London Gazette, 29th August, 1890. Charles Skipper and East, Printers. St. Dunstan's Hill, E.C.