PLON 13 REPORT, For the Year ended 31st December, 1907, of the MEDICAL OFFICER OF HEALTH for the PORT OF LONDON. by HERBERT WILLIAMS, M.D., M.D. (State Medicine), London University, M.R.C.S.Eng., L.R.C.P.Lond., D.P.H.Camb., medical officer of health, port of london, medical inspector for purposes of the aliens act, 1905, port of london, fellow and member of council, royal sanitary institute, fellow of the incorporated society of medical officers of health, fellow of the royal geographical society. LONDON: Printed by Charles Skipper & East, 49, Great Tower Street, E.C. 1908. Bell, Mayor. A Common Council holden in the Chamber of the Guildhall of the City of London, on Thursday, the 9th day of April, 1908, THE Port of London Sanitary Committee did this day deliver into tins Court a Report in writing under their hands, of their proceedings, and submitting the Annual Report of the Medical Officer of Health of the Port to the 31st December, 1907; 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. Ordered, That the Report be printed, and a copy sent to every Member of this Court. BELL. 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 powers assigned to the Corporation, as the Port Sanitary Authority of the Port of London, by the Local Government Board, under the Public Health (London) Act, 1891, beg to submit for the information of your Honourable Court the Annual Report of Dr. Herbert Williams, the Medical Officer of Health for the Port of London, for the year ended the 31st December, 1907, which Report contains a full and detailed account of the work carried out in the Port during that period by the Medical Officers and Inspectors. The Report also gives details respecting the various cases of Infectious Disease dealt with during the past year, and particulars with regard to small outbreaks of Scarlet Fever on two of the Training Ships, and certain recommendations made by your Medical Officer of Health for dealing with outbreaks of Infectious diseases in institutions of that description. An abstract is also given of the Regulations issued by the Local Government Board with a view to the prevention of the introduction of Cholera, Yellow Fever, and Plague into this country. A short account is given of the procedure necessary for carrying out these Regulations, and, with the exception of an adequate floating disinfecting plant, it is satisfactory to note that the Medical Officer reports that the Authority is possessed of everything necessary for complying with these Regulations, Attention is drawn by the Medical Officer in his Report to the unsatisfactory accommodation provided on new vessels, and a recommendation is made that crew's quarters should not be approved until they have been inspected and found to be satisfactory from a sanitary point of view, after they are fitted up and ready for occupation. The Public Health Regulations as to Food Bill became law during the past year, and the Local Government Board are making Regulations under this Act, which will increase the responsibility and work of the Port Sanitary Authority with regard to the inspection of Imported Food Stuffs, and will, in all probability, necessitate an increase in the staff of Inspectors. The Medical Officer of Health continues to carry out the duties of Medical Inspector, under the Aliens Act, 1905, for the Port of London, and particulars are given of the results of the working of the Act during the year. The condition of the water of the River Thames is dealt with at some length, and an account is given of the action taken by your Committee in opposing a Bill, introduced into the House of Lords by the Southendon-Sea Corporation, which would have legalized the discharge of a much larger amount of crude sewage into the Thames Estuary than heretofore. Particulars are set out of an Enquiry, neld at the Guildhall, in reference to an application made to the Local Government Board for the extension of further sections of the Public Health (London) Act, 1891, which, if granted, will enable your Committee to deal with various sanitary matters within the area of the dock gates. The results of the Medical and Sanitary Inspection of Vessels are also given in the Report, and a special report is made, as usual, on the working of the Canal Boats Act and Regulations. Particulars as to the administration and cost of maintenance of patients at the Hospital at Denton are also set out. In accordance with the Order of your Honourable Court, an Account of Receipts and Expenditure in connection with the Port of London Sanitary Authority for the year ended the 31st December last is appended for the information of the Court. All which we submit to the judgment of this Honourable Court. Dated this seventh day of April, 1908. Benj. Turner. James Lake. Horace S. Dove. J. Banks Pittman. W. H. Williamson. Tyson Crawford. Walter Dennis. J. R. W. Luck. J. Tollworthy. David Haydon. Chas. M. Wither. W. Hurst Brown. W. W. Green. J. J. Baddeley. E. H. Haywood. W. J. B. Tippetts. J. R. Pakeman. S. Alderton. OFFICES of the Port of London Sanitary Authority and Medical Officer of health at 51, KING WILLIAM STREET, GREENWICH, S.E. Telegraphic Address "MEDOFF," LONDON. Telephone No. 36 DEPTFORD. BOARDING STATIONS. RIVER THAMES Hulk " Hygeia," Gravesend. RIVER MEDWAY Garrison Point, Sheerness. INFECTIOUS HOSPITAL at DENTON, near GRAVESEND. Telephone No. 957 GRAVESEND. POET OF LONDON SANITARY COMMITTEE. Mr. Horace Spencer Dove, F.A.I., Coleman Street, Chairman. ALDERMEN. Sir Henry Edmund Knight, Knt. Sir Joseph Renals, Bart. Sir Horatio Davies, K.C.M.G. Sir Walter Vaughan Morgan, Bart. Sir Thomas Vezey Strong, Knt. David Burnett, Esq. COMMONERS. Mr. David Haydon Aldersgate. Pearse Morrison, Esq., Deputy Aldgate. Mr. James Banks Pittman Bassishaw. Thomas Hastings Miller, Esq. Billingsgate. Daniel Greenaway, Esq., Deputy Bisho sgate Mr. James Tollworthy Mr. Charles Cheers Wakefield, Sheriff Bread Street. William Henry Williamson, Esq. Bridge. Mr. William Hurst Brown Broad Street. Mr. Walter Dennis Candlewick. Mr. Charles McCaig Wither Castle Baynard. Mr. William Henry Thomas Cheap. Mr. Edward Hughes Cordwainer. Mr. Thomas Goldney Cornhill. Sir Robert Hargreaves Rogers, Knt., Deputy Cripplegate Within. Mr. James Lake Cripplegate Without. Mr. Edward Holroyde Haywood Dowgate. Mr. Tyson Crawford N.S. Farringdon Within. Mr. Cuthbert Wilfrid Whitaker, B.A. S.S. Farringdon Within. Benjamin Turner, Esq., Deputy N.S. Farringdon Without. Mr. Samuel Alderton S.S. Farringdon Without. Mr. John Layton Langbourn. Mr. Henry Edwin Moojen Lime Street. John Harris, Esq., J.P Portsoken. Mr. Sigismund Pollitzer Queenhithe. Mr. William Walter Green Tower. Mr. Samuel Spencer, A.I.C.E Vintry. John Richard Whitmore Luck, Esq., Deputy Walbrook. Corporation Representatives on the Thames Conservancy Board (ex-officio Members of the Committee):— Sir James Ritchie, Bart., Alderman. Sir Walter Wilkin, K.C.M.G., Alderman. William Henry Pannell, Esq., J.P., F.C.A., Mr. William Cooper. F.S.S., Deputy. John James Baddeley, Esq., J.P., Deputy. Alpheus Cleophas Morton, Esq., M.P. 4 INDEX page. Aliens Act, 1905 43-44 Beri-Beri 40 Bye-Laws—Proposed 66-68 Canal Boats Acts 79-84 Chicken-pox 37 Cholera 14 Choleraic Diarrhœa 15 Committee—List of Names 3 Continued Fever 39 Crews' Quarters 68-72 Deceased Seamen's Effects 33 Diphtheria 38 Enteric Fever 33 Erysipelas 38 Foreign Animals 52 Hospital 75-76 Infectious Disease 12-40 Ditto Compulsory Notification 39 Insanitary Barges 72 Introductory 7 Measles 36 Medical Inspection 8-9 Nuisances 58-61 Plague 16-19 Public Health (London) Act, 1891 64-68 Public Health Regulations 74-75 Regulations—Local Government Board 20-28 Relapsing Fever 38 River Thames 53-57 Sanitary Conveniences, &c. 61 Sanitary Inspection 10-11 Scarlet Fever 31-32 Scurvy 40 Shell Fish 53 Small-pox 28-31 Smoke Nuisances 59-60 Staff 6 and 78 Steam Launches 77-78 Structural Alterations 59-60 Thames, River—Condition of Water 53-57 Training Ships 76 Unsound Food 45-52 Yellow Fever 15 INDEX TO TABLES table. page. I. Medical Inspection—Gravesend 9 II. Ditto —Sheerness 9 III. Sanitary Inspection—Summary 11 IV. Infectious Disease—Summary 13 V. Cholera 14 VI. Choleraic Diarrhœa 15 VII. Plague 18 VIII. Rats destroyed—Return of 19 IX. Small-pox 31 X. Scarlet Fever 32 XI. Enteric Fever 34-35 XII. Measles 36 XIII. Chicken-pox 37 XIV. Relapsing Fever 38 XV. Erysipelas 38 XVI. Diphtheria 38 XVII. Continued Fever 39 XVIII. Beri-Beri 40 XIX. Vessels and premises disinfected 41 XX. Effects disinfected 42 XXI. Unsound Food destroyed 45 XXII. Nuisances 59 XXIII. Ditto 60 XXIV. Sanitary Works 61 XXV. Police Court Proceedings 73 XXVI. Hospital—Admissions, Discharges and Deaths 75 XXVII. Steam Launches 77 XXVIII. Ditto 78 XXIX. Canal Boats 84 Appendix. Statement of Receipts and Expenditure 85 6 STAFF. List of Officers forming the Staff of the Port of London Sanitary Authority, 31st December, 1907. Office. Name of Officer. Date of Appointment. MEDICAL OFFICER OF HEALTH Herbert Williams, M.D.Lond., M.R.C.S., L.R.C.P., D.P.H. Camb. June, 1901. ASSISTANT MEDICAL OFFICERS— Gravesend G.C.Hancock,M.R.C.S.,L.R.C.P., D.P.H.Lond. October, 1897. W. M. Willoughby, B.A., M.D., B.C., D.P.H.Camb. May, 1901. J. S. Warrack, M.A., M.D..C.M. Aberdeen, D.P.H.Camb. April, 1903. W.D.Betenson,M.R.C.S.,L.R.C.P., Lond. D.P.H. July, 1907. Sheerness E. Y. Legge, M.A., M.D., B.C., B.A.O., L.M.Dublin. (September, 1902, Temporary). GREENWICH OFFICES Clerk W. J. Albrow March, 1890. 1st Assistant E. A. Sorrell October, 1894. 2nd ditto W. C. Barham June, 1903. Junior ditto H. N. Jones June, 1903. FOOD INSPECTORS *H. Spadaccini, Cert.R.San.Inst. July, 1898. *W. Anderson, Cert.R.San.Inst. July, 1898. *T. W. Bailey, Cert.R.San.Inst. July, 1901. SANITARY INSPECTORS *W. G. Romeril, Cert.R.San.Inst. August, 1892. *A. Garland, Cert.R.San.Inst. May, 1894. *W. G. Wetjen. Cert.R.San.Inst. August, 1898. *W. W. Burr, Cert.R.San.Inst. August, 1898. *H. R. Hopkins, Cert.R.San.Inst. February, 1899. *P. R. Lambe, Cert.R.San.Inst. January, 1900. DENTON HOSPITAL— *J. H. Rolfe, Cert.R.San.Inst. September, 1901. Medical Officer G.C.Hancock,M.R.C.S.,L.R.C.P., D.P.H.Lond. July, 1901. Nurse Matron J. Hughes April, 1904. Assistant Nurse A. Taylor September, 1907. Nurse Probationer A. Barnes December, 1907. Ditto F. Cattell December, 1907. Cook E. Moon September, 1907. Maidservant H. Mayor May, 1907. Caretakers R. Adams September, 1905. E. Adams September, 1905. STEAM LAUNCHES- "David Burnett"— Master J. G. True July, 1893. Engineer G. H. Bagshaw July, 1893. Deckhand C.Boyd July, 1902. Stoker E. Coppin July, 1903. "Clotho"— Master W. Jarvis June, 1902. Engineer J. A. Hardman July, 1901. Deckhand A. G. M. Davies September, 1906. "Denton"— Master C. Strange June, 1902. Engineer G. Lane July, 1901. Deckhand P. Gadsdon December, 1907. GREENWICH MOORINGS— Watchmen W. Howell April, 1897. W.Shaw February. 1906. HULK "HYGEIA"— Shipkeeper I. Rogers April, 1893. Ditto A. Salter July, 1898. OFFICE CARETAKER F. Hudgell November, 1906. * These Inspectors possess the Special Certificate of the Royal Sanitary Institute for Inspectors of Food. 7 PORT LONDON SANITARY OFFICES, 51, KING WILLIAM STREET, GREENWICH, S.E. TO THE WORSHIPFUL THE PORT OF LONDON SANITARY COMMITTEE. Gentlemen, I have the honour to present herewith my Annual Report for the year ended 31st December, 1907, being the sixth of the series. As in former years, I have relied upon statistical tables as the most satisfactory method of illustrating the amount and progress of the work, and the results for the past year are quite satisfactory. A noticeable feature is the continued shrinkage of the number of vessels arriving in London from foreign ports. It will be seen on referring to Table I. that this reduction has been going on steadily for some years. It has to be borne in mind, however, that although the actual number has decreased, the tonnage has increased, and therefore, at present at least, the former larger number of relatively smaller vessels has given way to a smaller number of vessels of a larger type There is an apparent falling off in the number of coastwise and Inland Navigation inspections, though the number will be seen to approximate closely to the average. It is due to the fact that in 1906 there was a substantial increase owing to an extra number of this class of vessel entering the Port. The improvement in the sanitary condition of this class of vessel, referred to in my last Report, continues to be maintained, and there is no question but that there is a general waking up in this direction. 8 MEDICAL INSPECTION. The number of vessels medically inspected is not quite so large as during the previous two years. This diminution is due, of course, to the number of arrivals from ports which are infected with Cholera, Yellow Fever or Plague, being less than in former years. Gravesend.—Table I. Your Medical Officers have been called upon to investigate 9 cases of Cholera and 4 cases of Plague, either actual or suspected, which had occurred on vessels during the voyage, besides a number of cases of Small-pox and other Infectious Diseases, details of which are given elsewhere. I have again to express my thanks to the Officers of H.M. Customs for their courtesy and co-operation in carrying out the work of medical inspection on vessels arriving from foreign. Sheerness.—Table II. The work of medical inspection at Sheerness, carried out by Dr. Legge, shows no relaxation, and the number of vessels medically inspected on arrival off Garrison Point Fort is again larger than during preceding years, and above the average. The total number of vessels inspected was 376. A Notice Board, pointing out the Boarding Station for the Port of London and Rochester, has been erected on Garrison Point Fort, Sheerness, and is clearly visible from the sea. Masters of incoming vessels, bound up the Medway in the daytime, will no longer be able to plead ignorance as to the whereabouts of the boarding station. 9 TABLE I. MEDICAL INSPECTION—GRAVESEND. From 1st January to 31st December, 1907. Jan.. Feb. March April May June July Aug. Sept. Oct. Nov. Dec. Total. Number of foreign arrivals 744 687 819 804 825 801 854 823 808 870 814 790 9,639 Number medically inspected 210 198 236 226 239 240 212 210 234 255 224 216 2,700 Number of passengers 1,063 1,001 1,186 1,341 2,271 2,861 2,317 2,184 1,351 1,705 1,210 926 19,416 Number of crew 5,267 4,315 6,224 5,939 6,024 4,427 4,564 4,410 4,967 5,002 5,211 5,901 62,251 COMPARATIVE TABLE. GRAVESEND. 1898. 1899. 1900. 1901. 1902. 1903. 1904. 1905. 1906. Mean annual number for the 10 years ending 31st December, 1907. 1907. Number of foreign arrivals 10,332 10,297 10,394 10,521 10,520 10,711 10,030 9,962 9,955 10,236.1 9,639 Number of vessels medically inspected 1,096 1,276 1,256 1,080 1,668 2,522 2,559 2,813 2,853 1,984.3 2,700 Total number medically inspected at Gravesend— From August, 1892, to December, 1906 29,068 „ 1st January to 3l3t December, 1907 2,700 Total 31,768 TABLE II. MEDICAL INSPECTION—SHEERNESS. From 1st January to 31st December, 1907. Jan. Feb. March April May June July Aug. Sept. Oct. Nov. Dec. Total. Number of foreign arrivals 21 19 29 29 37 41 49 39 33 35 23 21 376 Number medically inspected 15 15 24 26 34 37 40 31 31 33 22 17 325 Number of passengers — 33 4 2 6 12 14 9 — 4 1 1 86 Number of crew 169 198 213 257 391 411 447 342 320 365 262 176 3,551 COMPARATIVE TABLE. SHEERNESS. 1898. 1899. 1900. 1901. 1902. 1903. 11904., 1905. 1906. Mean annual number for the 10 years ending 81st December, 1907. 1907. Number of arrivals 360 309 374 330 387 402 344 349 375 360.6 376 Number of vessels medically inspected 265 263 243 212 244 342 308 292 320 281.4 325 Total number medically inspected at Sheerness— From 1st September, 1894, to 31st December, 1906 3,635 „ 1st January to 31st December, 1907 325 Total 3,960 10 SANITARY INSPECTION. Table III. The total number of visits of inspection during the year was 37,385. This compares very favourably with previous years, and shows that the work in this direction is still being carried out with efficiency. Of this number, 17,971 inspections were of vessels arriving from foreign ports, and 19,414 were coastwise vessels, barges, canal boats and other inspections, including 1,716 visits paid to premises on land. The inspection of vessels lying in the River aggregated 15,766, or nearly one-half of the total number of inspections of vessels, and 14,819 of these visits were made in the steam launches. The Tilbury Dock stands next with 2,487 inspections, followed by the Millwall Dock with 2,225, then the Royal Albert, West India, Commercial, Victoria and London Docks, in order of number. Of the nationality of vessels arriving from foreign ports, the larger portion were, as usual, British, being 59.57 per cent. of the total. Swedish and Norwegian came next with 12.87 per cent., and then in the following order:—German, Dutch, Belgian, Danish, Russian, French and Spanish, and other nationalities in decreasing proportion. Of the total number, the crew's quarters on 3,019 vessels were found to be in a dirty condition, requiring immediate cleansing, which was carried out as usual under the personal supervision of your Inspectors. The barges which supply the drinking water to vessels, and are known as water barges, have been kept under careful supervision. There are 21 of these now working in the Port, and at the time of each inspection were found to be clean and in good order. 11 TABLE III COMPARATIVE TABLE. Total number of Inspections of vessels from— 1898. 1899. 1900. 1901. 1902. 1903. 1904. 1905. 1906. Yearly average for .the 10 years ending 31st December, 1907. 1907. "Foreign" 14,299 14,564 14,966 16,844 16,336 15,989 15,685 14,279 13,013 15,394.6 17,971 "Coastwise," "Inland Navigation," and other Inspections 17,359 19,052 15,839 15,231 17,270 19,496 19,700 19,975 22,335 18,567.1 19,414 Total 31,658 33,616 30,805 32,075 33,606 35,485 35,385 34,254 35,348 33,961.7 37,385 General Summary, and Analysis, of the Sanitary Inspection of Vessels, &c., in the Port of London, for the year ending 31st December, 1907. FOREIGN. Coastwise. Inland Navigation. Shore Premises. Sick Seamen referred to Hospital. Water Barges. Steam. Sail. Steam. Sail. Steam. Sail. Lighters (uninhabited). Canal Boats. Inspected. Defective. To be Cleaned. Inspected. Defective. To be Cleaned. Inspected. Defective. To be Cleaned. Inspected. Defective. To be Cleaned. Inspected. Defective. | To be Cleaned. Inspected. Defective. To be Cleaned. Inspected. Defective. To be Cleaned. Inspected. Defective. To be Cleaned. | Inspected. Defective. To be Cleaned. No. in District in good condition, 31st December, 1906. New Barges Condemned. Old Barges Refitted. No. in District 31st December, 1907. 11923 151 1570 2150 24 242 2976 55 267 949 24 165 967 6 46 13168 113 521 2130 8 166 1433 75 42 1689 75 317 — 20 — l 21 Total Inspections to 31st December, 1906 791,074 Docks and River. No. Nationality. Arrived from Foreign Ports. No. of inspections. Arrivals, Percent. of Total St. Katharine's 829 American 6 11 .06 Total Inspections from 1st January to 31st December, 1907 London 1,713 Argentine — 1† - "Foreign" 14,073 Regent's Canal 709 Austrian 20 21 .20 "Coastwise" 3,925 "Inland Navigation" 17,698 Millwall 2,225 Belgian 367 367 3.80 West India 2,021 British 5,742 12,708† 59.57 Premises. on shore 1,689 37,385 Poplar 312 Danish 236 363 2.44 East India 451 Dutch 595 635 6.17 Total - 828,459 Victoria 1,868 Finnish 26 29 .26 Cleansing of Crew's Quarters, &c.:— Royal Albert 2,102 French 172 267 1.78 Total to 31st December, 1906 49,363 Commercial 1,928 German 869 1,194 9.01 Total No. of Vessels from 1st January to 31st December, 1907 3,019 Tilbury 2,487 Greek 3 7 .03 Gravesend District 3,258 Italian 19 27 .19 Total 52,382 River—* Upper District 5,842 Japanese 57 71 .59 Number of vessels inspected:— *Middle „ 5,169 Russian 206 375 2.13 In the Launches— "David Burnett" 4,219 *Lower „ 4,755 Spanish 80 108 .82 Medway — Swedish & 1,241 1,787 12.87 "Clotho" 5,180 Norwegian "Denton" 5,420 Total vessels 35,669 Total vessels 9,639 17,971 Total 14,819 Shore premises 1,716 † Coastwise and Inland navigation 17,698 Shore premises 1,716 In the Docks, &c. 20,850 Total 37,385 Total 37,385 99.92 Total 35,669 * Upper District extends from Limehouse to Teddington. * Middle „ „ „ Limehouse to Erith. * Lower ,, „ „ Erith to outer limits of Port of London. 12 INFECTIOUS DISEASE. Table IV. I have to report a diminution in the amount of Infectious Disease in the Port during 1907, though the total is above the average. The decrease is noticeable with regard to every description of Infectious Disease, except Cholera and Chicken-pox. There have been more cases of Cholera reported on vessels arriving from the East, but the cases only numbered nine, and seven of these were on one vessel. Twenty-seven cases of Small-pox were reported, as against 31 in the previous year, the average for the ten years being 25.0. Scarlet Fever numbered 44, as against 82 in 1906. Most of these cases occurred on training ships. There were 55 cases of Enteric Fever reported. This number is much below the average. Of Measles, 51 cases were notified, as against 68 last year. The total number of cases reported being 252, while in the preceding year the total was 336. The average for the past ten years is shown to be 221.2. Of the total number of cases reported, 75 were removed to and treated in the Port Sanitary Hospital at Denton, this number including three or four suspected cases of Plague, and a case which, on admission, showed symptoms very suspiciously like those of Cholera. I have given a few details of this case under the heading of Cholera. Other cases of infectious disease which present any points of general interest have been similarly treated under their respective headings. 13 TABLE IV. INFECTIOUS DISEASE. Disease. 1898. 1899. 1900. 1901. 1902. 1903. 1904. 1905. 1906. Mean annual number for 10 years ending 31st December, 1907. 1907. (a) Cases reported: Cholera (including suspected cases) 1 ... 1 ... 20 9 4 6 3 5.3 9 Yellow Fever (ditto) ... ... ... ... ... ... ... 1 2 0.3 ... Plague (ditto) 3 4 6 19 10 6 6 9 9 7.6 4 Small-pox 11 12 15 13 93 13 11 24 31 25.0 27 Scarlet Fever 15 5 14 27 13 11 11 26 82 24.8 44 Diphtheria 5 7 20 28 26 7 3 8 7 11.8 7 Enteric Fever 53 66 126 78 66 88 50 65 81 72.8 55 Measles 18 38 67 83 36 14 38 36 68 44.9 51 Erysipelas 3 10 2 5 2 4 1 9 7 4.5 2 Typhus Fever ... ... ... ... ... 1 ... ... ... 0.1 ... Continued Fever 1 1 2 5 2 13 12 11 11 6.9 11 Other diseases (including Chickenpox). 1 17 12 9 14 9 17 16 35 17.2 42 Total 111 160 265 267 282 175 53 211 336 221.2 252 (b) Treated in Port Sanitary Hospital: Cholera (including suspected cases) ... ... ... ... ... ... ... ... ... 0.1 1 Yellow Fever (ditto) ... ... ... ... ... ... ... ... ... ... ... Plague (ditto) 1 1 3 13 4 3 4 3 1 3.6 3 Small-pox 8 8 9 7 29 11 5 4 ... 8.9 8 Scarlet Fever 2 1 2 5 2 5 7 3 28 5.9 4 Diphtheria 2 ... 1 5 2 4 ... 2 1 2.0 3 Enteric Fever 27 23 55 37 27 55 33 23 26 33.3 27 Measles 10 7 4 5 11 7 8 13 3 8.2 14 Erysipelas 1 3 ... 1 1 1 ... 2 1 1.0 ... Typhus Fever ... ... ... ... ... ... ... ... ... ... ... Continued Fever 1 1 2 5 4 13 12 9 7 6.4 10 Other diseases (including Chicken-pox). 6 6 8 1 8 4 4 1 24 6.7 5 Total 58 50 84 79 88 103 73 60 91 76.1 75 14 CHOLERA. Table V. Cholera, as usual, existed in Indian ports, but it made its appearance in Russia in July, several towns situated on the Volga being infected. In all, 10,107 cases occurred, with 4,772 deaths. In August a few cases occurred in St. Petersburg, which necessitated a careful inspection being made of all arrivals from that and other Russian ports, and special precautions were taken to inspect the Russian immigrants arriving from the continent of Europe. It is important to recognise the advent of Cholera at St. Petersburg, and a careful watch will be kept on arrivals from Russian Baltic ports next year, for, with the advent of warm weather, the probability of the recrudescence of Cholera in European Russia during next summer cannot be unexpected, whilst the danger of the importation of that disease to this country by means of alien passengers from Russia cannot be disregarded. The s.s. "Politician" arrived on the 19th December, from Calcutta. Whilst lying there seven members of the crew were attacked with Cholera, of whom three died, and four recovered. The effects and bedding were destroyed, and the ship was disinfected there. On arrival at Gravesend, everyone was carefully examined, and there was found to be no one suffering from any symptom suspicious of Cholera. The s.s. " Clan Farquhar " arrived on the 23rd December, from Chittagong. Whilst lying in that port, a Native member of the crew was taken ill with Cholera and died. All necessary disinfection was carried out there. TABLE V. (Cholera.) Date. Name of Vessel, Port of Registry, and Official Number. Where from. Number of Cases. How dealt with. 1907. Dec. 14 s.s. "Tamba Maru," of Tokio Yokohama 1 Removed to Hospital at Moji. ” 20 s.s. "Politician," of Liverpool, 110,533 Calcutta 7 Four removed to Hospital at Calcutta. Three died, and bodies were taken ashore at Calcutta. ” 22 s.s. "Clan Farquhar," of Glasgow, 111,259. Chittagong 1 Removed to Hospital at Chittagong, and died same day. Total 9 15 CHOLERAIC DIARRHŒA. The s.s. "San Lucar," of Christiania, from Las Palmas, arrived at Gravesend on the 20th January, when a fireman was removed to the Port Sanitary Hospital at Denton suffering from severe diarrhoea, vomiting, cramps in his abdomen and limbs, and he was in a collapsed condition. The vessel left Drammen on the 22nd December. On the 25th December a fireman was taken ill with vomiting, slight diarrhoea, which lasted three days, and,then the man resumed work. On the 12th January another fireman was taken ill with similar symptoms which lasted four days. On the 16th January the fireman taken ill on the 25th December again suffered from similar symptoms, which, however, only lasted about twelve hours. On the 19th January the fireman who was subsequently removed to Denton Hospital was taken ill. The man appears to have ailed after partaking of a meal of hash made of tinned meats and potatoes, and a cup of coffee. He became much better after admission to hospital, and the improvement continued for three days, when he had a relapse, became collapsed, with vomiting, cramps, severe diarrhoea, watery stools, &c. My opinion is that the symptoms were produced by some unsound article of food, but as the symptoms were very much like those of Asiatic Cholera, a specimen of faecal matter was sent to the Local Government Board for bacteriological examination, the result being negative as regards Cholera. As a precautionary measure the vessel was disinfected and the names and addresses of the passengers taken and notified to the Medical Officers of Health of the various districts to which they were proceeding. The vessel left London on the 22nd January for the Tyne, and the facts were reported to the Medical Officer of Health" for that district. TABLE VI. (Choleraic Diarrhcea.) Date. Name of Vessel, Port of Registry, and Official Number. Where from. Number of Cases. How dealt with. 1907. Jan. 20 s.s. "San Lucar," of Christiania Las Palmas 1 Removed to Port Sanitary Hospital. Total - 1 YELLOW FEVER. Yellow Fever existed in Brazil, Rio de Janeiro, Ecuador, Mexico, Trinidad, Barbadoes, Cuba, Western Africa. No case has been reported on any vessel arriving in the Port of London during the year. 16 PLAGUE. This disease has been extremely prevalent in India during the past year. It has been estimated that the deaths up to the end of the year will probably exceed one million and a quarter. During the year a large number of ports have been, at one time or other, considered and treated as infected—amongst these are ports in the Persian Gulf, Straits Settlements, Siam, Cambodia, Chinese Ports, Japan, Formosa, Australasia, South Africa, South American ports, San Francisco, Mauritius, Northern Africa, especially Orang, Phillipville, Bona, Tunis, Egypt, and Levant ports. At Hamburg, in May, a vessel from Buenos Aires landed two cases of Plague which had developed during the voyage, and in July, a vessel from the same place also landed a case of Plague. In Glasgow there appears to have been two cases of Plague, but the infection did not spread, and it was not necessary to exercise special medical inspection of vessels arriving in London from that port. The s.s. "Clan Macalister," of Glasgow, official number 115,756, from Chittagong, arrived at Gravesend on the 17th January. On making enquiries it was ascertained that during the voyage dead rats had been found in the room where the natives' foodstuffs were stored, on the following dates :— 29th December, 1906 6 dead rats. 5th January, 1907 3 „ 11th ,, ,, 3 ,, It would appear that these were the dates on which the natives' store rooms were cleaned out, and on the 11th January the store room was fumigated with sulphur dioxide gas. One dead rat was found next day, and its death was probably due to the fumes of the gas. No dead rats were subsequently found either in the natives' store room or elsewhere, consequently no bacteriological examination was made. There seemed to be no apparent cause for the death of the rats. All persons were found to be well on arrival, and no suspicious symptom occurred during the stay of the vessel in the Port. Bearing in mind how susceptible rats are to contract Plague, it was deemed necessary to keep the vessel under strict observation during its stay in Port. The facts were reported to the Local Government Board, and the ship sailed for Dundee on the 21st January, the Medical Officer of Health of that port being duly notified. 17 The s.s. "Clan Macaulay,'' of Glasgow, official number 108,800, from Vizagapatam, arrived at Gravesend on the 10th April, when a native fireman was removed to the Port Sanitary Hospital with symptoms suspicious of Plague. The crew's effects and the ship were thoroughly disinfected, and some material from the bubo of the patient was forwarded to the Local Government Board for bacterioscopic examination. The result of the examination was negative as regards Plague, and the patient has since left the Hospital convalescent. On September 7th, while the s.s. "Swaledale," of Sunderland, Official number 114,644, was loading cargo, outward bound, in the Royal Victoria Dock, one of the engineers attended at the surgery of a local medical practitioner complaining of swellings in the groin. No apparent cause fortius was found, and being feverish, he was sent to the Branch Seamen's Hospital in the Royal Albert Dock. Subsequently, on clearing out the cabin occupied by him, a dead rat was found behind the wainscoting. In view of the possible transmission of Plague by means of rats and their parasites, this was deemed to be suspicious. I accordingly visited the Branch Seaman's Hospital, and, through the courtesy of the House Surgeon, saw the patient, and we arrived at the opinion that the man was not suffering from Plague, both on clinical and bacteriological evidence. The facts were, however, reported to the Local Government Board for their information. The s.s. "Cheshire," of Liverpool, 99,310, arrived at Gravesend on November 9th. The vessel left Rangoon on October 9th, all the crew being medically inspected before embarkation, and their clothing disinfected. On October 22nd, a Lascar complained and was found to have a bubo in his right groin. This was accompanied by fever, and on arrival at Suez on October 27th, he was landed and taken to hospital, where the diagnosis was made that the man was suffering from Plague. In order to avoid detention at Marseilles, a usual port of call, the master decided to bring the vessel straight on to London. No case of Plague having occurred within eight days of the vessel's arrival at Gravesend, the vessel was treated as "suspected" only, and on arrival all persons on board were medically inspected and found to be in good health. The names and addresses of all passengers were taken. There did not appear to have been any mortality amongst the rats, and there was no evidence that any disease existed amongst these animals, or that the patient contracted his disease from them. 18 The crew's quarters and all contents were thoroughly disinfected at Suez by steam heat and fumigation, and the vessel was allowed to enter dock. Certain precautions were taken to prevent the landing of rats, and the crew on board were medically inspected daily. The vessel left on the 16th November for Liverpool, and the facts were duly reported both to the Local Government Board and the Medical Officer of Health for Liverpool. The s.s. "City of Edinburgh" arrived at Gravesend on December 5th, from Calcutta. During the medical examination of the crew, an Indian cook was found suffering with a large bubo, accompanied with fever. There was nothing to account for this, and the man was landed at the Port Sanitary Hospital for observation, whilst the quarters and any effects likely to be infected were disinfected. Bacteriological examination showed that the man was not suffering from Plague. The s.s. "Clan Alpine" arrived on the 17th December, from Calcutta. A member of the Native crew was landed for observation, at the Port Sanitary Hospital, suffering from a bubo and fever. The crew's quarters and effects were disinfected. Bacteriological examination showed that this man was not suffering from Plague. TABLE VII. (Plague.) Date. Name of Vessel, Port of Registry and Official Number. Where from. Number of Cases. How dealt with 1907. Apl. 10 s.s. " Clan Macaulay," of Glasgow, 108,800 Vizagapatam 1 Removed to Port Sanitary Hospital. Nov. 9 s.s. " Cheshire," of Liverpool, 99,310. Rangoon 1 Removed to Hospital at Suez. Dec. 5 s.s. " City of Edinburgh," of Liverpool, 110,539. Calcutta 1 Removed to Port Sanitary Hospital. ,, 17 s.s. "Clan Alpine," of Glasgow, 111,232. Calcutta 1 Removed to Port Sanitary Hospital. Total 4 The capture and destruction of rats in the docks and on ships arriving in the Port of London from Plague-infected ports, continues to be carried out, and the results are collected by your Inspectors and recorded at the Office. This system was adopted in February, 1901, and the total number of rats recorded as destroyed up to the 31st December approximates very nearly to half a million. 19 TABLE VIII. Return of Rats caught and destroyed during 1907. The entire cost of destroying these rats has been borne by the Shipowners and Dock Companies. Jan. Feb. Mar. April. May. June. July. Aug. Sept. Oct. Nov. Dec. Totals Mill wall Dock— Warehouses 127 127 108 89 106 129 98 123 95 100 106 80 1,288 Vessels during voyage - 40 — - - 14 - 60 — 12 — — 126 „ while in dock 102 35 172 255 69 219 281 296 67 124 336 285 2,241 Surrey Commercial Dk.— Warehouses 68 74 105 87 83 105 76 118 85 115 117 100 1,133 Vessels during voyage — — 27 — 10 12 — — — — -- — 49 while in dock — 43 17 — — 21 38 — — 67 332 196 714 Regent's Canal Dock— Warehouses 18 25 26 28 27 29 24 31 13 28 29 22 300 Vessels during voyage — — — — — — — — — — — — — „ while in dock St. Katharine's Dock— Warehouses 49 62 60 58 56 62 57 64 79 50 96 69 760 Vessels during voyage — — — — — — — — — — — — — „ while in dock London Dock— Warehouses 100 98 150 148 92 174 132 177 116 74 117 102 1,480 Vessels during voyage — — — — — 50 — — — 10 — — 60 ,, while in dock — 57 — — 90 347 70 — — — 102 55 721 Albert and Victoria Dks.— Warehouses 476 475 669 529 520 590 499 649 465 482 619 572 6,545 Vessels during voyage 193 246 451 321 464 259 112 272 205 1,004 211 172 3,910 „ while in dock 401 354 337 399 624 464 502 272 297 229 420 161 4,460 West India Dock— Warehouses 148 122 - - - - - - - - - - 270 Vessels during voyage 40 95 - 10 44 52 40 — — — — — 281 „ while in dock 188 162 98 162 467 626 648 330 389 158 367 295 3,890 East India Dock— Warehouses 24 23 29 25 24 29 26 34 19 21 40 21 315 Vessels during voyage — — — — 2 — — — 12 — — — 14 „ while in dock 170 60 62 — 76 30 55 136 32 73 119 29 842 Tilbury Dock— W arehouses 298 256 315 232 253 287 202 357 154 341 227 149 3,071 Vessels during voyage 1,258 995 962 740 388 1,341 1,223 883 810 947 2,536 1,398 13,481 „ while in dock 408 594 902 604 302 571 569 512 498 318 847 740 6,865 Totals 4,068 3,943 4,490 3,685 3,697 5,411 4,652 4,314 3,336 4,153 6,621 4,446 52,816 Total from February, 1901, to 31st December, 1906 441,607 Total from 1st January to 31st December, 1907:— In Dock Warehouses 15,162 On Vessels during voyage 17,921 52,816 On Vessels while in dock 19,733 Total 494,423 20 REGULATIONS have been issued by the Local Government Board with regard to the precautions to be adopted, (1) as to ships arriving from foreign ports, (2) outward bound ships, and (3) coasting ships and specified articles, 1.—Ships arriving from Foreign Ports. These Regulations have been made in pursuance of Section 130 of the Public Health Act, 1875, as amended or extended by the Public Health (London) Act, 1891, the Public Health Act, 1896, and the Public Health Act, 1904, with a view to the treatment of persons affected with Cholera, Yellow Fever or Plague, and for preventing the spread of the disease both on land and water, and I give herewith a condensed account of the principal provisions. Part I. defines the various expressions used in the Order, the chief variation from the previous Order being the definition of ships "infected" and "suspected." An "infected" ship means a ship which at the time of its arrival from a foreign port, has on board a case of Cholera, Yellow. Fever or Plague, or which has had on board a case of Cholera or Plague within a period of seven days, or a case of Yellow Fever within a period of eighteen days prior to that time. A "suspected" ship means a ship which has had on board during the voyage, or during the stay of the ship in the port of departure, or in a port in the course of the voyage, a case of Cholera, Yellow Fever or Plague, but which has not had on board a fresh case of Cholera or Plague within a period of seven days, or of Yellow Fever within a period of eighteen days prior to the time of its arrival from a foreign port. Part II. defines the action to be adopted by Officers of Customs, who visit ships on arrival from foreign ports. They shall ascertain as far as possible, whether a ship is an "infected" ship or a "suspected" ship, or whether the ship has come from, or has during the voyage called at a port infected with Cholera, Yellow Fever or Plague. If the Officer of Customs has reason to suppose that the ship is an "infected" or "suspected" ship he shall detain the ship, and if he has reason to suppose that the ship has come from, or has during the voyage called at a port infected with Cholera, Yellow Fever or Plague, he may detain the ship, and shall order the master to moor or anchor in such a position as the Officer of Customs directs, and the Officer of Customs shall forthwith give notice of the same to the Sanitary Authority of the place in which the vessel is lying. Such detention shall cease as soon as the ship has been duly visited and examined by the Medical Officer of Health, or if such examination be not commenced within 12 hours after the ship has been moored or anchored, 21 In the previous Order an Officer of H.M. Customs had no power to detain a vessel for medical inspection if the master of such vessel had answered the questions put as to the existence of Plague, Yellow Fever or Cholera in a satisfactory manner. This provision in the recent Order will be of great service to the smaller Port Sanitary Authorities. Part III. deals with the action of Port Sanitary Authorities. In accordance with the provisions of Article VI, a mooring place has, with the approval of His Majesty's Customs, been fixed abreast of Denton Hospital in Gravesend Reach, and this also applies to such vessels as may arrive at Sheerness. Article VII. provides that the Sanitary Authority, on notice of such detention, shall forthwith cause the ship to be visited and examined by their Medical Officer of Health. Inasmuch as a Medical Officer of this Authority is always on duty at Gravesend by day and night, and accompanies the Officer of His Majesty's Customs, such notice is unnecessary, and any delay that may arise therefrom is entirely obviated. Article VIII.—The Medical Officer of Health, if he has reason to suppose that a ship lying within the Port of London is an "infected" or "suspected" ship, he shall visit and examine the ship, or if he has reason to suppose that the ship has come from, or has during the voyage called at an infected port, he may visit and examine the ship, and the master of such ship shall, on being required so to do by the Medical Officer of Health, cause the ship to be brought to, and if necessary, moored or anchored, and shall permit the ship to be so visited and examined. Article IX. provides for the issuing of the certificate in the event of the Medical Officer of Health forming the opinion that the ship is an " infected " or "suspected" ship. Article X. provides for the mooring or anchoring of "infected" or "suspected " ships. Article XI. provides that no person, other than the Officer of Customs, or person in execution of this Order, shall leave such ship when moored or anchored. Every person certified by the Medical Officer of Health on board such ship to be suffering from Cholera, Yellow Fever or Plague, shall be removed to Hospital. Article XV. provides that persons on board "infected" ships shall not be allowed to land until the Medical Officer of Health has been satisfied as to the name and intended address of such persons. Article XVI. gives the Medical Officer of Health power to take such steps as may appear to him to be necessary for preventing the spread of infection. 22 Article XVII.—In the event of a death from either of these diseases, gives the Sanitary Authority or Medical Officer of Health power to dispose of the body. Article XVIII. provides that any infected clothing or bedding, or article of personal use, may be disinfected or destroyed. Article XIX. provides for the disinfection of the infected quarters, and their contents, on board "infected" ships. Article XX. gives the Medical Officer of Health power to serve a certificate to prevent the landing from any ship which may be "suspected" or which may have come from, or has during the voyage called at an infected port, or whether the ship is one which has passengers on board in a filthy or unwholesome condition, or whether there are rats infected with plague, or in which there has been daring the voyage an unusual mortality among rats. Article XXI.—When a certificate has been given under Article XX., no person shall leave or be allowed to leave the ship unless he satisfies the Medical Officer of Health as to his name and intended address. Article XXII. provides for the pumping out of bilge water, and water ballast, in the case of vessels "infected" or "suspected" by reason of Cholera, or which has come from a port infected with that disease. Article XXIII.—If the ship is certified to be "infected," the master shall, under the direction and to the satisfaction of the Medical Officer of Health, employ suitable means for the destruction of rats on the ship. If the ship is "suspected," the master shall, if the Medical Officer of Health make a requisition to that effect, employ suitable means for the effectual destruction of the rats in the ship. If the Medical Officer of Health certifies that the destruction of rats is necessary as a precaution, the master of a ship which has come from an infected port shall employ suitable means for the effectual destruction of the rats in the ship. In the latter case, the expenses shall be borne by the Sanitary Authority. Article XXIV. provides that where the Medical Officer of Health certifies in writing that a rat in the ship is infected with Plague, the master of the ship shall employ suitable means for the effectual destruction of the rats in the ship. If the ship is an "infected" ship, or a "suspected" ship, or as come from, or during the voyage called at a port infected with Plague, or in which there are rats infected with Plague, or in which there is or has been during the voyage an unusual mortality among rats, the master shall, under the direction, and to the satisfaction of the Medical Officer of Health, take all such precautions for stopping the access of rats from the ship to the shore. 23 A handbill under this Article, as follows, has been issued to the owners of ships coming from infected ports, and one of these handbills will be placed by the Medical Officers at Gravesend, on all ships coming from ports infected with Plague. PORT OF LONDON SANITARY AUTHORITY. "The Local Government Board have issued Regulations for the "prevention of the introduction of Plague, Yellow Fever and Cholera " into this country, and whereas by such Regulations it is provided, " inter alia, as follows :— REGULATION 24 (2). " 'The master of a ship which by reason of Plague is an infected ship, " 'or a suspected ship, or which has come from, or has, during the voyage, " 'called at a port infected with Plague, or in which there are rats infected " 'with Plague, or in which there is or has been during the voyage an " 'unusual mortality among rats, shall, under the direction and to the " 'satisfaction of the Medical Officer of Health, take all such precautions " 'or employ all such means for effectually stopping the access of rats " 'from the ship to the shore as in the opinion of the Medical Officer of " 'Health are measures reasonably necessary for the prevention of danger " 'arising to public health from the ship.' "This is to give notice that, in my opinion, given under the Regulation "aforesaid, the following precautions are reasonably necessary for stopping "the access of rats from the ship to the shore :— 1. "All ropes and mooring tackle for securing the vessel either to the "shore or mooring buoys, shall be fitted with metal brushes, funnels, or "other effective guards, the portions of such ropes and mooring tackle "leading from the vessel to a distance from the vessel's side of at least "four feet shall be coated each night with fresh tar. Ropes may, if "desired, be protected by a covering of canvas or yarns before tarring. 2. "When not engaged in discharging cargo, one gangway only shall "be permitted to afford means of communication between the ship " and the shore. 3. "The end of the gangway near the ship shall be whitened for a "length of 10 feet, and the watchman shall keep the gangway pulled in "board after sunset. 4. "When alongside the quay, the ports on the side of the vessel " nearest the quay shall be kept closed after sunset. 5. "All empty cases and barrels, especially those from the store "rooms, shall be examined before being landed, to ensure that no rats "are contained therein. 24 "It is recommended that all possible means be adopted for catching "and destroying rats, both on the voyage and during the stay of the "vessel in port. Any rats so caught shall be killed, then placed in a "bucket of strong disinfecting solution, and afterwards burnt in the "ship's furnace. 7. "No rats, alive or dead, are to be removed from the ship without "my permission in writing. " 'If any person wilfully neglects or refuses to obey or carry out, or " 'obstructs the execution of this Regulation, he shall be liable to a " 'penalty not exceeding ONE HUNDRED POUNDS, and in the case "'of a continuing offence, to a further penalty not exceeding FIFTY " ' POUNDS for every day during which the offence continues.' " December 31st, 1907. HERBERT WILLIAMS, M.D. London, " Office—51, King William Street, Medical Officer of Health for the " Greenwich, Port of London. " London, S.E." Article XXV. provides for the destruction of mosquitoes and of the larvæ of mosquitoes in ships "infected" or "suspected" by reason of Yellow Fever. Article XXVI. obliges the master of a ship, or any person, to answer truly all questions put to him by any Officer of Customs or Medical Officer of Health, as are necessary for any purpose of this order. Article XXVIII. The Sanitary Authority shall—at the request of. in substitution for, and, if they think fit, at the cost of the Master—cause any clothing, bedding, or other article to be disinfected or destroyed, to cause any part of the ship to be disinfected, to cause any casks or tanks containing water to be emptied and cleansed, or to employ suitable means for the effectual destruction of rats or mosquitoes, or the larvæ of mosquitoes. They may not, however, derive any profit by reason of the sum charged, and the amount recoverable shall not exceed 20/. Part IV. prescribes the signals to be borne by an "infected" or "suspected" ship, namely—Between sunrise and sunset, a large flag of yellow and black borne quarterly ; Between sunset and sunrise a signal consisting of three lights in the form of an equilateral triangle—the light at the apex shall be white, and the lights at the ends of the base of the triangle shall be red. The penalty for wilfully neglecting or refusing to obey or carry out, or obstructing the execution of any regulation, shall be a penalty not exceeding 100/., and in the case of a continuing offence, to a further penalty not exceeding 50/. for every day during which the offence continues. 2.—Outward Bound Ships. These provide for the taking of certain measures for preventing the transmission of Cholera or Plague to foreign countries, in the event of a district or part of a district in England and Wales, becoming infected with one of these diseases. Part I. defines the expressions used in these Regulations. 25 The expression Cholera-affected area or Plague-affected area means an area within the United Kingdom, and which for the time being is affected with Cholera or Plague. An Outward Bound ship means, a ship employed or in course of preparation for employment, in trading or going beyond the United Kingdom, Channel Islands, and the Isle of Man. The expression "Specified Article" means, in relation to Cholera- or Plagueinfected areas, body linen or clothing, or bedding which has been in use. In relation to a Cholera-infected area, it means rags, except such rags as are compressed and carried in bales as merchandise in bulk. In relation to a Plague-infected area, rags including such rags as are compressed, and carried in bales as merchandise in bulk. The expression "Local Commodity" used in relation to a specified article means, an article kept, placed, or deposited for any purpose of manufacture, trade, or industry, within a Cholera-infected area or a Plague-infected area. Part II. Article V— Where an outward bound ship is in a district which is or comprises a Cholera- or Plague-infected area, the Medical Officer of Health in the exercise of his discretion, may at any time, and on the requisition in writing of the master shall, within twelve hours after receiving such requisition, visit an outward bound ship, and examine every person on board. He may also, and on the requisition of the master, shall examine any clothing, or bedding, or any other article of personal use which, in the opinion of the Medical Officer of Health, may have been exposed to infection. Article VI.—Provides that every person on board shall answer truly all such questions as may be put to him, and give all such information as may be required by the Medical Officer of Health. Article VII.—If the Medical Officer of Health, after examining the persons &c.,on board an outward bound ship, is of opinion that there are no cases of Cholera or Plague, or any illness which may prove to be Cholera or Plague, if he has made the examination in the exercise of his discretion he may, and if he has made the examination at the request of the master, he shall give a certificate in writing, recording any matters which he deems necessary. This certificate may state that the clothing, bedding, or other articles, have been cleansed or disinfected, or that rats on board have been destroyed, and so may facilitate the admission into pratique in foreign ports of such vessel, or no. Article VIII. provides that if any person on board is found suffering from Cholera or Plague, or from an illness which may prove to be Cholera or Plague, such person shall be forthwith removed to hospital, and the Medical Officer of Health shall take such steps as appear to him necessary for preventing the spread of infection, and the ship shall not proceed to sea until the work of disinfection or destruction has been completed to the satisfaction of the Medical Officer of Health. 26 Article IX.—Whereas during the stay of an outward bound ship within a Plague-infected area, the master shall take all precautions to prevent the access of rats from the shore to the ship. Article X.—During the stay of an outward bound ship within a Cholerainfected area, the master shall take all precautions for securing and maintaining in a wholesome condition, any water taken on hoard for drinking purposes. Article XI.—The Master of an outward bound ship shall, before any such certificate as is mentioned in Article VII. is given or delivered by the Medical Officer of Health, pay to the Local Authority or to the Medical Officer of Health on behalf of the Local Authority, a sum which shall be fixed by the Local Authority, and shall not exceed the amount which appears in the following Table as the prescribed rate of charge applicable to the outward bound ship: — TABLE OF CHARGES. Description of Ship. Prescribed Eate of Charge. For an outward bound ship carrying not more than ten persons, including the Master and Crew - Ten Shillings. For an outward bound ship carrying more than ten persons and not more than thirty persons, including the Master and Crew One Pound. For an outward bound ship carrying more than thirty persons and not more than one hundred persons, including the Master and Crew - Two Pounds. and For an outward bound ship carrying more than one hundred persons, including the Master and Crew Three Pounds. It states that the charges shall not exceed this sum, but the amounts shall be fixed by the Sanitary Authority, and the Port Sanitary Authority have decided that they be those set out in the Table of Charges herewith. It should be borne in mind that the Local Government Board anticipate that the grant of such certificate to the master of a ship may lead to the application at foreign ports of less stringent treatment than is likely to be applied in the absence of such a certificate, and so the shipowner is the person to benefit, whilst there is no obligation on his part to have the certificate should he not desire to pay the cost of the same. Part III. prohibits, except under certain conditions, the conveyance of certain specified articles out of a Cholera- or Plague-affected area, by means of an outward bound ship. Article XIV.—Where a certificate of efficient disinfection is required in the case of a specified article, the owner shall pay to the Local Authority the sum of five shillings. 2 7 3.—Coasting Ships. The expression, "coasting ship" and coast voyage, means a ship employed, or in course of preparation for employment in trading, or going on a voyage beginning and ending within the limits of the United Kingdom, Channel Islands and the Isle of Man. The precautions with regard to coasting ships are similar to those on outward bound ships, with this difference—that only when the Medical Officer of Health has reason to suppose that a coasting ship is infected, it is compulsory on him to visit the ship and examine the master and crew and other persons on board. It will be seen from a perusal of the above extracts from the regulations relating to Cholera, Yellow Fever and Plague, that additional and great responsibility is placed upon the Port of London Sanitary Authority with regard to the prevention of the introduction of such diseases into this country, and I herewith give for your information a short account of the machinery and procedure necessary for dealing with this matter. A Medical Officer is constantly on duty at Gravesend by day and night, and he accompanies, in a launch of His Majesty's Customs, the Preventive Officer, who visits every ship arriving from "foreign." His duty is to investigate every case of illness that occurs, or that has occurred, during the voyage, with a view to ascertaining whether it is of an infectious nature, and should the ship have come from, or touched at, a port infected with Cholera, Yellow Fever or Plague, he boards the vessel, and satisfies himself by a personal examination and by careful enquiry, that there is no person on board suffering from either of these diseases, or with any symptoms suspicious of the same. In the event of a case of Cholera, Yellow Fever or Plague, or any other Infectious Disease being discovered, the patient is removed to the Hospital of this Authority at Denton, where he is isolated until all danger of his spreading infection is passed. Such measures of disinfection are carried out on the vessel as may be considered necessary to prevent the spread of disease. After disinfection the vessel is allowed to proceed to dock, where careful enquiries are made every day by an Inspector of the Authority, who reports anything of a suspicious nature forthwith to your Medical Officer of Health at Greenwich. A Medical Officer is also stationed at Sheerness to carry out the same duties under these Regulations with regard to vessels entering the River Med way. Three launches are available for the removal to Hospital of any case of Infectious Disease that may be discovered within the jurisdiction of the Port of London Sanitary Authority. 28 The Regulations as to ships arriving from foreign ports make provisions prescribing the procedure to be followed with a view to preventing the transmission of Plague by rats on board ship, and to obviate this, rats are in all cases to be destroyed when the ship is infected with Plague, or when rats in the ship are infected with that disease. In the case of a suspected ship by reason of Plague, this procedure is also obligatory when the Medical Officer of Health requires it to be followed. Many vessels arrive from Plague-infected ports, and these may be infected or suspected, and only enter the Port of London for the purpose of discharging part of the cargo, afterwards proceeding to some other port in the United Kingdom. It therefore follows that these Regulations require that in certain contingencies the rats shall be destroyed on board whilst the cargo, or part of the cargo, is in the holds. The question of providing a suitable apparatus to enable rats to be destroyed on board ship before the discharge of cargo, is under consideration by the Port of London Sanitary Committee. When that has been installed, all the staff and machinery will be possessed by the Port of London Sanitary Authorities necessary for effectively carrying out the regulations issued by the Local Government Board. SMALL-POX. Eight cases were admitted and treated in Denton Hospital, a larger number than were treated by the Metropolitan Asylums Board's Hospitals during the year. The s.s. "Adansi," of Liverpool, official number 113,485, left Maceio on the 22nd December, 1906, and called at Parahyba on the 12th January, 1907, where a distressed British seaman was taken on board. This man developed the rash of Small-pox on the 22nd January, and on arrival of the vessel in Liverpool on the 7th February he was landed and placed in hospital. The ship and all effects were disinfected and the crew vaccinated. The vessel left Liverpool for London on Saturday, the 9th February, and arrived at Gravesend on the morning of the 13th. The Medical Officer of Health for Liverpool had duly informed me that a case of Small-pox had been landed there, and that the vessel was leaving for London. On arrival of the vessel at Gravesend, the Master reported all well and that there had been no sickness during the voyage, and repeated this to the Medical Officer who boarded the vessel. He deemed it necessary to muster everyone, and on examining them carefully he discovered the fourth engineer with the rash of Small-pox well out upon him, and forthwith landed him at Denton Hospital. It was ascertained that the rash came out on the evening of the 9th February, and was shown to the Master either that night or the next day, who considered it of no importance. 29 On the 14th February, the third officer ailed with feverish symptoms and a pain in the chest, and was at once isolated in his cabin. He was attended by a doctor, who promptly sent him to the Seamen's Hospital at Greenwich, informing me by telephone. Bearing in mind the history of the ship, I at once acquainted the Medical Superintendent of the Hospital with the facts, and on the patient's arrival at the Hospital he was at once placed in a room by himself, where I examined him in consultation with the Medical Superintendent. It was not possible at that early stage of the disease to certify definitely that the patient was suffering from Small-pox, and he was eccordingly isolated, but on seeing him next morning I definitely diagnosed Small-pox. The patient was taken in an ambulance to the South Wharf Shelter of the Metropolitan Asylums Board, and thence despatched by launch to Denton Hospital. No further cases occurred on board. The majority of the crew having been paid off, their names and addresses were notified to the Medical Officers of Health of the districts concerned. The first patient was isolated in a tent on the after part of the ship, and the two other cases were infected from him probably in the following manner: the Engineer had to visit daily the shaft tunnel from which a ventilator opened on to the deck close to the tent, the third officer had to examine the log daily at noon and had to pass close to the tent, and thus each officer was daily exposed to the risk of infection. The s.s. "Rohilla," of Glasgow, official number 124,149, from Calcutta, arrived at Gravesend on the 4th March. The vessel left Calcutta on the 26th January. On 28th March a lady passenger, and on the 30th one of the native crew, a sculleryman, were taken ill with Small-pox. Both the cases were landed at Madras on the 30th January with all effects. The vessel was fumigated there and the crew vaccinated. The s.s. "Clan Ranald," of Glasgow, official number 111,290, from Calcutta, arrived at Gravesend on the 16th March. One of the native crew ailed five days after leaving Calcutta, and the rash of Small-pox came out subsequently. He was landed at Perim on the 24th February. The chief officer assisted to carry him on shore there, and fifteen days later the chief officer developed the rash of Small-pox, and on the arrival of the vessel at Gravesend he was landed at Denton Hospital with all effects. He had only been vaccinated in infancy and showed only one faint mark. The crew were kept under observation during the stay of the vessel in this port, and the vessel sailed on 20th March for Dunkirk. The s.s. "Pomeranian," of Glasgow, official number 85,193, from Halifax, N.S., arrived at Gravesend on the 20th March. The history of the vessel is as follows: Left London 8th February, and Havre on 9th February. One 30 of the passengers who embarked at Havre ailed on 16th February, and the rash of Small-pox came out on the 17th. He was at once isolated, and landed at Halifax on 22nd February, where he died. A second case, the steerage steward, was also landed at Halifax on the 4t,h March. On the 5th March, the assistant steerage steward ailed, and the rash of Small-pox came out on the 8th March. He was at once isolated, and on the arrival of the vessel at Gravesend was landed at Denton Hospital. Those members of the crew who were not vaccinated or re-vaccinated at Halifax were vaccinated at Gravesend. All persons leaving the vessel in London were notified to the Medical Officers of Health of the districts to which they proceeded, and the vessel sailed for Havre on the 28th March. On the 26th March, the s.s. "Southville," of North Shields, official number 117,963, from Odessa, arrived at Gravesend, when the Master reported that one of the engineers was unwell and had a little rash on him. On tion this proved to be the rash of Small-pox. He was first taken ill on 16th March, and kept more or less in his own cabin from that date with a mess-room boy in attendance on him. I discovered that this boy had never been vaccinated, and I therefore deemed it necessary to land him at Denton Hospital for observation, as it was most probable he would develop symptoms of the disease during the next few days. On the 27th March, he ailed with headache, pain in back, and fever, and was at once treated as a case of Small-pox. The rash came out on 30th March, and was of a very severe confluent type. The boy was infected on the first day of exposure, viz., 16th March. He stated "his father and mother did not believe in vaccination." He recovered, but had a narrow escape of his life, and at best was considerably disfigured. The s.s. "Shadwell," of Sunderland, official number 114,659, from Calcutta, arrived at Gravesend on the 10th May, via Dunkirk and Middlesbrough. On the 9th March, a native quartermaster was landed at Colombo suffering from Small-pox. Two cases suspicious of Small-pox were landed at Dunkirk on the 18th April, and a lascar was landed at Middlesbrough suffering from Small-pox on the 29th April. On August 2nd, an able seaman was paid off from a British vessel at Rotterdam. He came over to London, arriving on August 3rd, apparently well. He left the ship at Tilbury and proceeded by train to London, and thence to an address in Poplar. The rash of Small-pox appeared on August 8th, and he was removed to hospital. The passengers' quarters occupied by him on the vessel were disinfected as a precautionary measure. 31 TABLE IX. (Small-pox.) Date. Name of Vessel. Port of Registry and Official No. Where from. No. of Cases. How dealt with. 1907. Jan. 17 s.s. "Luristan," of Swansea, 124,353. Marseilles 1 Removed to Hospital at Gibraltar. 28 s.s. "Mazagon," of Glasgow, 104,541. Kobe - 1 Removed to Hospital at Cebu. Feb. IB s.s. " Adansi," of Liverpool, 113,485. Maceio 3 One removed to Hospital at Liverpool ; two to Port Sanitary Hospital. 20 s.s. "Tactician." of Liverpool, 113,398. Calcutta 1 Removed to Port Sanitary Hospital. March 4 s.s. "Rohilla," of Glasgow, 124,149. Do. 2 Removed to Hospital at Madras. 16 s.s. "Clan Ranald," of Glasgow, 111,290. Do. 2 One removed to Hospital at Perim, and one to Port Sanitary Hospital. 20 s.s. "Pomeranian," of Glasgow, 85,193. Halifax, N.S. 3 Two removed to Hospital at Halifax, and one to Port Sanitary Hospital. „ 26 s.s. " Southville," of N. Shields, 117,963. Odessa 2 Removed to Port Sanitary Hospital. April 5 s.s. " Collegian," of Liverpool, 110,534. Calcutta 1 Removed to Hospital at Suez. 10 s.s. " Persia," of Glasgow, 87,701. Do. 1 Ditto. 15 s.s. " Jelunga," of Glasgow, 98,596. Do. 1 Removed to Hospital at Colombo. May 9 s.s. " Sunda," of Greenock, 102,399. Do. 1 Removed to Hospital at Suez. 10 s.s. "Sbadwell," of Sunderland, 114,669. Do. 4 One removed to Hospital at Colombo, two at Dunkirk, and one at Middlesbrough. July 22 s.s. " Henri Gerlinger," of Anvers. Tarragona 1 Removed to Port Sanitary Hospital. Aug. 10 s.s. " Batavia III.," of Rotterdam. Rotterdam - 1 Removed to Poplar Hospital. Sept. 1 s.s. " Macedonia," of Belfast, 116,012, Sydney 1 Removed to Hospital at Marseilles. Dec. 15 s.s. " Egypt," of Greenock, 105,581. Bombay 1 Died, and body buried at sea. Total 27 SCARLET FEVER. Of the total number of cases, 34 will be seen to have occurred on the Training Ships "Arethusa" and "Cornwall." As might be expected, Scarlet Fever, once it breaks out in institutions of this kind where the inmates are all of susceptible age, there is a difficulty in at once checking the epidemic. The French barque "Thiers," of Nantes, arrived at Gravesend on the 11th May from St. Nazaire, in which port it had been lying for about six months. A case of Scarlet Fever was removed to hospital at St. Nazaire on the 3rd May, a second case was removed on the 4th, and a third case on the 6th of that month. The vessel was thoroughly disinfected before leaving the port. During the stay of the vessel in the Port of London it was kept under daily observation, and no further cases occurred. 32 TABLE X. (Scarlet Fever.) Date. Name of Vessel, Port of Registry, and Official Number. Where from. N umber of Cases. How dealt with. 1907. Jan. 21 "Warspite" Training Ship, lying off Greenhithe. - 1 Removed to Ship's Hospital on shore at Greenhithe. Feb. 6 s.s. "Somali," of Greenock, 114,046 Calcutta 1 Removed to Port Sanitary Hospital. March 22 "Arethusa" Training Ship, lying off Greenhithe. — 1 Ditto. ,, 30 "Cornwall" Training Ship, lying off Purfleet. - 1 Removed to Hospital at Wen nington. April 25 Ditto - 2 Isolated in ship's lodge on shore. May 11 Barque " Thiers," of Nantes St. Nazaire 3 Removed to Hospital at St. Nazaire. June 7 " Arethusa " Training Ship, lying off Greenhithe. — 1 Removed to Hospital at Dartford. ,, 17 Ditto. - 2 Ditto. August 8 Barge " Valdora," of London, 118,442 Yarmouth- 1 Removed to Hospital of Metropolitan Asylums Board. ,, 14 s.s. "Galeka," of Southampton, 110,265. East London. 1 Removed to Port Sanitary Hospital. Sept. 5 s.s. " St. John City," of West Hartlepool, 98,645. Newport News. 1 Removed to Hospital at West Ham. ,, 11 " Cornwall " Training Ship, lying off Purfleet. - 3 Removed to Hospital at Wennington. ,, 14 Ditto. — 1 Ditto. ,, 18 Watch Barge "Seagull" Moored off East Greenwich Patient went to his home at Grays. ,, 14 "Cornwall" Training Ship, lying off Purfleet. - 1 Removed to Hospital at Wennington. ,, 16 Ditto. - 1 Ditto. ,, 19 Ditto. — 1 Ditto. ,, 21 Ditto. — 1 Ditto. ,, 27 Ditto. - 2 Ditto. Oct. 12 Ditto. — 1 Ditto. ,, 15 Ditto. — 1 Ditto. Sept. 24 "Arethusa" Training Ship, lying off Greenhithe. - 1 Removed to Hospital at Bow Arrow, Dartford. ,, 30 Ditto. — 1 Ditto. Oct. 1 Ditto. — 1 Ditto ,, 6 Ditto. — 2 Ditto. ,, 8 Ditto. 1 Removed to Ship's Hospital on shore. ,, 20 Ditto. — 1 Ditto. Sept. 24 s.s. "Newark Castle," of London, 115,806. Mauritius 1 Removed to Hospital at Cape Town. ,, 30 s.s. "Wakool," of London, 109,996 - Sydney 1 Removed to Port Sanitary Hospital. Nov. 7 "Cornwall" Training Ship, lying off Purfleet. - 1 Removed to Hospital at Wennington. ,, 25 "Arethusa" Training Ship, lying off Greenhithe. - 1 Removed to Hospital at Dartford. Dec. 2 Ditto. -• 1 Removed to Hospital of Metropolitan Asylums Board. „ 17 Ditto. - 1 Removed to Hospital at Dartford. ,,19 Ditto. - 2 Ditto. ,, 30 "Cornwall" Training Ship, lying off Purfleet. 1 Removed to Hospital at Wennington. Total - 44 33 ENTERIC FEVER. "The s.s. "Flandria," of Ghent, from Cherbourg, via Guernsey, arrived at Gravesend on the 27th April. One of the crew, a fireman, was taken ill in Cherbourg, and on arrival at Gravesend was found to be in a very serious condition. The Medical Officer who boarded the vessel thought the case very suspicious of Enteric Fever, and ordered the removal of the patient to Denton Hospital, where a more careful examination was made. The patient then presented the signs and symptoms of Cerebro-Spinal Meningitis or Spotted Fever. His condition became worse and he was quite unconscious and finally died on 1st May. A post-mortem examination revealed lesions of Enteric Fever in the intestines and also meningitis of the brain and spinal chord. A bacteriological examination of the fluid from the spinal canal showed that it did not contain the organism of epidemic Cerebro-Spinal Meningitis, but abundant colonies of the organism of Enteric Fever were discovered. DECEASED SEAMEN'S EFFECTS. On the 31st January last I received a letter from the Superintendent of the Mercantile Marine Office, at Dock Street, London, E., stating that the effects of a seaman who had died of Enteric Fever had been forwarded by the Consul at Dunkirk, and that the effects had not been disinfected. They were accordingly removed to the Hospital at Denton and disinfected by means of superheated steam. On July 26th, I received a telegram informing me that certain effects of a deceased seaman had been landed in Tilbury Dock. On making enquiries it was ascertained that these were the effects of a man who had died abroad of Enteric Fever. The effects had not been disinfected, and were brought to this country as cargo. It is customary to remove all such effects to Denton for the purpose of disinfection, unless documentary evidence is produced to the effect that the articles have either been satisfactorily disinfected or that the cause of death was not due to infectious disease. 34 TABLE XI. (Enteric Fever.) Date. Name of Vessel, Port of Registry, and Official Number. Where from. No. of Cases. How dealt with. 1907. January 20 s.s " Ulabrand," of Tonsberg Bangkok 1 Removed to Hospital at Algiers. ,, 26 s.s. " Crown Point," of Liverpool, 110,644. Philadelphia 1 Removed to Port Sanitary Hospital. February 17 s.s. "China," of Belfast, 104,407. Sydney 1 Ditto. ,, 19 s.s. " Malacca," of Barrow, 93,426. Calcutta 1 Removed to Hospital at Colombo. ,, 21 s.s. "Parana," of Belfast, 116,016. La Plata 1 Removed to Hospital at Las Palmas. March 4 s.s. "Hostilius," of Liverpool, 113,874. Bahia Blanca 1 Removed to Port Sanitary Hospital. ,, 4 s.s. "Cawdor Castle," of London. 114,823. Mauritius 1 Removed to Hospital at Southampton. ,, 30 s.s. "Britannia," of Greenock, 93,196. Sydney 1 Removed to Hospital at Colombo. April 5 s.s. "City of Glasgow," of Glasgow, 121,304. Calcutta 1 Removed to Hospital at Malta. ,, 5 s.s. "Eagle Point," of Liverpool, 113,370. Philadelphia 1 Removed to Port Sanitary Hospital. ,, 13 s,s. " Graika," of Southampton, 106,908. East London 1 Ditto. ,, 26 s.s. "Mooltan," of Greenock, 117,397. Sydney 1 Removed to Hospital at Marseilles. ,, 27 s.s. "Montezuma," of Liverpool, 110,604. St. John's, N.B. 1 Removed to Port Sanitary Hospital. May 7 s.s. " Gamecock," of London, 87,063. Plying between London and Gravesend. 1 Removed to Gravesend Hospital. ,, 21 s.s. "City of Calcutta," of Glasgow, 115,759. Calcutta 1 Removed to Port Sanitary Hospital. ,, 24 s.s. "Greenbank," of West Hartlepool, 119,864. Savannah 1 Died, and body buried at sea. June 4 s.s. "Michigan," of Liverpool, 108,337. New Orleans 1 Removed to Branch Seamen's Hospital. ,, 6 s.s. "Oroya," of Liverpool, 93,712. Brisbane 1 Removed to Hospital at Plymouth. ,, 10 s.s. "Inchkeith," of Liverpool, 110,590. Bahai Blanca 1 Removed to Hospital at St, Vincent. ,, 12 s.s. "Arndale," of Whitby, 118,857. Buenos Ayres 1 Removed to Hospital at Madeira. ,, 15 s.s. " Ortona," of Liverpool, 110,615. Brisbane 1 Removed to Hospital at Colombo. ,, 17 s.s. "Starcross," of Cardiff, 98,448. Rosario 1 Removed to Hospital at Monte Video. ,, 19 s.s. " Welikij Knjas Alexander Michailowitsch," of Riga. Libau 1 Removed to Port Sanitary Hospital. ,, 29 s.s. " Illovo," of Aberdeen, 94,543. Delagoa Bay 1 Ditto. ,, 29 s.s. " Newlands," of West Hartlepool, 115,125. Mobile 1 Removed to Hospital at Salford. July 5 s.s. " Sola," of London, 108,243 Buenos Ayres 2 Removed to Hospital at Las Palmas. ,, 8 s.s. "Magda,"of West Hartlepool, 92,927. St. Lawrence 1 Removed to Port Sanitary Hospital. ,, 15 s.s. " City of Benares," of Glasgow, 114,004. Calcutta 1 Ditto. ,, 15 s.s. "Kurgan," of Riga St. Petersburg. 1 Removed to Hospital at St. Petersburg. ,, 17 s.s. "Manitou," of Wes Hartlepool, 106,971. Philadelphia Forward - 1 Removed to Hospital at Southampton. 31 35 Date. Name of Vessel, Port of Registry, and Official Number. Where from. No. of Cases. How dealt with. 1907. Broug ht forward 31 August 1 s.s. "Phoenicia," of Whitby, 99,230. Fernandina 1 Removed to Port Sanitary Hospital, 6 s.s. " Kura," of Newcastle, 96,153. Batoum 1 Ditto. • 11 s.s. " Arabia," of Greenock, 105,587. Bombay 3 Removed to Hospital at Port Said. ,, 25 s.s. "Moringen," of Christiansund. Lisbon 3 Removed to Port Sanitary Hospital. September 8 s.s. "Albiana," of West Hartlepool, 119,887. Newport News 2 Ditto. 30 s.s. " St. John," of Gothenburg. Sfax - 1 Ditto. October 6 s.s. " Egypt," of Greenock, 105,581. Bombay 1 Ditto. ,, 10 s.s. "Amatonga," of London, 115,957. Karachi 1 Removed to Hospital at Port Said. ,, 13 s.s. " City of Dundee," of Glasgow, 97,668. Smyrna 1 Removed to Port Sanitary Hospital. ,, 13 s.s. " Sunda," of Greenock, 102,399. Yokohama 2 Ditto. ,, 13 s.s. " Anamba," of Copenhagen Bangkok 1 Ditto. ,, 20 s.s. "Iago," of Hull, 95,781 - Palermo 1 Removed to Hospital at Fiume. ,, 22 s.s. "Moringen," of Christiansund. Aviles 1 Removed to Port Sanitary Hospital. ,, 22 s.s. " Illovo," of Aberdeen, 94,543. Beira - 1 Died, and body buried at sea. ,, 22 " Lyyli," of Hull, 123,291 - Bremen 1 Removed to Seamen's Hospital at Greenwich. ,, 25 s.s. " Golconda," of Glasgow, 95,098. Calcutta 1 Died, and body buried at sea. November 29 s.s. " Hungarian," of Glasgow, 115,298. Montreal 1 Removed to Bermondsey Borough Council's Infirmary. December 1 s.s. "Fancy," of Tonsberg Abo - 1 Removed to Port Sanitary Hospital. 55 36 TABLE XII. (Measles.) Date. Name o£ Vessel, Port of Registry and Official Number. Where from. No. of Cases. How dealt with. 1907. January 8 s.s. " Ibis," of Cork, 92,016, Antwerp 1 | Removed to Port Sanitary Hospital. ,, 12 9.8. " Mooltan," of Greenock, 117,397. Sydney 1 Ditto. February 6 s.s. " Minneapolis," of Belfast, 110,515. New York 1 Patient convalescent on arrival of vessel in London. March 1 s.s. " Marathon," of Aberdeen, 118,184. Brisbane 2 One landed at Cape Town, and one at Plymouth, both conva lescent. April 2 s.s. " Syria," of Glasgow, 113,959. Calcutta 2 Patients convalescent on arrival of vessel in London. ,, 21 s.s. " Orotava," of Liverpool, 96,348. Brisbane 3 One recovered before vessel arrived in London ; two removed to Tilbury Cottage Hospital. ,, 21 s.s. " Citv of York," of Glasgow, 119,100. Calcutta 1 Patient convalescent on arrival in London. ,, 22 s.s. " Nicolay Belozwetow," of St. Petersburg. Riga 1 Ditto. May 23 s.s. "Nile," of Greenock, 123,527. Yokohama 1 Removed to hospital at Singapore. June 8 s.s. " Montrose," of London, 108,251. Montreal 1 Patient convalescent on arrival of vessel in London. ,, 10 s.s. " Volturne," of Hull, 93,148. Palermo 1 Removed to Hospital at Fiume. ,, 23 s.s. " Mount Temple," of Liverpool, 113,496. Montreal 1 Patient convalescent on arrival of vessel in London. July 11 s.s. " Avondale Castle," of London, 108,160. Cape Town 1 Ditto. ,, 15 Central Hotel, Royal Albert Dock. — 1 Isolated at own residence. ,, 17 s.s. "Gaika," of Southampton, 106,908. Cape Town 1 Convalescent on arrival of vessel in London. August 1 s.s. " Geelong," of London, 118,426. Sydney Removed to Hospital at Durban. ,, 10 s.s. " Sardinian," of Glasgow, 71,695. Montreal 1 Convalescent on arrival of vessel in London. ,, 19 s.s. " Morocco," of London, 79,660. Madeira 1 Removed to Hospital at Mazagan. ,, 25 s.s. " China," of Belfast, 104,467. Shanghai 1 Removed to Port Sanitary Hospital. ,, 26 s.s. " Commonwealth," of London, 115,903. Sydney Patients well on arrival of vessel in London. September 7 s s. " Persic," of Liverpool, 110,620. Ditto - 1 Removed to Port Sanitary Hospital. ,, 9 s.s. " Clan Chattan," of Glasgow, 115,711. Bimlipatam 1 Removed to Hospital at Madras. ,, 29 s.s. " Moldavia," of Greenock, 117,382. Sydney 2 One removed at Port Said, and one convalescent on arrival of vessel in LondoD. October 19 s.s. "Marmora," of Belfast, 116,011. Bombay 1 Left vessel at Plymouth. „ 30 s.s. " Medic," of Liverpool, 110,573. Sydney 14 Two landed at Cape Town, one convalescent on arrival of vessel in London, seven removed to Port Sanitary Hospital. November 3 s.s. " Oruoa," of Liverpool, 96,310. Brisbane 1 Removed to Hospital at Freemantle. ,,3 s.s. " Mount Temple," of Liverpool, 113,496. Montreal 1 Removed to Port Sanitary Hospital. „ 29 s.s. " Afric," of Liverpool, 110,537. Sydney 1 Convalescent on arrival of vessel in London. Total 51 37 TABLE XIII. (Chicken-pox.) Date. Name of Vessel, Port of Registry, and Official Number. Where from. Number of Cases. How dealt with. 1907. Jan. 4 s.s. "Clan Cameron," of Glasgow, 113,919. Chittagong 3 Removed to Port Sanitary Hospital. „ 30 s.s. "Craftsman," of Liverpool, 106,865. Calcutta - 1 Removed to Hospital at Colombo. March 14 s.s. "Cape Lopez," of Antwerp Valencia - 1 Removed to Port Sanitary Hospital. „ 17 s.s. "Gascon," of Southampton, 106,907 Cape Town 14 Removed to Hospital at Southampton. „ 30 s.s. "Pathan," of Rochester, 118,219- Monte Video 1 Patient convalescent on arrival of vessel in London. May 4 s.s. "China," of Belfast, 104,467 Bombay - 1 Ditto. „ 11 s.s. "Moldavia," of Greenock, 117,382 Sydney - 4 One removed to Hospital at Colombo, and three were convalescent on arrival of vessel in London. „ 15 s.s. "Shadwell," of Sunderland, 114,659. Calcutta - 1 Removed to Port Sanitary Hospital. June 6 s.s. "German," of Southampton, 109,290. Cape Town 1 Patient convalescent on arrival of vessel in London. „ 8 s.s. "Dilwara," of Glasgow, 102,645 Calcutta - 1 Removed to Hospital at Colombo. October 1 s.s. "Inanda," of Aberdeen, 118,187 Natal 10 All convalescent on arrival of vessel in London. Nov. 8 s.s. "Goorkha," of Southampton, 106,917. - Cape Town 1 Removed to Hospital at East London. Dec. 11 s.s. "Turkestan," of Swansea - Bussorah - 1 Convalescent' on arrival of vessel in London. Total - 40 38 TABLE XIV. (Relapsing Fever.) Date Name of Vessel, Port of Registry and Official Number. Where from. No. of Cases. How dealt with. 1907. Oct. 25 - s.s. "Golconda," of Glasgow, Calcutta - 1 Convalescent on arrival of 95,098. vessel in London. TABLE XV. (Erysipelas.) Date. Name of Vessel, Port of Registry and Official Number. Where from. No. of Cases. How dealt with. 1907. Aug. 26 - s.s. "Commonwealth," of London, 115,903. Sydney - 1 Patient well on arrival of vessel in London. Nov. 7 Barque "Helvetia," of Sandefjord Drobak - 1 Isolated on board. Total 2 TABLE XVI. (Diphtheria.) Date. Name of Vessel, Port of Registry and Official Number. Where from. No. of Cases. How dealt with. 1907. April 3 - s.s. "Kurgan," of Windau - - Riga - 2 Removed to Port Sanitary Hospital. Aug. 11 - "Hedwig," of Marstrand - - Nederkalix 1 Removed to Hospital at Malmo. Sept. 13 - s.s. "German," of Southampton, 109,290. East London 1 Removed to Port Sanitary Hospital- „ 25 - s.s. "Hyperia," of Liverpool, 105,342 - 1 Removed to Hospital of Metropolitan Asylums Board. » 25 - H.M.S. " President," lying in South-We st India Dk. 1 Ditto. Oct. 21 - s.s. "City of Glasgow," of Glasgow, 121,304. Calcutta - 1 Died, and body buried at sea. Total - 7 39 TABLE XVII. (Continued Fever.) Date Name of Vessel, Port of Registry and Official Number. Where from. No. of Cases. How dealt with. 1907. Jan. 9 - s.s. "Manora," of Glasgow, 89,908 - Calcutta - 1 Removed to Port Sanitary Hospital. March 3 - s.s. "Georg," of Flensborg - - Tarragona 1 Ditto. „ 6 - s.s. "Whitehall," of West Hartlepool, 106,968. Pensacola 1 Ditto. „ 20 - s.s. "Mendelssohn," of Sunderland, 97,529. Odessa - 1 Ditto. April 14 - s.s. "Clan Sutherland," of Glasgow, 106,037. Bimlipatam 1 Ditto. „ 16 - s.s. ''Hermiston," of Glasgow, 113,964 Rosario - 1 Ditto. „ 27 - s.s. "Flandria," of Ghent Guernsey 1 Ditto. June 26 - s.s. "Glenstrae," of London, 120,503 - Otarn - 1 Ditto. Sept. 7 - s.s. "Swaledale," of Sunderland, 114,644. Bombay & Australia. 1 Removed to Branch Seamen's Hospital. „ 12 - s.s. "China," of Belfast, 104,467 Shanghai 1 Removed to Port Sanitary Hospital. Dec. 5 - s.s. "City of Edinburgh," of Liverpool, 110,539. Calcutta - 1 Ditto. Total - 11 COMPULSORY NOTIFICATION OF INFECTIOUS DISEASES. The Order of the Court of Common Council, making Cerebro-Spinal Meningitis, commonly known as Spotted Fever, a notifiable disease expired on the 30th September, 1907. This Order was, by Resolution of the Common Council, extended for a further period until December 31st, 1908, and Chicken-pox was also made a notifiable disease until May 31st, 1908. These Orders were approved by the Local Government Board, and public notice thereof was duly given in the manner required by the Public Health (London) Act, 1891. Port of London Port Sanitary District. Return of the number of cases of Infectious Disease medically reported to the Medical Officer of Health during the year 1907, and of deaths from the diseases notified:— 40  Cases notified in 1907. Deaths registered in 1907. Small-pox 8 Nil. Scarlet Fever 37 Nil. Diphtheria 5 Nil. Membranous Croup Nil. Nil. Typhus Fever Nil. Nil. Enteric or Typhoid 29 4 Continued Fever 9 1* Relapsing Fever Nil. Nil. Puerperal Fever Nil. Nil. Cholera (suspected) 1 Nil. Erysipelas 1 Nil. Plague (suspected) 3 Nil. Measles 18 Nil. Chicken-pox 4 Nil. Cerebro-Spinal Meningitis † 1 1 116 6 *Death due to pneumonia, †Diagnosis doubtful. TABLE XVIII. BERI-BERI. Date. Name of Vessel. Where from. No. of Cases. 1907. 6th February s.s. "Somali," of Greenock, 114,056. Calcutta 1 13th „ s.s. "Neptune," of London, 104,300. Rio de Janeiro 2 11th May s.s. "Clan Forbes," of Glasgow, 115,762. Bunbury 3 1st October s.s. "Simla," of Greenock, 102,393. Yokohama 1 13th „ s.s. "Sunda," of Greenock, 102,399. Ditto 7 (one fatal) 2nd November s.s. "Goth," of Southampton, 98,866. Delagoa Bay 1 29th „ s.s. "Tintagel Castle," of London, 105,900. Ditto 9 21st December s.s. "Pera," of Belfast, 116,002. Sydney 1 Total 25 SCURVY. The barque "Frieda Mahn," of Rostock, from Vinda, arrived at Gravesend on the 3rd October, when it was found that one of the crew was suffering with scurvy. Two other cases had occurred during the voyage, but were convalescing at the time of the arrival of the vessel. This disease is now very rarely met with on incoming vessels. Voyages are shorter, and better methods of preserving food-stuffs are adopted. This explains the practical disappearance of this disease from the mercantile marine. 41 TABLE XIX. Vessels and Premises Disinfected, from 1st January to 31st December, 1907. Month. Reason for Disinfection. Number of Disinfections. Cerebro-Spinal Meningitis. Chicken-pox. Cholera (Suspected). Continued Fever. Diphtheria. Enteric Fever. Erysipelas. Measles. Plague (Suspected). Scarlet Fever. Small-pox. Precautionary Measure. January ... 1 1 1 ... 1 ... 2 ... ... ... 1 7 February ... ... ... ... ... 2 ... 1 ... 2 2 2 9 March ... 1 ... 3 ... 2 ... ... ... ... 3 3 12 April 1 ... ... 2 1 5 ... 4 1 1 1 3 19 May ... 1 ... ... ... 3 ... ... ... ... ... 4 8 June ... 1 ... 1 ... 5 ... 3 ... ... • •• 2 12 July ... ... ... ... ... 2 ... ... ... ... 1 3 6 August ... ... ... ... 1 3 ... 2 ... 2 1 1 10 September ... ... ... ... 2 2 ... 1 ... 3 ... 2 10 October ... 1 ... 1 1 5 ... 2 ... ... ... ... 10 November ... ... ... ... ... 1 1 1 ... ... ... 3 6 December ... ... ... 1 ... 2 ... ... 2 ... ... 2 7 Totals 1 5 1 9 5 33 1 16 3 8 8 26 116 42 TABLE XX. Number of Disinfections of Effects, Bedding, &c., from 1st January to 31st December, 1907. Month. Reason for Disinfection. Hospital Bedding, &c. Total Effects. Number of times Steam Disinfeetor was used. Disinfected by Fumigation. Chicken-pox. Continued Fever. Diphtheria. Enteric Fever. Erysipelas. Measles. Suspected Plague. Scarlet Fever. Small-pox. Precautionary Measure. January 1 1 ... 2 ... 2 ... ... ... 1 5 12 5 1 February ... ... ... 3 ... 1 ... 3 3 1 8 19 22 1 March 2 3 ... 2 ... ... ... 1 4 2 6 20 12 2 April ... 2 1 5 ... 3 1 1 1 ... 10 24 12 3 May 1 ... ... 3 ... ... ... ... ... 5 9 5 ... June 1 1 ... 4 ... 1 ... ... ... ... 7 14 10 1 July ... ... ... 4 ... 1 ... ... 1 ... 8 14 11 ... August ... ... 1 3 ... 1 ... 2 ... ... 3 10 5 ... September ... ... 1 2 ... 1 ... 3 ... ... 7 14 8 1 October 1 ... 1 5 .. 2 ... 2 ... ... 5 16 9 1 November ... ... ... ... 1 ... ... ... ... ... 7 8 9 1 December ... 1 ... 1 ... ... 2 ... ... ... 5 9 6 1 Totals 6 8 4 34 1 12 3 12 9 4 76 169 115 12 43 ALIENS ACT, 1905. Aliens arriving in the United Kingdom during the twelve months ending December 31st, 1907, according to the official returns issued by the Home Office:— All Ports. In London. Cabin passengers 149,332 30,078 Exempted second-class passengers 97,213 12,923 Transmigrants 172,437 8,511 Other Alien passengers 61,759 11,262 480,741 62,774 Particulars of other Alien Passengers. Proceeding to destination outside United Kingdom 8,906 2,149 Holding return tickets 6,803 540 Seamen 12,002 1,391 Refused leave to land 798 124 Balance 33,250 7,058 61,759 11,262 The number of expulsion orders made under the Act was 317. The total number of alien steerage passengers arriving in the United Kingdom liable to examination under the Aliens Act was 61,759, of whom 11,262 arrived in the Port of London. Non-Immigrant and Immigrant Ships. During the year, 2,072 non-immigrant ships arrived in the Port of London, bringing 29,420 passengers; and 449 immigrant ships bringing 33,084 passengers. Transmigrants were all examined with a view to the detection of any case of an infectious disorder amongst them, whilst the immigrants were subjected to a more careful and thorough examination. Aliens. Number of non-immigrant ships arriving in Port of London 2,072 Ditto, in other ports 7,518 Total 9,590 44 Number of alien passengers on non-immigrant ships arriving in Port of London 29,420 Ditto, in other porta 104,081 Total 133,501 Number of immigrant ships arriving in Port of London 449 Number in other ports 3,490 Total 3,939 Number of alien passengers arriving on immigrant ships in Port of London 33,084 Ditto, in other ports 313,790 Total 346,874 Arrivals in the Port of London. Ships. Passengers. NonImmigrant. Immigrant. Total. NonImmigrant. Immigrant. Total. January 164 15 179 2,368 1,167 3,535 February 164 11 175 2,147 834 2,981 March 165 15 180 2,579 1,194 3,773 April 174 34 208 2,653 2,474 5,127 May 176 49 225 2,500 3,672 6,172 June 171 43 214 3,257 3,655 6,912 July 173 76 249 2,066 5,677 7,743 August 181 70 251 2,118 5,072 7,190 September 171 64 235 1,919 4,598 6,517 October 192 37 229 2,853 2,552 5,405 November 173 18 191 2,695 1,066 3,761 December 168 17 185 2,265 1,123 3,388 2,072 449 2,521 29,420 33,084 62,504 The s.s. "Mount Temple" arrived from Canada on the 3rd November. Amongst the passengers were a man, his wife and three children, who had proceeded to Canada from Antwerp. They had been prevented from landing there by the Immigration Authorities because the man suffered with Epilepsy, and were accordingly returned viâ London. During the voyage one of the children was found to be suffering with Measles, and the mother and children were landed at Denton Hospital. They were kept there until the child was convalescent, when, after thorough disinfection, they were handed over to the shipping company and conveyed to Antwerp. 45 TABLE XXI. Quantity and Description of Unsound Food Seized and Destroyed for the Year ending 31st December, 1907. MEAT— Original packages. Sundry quantities by weight. Loose Articles. Approximate Total weight of Goods destroyed. No. Description. Tons. cwts. qrs. lbs. No. Description. Tons. cwts. qrs. lbs. Fresh and Frozen— 16 Beef 278 quarters ... ... ... ... 430 pieces 47 5 2 Mutton and Lamb 3,229 carcases ... ... ... ... 456 „ 63 6 2 24 Veal, Pork and Offal 666 packages ... ... ... ... 68 tins 8 11 1 6 Preserved— Tinned 388 „ ... ... ... ... 535 „ 2 14 4 5 Smoked and Salted 573 cases ... ... ... 12 ... 63 8 0 22 RABBITS— Frozen 32 crates ... ... ... ... 207 loose 1 3 3 0 Tinned 3 cases ... ... ... ... 0 1 0 4 POULTRY and GAME— 2 0 Frozen 110 packages 0 0 0 28 ... 0 2 FISH— Wet 240 boxes ... ... ... ... ... 12 1 2 0 Preserved, Tinned 54 cases ... ... ... ... 2,387 tins 2 10 0 2 „ Dried ... ... ... ... ... ... ... 0 ... ... FRUIT— Fresh 5,503½ packages 0 4 0 0 ... 149 9 1 1 Preserved, Dried 16 boxes ... ... ... ... ... 15 9 1 17 „ Tinned and Bottled 70 cases ... ... ... ... 2,762 tins 6 9 2 24 „ Jam and Marmalade 796 „ ... ... ... ... 79 4 7 6 8 VEGETABLES— Fresh 36 packages 6 15 0 0 ... 7 6 0 0 Preserved, Dried 45 „ ... ... ... ... 727 tins 6 6 0 4 NUTS- Whole 3 bags ... ... ... ... ... 0 13 2 0 Ground ... ... 0 10 0 0 ... PROVISIONS— Tea 1,074 chests ... ... ... 16 bags 41 11 2 16 Coffee ... ... ... ... ... ... ... ... ... ... ... Cocoa 280 bags 7 0 0 0 ... 21 2 2 0 Butter, Cheese, Lard, Margarine 170 boxes 0 18 1 22 ... 7 1 3 4 Condensed Milk 389 cases ... . . . ... ... 289 tins 14 0 2 5 Prepared Foods 4 „ ... ... • •• 85 bottles 11 13 2 21 Biscuits and Confectionery ... ... ... ... ... ... ... ... ... ... ... Sugar 17 casks ... ... ... ... 4 6 2 18 GRAIN— Wheat, Maize, Barley, Rice, &c. ... ... ... ... ... ... ... 2,289 12 2 14 MEAL and FLOUR 305 bags 2 15 3 9 ... 8 S 2 11 CONDIMENTS and SPICES ... ... 2 13 3 26 ... 2 13 3 26 EGGS ... ... ... ... ... ... 7,300 0 6 5 0 Dried 4 cases . . . ... ... ... ... 0 4 1 24 Liquid 212 „ ... ... ... ... ••• 8 17 0 0 SUNDRIES 1,909 packages 10 0 0 0 1,069 tins 60 1 8 1 Total 16,406i - 31 0 0 3 16,410 - 2,862 8 3 21 46 UNSOUND FOOD. Table XXI. This Table has been amplified and improved by the addition of a column showing the approximate weight of food stuffs seized and destroyed. In the case of most of the articles, the weight given is the actual weight. By this it will be seen that the total quantity of food stuffs seized and destroyed during the year amounted to 164,062 original packages, and 16,410 loose articles, a total weight of about 573 tons. To this may be added some 2,289 tons of grain, making a grand total of 2,862 tons of unsound food stuffs seized and dealt with by your Inspectors. With regard to the damaged grain, your Inspectors perform a very useful duty, inasmuch as this material is checked on arrival, and it has not the chance of being carried away and ground into inferior flour, but for such portions as are not absolutely decomposed, there is a ready means of disposal for the feeding of cattle and poultry, and under satisfactory restrictions and guarantees this is permitted. The total weight of fresh or frozen meat seized and destroyed is nearly 120 tons. Included in this amount is 3,229 carcases of mutton. There were also 63 tons of bacon and hams, 14 tons of fish, 149 tons of fresh and 25 tons of preserved fruit, 41 tons of tea, 21 tons of cocoa, 14 tons of condensed milk, 11 tons prepared foods, and 7 tons fat foods, such as butter, cheese, &c., and similar quantities of other articles. The record is a very satisfactory one, and gives a better idea of the enormous bulk of goods dealt with by your officers, than does perhaps the mere number of packages or of articles. Of course, the quantity of foodstuffs destroyed forms only a small percentage of the actual quantity examined. Speaking generally the condition of foodstuffs landed in the Port of London is excellent. In the beginning of the year I called attention to a statement which had been made in a report on the inspection of food by Riparian Sanitary Authorities, by the London County Council, in which it appeared that a wrong impression was held as to the method of inspection adopted by the Port Sanitary Authority. The statement made was that seizures properly so called were rarely ever made, but that the Inspector was merely called in to certify that unsound food was not fit for human consumption. As a matter of fact the "calling in" of an inspector is by no means frequent, and a record is kept of all cases where goods are surrendered 47 voluntarily by the owners, and the number of these cases during last year was 41, being 8.9 per cent. of the total number of seizures. The various quantities of unsound food which are found are discovered by the Inspectors during the daily round of their districts, as they examine a proportion of all the food stuffs that come into the Port, and anything which is found in an unsound condition is formally seized, and a written notice to that effect is served not only upon the Dock Company, but upon the person to whom the stuff is consigned. More than this, as a first step, would not in most circumstances be practicable. The fact that the Port Sanitary Authority had never obtained a conviction was commented upon, but the absence of reasonable grounds for applying for a conviction was not mentioned. It is, however, a fact that in the vast majority of cases, as soon as information of the seizure reaches the persons concerned, they promptly comply with the directions of the Port Sanitary Authority. This means very often a great saving of time where sorting out of the good from the bad is necessary in the case of a large consignment of goods. It has, consequently, rarely appeared to your Officers that there were any reasonable grounds for applying, except in some special cases which have been duly recorded, for a Magistrate's Order, and still fewer grounds upon which to base an application for a conviction. It should be obvious that some discretion is necessary in dealing with articles of food deposited in a wholesale way as merchandise, and that the offence committed, if any, is not precisely of the same quality or nature as in the case of the actual retailer to the public. Whilst this report was in the Press, a conviction has been obtained against the importer of a quantity of unsound albumen, or white of egg, in the following circumstances:— During October a parcel of six cases of this material was imported from Marseilles, and deposited in the docks. Two of these cases were sold, and upon examination of the remainder it was found to be unsound and offensive. The owner stated that it was not intended to be used for human food, but on finding that two cases of the original consignment had been sold to a manufacturing confectioner, and was being used for making nougat, the four remaining cases were thereupon taken before a Magistrate who, upon hearing the evidence, ordered it to be destroyed, which was done. 48 Subsequently, the owner was summoned for having in his possession an article intended for the food of man which was unsound and unfit for the food of man. At the hearing, the defendant altogether changed his defence, and alleged that the stuff was perfectly fit for human food. At the Police Court, when application was made for the order for destruction, he had denied that it was intended for food at all, notwithstanding the fact that he had already sold some of it for this purpose. It became necessary to submit expert evidence on behalf of the Corporation, and in the end, as shown elsewhere, the defendant was convicted and fined 10/. and twenty guineas costs. In this case there was no question of a parcel of goods, a portion of which had become unsound through possible damage on the voyage, or otherwise, and a portion of which might be utilised. It was a case in which the Port Sanitary Authority were justified in summoning the owner in the interests of the public. As has already been stated, these cases are happily very rare, and the general experience is that merchants and others are generally glad to co-operate with the Authority in preventing unsound food reaching the public. The s.s. "Persia," of Greenock, official number 109,258, from Bombay, arrived at Gravesend on the 27th January; the surgeon reported that twenty-four cases of apparently ptomaine poisoning had occurred on board during the voyage. The symptoms were those of acute diarrhoea, vomiting, severe pains in the stomach, and in some cases fever. A careful inquiry was made into all the foodstuffs used during the voyage, but no cause for the outbreak could be ascertained. With the exception of the engine-room staff, every department, including the passengers, was affected. These included six officers, two quartermasters, eleven stewards, one lascar and five passengers. On the 19th March, I received notice from the Medical Officer of Health for the City of London that a quantity of foodstuffs would be sold by public auction on the 21st March. Some of the goods, about 1,600 cases, were lying in the East India Dock, and I deemed it necessary to have them re-examined, as some time had elapsed since their arrival. The result of the inspection was that 12 cases of tinned apricot puddings, four cases of tinned peach puddings, three cases of tinned peach pies, seven cases of apricot pies, and 127 cases of apple puddings were found to be unsound and unfit for human food, and were accordingly seized. During the year, a report appeared in the Press that flour in France was adulterated with talc and other mineral matters. 49 A quantity of flour from France is imported into this country annually, and I deemed it advisable to take samples of such flour with a view to the same being submitted to chemical analysis. Two samples were accordingly analysed by Dr. Teed, the City Analyst, who reported that both were samples of genuine flour. On July 16th, a Food Inspector, on visiting Tilbury Docks, ascertained that about 500 carcases of lamb had been discharged from a ship early in the morning and forwarded to London, and that the condition of the meat was not quite satisfactory. He telephoned the information to me, giving the address to which the meat had been sent. I telephoned to the Medical Officer of Health for that district, and he sent an inspector to the address given, and whilst there, the consignment arrived. The condition of the meat was such that 143 carcases were found to be quite unsound, and unfit for the food of man. There is but little doubt that this consignment was landed and quickly sent to London with a view to escaping inspection and action by the Food Inspector of the Port Sanitary Authority. The matter was taken up with the Dock Company, and the Manager has written saying that on behalf of the Dock Company "I have to assure you that the matter shall receive special attention in future, with a view to preventing the recurrence of an incident such as that about which your complaint was made." I have also made arrangements for an Inspector to be in attendance whenever meat is being discharged from vessels lying in the Tilbury Dock. On the 19th July, one of the Food Inspectors examined one of a number of cases of tinned sausages, which had been discharged into a lighter bound for a riverside wharf. The goods were "returned" from Malta, and the result of the examination was such as to arouse suspicion as to the condition of the whole consignment. Further examination was impossible on the spot as the goods were in actual transit, in fact leaving the dock at the time. Their destination being known, the local authority was communicated with. Meanwhile the goods reached the wharf, where they were merely re-addressed and returned to the original packers "for examination as to the cause of damage." The packers were a well-known firm in the South of England. I communicated with the Medical Officer of Health of the district concerned, and I learn that on arrival the consignment was examined, with the result that three-fourths of the whole quantity was condemned as unfit for food, and destroyed. The remainder, from external appearance and examination of a few tins, was claimed by the packers as perfectly sound, but in the end they consented to the destruction of the whole lot. 50 Any other course, in my opinion, would have been exceedingly dangerous, and amply illustrates the necessity for some power whereby unsound goods, though in transit, may be detained for examination at the port of entry. The Public Health regulations as to Food Act, 1907, will probably enable such a case to be dealt with efficiently in the future. The importation of meat from the Colonies and other foreign countries shows a large increase during the year 1907, and it is interesting to note that there is a large and growing proportion of the meat landed at the Port of London which is distributed either direct from the ship or store without passing through the Smithfield Market to many depôts which have been opened in the South of England, and this emphasises the importance of inspection either on the vessel or during the discharge of same. For the following particulars I am indebted to the Review of the Frozen Meat Trade, 1907, issued by Messrs. W. Weddel and Co. During the year 1907 the following importations from Australia, New Zealand and the River Plate, were discharged in the Port of London:— Australia— Mutton 716,018 Carcases. Lamb 1,046,029 „ Beef 66,410 Quarters. New Zealand— Mutton 1,913,088 Carcases. Lamb 2,440,000 „ Beef 215,764 Quarters. River Plate— Mutton 954,702 Carcases. Lamb 47,701 „ Beef, frozen 364,663 Quarters. Beef, chilled 63,720 „ In comparison with other ports, the following Table dealing with frozen mutton and lamb will indicate the quantity discharged in London as compared with other ports:— Australia— London 1,762,047 Carcases. Other Ports 575,884 „ New Zealand— London 4,353,088 „ Other Ports 444,279 „ River Plate, Uruguay, &c.— London 1,002,403 „ Liverpool 1,607,520 „ Other Ports 405,306 „ Totals 10,150,527 Carcases. 51 I append a list of the Refrigerating Stores which exist within the jurisdiction of the Port of London Sanitary Authority, and also the number and carrying capacity of the steamers fitted with refrigerating machinery, and engaged in the frozen meat trade at the 31st December, 1907. London and India Docks Co.— Capacity. Victoria Dock 315,000 Carcases. Victoria Dock Extension 180,000 „ West India Dock 90,000 „ West Smithfield 90,000 „ South Dock 13,000 „ London Central Markets Cold Storage Co., Ltd.— Poplar 150,000 „ Summary. Route. Ships. Carrying Capacity. Australia to United Kingdom, &c. 44 1,668,800 Carcases. New Zealand to London, &c. 44 3,918,700 „ Australasia and/or River Plate to Cape, United Kingdom, &c. 30 2,840,400 „ River Plate to United Kingdom, &c. 55 3,402,100 ,, Total 173 11,830,000 „ INSPECTION OF FOODSTUFFS. The Manchester Port Sanitary Authority, in November, 1907, instituted proceedings in the Police Court, before a Stipendiary Magistrate at Manchester, which are of considerable interest to Port Sanitary Authorities. The first summons was against Mr. Renwick, of Messrs. Fisher, Renwick and Co., for obstruction. The Medical Officer of Health and the Food Inspector for the Port of Manchester entered a shed belonging to Messrs. Fisher, Renwick and Co., for the purpose of inspecting and examining some cases of tinned mutton lying there. They were refused admission, and were told that if they attended again they would be put outside, their legal right to enter, inspect and examine being disputed. The second summons was against an employee of the same firm. It appeared that a large number of cases (223) of apricot pulp had been inspected and seized as being unfit for food, and subsequently a Magistrate attended, and as they were in his opinion unfit for food, he condemned them and ordered them to be destroyed, The employee refused to deliver up these tins which had been condemned, alleging that neither the Medical Officer of Health nor the Magistrate had any right to enter, inspect or examine, consequently the seizure was illegal, and in their opinion condemnation was also illegal. 52 This case was argued at considerable length before the magistrate gave his judgment in the following terms:— "I am of opinion that it is not a condition precedent to the inspection "by the Medical Officer or Inspector that the article should have been "sold or exposed for sale or deposited for sale or of preparation for "sale within the jurisdiction. I think that if the articles were brought "within the jurisdiction of the Authority, then the right to inspect "accrued, provided they were articles intended, as I think they were, for "the food of man. If, however, I am wrong in this, and it is necessary ''that the articles should either be sold or exposed for sale or deposited "for the purposes of sale within the jurisdiction of the Port Sanitary "Authority, then I think these cases were deposited at this transit shed "for the purpose by delivery when the order was given of carrying out "within the jurisdiction an agreement for sale made outside it, and so "were deposited for the purpose of sale within the jurisdiction. "I think a magistrate, provided he is asked to go and condemn goods "which an Inspector has seized, as soon as he sees the goods and is "satisfied that they are intended for human food, and are unfit to be so "used, he is bound to condemn them. The Act says so in terms and he "is not to inquire, and it is no part of his duty to inquire if such seizure "was legal." The magistrate fined the defendants 40s. and costs of 35 guineas in each case. The defendants gave notice of appeal. FOREIGN ANIMALS. In July, the s.s. "Sperber" conveyed to Bremen, from London, ten rams, which were there rejected on the ground of disease, and brought back to London. The Board of Agriculture would not permit the relanding of the animals dead or alive. The shipowners were naturally in a difficulty, and approached the Port Sanitary Authority to learn if any objection would be taken to the slaughter of the animals on the vessel at sea and the casting overboard of the carcases. They were informed that, subject to the carcases being thrown overboard at such a distance from land as would prevent them being cast up on any part of the foreshore of this country, no objection could be taken to the course proposed, as no nuisance would be likely to arise. These rams made several voyages across the North Sea, and I am informed they improved in health so much that they were ultimately landed at Bremen. The Board of Agriculture and Fisheries, by an order dated 13th September, 1907, appointed a piece of waste land to the south of No. 6 Berth in the Royal Albert Dock to be a foreign animal quarantine station, in accordance with the Diseases of Animals Acts, 1894 to 1903. This was only a temporary measure for a few months. 53 SHELL FISH. One of your Inspectors has regularly visited Leigh Creek, and he reports that he has not found any cockles laid in the creek, and that the arrangement mentioned in my last Annual Report still continues, namely, that the cockles are brought direct from the gathering grounds on the Maplin Sands, and are cooked forthwith. RIVER THAMES WATER. In my last Annual Report, I wrote at some length on the condition of the River Thames, and gave the results of a number of analyses of samples of water which had been taken from various parts of the River Thames and its estuary, situated within the jurisdiction of the Port Sanitary Authority. I showed that the main sources of pollution were various storm outfalls from the main sewerage system of the London County Council—the discharge of sewage effluents at Barking and Crossness—the discharge of crude sewage at Southend and Sheerness-on-Sea. I give the rainfall for each month collected at Greenwich, and also for each quarter of the year in the London District, and showing the difference from the average for each quarter, and for the whole year, extracted from the Quarterly Reports of the Registrar-General. Quarter. Difference Month. Inches. from. Average. January 1.09 February 1.27 March 0.91 3.04 -2.01 3.27 April 3.14 May l.47 June 2.65 7.28 +1.61 7.26 July 0.97 August 1.92 September 0.62 4.16 -2.91 3.51 October 3.25 November 2.23 December 2.73 8.59 +1.58 8.21 23.07 +1.58 above average. 22.25 The purification of the Thames largely depends upon the amount of water flowing over Teddington Weir, and into the tributaries of the Thames. The sewage effluent discharged into the Thames from the County Council outfalls at Barking and Crossness oscillates upwards and downwards with the flow and ebb of the tide, and is finally oxidised and carried to sea, the process being practically completed at the Chapman Lighthouse, about twelve miles below Gravesend. 54 The general condition of the River during the past year has been fairly good, largely due to the rush of fresh water during the second and fourth quarters of the year. The Conservators of the River Thames, with whom the question of preventing the pollution of the River Thames largely rests, have done a great deal of work in the direction of dredging the River, thus removing large quantities of putrescible matter, and providing a larger volume of water which is available for the oxidation of organic matter discharged into it. The general report of the proceedings of the Conservators of the River Thames, during the year ended 31st December, 1906, contains some valuable information as to the work done in regard to dredging the river, and the following extract will be of interest:— "In Barking Reach, between Crossness and Margaretness, a distance "of 1¾ miles, the channel was deepened to 22 feet over the greater part, "but owing to the continual silting up, the present depth of the channel "is 16 feet only for a width of 500 feet, and there are a few patches "where the depth is 15 feet only. "Continuous dredging has been carried out in this reach throughout "the year. From January, 1901, to December, 1906, about 940,000 cubic "yards of material have been dredged, but notwithstanding this there is "no general improvement in the navigation channel since the work was "commenced six years ago. The reach is, however, deeper in places. "The cause of the continual silting up in this reach has been "investigated, and 152 samples were taken of the effluents from the "Barking and Crossness Outfalls on 38 days between 1st May and "30th July. They were examined by the Conservators' Analyst, "Mr. C. S. Groves, F.R.S., who certified that the result showed "that one million gallons of the effluents carries into the river more solid "matter than is sufficient to form a deposit of 100 cubic feet of mud. "Mr. Groves also examined 24 samples of silt taken from the river "bed in Galleons, Barking and Halfway Reaches, and he certifies that "a considerable portion of the finer particles of mud in the silt is of the "same nature as the solid matter passing into the river from the "outfalls, and that the silting is due, therefore, in part, to the suspended "matter in the affluents. "From calculations based on the statistics of the London County "Council, it appears that in 1904 the volume of effluent passed into the "river was 91,216,254,000 gallons. The amount of solid matter "contained therein would therefore represent 9,121,000 cubic feet, or "about 337,000 cubic yards of mud, which exceeds the quantity which "No. 1 or No. 2 Dredger raises in a year. The Conservators have been engaged in generally dredging the river, and have been in the habit of depositing the hard material dredged up in a 55 certain buoyed area to the West of Leigh Middle Shoal, with a view to the filling up of a deep hole there and increasing the scour of the river through the navigable channel. A complaint was received from the Borough Council of Southend as to the nature of the material which was deposited off Leigh, they alleged that this polluted the Thames Estuary at this part. The various dredgers were kept under observation for some period, the general result being that the material so dredged up was found principally to consist of hard ballast and chalk. On some occasions, however, it was noticed that the material dredged up from the river, abreast of the Royal Albert Dock, contained a certain proportion of the offensive black mud which the Conservators' chemist had described as of the same nature as the solid matter passing into the river from the outfalls. The attention of the Conservators was drawn to this by the Port Sanitary Committee, and it appeared that stringent instructions had been given that material of this nature was to be taken out to the Black Deeps. The result of the observations was that there was no reason to believe that it was the practice to discharge offensive black material in the vicinity of Leigh. The Southend-on-Sea Corporation introduced a Bill into Parliament. during the Session of 1907, to obtain certain powers to provide for the sewerage of their Borough, and in order to enable them to perform such duty it is expedient to empower them to construct, maintain and use the works authorised by this Act, and to confer upon them the further powers in this Act. Clauses 7 and 7a received the careful consideration of the Port Sanitary Committee. They are as follows:— "7. The Corporation may, by means of the works authorised by this "Act, and of their existing sewerage works or any works constructed in "lieu thereof, discharge sewage into the sea, and any bye-law made or to "be made under the Sea Fisheries Regulation Act, 1888, shall not apply "to the Corporation in the exercise of the powers of this section. "7a. As from the date of the completion of the works authorised by "this Act, the Corporation, in discharging sewage into the sea, shall " observe the following provisions (that is to say):— "(1) Before allowing sewage to be discharged into the sea the "Corporation shall cause it to pass through screens or other suitable "apparatus for the removal, so far as is reasonably practicable, of "solid matter; "(2) The sewage discharged into the sea by means of the "existing 27-inch outfall sewer of the Corporation, situate east of "the pier, shall be caused to pass through the existing tanks, known 56 "respectively as 'the western valley tank' and 'the eastern valley “tank,' or other tanks provided by the Corporation in substitution "therefor, with the consent of the Local Government Board; "(3) The outlet valve at the western valley tank shall not be "opened except between the hours of one hour before high tide and "three and a quarter hours after high tide; "(4) The outlet valve at the eastern valley tank shall not be "opened except between the hours of high tide and three and a "half hours after high tide; "(5) The sewage discharged into the sea by means of the outfall "sewer (Work No. 3) authorised by this Act, shall be caused to "pass through the tank (Work No. 2) authorised by this Act. the "capacity of which shall not be less than one million two hundred "thousand gallons, or such other tank as may be provided by the "Corporation in substitution therefor with the consent of the Local "Government Board, and the outlet valve at such tank shall be "opened only between the hours of one hour before high tide and "three and a quarter hours after high tide; "(6) Immediately after closing the outlet valve at the eastern "valley tank hereinbefore referred to, the Corporation shall cause to "be discharged through the said existing outfall sewer a quantity "of sea water not less than one hundred and forty thousand "gallons; "(7) Immediately after closing the outlet valve at the tank "(Work No. 2), constructed in pursuance of this Act, the "Corporation shall cause to be discharged through the outfall sewer "(Work No. 3) authorised by this Act, a quantity of sea water not "less than three hundred thousand gallons ; "(8) The Local Government Board may, on the application of "the Corporation, vary the times referred to in sub-sections (3) "(4) and (5) of this section; provided that one month before "applying to the said Board for a variation of such times the "Corporation shall give notice of the intended application by means "of advertisements inserted in two or more newspapers published "or circulating in the borough; "(9) The provisions of this section shall not apply at times when, "in consequence of rain, it is necessary for the Corporation to "discharge sewage by means of their storm water overflow sewers, "or to use the said outfall sewers as storm water overflow sewers ; "(10) Subject to the last preceding sub-section, if the Corporation "fail to comply with the provisions of this section, they shall be 57 "liable to a penalty not exceeding five pounds, and to a further "penalty not exceeding five pounds for every day on which such "failure shall continue after conviction. Provided that no penalty "shall be inflicted under this section if the Court are of opinion "that the failure was in consequence of circumstances beyond the "control of the Corporation." The Port Sanitary Committee decided to oppose the passing of this Bill, on the grounds that if it became law, it would legalise the discharge of practically crude sewage into the Thames estuary. Sir Ralph Littler, C.B., K.C., and Mr. Lewis Coward, K.C., appeared as Counsel for the Port Sanitary Authority in opposition to the Bill. Your Medical Officer of Health attended before a Select Committee of the House of Lords, and gave evidence on behalf of the Corporation. Sir Ralph Littler, in the course of his Address, was asked by Counsel for the promoters of the Bill why the Port Sanitary Committee did not interfere with the London County Council's sewers, and he gave the answer that— "It is because we cannot, simply because they have got legalised what "is wanted to be legalised lower down. That is exactly the mischief "that we want to prevent here. We wish we could deal with them. If "we could, we should have a very different condition of river below the "outfall of the London County Council sewers from that which exists "to-day." Petitions against the Bill were lodged by the Essex County Council, Leigh-on-Sea Urban District Council, The Conservators of the River Thames, Mr. Alfred James Hobart, the Owner of a Shellfish Fishery in Hadleigh Bay, The Port of London Sanitary Authority, The Shoeburyness Urban District Council. Strenuous opposition was offered by the Essex County Council, Mr. Hobart, The Shoeburyness Urban District Council, and after hearing a number of witnesses both for and against the Bill, and hearing the addresses of the learned Counsel, the Chairman gave his decision "that the Committee consider that the preamble has not been proved, "and they suggest that a more complete scheme should be brought "before Parliament at some future date." 58 NUISANCES. Tables XXIII. and XXIV. The total number of complaints of nuisances dealt with during the year conforms very closely to last year. The total for the past year was 4,669, as against 4,391 for 1906, an increase proportionate to the number of vessels. Of this number, 389 related to smoke, 34 to offensive cargoes, 14 to questions of drainage, &c., while 4,231 related to general nuisances, of which many involved structural alterations. Details of these structural alterations are given in Table XXII. relating to vessels, and Table XXIII. relating to premises on shore. The written intimations sent numbered 664, while in 130 cases statutory notice was served by the direction of your Committee. Legal proceedings were recommended in 7 cases, and proceeded with in 6, a conviction being obtained on every case. The record of sanitary works carried out during the year is of some interest (Table XXIV.), and shows the provision of new lavatories, water closets, earth closets, urinals and drainage. As in former years, it is representative of the general class of sanitary work which your officers are called upon to supervise, and details of which should receive the approval of the Port Sanitary Authority. The question of further powers in relation to this is now under consideration by the Local Government Board, who have held a public Enquiry into the matter. Some notes on this Enquiry will be found on page 62. 59 TABLE XXII. NUMBER OF NUISANCES ON VESSELS REPORTED AND DEALT WITH during the year ending 31st December, 1907. Description of Nuisances. January. February. March. April. May. June. July. August. September. October. November. December. Total. Smoke Nuisances :— Number of complaints received 9 14 20 25 36 28 40 18 30 30 25 17 292 Number of recurrences reported 3 1 ... 3 2 9 24 7 14 4 4 2 73 Offensive Cargoes (Bye-laws):— Number of Infringements reported 3 2 ... 3 2 2 4 ... 6 1 6 5 34 Structural and other Defects :— Ventilation 18 9 8 5 9 12 7 3 6 5 4 6 92 Lighting 16 9 7 11 9 9 10 4 8 7 9 6 105 Heating 23 11 5 3 5 4 1 1 4 7 5 9 78 Bare iron in crew's quarters 1 5 3 1 1 1 ... ... 1 2 1 3 19 Leaky decks, hawsepipes, cable casings, &c. 20 10 9 10 15 15 13 3 9 9 12 11 136 Defective bulkheads and floors 15 6 8 9 11 14 6 4 7 4 5 8 97 Sanitary conveniences 5 ... 1 2 2 5 5 10 2 1 3 4 40 Ship's gear or stores stowed in crew's quarters 3 1 ... 3 1 5 1 ... 2 3 3 3 25 Foul bilges or peaks 5 2 5 3 7 12 5 8 12 8 15 7 89 Storage of drinking water (defective or dirty tanks) 2 1 1 ... 1 1 1 1 3 1 1 2 15 Dirty quarters 294 273 233 245 232 247 248 193 247 276 280 267 3,035 Accumulation of offensive matter ... ... 1 5 1 1 1 ... ... ... ... ... 9 Miscellaneous Nuisances 6 3 1 3 1 8 1 2 ... ... 4 2 31 Totals 423 347 302 331 335 373 367 254 351 358 377 352 4,170 Total number of vessels on which structural alterations were ordered 49 32 23 24 33 39 27 17 21 20 29 23 337 Total number of vessels on which structural alterations were reported as carried out 26 28 27 61 27 31 57 22 9 13 47 16 364 NUMBER OF NUISANCES IN THE RIVER REPORTED AND DEALT WITH during the year ending 31st December, 1907. From discharge of foul liquid, sewage, &c., into the River... ... 2 ... 1 ... ... 1 ... 2 ... ... ... 6 Accumulation of offensive matter ... ... ... ... ... ... ... ... 1 ... 1 Totals ... 2 ... 1 ... ... 1 ... 2 ... 1 ... 7 60 TABLE XXIII.— continued. NUMBER OF NUISANCES ON SHORE PREMISES REPORTED AND DEALT WITH during the year ending 31st December, 1907. Description of Nuisances. January. February. March. April. May. June. July. August. September. October. November. December. Totals. Smoke Nuisances:— Number of complaints received . 1 ... ... 1 7 ... 2 ... 1 1 3 1 17 Number of recurrences reported 1 1 .... ... 1 2 ... ... ... 1 ... 1 7 Structural and other Defects:— Ventilation ... ... ... ... ... ... ... ... ... ... ... ... ... Lighting ... ... ... ... ... ... ... ... ... ... .. .. .. Heating 1 . . . 8 .... ... ... ... ... ... ... ... ... 9 Dilapidations 2 1 8 ... 1 ... 1 2 ... ... ... ... 15 Sanitary conveniences ... 52 2 ... ... ... 3 2 ... 2 ... . . . 61 Water supply ... ... • • • ... ... 2 ... 1 ... ... ... 1 4 Dirty premises 17 87 29 28 24 46 20 26 22 16 .19 3 337 Accumulation of offensive matter ... 2 ... 2 10 1 1 1 2 ... ... ... 19 Drainage ... ... ... 1 ... ... 3 .... ... 1 1 2 8 Foul cesspits, latrines, &c ... ... ... ... 1 ... ... ... ... 1 ... • •• 2 Miscellaneous nuisances ... ... ... ... 2 2 4 1 1 ... 3 13 Totals 22 143 47 32 44 53 32 36 26 23 23 11 492 Number of shore premises on which structural alterations were ordered 2 52 9 1 1 1 3 3 ... 1 1 3 77 Number of shore premises on which structural alterations were reported as carried out 1 ... 10 1 29 3 1 1 2 1 1 1 51 SUMMARY. Smoke. Structural. Offensive Cargoes. Sewage, Drainage, &c. Floating Carcases, &c. Total. Number of Nuisances reported— (a) On vessels 365 3.771 34 ... ... 4,170 (6) On shore 24 460 ... 8 ... 492 (c) On the River ... ... ... 6 1 7 Totals 389 4,231 34 14 1 4,669 Number of written Intimations— (a) On vessels 312 275 34 ... ... 621 (b) On shore 15 13 ... 8 ... 36 (c) On the River ... ... ... 6 1 7 Totals ... ... 327 288 34 14 1 664 Number of Statutory Notices— (a) On vessels 71 53 ... ... ... 124 (b) On shore 6 ... ... ... 6 (c) On the River ... ... ... ... ... Totals 77 53 ... ... ... 130 POLICE COURT PROCEEDINGS. ] January. February. March. April. May. June. July. August. September. October. November. December. Total. Total number of cases in which legal proceedings were recommended ... ... ... ... ... ... ... ... ... 3 2 2 7 Total number of cases in which legal proceedings were taken ... ... ... ... ... ... ... ... ... 2 3 1 6 61 TABLE XXIV. Part I. Sanitary Works and Alterations in connection with Buildings, Premises and Vessels within the Docks, &c., completed during the year :— Date completed. Works. 1907. Feb. 4 Construction of main drain in Tilbury Dock, by Orsett Rural District Council. March 23 Construction of new lavatories and water-closets for the Clerical Staff employed at the West India Docks Naval Store Depot. May 1 Construction of lavatory and water-closet at a tailor's shop in Royal Albert Dock by Mr. A. Goldberg. „ 21 Construction of two Moule's Patent earth-closets at Messrs. Jenkins and Co.'s, Ltd., premises, Royal Albert Dock. July 5 Construction of water-closet, urinal and drainage connected therewith in the vicinity of the Canadian Produce Warehouses West, Surrey Commercial Dock. 5 Construction of water-closet, urinal and drainage connected therewith at Swedish Yard, Surrey Commercial Dock. Oct. 22 Removal of urinal from inside to outside of Customs' Clerical Office, Rum Quay, West India Dock, and the construction of a 4-inch drain in connection therewith. 26 Re-construction of drainage at Great Western Railway Company's Warehouses, Poplar Dock. Part II. Sanitary Works and alterations, not yet reported as completed Date Plan submitted. Works. 1907. July 4 Connections proposed to be made by the London and India Docks Company to the sewer which has been laid by the Orsett Rural District Council in Tilbury Dock. „ 31 Proposed conversion of cess-pit closets into water closets, in Albion and Station Yards, Surrey Commercial Dock. 62 PUBLIC HEALTH (LONDON) ACT, 1891. Further Powers. In my Report for the half-year ending 31st December, 1901, I called attention to the disadvantages under which your officers worked owing to the absence of Bye-laws dealing with water closets and other sanitary conveniences. Subsequent experience confirmed the necessity of obtaining further powers, and I again referred to it in 1905, with the result that your Committee instructed Mr. Solicitor and myself to report on the question, with a result that an application was made to the Local Government Board in February, 1906, for the assignment of further powers. Upon representations duly made in accordance therewith, the Local Government Board, after careful consideration of the application, ordered an Enquiry to be held, and this took place at the Guildhall on the 29th October last, before Theodore Thompson, Esq., C.M.G., M.D., Barrister-at-Law. The following Public Bodies and Municipal Boroughs were represented in opposition to the application of the Port Sanitary Authority:— London County Council, by Mr. Corrie Grant, K.C., M.P. City of Westminster, by their Town Clerk, Mr. J. Hunt. Corporation of West Ham, by Mr. Edward Morten. Borough of Southwark, by Mr. Manisty, K.C., with him, Mr. R. I. Simey. Borough of Bermondsey, by Mr. Walter Frampton. Borough of Chelsea, by their Town Clerk, Mr. Holland. Borough of Fulham, by Mr. R. M. Prescott. Borough of Lambeth, by Mr. Henry J. Smith. Borough of Woolwich, by their Town Clerk, Mr. Bryceson. Borough of Battersea, by Mr. Caudwell. Borough of Poplar, by their Medical Officer of Health, Dr. Alexander. Borough of Stepney, by their Town Clerk. The Corporation of London were represented by Mr. Cunningham Glen (instructed by the City Solicitor), and in attendance were the Assistant City Solicitor and Medical Officers of Health for the City and Port of London. The following is the text of the formal notice convening the Enquiry :— 63 The case for the Corporation as the Port Sanitary Authority was set out by learned counsel, who stated that— The application was made on behalf of the Corporation acting as the Port Sanitary Authority of the Port of London under Section 112 of the Public Health (London) Act, 1891. Under the previous section of that Act, section 111, the Mayor and Commonalty and Citizens of the City of London were to continue to be the Port Sanitary Authority of the Port of London and were to pay out of their corporate funds all their expenses as such Port Sanitary Authority. Then section 112 enabled the Local Government Board by order to "assign to the "Port Sanitary Authority of the Port of London any powers, rights, duties, "capacities, liabilities, or obligations of a Sanitary Authority under this Act, "or a Sanitary Authority under the Public Health Act, 1875, and any Act "extending or amending the same respectively, with such modifications and "additions (if any) as may appear to the Board to be required, and the order "may extend to the said Port a bye-law made under this Act otherwise than "by the Port Sanitary Authority, and any such bye-law until so extended "shall not extend to the said Port ; and the said Port Sanitary Authority "shall have the powers, rights, duties, capacities, liabilities, and obligations "assigned by such order in and over all waters within the limits of the said "Port, and also in and over such districts or parts of districts of riparian "authorities as may be specified in any such order, and the order may extend "this Act, and any part thereof, and any bye-law made thereunder, to such "waters and districts and parts of districts when not situate in London." Then sub-section 3 of that section contains a provision enabling the Port Sanitary Authority to delegate any of its powers to any of the riparian authorities, and provides that except in so far as such delegation extends, no other authority shall exercise any powers conferred on such Port Sanitary Authority by the order of the Board within the limits of the Port of London. The limits of the Port of London were originally defined by a Treasury Minute of the 1st of August, 1883, and for the purpose of exercising their jurisdiction over the area, as it then was, an Order was made under this section by the Local Government Board on the 25th March, 1892. On the 30th June, 1898, an Order of the Local Government Board extended the powers and duties of the Port Sanitary Authority to the whole of any wharf and of the area within the gates of any dock, and the buildings thereon respectively. The object of this order was to clear up certain doubts that had arisen or that might arise with regard to the jurisdiction of the Port Sanitary Authority within the area of the docks themselves, or on any wharf, but since then, cases 64 had arisen in particular with regard to a certain dock which made it desirable that the powers of the Port Sanitary Authority with regard to the land area of the docks should be more clearly defined. Thus a really important question exists as to the jurisdiction of the riparian authorities over those areas which are within the Port Sanitary area of London, and the question could not arise if the Local Government Board were to make the Order asked for under the powers possessed by them under section 112. The outcome of the cases referred to was that the officers of the Port Sanitary Authority who had formerly been able to get sanitary defects remedied, although without statutory power in some cases to insist, latterly found a difficulty with regard to certain sanitary matters. In one case, that of the sanitary conveniences in the Royal Albert Dock, which required to be altered and modernised, the Dock Company, owing presumably to the question of the jurisdiction and powers of the Port Sanitary Authority having been raised elsewhere, would not provide suitable sanitary conveniences, and it was therefore apparent that if the various dock owners did not willingly do what they were asked to do, there was some doubt as to whether there were sufficient powers possessed by the Port Sanitary Authority to insist upon those things being done. With reference to a view which appeared to have been taken by some of the Riparian Authorities, that the Port Sanitary Authority were seeking powers to extend their present area, it was explained that there was no desire or attempt to do this, and that the powers sought would be exercised only within the limits within which the Port Sanitary Authority already possessed powers. Evidence in support of the application was given at considerable length by your Medical Officer of Health, who gave particulars as to the district and staff of the Port Sanitary Authority, and of the various sanitary works which had been carried out under the supervision of your officers, such works having been done without, in some instances, adequate legal powers, but in every case it was extremely desirable that the Port Sanitary Authority should have full knowledge of all Sanitary works executed within their jurisdiction. He set out the nature of the difficulties encountered with regard—firstly, to the deposit of plans, and secondly, to the execution of the work in accordance with the views of the Port Sanitary Authority thereon, and it was shown that the method involved much unnecessary correspondence, was not expeditious, and sometimes failed through the absence of legal power to enforce the requirements. This was notoriously the case with regard to the obsolete out-of-date arrangement of cesspit-closets and privies obtaining in certain of the docks, which are extremely objectionable from a sanitary point of view. 65, That it was necessary in all cases where new work was being done, that plans should be deposited with the Port Sanitary Authority, and that they should possess powers for regulating the construction of all water closets, earth closets, privies and drainage works in connection therewith. That any overlapping of two Sanitary Authorities within the same district, working for the same object and under the same powers, was most undesirable. That with regard to Section 16, sub-section 1 (a) under which the Port Sanitary Authority now have Bye-laws regulating the carriage and removal of offensive matters through the Port, it was desirable that the Bye-laws should be made to extend to such matters when on shore within the dock area, and that Bye-laws should be made for preventing nuisances arising from offensive matters discharged from manufactories, breweries, slaughter-houses, knackers' yards, butchers' or fishmongers' shops, and dung-hills, in view of the existence of a number of factories within the dock areas, and owing to vessels entering the docks with large accumulations of cattle dung on the decks, where they often remained for days, with liquid filth running down the sides of the vessel into the dock. Also, with regard to sub-section (c) of the same section for preventing the keeping of animals on any premises in such place or manner as to be a nuisance or injurious or dangerous to health (it being shown that in many cases animals—for example, swine and cattle were kept on board ships, and horses in stables within the docks), and with regard to sub-section (d) of the same section as to the paving of yards and open spaces in connection with dwelling-houses, it is desired, by reason of the fact that there are many dwelling-houses within the docks, and some of these have been found from time to time with ill-paved yards and insanitary surroundings. Further, that it was very desirable that the existing Bye-laws made by the London County Council should be applied, if necessary, within the whole of the district of the Port Sanitary Authority, with this modification : That such Bye-laws should be enforced by the Corporation as the Port Sanitary Authority, but that in default, questions of appeal should lie, not to the County Council, but to the Local Government Board. It was further sought to amend the order of the Local Government Board dated 25th March, 1892, which states that " for the purposes of the aforesaid section and parts of section, any vessel lying within the district of the Port Sanitary Authority shall be subject to the jurisdiction of such Authority as if it were a house," by omitting the word " lying." This is an important amendment, and would make the order apply, of course, to any vessel whether stationary or moving, and the point was brought out in a case heard relating to a smoke nuisance, where the vessel was proceeding down the river at the time. 66 The point was not decided judicially, and it is therefore now sought to amend the order so as to avoid a similar question in the future. Your Medical Officer was cross-examined on his evidence by representatives of the London County Council, Borough of Southwark, Corporation of West Ham, Borough of Bermondsey, City of Westminster, Borough of Woolwich, Borough of Battersea, Borough of Stepney and Borough of Lambeth. A point was raised as to whether the powers sought intended to apply to the general construction of buildings, and it was explained that this was not within the terms of the application. The application also included a proposal for amendment of the bye-laws made under section 5 of the Public Health (London) Act, 1891, requiring removal to hospital of patients suffering from a dangerous infectious disorder, so as to make them apply to vessels entering the River Med way, and also those entering the Port of London and mooring at places below Gravesend. Provision was also made for keeping of patients in hospital. Draft of amended bye-laws as submitted to the Local Government Board:— BYE-LAWS made by the Port Sanitary Authority of the Port of London, pursuant to the Public Health (London) Act, 1891, Section 66 (3), and confirmed by the Local Government Board, for removing to Hospital, and for keeping in Hospital so long as may be necessary, any persons brought within the Port by any Vessel who are infected with a dangerous Infectious Disease. 1. In these Bye-laws the expression "The Port Sanitary Authority" means the Mayor, Commonalty, and Citizens of the City of London, acting as the Port Sanitary Authority of the Port of London. The term Medical Officer of Health or Medical Officer of the Port of London Sanitary Authority shall include any duly qualified medical practitioner appointed or employed to act on their behalf. The expression "Dangerous Infectious Disease" means any one of the following diseases :— Small-pox, Diphtheria, Membranous Croup, Scarlatina or Scarlet Fever, Typhus Fever, Typhoid Fever, Enteric Fever, Relapsing Fever, Continued Fever, Measles, 67 and shall include any infectious disease to which Section 55 of the Public Health (London) Act, 1891, has been applied by the Port Sanitary Authority in manner provided by that Act. 2. Every master or other person having charge of a vessel 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 disease, shall, if bound up the River Thames to any place situated Westward of a line drawn from Havengore Creek in Essex, to Warden Point in the Isle of Sheppey, proceed to Gravesend and stop off the Custom House, Gravesend, and if bound up the River Medway, shall stop on arrival off Garrison Point, Sheerness, and forthwith send notice to the Medical Officer of the Port Sanitary Authority stationed at Gravesend or Sheerness, as the case may be, that there is a person on board suffering from such a disease. 3. The master or other person in charge shall cause the vessel to remain off the Custom House, Gravesend, or Garrison Point, Sheerness, until the Medical Officer of Health, or Medical Officer of Port of London Sanitary Authority has boarded the said vessel. 4. The Medical Officer to whom notice is given as aforesaid, shall, as soon as practicable, visit the vessel, and ascertain whether the person referred to in the notice is suffering from a dangerous infectious disease, and, if in the opinion of the Medical Officer 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, and it is desirable that he should be removed thereto, the master or other person having charge of the vessel shall forthwith cause such person to be removed to such Hospital according to the directions of the Medical Officer. 5. Every person infected with a dangerous infectious disease who may be removed to the Hospital of the Port of London Sanitary Authority at Denton, below Gravesend, or to any other Hospital to which the Port Sanitary Authority are entitled to remove patients, shall remain in such Hospital so long as may be considered necessary by the Medical Officer in charge of the Hospital, for the purpose of preventing the spread of infection. 6. If any dangerous infectious disease shall break out on board any vessel arriving in the Port of London, and after she has passed Gravesend, the master or other person having charge of such vessel shall give notice to the Medical Officer of Health of the Port Sanitary Authority, at his Office at 51, King William Street, Greenwich, S.E., that there is on board a person suffering from such a disease, 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 vessel 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. 69 Entering the port side alleyway, first of all on the right is situated the native galley or cook-house, and immediately opposite is a range of five water closets for the use of 60 persons (Europeans). Further on, on the right, is a berth occupied by bakers, and opposite to this is a range of trough closets, with ten seats, for the use of 81 Asiatics. With the exception of a side port, there is no ventilation of the whole of these closets except into the alleyway giving communication to the native cookhouse, the living quarters of the crew, and the lower forecastle. At the end of this alleyway one enters that part of the top-gallant forecastle occupied by the Lascar seamen, and the plan shows that accommodation is afforded for 29 Lascars, but the bunks provided being insufficient for this number, extra sleeping accommodation is afforded by slinging hammocks. The ventilation of this space, which is about 40 feet long, and varying from about 24 feet in width, for the accommodation of 29 men, is simply an 18-inch ventilator in the fore part, and two 7-inch ventilators in the after part. These last are close together and immediately over a bunk, with the natural consequence that they were both promptly blocked up by the occupant, who happened to be the serang, or headman. The ventilator in the fore part would act generally as an "uptake'' Therefore, any renewal of air would take place through the door communicating with the alleyway, in which is situated the range of water closets and the galley. A portion of this forecastle on the starboard side is partitioned off and occupied by 16 European stewards. The ventilation provided here consists of two bitt ventilators, as on the port side, which, being situated over and in immediate proximity to bunks, were treated as before described, with the result that there was no air supply except through the door communicating with the alleyway. This alleyway on the starboard side gives access to quarters occupied by petty officers, and to those on the lower deck occupied by native servants. These are reached by a stairway. That part of the lower forecastle now entered (See plan B), accommodates 26 native servants, who occupy that number of bunks. The place is fitted with a 12-inch ventilator on the port side, immediately over a bunk, and a 6-inch ventilator on the starboard side, also over a bunk. Both of these were found blocked up, for the usual reason, leaving the quarters devoid of any ventilation whatever, except that obtained by the stairway, which in itself does not communicate with the open air. The quarters forward of these, occupied by 36 native firemen, and 16 native coal-trimmers, 52 persons in all, have a separate entrance by a stairway in the alleyway on the port side. 70 As in the case of the Lascar seamen, these Asiatics—their number being in excess of the number of bunks—are supplied with hammocks. The ventilation is by means of a swan-neck ventilator of oval section, 12 inches by 4, and a cowl ventilator of 18 inches diameter. The swan-neck ventilator being over a bunk was, of course, stopped up, the 18-inch ventilator acting as an "uptake," any replacement of air would occur by the stairway which opens in the immediate vicinity of the water closets. All the crews' quarters will be seen were fitted with side ports, but these were not always available for ventilation, and were inadequate so far as lighting was concerned. All these arrangements appear to have been approved by the Authorities responsible for the administration of the Merchant Shipping Act, but I am glad to record that on my making representations in the proper quarter, considerable improvements were carried out. The case of these vessels serves once more to illustrate the difficulty which exists, and always will exist where sanitary questions, such as ventilation and so forth are carried out apparently without any regard to the object to be attained. It was quite evident that whoever was responsible for approving the plans of the crews' quarters of the above mentioned four vessels, must have sanctioned the position of the ventilators without considering or even caring where they were to be placed in relation to the bunks, certainly no one with any knowledge of human nature or the principles of ventilation would have sanctioned such an arrangement. Perhaps the approval was given before the quarters were fitted up, and I recommend that a communication be sent to the Board of Trade, urging them to give instructions that crews' quarters are not to be approved until inspected and found to be satisfactory from a sanitary point of view, after they are fitted up and ready for occupation. The accommodation usually provided for seamen is a disgrace to 20th century civilisation, being much like that possessed by the cave dweller of old, and this condition will remain so long as so many shipowners, when building new vessels, are more concerned with reducing the registered tonnage than in providing sanitary and humane accommodation for the seamen who have to live and work on board. New vessels are daily being built with the crew's quarters situated in the fore part, where sufficient light cannot be provided, where ventilators have to be removed in bad weather, where the firemen on leaving the stokehold, hot and perspiring, in bad weather are drenched with cold water on their way to their miserable quarters forward, in fact I have often been told by certain masters of ships that they have had to slow the vessel down sometimes to 71 ensure the men getting forward at all. There is no reason, apart from a mercenary one, why crew's quarters should not be provided in the after-part of the ship, where the men could enjoy light, air, warmth, and reasonable space and accommodation. On the 3rd June, 1907, the s.s. "Spray," of Leith, 99,229, was inspected, when it was found that the crew's quarters in the forecastle were verminous, dirty, leaky, and the space under the flooring was filled with an accumulation of filth. There being no cooking galley on the vessel, the cooking was carried out in the forecastle, which was also used for the stowage of ropes, paints and other ship's gear and stores. This combination, as may easily be imagined, constituted a very obvious nuisance, of which formal intimation was at once forwarded to the owner of the vessel, who at once carried out the necessary work. On the 5th June, 1907, the schooner "Dairymaid," of Fleetwood, 56,698, was inspected, when it was found that the deck over the lower forecastle was leaking badly, and required to be made tight, the lower forecastle was also found to be damp, dirty and verminous, and in what appeared to be a disused butter keg, which was very filthy, were 15 lbs. of corned meat in a putrid condition. This was destroyed, and arrangements were made to fumigate the forecastle with sulphur for the destruction of vermin. It was afterwards thoroughly cleaned out, and as a result of some correspondence with the owner, the other insanitary conditions were remedied before the vessel left the Port On July 2nd, one of your Inspectors on visiting the schooner "Betty Russell," of Lancaster, 47,796, found stowed away in a paint and rope locker which was in a filthy condition and adjoining a privy, about 30 lbs. of dry salted meat, which was unsound and unfit for human food. The meat was kept in what appeared to be a butter keg with a rough wooden top. The matter was brought to the notice of the master of the vessel, with the result that the meat, which formed part of the crew's provisions, was saturated in a disinfecting solution and afterwards destroyed by burning. The s.s. "Parisian," of Glasgow, was inspected on the 2Gth August last. The "greasers'" quarters, certified for six men, were found occupied by eight. The available floor area was 46.5 feet, or less than six square feet per man. There was no daylight in the place at all; artificial light had to be used at all times. The only ventilator was 7 inches in diameter, and had a bend in its course. 72 The firemen's quarters in the forecastle were certified for 24 men, and' occupied by 30. I placed these facts before the Principal Officer of the Board of Trade for possible action on his part in respect of overcrowding, lighting, &c. INSANITARY BARGES. The case of the barge "Thirza Little," is one of some interest. Notice was first drawn to this barge in January, 1903, when she was found loaded with an offensive cargo, which was the cause of a serious nuisance in the cabin of the barge. The owner having been warned in the usual manner, the matter was subsequently brought to the notice of your Committee, and it was ordered that a Notice be served upon the owner, which was done on the 7 th February, 1903. This appeared to have had some effect, for when next seen, the barge was not carrying any offensive cargo, and no complaint was again made until May, 1904, when the barge was again met with, this time carrying a cargo of refuse matter largely consisting of dung. A similar nuisance existed in the cabin, no steps having been taken to properly disconnect the hold from the cabin by a proper bulkhead. Your Committee again ordered a Notice to be served, which was accordingly done on the 16th June, 1904. From the subsequent record it Avould seem that up to the end of that year, the barge was not employed in carrying offensive cargoes. During 1905, the barge appears to have been employed in the Port of London, but seldom, if at all. In 1906, the barge was several times inspected, but on no occasion was any offensive cargo found on board and no nuisance existed. On the 11th June, 1907, however, the barge was found lying off Gravesend, again laden with dung, and the same offensive conditions as formerly complained of, no steps having been taken to render this vessel suitable for the carriage of filthy matter. In addition, the nuisance on this occasion was much aggravated by a serious overcrowding of the cabin, which, although provided with but two bunks, was occupied as a sleeping place by the master, his wife, two children, and the mate, an adult male. 73 The cabin generally was leaky and structurally defective, and I have no hesitation in stating that the conditions found constituted a serious nuisance, injurious to the health of the inmates. As some indication of the nature of the emanations from the cargo, I may state that in the fore-cabin, which fortunately and probably for good reasons was not occupied, the air was so foul that a light would not burn. This fact may have been known to the crew of the barge, and may account for the mate sleeping in the after-cabin. It need only be pointed out that an alteration in the position of the barge, or change of wind, might have been sulficient to transfer the accumulation of foul gas from the fore-part of the vessel to the after-cabin, with the fatal results which have, on several occasions previously, been brought to the notice of your Committee. A further notice was served upon the owner, in accordance with the advice of Mr. Solicitor, in July, since when the barge has not been seen. POLICE COURT PROCEEDINGS. TABLE XXY. Date. Name of Vessel. Offence. Police Court. Result. 1907. Oct. 23 Lighter "Cambridge." Leading or carrying a cargo of fish offal which was not properly and securely covered so as to prevent any nuisance arising therefrom. Mansion House. Fined 10s. and 3s. costs. ,, 23 Lighter "Australia." Ditto. Ditto. Fined 10s. and 3s. costs. Nov. 27 Lighter "Hesperus." Ditto. Woolwich Fined 21. and 31. 3s. costs. „ 27 Lighter "George." Ditto. Ditto. Fined 10s. „ 27 Lighter "Henry." Ditto. Ditto. Fined 10s. Dec. 9 s.s. "Charente"- Unfit for human food, four cases of dried white of egg, marked 'M.J.D.,' lying at Western Department, Royal Victoria Dock. West Ham Ordered to be destroyed, and on summary conviction was fined 10l. and 20 guineas costs. 74 PUBLIC HEALTH LEGISLATION IN 1907. The Yaccination Act of 1907 modifies the Act of 1898 by substituting a statutory declaration of conscientious belief in the place of the provision for satisfying two justices of such belief, which obtained in the former Act. The Public Health Amendment Act, 1907, only applies to England, Wale and Ireland, exclusive of the Administrative County of London. These provisions may, therefore, apply in the Victoria, Royal Albert and Tilbury Docks, exclusive of a small portion of the Royal Albert Dock, which is within the Metropolitan Borough of Woolwich. The Butter and Margarine Act, 1907, prohibits the importation from abroad of margarine and certain dairy products which do not conform to the conditions imposed on Home products. The power of inspection, taking samples, and instituting prosecutions, rests with His Majesty's Commissioners of Customs, and therefore the Port Sanitary Authority is not affected by this Act. The Public Health Regulations as to Food Act is of great importance. The following is a full text of the Act:— Chapter 32. "An Act to enable regulations to be made for the prevention of "danger arising to public health from the importation, prepara"tion, storage, and distribution of articles of food. (28th August, "1907.) A.D. 1907 "Be it enacted by the King's Most Excellent. Majesty, by and with the "advice and consent of the Lords Spiritual and Temporal, and Commons, "in this present Parliament assembled, and by the authority of the same, "as follows:— "1. (1) The power of making regulations under the Public Health "Act, 1896, and the enactments mentioned in that Act, shall include "the power of making regulations, authorising measures to be taken for "the prevention of danger arising to public health from the importation, "preparation, storage, and distribution of articles of food or drink (other "than drugs or water) intended for sale for human consumption, and, "without prejudice to the generality of the powers so conferred, the "regulations may— "(a) provide for the examination and taking of samples of any " such articles ; "(b) apply, as respects any matters to be dealt with by the regula"tions, any provision in any Act of Parliament dealing with the "like matters, with the necessary modifications and adaptations ; "(c) provide for the recovery of any charges authorised to be made "by the regulations for the purposes of the regulations or any "services performed thereunder ; Power to make regulations as to the importation, preparation, storage, and distribution of articles of food. 59 & 60 Vict., c. 19. 75 "(2) For the purposes of regulations made under this Act, articles "commonly used for the food or drink of man shall be deemed to be "intended for sale for human consumption unless the contrary is proved. "(3) In the application of this Act to Scotland, Part IV. of the "Public Health (Scotland) Act, 1897, shall be substituted for the "Public Health Act, 1896. 60 & 61 Vict., c. 38. "2 All regulations made under this Act shall be laid as soon as may "be before Parliament, and the Rules Publication Act, 1893, shall apply "to such regulations as if they were statutory rules within the meaning "of Section I. of that Act, and that Act as so applied shall, notwith"standing anything in Sub-section V. of Section I. thereof, extend to "Scotland, with the substitution of a reference to the ' Edinburgh "Gazette ' for the reference to the ' London Gazette.' Publication of regulations, 56 & 57 Vict., c. 66. "3. This Act may be cited as the Public Health (Regulations as to "Food) Act, 1907." Short title. No efforts have been made during the year to carry into effect the recommendations contained in the Fourth Report of the Royal Commission on Sewage Disposal, with a view to the formation of River Boards and preventing the pollution of rivers and shell-fish beds. TABLE XXVI. HOSPITAL. Number of Cases Admitted, Cost of Maintenance, &c. Patients remaining in Hospital on 31st December, 1906 8 Admitted. Discharged. Died. Remaining under treatment Cholera (suspected) 1 1 0 0 Bubonic Plague 0 0 0 0 Suspected ditto 3 2 0 1 Small-pox 8 8 0 0 Scarlet Fever 4 10 0 0 Enteric Fever 27 25 4 0 Continued Fever 10 9 1 0 Diphtheria - 3 3 0 0 Measles 14 14 0 0 Erysipelas - 0 0 0 0 Chicken-pox 5 5 0 0 Totals 75 77 5 1 Remaining in Hospital on 1st January, 1908 1 Total number of days' treatment during the year 1,872 Average number of days' treatment for each case 22.55 The average daily cost of maintenance per head was 1s, 11.03 d. 76 The total number of cases of Infectious Disease admitted to the Hospital during the year was 75. There were eight remaining in Hospital from the previous year, making 83 cases under treatment during the year, of which 77 recovered and were discharged. There were five deaths, and one remained in Hospital at the close of the year. Of the five deaths, four occurred from Enteric Fever, and one from Pneumonia. The largest number of cases admitted were of Enteric Fever, of which there were 27, Measles coming next with 14. There were eight cases of Small-pox, all of which recovered. The other cases included three of suspected Plague, and one of suspected Cholera; particulars of these are given elsewhere. The average number of days' treatment for each case was 22.55, and the average daily cost of maintenance per patient was 1s. lld. TRAINING SHIPS. During the past year, Scarlet Fever has been very prevalent within the County of London, and it would have been strange if the Training Ships situated on the Thames had escaped. They contain a number of boys of susceptible age, who are visited at certain times by their friends from London. The above Table will show the actual number of cases which have occurred. The principal outbreak occurred on the "Arethusa." The first case ailed on the 20th September, and the rash was noticed on the 24th, when the boy was removed to hospital. The second case ailed on the 29th, and the rash was noticed on the 30th. This boy was obviously infected from the first case, and subsequently, cases ailed from the same cause. I urged upon the Commander of the ship, and the Medical Officer in charge, that the boys should be mustered daily, and their temperatures taken, and any boy whose temperature was found to be raised above the normal, should be at once isolated on shore, and kept under observation until a definite diagnosis could be made. 77 This course was adopted, and I think the small number of cases which have occurred are due to the manner in which these precautions were taken by the ship's authorities. A second outbreak occurred at the end of November, and this was probably due to the return of some of the boys who had suffered from Scarlet Fever, and who were not quite free from all risk of infection. I have advised that any boy who suffers from Scarlet Fever should not be received back to the ship until at least a period of six weeks has elapsed since his discharge from hospital. A small outbreak occurred on the Training Ship "Cornwall," which was due to the introduction of a boy who was incubating the disease, in consequence it spread to others. Every boy who ailed was at once isolated on shore, with the result that the outbreak was soon controlled. The Training Ship "Arethusa" was, at the request of the authorities, thoroughly disinfected by fumigation with Sulphur-Dioxide gas, and the whole ship washed down with a disinfecting solution. The bedding and effects of all the boys were removed to Denton Hospital, and disinfected by steam. STEAM LAUNCHES. These continue to do good and efficient service; the Denton is, however, very slow, and I propose to submit a plan with the object of fitting her up with a disinfecting apparatus. In the following short Table, I have set out the number of days each launch was employed during the year, the number of visits of inspection and the average daily number of visits for each launch. Table XXVII. Launch. Total No. of working days. No. of days laid by. Total No. of vessels visited. Average daily No. of vessels visited. "David Burnett" 3.19 46 4,219 13.2 "Clotho" 329 36 5,180 15.7 "Denton" 324 41 5,420 16.7 These figures give the highest daily average to the small launch "Denton," which works in the Pool, &c., where vessels lie at short distance. The "David Burnett" has the low average—this boat having longer distances to cover, and special duties apart from sanitary inspection. 78 By payment of a slightly increased premium, full insurance of the launches has been effected. This is important, as minor damages from collisions are more or less frequent in the traffic of the river, and the work of boarding. With regard to working expenses, the year has proved an average one, not marked by any considerable item for repairs, except a new dinghy for the " Clotho." Some information, therefore, of the average daily and annual cost of working the launches will be of interest. Table XXVIII. 1907. Wages. Coals. Stores. Repairs, &c. Total. Daily average cost.* £ s. d. £ s. d. £ s. d. £ s. d. £ s. d. £ s. d. "David Burnett" 396 10 0 130 10 0 64 7 2 41 3 9 632 10 11 2 0 3 "Clotho" 266 14 0 82 12 0 25 6 0 35 5 11 409 17 11 1 4 11 "Denton" 244 8 0 44 16 0 22 17 8 22 3 0 334 4 8 1 0 7 Total 907 12 0 257 18 0 112 10 10 98 12 8 1,376 13 6 4 5 9 *Calculated on the number of "working" days. STAFF. There have been but few changes in the personnel of the staff calling for notice. Of your staff of Assistant Medical Officers, Dr. A. H. Hogarth retired in June last, having received another appointment; his place was taken by Dr. W. D. Betenson, who has had extensive experience of Plague in India and South Africa, and who had already given satisfaction when acting temporarily as an Assistant Medical Officer. There are no changes in the staff of Inspectors. With the qualification in June last of Inspector Rolfe as an Inspector of Food, the whole of your Inspectors now hold this important certificate. The Hospital Staff has been increased by the additional appointment of a laundry maid, who also acts as general maid. This is in place of the employment of occasional temporary help from outside, for laundry work, objectionable for obvious reasons in the case of an infectious hospital. 79 CANAL BOATS ACTS. Section 3 of the Canal Boats Act, 1884, provides that every Sanitary Authority within whose District any canal or part of a canal is situate, shall make an annual report to the Local Government Board as to the execution of the Canal Boats Acts, 1877 and 1884, and of the Regulations made thereunder and as to the steps taken by such Authority during the year to give effect to the provisions of the said Acts and Regulations. The expression "canal" includes any river, inland navigation, lake, or water being within the body of a county, whether it is or is not within the ebb or flow of the tide. (1.) Each Sanitary Inspector is responsible for the inspection of all canal boats found within his district. I append a list of the names of the Sanitary Inspectors, with their remunerations. The official address of each Sanitary Inspector is 51, King William Street, Greenwich, London, S.E. Inspector Garland 208l per annum. Western District. London Dock. St. Katharine's Dock. Regent's Dock. Surrey Commercial Dock. Inspector Wetjen 182l. per annum. Eastern District. East India Dock. Royal Albert Dock. Royal Victoria Dock. Inspector Burr 182l. per annum. Central District. West India Dock. South West India Dock. Poplar Dock. Millwall Dock. 80 Inspector Lambe 162l. 10s. per annum. Gravesend District. Tilbury Dock. North Shore—from Purfleet down. South Shore—from Erith down. RIVER. Upper District. Teddington to Limehouse. Inspector Hopkins 182l. per annum. Middle District. Limehouse to Erith. Inspector Romeril 208l. per annum. Lower District. Erith to seaward limits of the Port of London (including part of River Med way). Inspector Rolfe 162l. 10s. per annum. (2.) The total number of boats inspected during the year was 1,294. Of these 1,188 were found to conform to the Acts and Regulations. The total number of infringements found was 134. In each case written notice was sent to the owner, on a form, one half of which is to be detached and returned when the infringement no longer exists, such form having been first signed by an Inspector of Canal Boats. The number of cautions given was 82, whilst the number of infringements reported remedied was 85. This apparent discrepancy is due to the fact that some of the infringements reported in 1906 were remedied in the early part of 1907. The number of boats found to be unregistered was five. Of these four have been duly registered, after undergoing the necessary structural alterations, &c., in order to comply with the Regulations. In the case of the remaining boat, although technically a canal boat, there is no evidence so far to show that it is used as a dwelling. When this is obtained, the necessary steps will be taken to register it as a canal boat. 81 Of the four canal boats registered during the year, three were used for the carriage of offensive cargoes, namely, oil, tar, or gas liquor. One of the boats was constructed with an iron bulkhead which completely cut off the hold from the cabin. The cargo was carried in iron tanks, the after one being about ten inches from the cabin bulkhead. The other two boats were constructed of wood, and the cargoes of gas liquor were stored in wooden tanks. The bulkhead separating the cabin from the hold of each barge was found to be defective, allowing the gases of ammonia and sulphuretted hydrogen to pass freely into the cabin, blackening the paintwork, and rendering the cabin practically unfit for habitation. Before these two boats were registered, the following alterations were carried out by the owners:— (a) The cabins were thoroughly cleaned and painted, and the cabin bulkheads made perfectly tight so as to prevent gases entering the cabins through the bulkheads. (b) Existing skylights removed, and larger ones, glazed and made to open, fitted. (c) Coal lockers and cupboards in which to store food to be provided. (d) Broken stoves and funnels removed and replaced by new ones. (e) The bilge courses closed so as to prevent liquor passing under the cabin floor, and gratings fitted over the space between the after end of the tanks and the cabin bulkheads. (f) Suitable vessels provided for the storage of not less than three gallons of drinking water. Certificates of registration were not produced in 24 cases. In some instances this was due to carelessness, the certificates having either been left behind, or having got old and destroyed. In three cases the certificates of registration did not identify the owner with the boat. Eighteen boats were not properly lettered, marked, or numbered. Overcrowding was found to exist in the undermentioned eight cases :— The "Linslade," registered Port of London, No. 371, was inspected on the 7th March, 1907. The after cabin, which is registered for three adults, was occupied by two adults and three children, namely, the master, his wife, and three children, being one child in excess of the number for which it is registered. 82 The "Sally," registered at Brierly Hill, No. 228, was inspected on the 12th and 15th April respectively. The after cabin, which is registered for three adults, was found to be occupied by three adult males and one child, being one child in excess of the number for which it is registered. The "Phebe," registered at Brierly Hill, No. 144, was inspected on the 12th June. The after cabin, which was registered for three adults, was occupied by the master, his wife, and three children, being one child in excess of the number for which it is registered. The "Alice," registered at Wolverhampton, No. 949, was inspected on the 17th August. The after cabin, registered for three adults, was found to be occupied by the master, his wife, and four children, being two children in excess of the number for which it is registered. The "Stoke," registered at Wolverhampton, No. 899, was inspected on the 24th October. The after cabin is registered for three adults, or two adults and two children, and the fore cabin is registered for one adult or two children. Owing to the dilapidated condition of the fore cabin, all the persons on board occupied the after cabin, the result being that the cabin was occupied by one child in excess of the number for which it is registered. The "Eliza," registered at Brierley Hill, No. 214, was inspected on the 6th December. The after cabin, registered for two adults, was found to be occupied by two adults and one child, being one child in excess of the number for which it is registered. The "Avon," registered at Wolverhampton, No. 846, was inspected on the 27th December. The after cabin is registered for three adults, and the fore cabin for one adult. Owing to the dilapidated condition of the fore cabin, which was unfit for habitation, all the persons on the boat, namely, the master, his wife, and three children (the eldest of whom was only five years of age), occupied the after cabin, with the result that it was occupied by one child in excess of the number for which it is registered. In the case of the following two canal boats, it was found that although no overcrowding existed, the fore cabin in each case was used as a dwelling, although it was not registered for occupation. The "Isis," registered at Berkhampstead, No. 455, was inspected on the 17th December. The after cabin, which is registered for four adults, was occupied by the master, his wife, and two children. The fore cabin, which was not registered for occupation, was occupied by a person of the female sex above the age of twelve years, namely a niece of the master. On the same date, the "Bourne," registered at Berkhampstead, No. 442, was inspected. The after cabin, registered for four adults, was occupied by the 83 muster and his wife. The fore cabin, which was not registered for occupation, was occupied by a person of the male sex above the age of fourteen years, namely, the father of the master. The occupations of the fore cabins were infringements of the Canal Boats Act, 1877, but these were occupied in order to comply with the Canal Boats Regulations 111 (8b), which provide that:— "A cabin occupied as a sleeping place by a husband and wife shall not "at any time while in such occupation, be occupied as a sleeping place "by any other person of the female sex above the age of twelve years, "or by any person of the male sex above the age of fourteen years." It is satisfactory to record that during the year no case was reported of a boat not having a proper partition separating the sexes, and in not one instance was it found that a person of the male or female sex over the legal age occupied the same cabin with other adults. The largest number of infringements reported were under the heading of "cleanliness," no less than 35 being so reported. In the case of four boats, the ventilation of the cabins was reported to be deficient, This, however, was on unregistered boats, and the defects were remedied before registration. Two boats were reported as infringing the Regulations as regards painting, which is required to be done once at least in every three years. Twenty-nine boats were found in a dilapidated condition. Five boats were without a suitable receptacle for the storage of not less than three gallons of water for drinking purposes. There were no cases of Infectious Disease notified, and in only one instance was the authority of the Inspector to enter upon and examine the canal boat questioned. I have visited a large number of canal boats, and in every instance I have found that the occupants welcome the appearance of the Inspector. They took upon him as their friend, and indeed have freely stated in many cases that without the aid of the officers of this Authority they would have been unable to get many defects remedied, and they appreciate the action of the Authority in looking after the welfare of the occupants of canal boats. I have the honour to be, Gentlemen, Your obedient Servant, HERBERT WILLIAMS, Medical Officer of Health, Port of London 84 TABLE XXIX. SUMMARY OF CANAL BOATS FOR THE YEAR ENDING 31ST DECEMBER, 1907. January. February. March. April. May. June. July. August. September. October. November. December. TOTAL. TOTAL FOR THE YEAR 1902. 1903. 1904. 1905. 1906. New boats registered ... ... ... ... ... ... ... ... ... ... ... ... ... 1 3 3 1 2 Registration owing to structural alterations ... ... ... 1 ... ... ... ... ... ... ... ... 1 ... ... ... ... ... Registration for other purposes ... ... ... 1 ... ... ... ... ... 1 1 ... 3 11 5 7 8 3 Inspected 86 103 158 138 136 94 133 94 86 85 82 99 1,294 894 1,139 1,022 1,087 1,502 Conforming to Acts and Regulations 81 95 146 120 127 89 123 87 78 78 80 84 1,188 748 989 905 961 1,377 Infringements in respect to:— Registration ... ... 2 1 ... ... ... ... ... 2 1 ... 6 22 21 19 20 10 Notification of change of master ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Absence of certificate 1 2 6 2 5 ... 2 3 2 1 ... ... 24 38 28 16 30 29 Certificate not identifying owner with boat ... ... ... ... ... 1 1 ... ... 1 ... ... 3 18 10 9 5 5 Marking, &c. 1 2 ... 2 1 2 4 4 1 ... 1 ... 18 24 19 10 17 28 Overcrowding ... ... 1 2 ... 1 ... 1 ... 1 ... 2 8 3 5 6 2 8 Partition separating sexes ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Males over age ... ... ... ... ... ... ... ... ... ... ... ... ... 1 1 1 1 2 Females over age ... ... ... ... ... ... ... ... ... ... ... ... ... 2 4 2 1 3 Cleanliness 3 2 3 8 3 1 1 ... 4 3 1 5 35 33 28 37 28 36 Painting ... 1 ... ... ... ... 1 ... ... ... ... ... 2 1 1 1 2 2 Ventilation ... 1 ... 2 ... ... 1 ... ... ... ... ... 4 8 11 6 7 2 Dilapidation 3 3 ... 6 ... 1 3 2 1 5 ... 5 29 47 47 38 34 37 Removal of bilge water ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 1 Without pump ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Refusal to admit Inspector ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... No proper water vessel 1 ... ... ... 1 ... ... 2 ... 1 ... ... 5 23 21 13 21 1 Without double bulkhead ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Notification of infectious disease ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Detained for cleansing ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Proceedings taken ... ... ... ... ... ... ... ... ... ... ... ... ... ... 2 ... ... ... Cautions given 5 6 9 14 5 7 9 7 8 5 1 6 82 138 126 91 123 113 „ attended to 11 6 12 9 8 7 3 5 7 6 7 4 85 114 119 89 122 107 Total registered by Port Sanitary Authority since 1887 442 Cancelled 163 Registered for 4,657 persons. Actual number on Register, 31st December, 1907 279 Carrying 2,520 persons. 85 APPENDIX. administration of the port of london public health act, 1872. Dr. REVENUE ACCOUNT for the Year ended 31st December, 1907. Cr. To Salaries, viz.:— £ s. d. £ s. d. £ s. d. £ s. d. £ s. d. Dr. H. Williams. Medical Officer of Health 800 0 0 By Fees re Condemned Food 384 14 9 Assistant Medical Officers:— „ Sundry Fees, viz.:— Dr. W. M. Willoughby £390 0 0 Disinfection of Vessels 59 17 0 „ J. S. Warrack 350 0 0 Health Certificates 18 7 6 „ G. E. Hancock 109 4 0 Metropolitan Asylums Board, Fees under 1891 Act 0 16 0 Ditto 400 0 0 „ E. V. Legge and others 645 0 0 Canal Boat Registration 1 10 0 Locum Tenens 78 15 0 80 10 6 1,972 19 0 „ Training Ship "Arethusa," for maintenance and treatment of boys in Hospital 46 5 0 W. J. Albrow. Clerk 235 0 0 3,007 19 0 „ Grant from Home Office in respect of Medical Officer under the Aliens Act, 1905 712 10 0 „ Uniforms ... 108 16 11 „ Fidelity Guarantees 1 16 0 „ Refund of proportion of Medical Officer's Salary, &c., by Rochester Port Sanitary Authority 100 0 0 „ Wages, per Dr. Williams, viz.:— Office 351 0 0 Inspectors 2,076 5 10 ,, Ditto, forwarding Telegrams 1 4 7 Launch Crews 1,122 0 1 101 4 7 Hospital Staff .238 12 2 „ Amount received in respect of Funerals 12 15 0 3,787 18 1 „ Sundry Reimbursements, viz.:— „ Contributions to Officers' Pension Fund 86 5 3 Re Insurance of Launch 3 4 3 131 19 4 Miscellaneous 2 15 0 218 4 7 Half-cost of Notice Board at Sheerness 9 14 1 „ Contributions to Officers' Pension Fund re Pensions 169 8 8 15 13 4 „ Pensions 42 17 0 „ Fine inflicted re Smoke Nuisance 3 0 0 „ Disbursements, per Dr. Williams, viz.: — „ Ditto re Unsound Food 10 0 0 1,366 13 2 Petty Cash Expenses 304 5 10 Inspectors and others 42 0 0 Sundry Office Expenses 33 14 9 380 0 7 „ Excess of Expenditure over Income 9,229 0 11 „ Expenses of Steam Launches, Hulk, &c., viz.:— Insurance 134 8 7 Coal and Coke 268 15 0 Repairs and Stores 246 6 5 649 10 0 „ Offices at Greenwich, viz.:— Rent 51 5 0 Office Equipment 4 10 0 Rates and Taxes 18 18 11 Fire and Boiler Insurance 1 0 6 Telephone Rent 19 10 2 Gas 7 10 4 Water 2 10 0 Coal 5 6 0 Mr. Surveyor for Repairs 1 2 0 111 12 11 „ Hospital at Denton, viz.:— Expenses of extra Nurses 217 12 7 Rent of Causeway, &c. 23 16 2 Rates and Taxes 45 5 8 Fire and Boiler Insurance 11 8 1 Telephone Rent 7 10 6 Gas 50 12 3 Coal 57 18 6 Oil and Stores 65 2 4 Maintenance of Patients 163 14 7 Funerals and Conveyance of ditto 12 15 0 General Repairs 589 11 6 1,245 7 2 „ Printing and Stationery 131 19 3 „ Telegrams and Maintenance of Private Wire 19 7 10 „ Expenses in relation to condemning Unsound Food 21 10 7 „ Analysis of Samples of Food 5 10 0 „ Disinfections 3 17 4 „ Subscriptions 18 •18 0 „ Advertisements 4 15 10 ,, Miscellaneous 29 15 6 „ Law Charges, viz.— Mr. Comptroller 3 16 10 Mr. Solicitor 42 10 7 46 7 5 „ Mr. Remembrancer, in respect of Parliamentary Expenses 283 14 8 „ Expenses of Delegates to Congress (Royal Sanitary Institute) 29 8 0 Less Amount unexpended 7 1 6 22 6 6 ,, Committee's Allowance 150 0 0 „ Ditto re Inspection of River £90 0 0 Less Amount unexpended 8 9 9 81 10 3 „ Expenses re Conference relative to Purification of the Estuary of the River Thames 52 10 0 284 0 3 £10,595 14 1 £10,59: 5 14 1 Chamber of London, JOSEPH C. DIMSDALE, 2nd March, 1908. Chamberlain.