67. POET OF LONDON SANITARY COMMITTEE. ANNUAL REPORT OF THE MEDICAL OFFICER OF HEALTH, To 31st December, 1911. Presented 18th April, 1912. REPORT, For the Year ended 31st December, 1911, 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. lecturer on port hygiene, london school of tropical medicine, 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.G. 1912. CROSBY, Mayor. A Common Council holden in the Chamber of the Guildhall of the City of London, on Thursday, the 18th day of April, 1912. THE Port of London Sanitary Committee did this day deliver into this 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, 1911 ; 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 31st December, 1911, 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. In the summary of Medical Inspection of Shipping arriving from Foreign Ports as set out in detail by the Medical Officer, mention is made of the prevalence of Cholera in the Mediterranean ports, and the necessity for careful examination of all vessels arriving therefrom. Plague has been more prevalent in India, but it is satisfactory to record that only one rat was found infected with Plague within the district of the Port of London Sanitary Authority during the year. A small isolated outbreak occurred in one of the warehouses bordering on the river, but not within the district of this Authority. Your Committee, on the advice of the Medical Officer, decided that having regard to the fact that Plague had broken out amongst the rats in the docks for three years in succession, a bacteriological examination of rats caught in different docks should be made, so that we should receive the earliest possible intimation of any outbreak of Plague amongst rats, and, moreover, what is of equal importance in the interests of commerce, that we should be able to state definitely that no Plague existed to our knowledge within the Port of London at any definite time or during the year. Small-pox is dealt with at some length. The Medical Officer points out the danger to the community, owing to the possible introduction of Small-pox into this country from abroad, on the persons of those who are in the incubation stage of the disease or are suffering from the disease in an early or unrecognised form. Particulars are given of the restrictions which are deemed necessary in the Commonwealth of Australia. This is a country practically unprotected by vaccination, and the Medical Officer is of opinion that a greater power of control should be given to Port Sanitary Authorities to deal with possible " contacts" with Small-pox so as to ensure their being kept under proper supervision for a definite period after landing in this country. Food Inspection has entailed a large amount of work on the Officers of the Port. The Commonwealth of Australia has decided to remove all briskets from the fore quarters which were infested with " worm'' nests in so large a proportion. It was found that the hind-quarters were affected, although to a lesser degree, but still sufficiently to require the careful examination of every quarter. The Commonwealth of Australia has appointed a staff of Veterinary Inspectors, and have issued detailed instructions as to the supervision and examination of meat destined for export. The Medical Officer hopes that this examination, if carried out efficiently, will materially lessen the work of the Food Inspectors during the coming year, and obviate the necessity of making any addition to the staff, which, during the past year, was on several occasions feared to be absolutely necessary. The Medical Officer also sets out the Regulations for Notification of Tuberculosis 1911, which came into force at the end of the year. He points out that he has for some years advised methods of disinfection for this, of all parts of the vessel occupied bv those persons found to be suffering from this disease. The Local Government Board urge upon all Local Authorities the great importance of making full use of their powers of preventing overcrowding and of securing the removal of any onditions tending to injure the health of persons residing in their districts. Our attention has been drawn on several occasions by the Medical Officer of Health to the small amount of cubical space which is allotted to seamen on board vessels, and although your Committee were mainly instrumental in getting this minimum of 72 cubic feet increased to 122 cubic feet when the Merchant Shipping Act was amended in 1906, we are cognisant of the fact that the present conditions on board ordinary steamers are such as to be particularly favourable for the dissemination of Pulmonary Tuberculosis among seamen. Some interesting statistics are given of the cases of Pulmonary Tuberculosis occurring amongst seamen and admitted to the Seamen's Hospital during the past ten years, which indicate the great prevalence of this disease amongst this class of the community. The steam launch "Lady Truscott" has continued to work satisfactorily during the past year and has answered the expectations of your Committee. The two smaller launches are becoming old, and it will probably be necessary to consider the question during the present year of re-placing one of them by a new vessel. The sanitary inspection of shipping has been carefully carried out, and this is one of the most important duties which falls to your Committee. In accordance with the Order of your Honourable Court, an Account of Receipts and Expenditure in connection with the Fort of London Sanitary Authority for the year ended December last is appended for the information of the Court. All which we submit to the judgment of this Honourable Court. Dated this second day of April, 1912. H. Roper Barrett. Clarence Hayden. H. Percy Monckton. James Lake. A. Jerrold-Nathan. Geo. E. Ellis. J. S. Robinson. J. R. Pakeman. David Haydon. John Pound. Horace S. Dove. John B. Wild. E. S. Jacob. S. Beal. Fred. Geo. Mellows. H. M. Gaydon. 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. .... NEW CROSS 36. BOARDING STATIONS. RIVER THAMES - - Hulk " Hygeia," Gravesend. RIVER MEDWAY - - Garrison Point, Sheerness. HOSPITAL FOR INFECTIOUS DISEASES at DENTON, near GRAVESEND. Telephone No. (Hospital) - - - GRAVESEND 957. Ditto (Medical Officer in Charge) „ 86. 1911 PORT OF LONDON SANITARY COMMITTEE. Mr. David Haydon (Chairman), Aldersgate. ALDERMEN. Sir John Pound, Bart. Sir John Charles Bell, Bart. Sir G. Wyatt Truscott, Bart. Sir Charles Cheers Wakefield, Knt. Sir William Henry Dunn, Km. Charles Augustin Hanson, Esq. Sheriff. COMMONERS. Mr. Frederick George Mellows Aldgate. Mr. Clarence Hayden Bassishaw. Mr. Edward Seaman Billingsgate. Mr. John Sawyer Robinson Bihopsgate. Mr. James Tollworthy Major Charles Clement Hodges Bread Street. Mr. Samuel Beal Bridge. Mr. William Hurst Brown Broad Street. Mr. George Everest Ellis Candlewick. Mr. Ernest Samuel Jacob Castle Baynard. Mr. John Robert Pakeman Cheap. Mr. Horace Spencer Dove Coleman Street. Mr. Edward Hughes Cordwainer. Mr. Thomas Goldney Cornhill. George Briggs, Esq , Sheriff Cripplegate Within. Mr. James Lake Cripplegate Without. Mr. Albion Thomas Snell Dowgate. Mr. John Brear Wild N.S. Farringdon Within. Mr. Herbert G. W. Brinsley S.S. Farringdon Within. Mr. George Lavington N.S. Farringdon Without. Mr. Alfred Jerrold-Nathan S.S. Farringdon Without. Mr. William Henry Liversidge Langbourn. Mr. Herbert Roper Barrett Lime Street. Lewis Michael Myers, Esq., Deputy Portsoken. Mr. Edgar Edwin Bond Queenhithe. William Walter Green Esq., J.P Tower. Mr. Frederick George Dray Vintry. Mr. H. Percy Monckton Walbrook. Corporation Representatives on the Port of London Authority and Thames Conservancy Board (ex-officio Members of the Committee) :— Mr. James William Domoney, L.C.C. Sir James Thomson Ritchie, Bart., Alderman. Spencer William Morris, Esq. 4 INDEX. page | Aliens Act, 1905 67 Beri-Beri 34 Canal Boats Acts 72 Chicken-pox 33 Cholera 13 Committee—List of Names 3 Compulsory Notification 42 Continued Fever 32 Diphtheria 27 Disinfection 35 Enteric Fever 28 Erysipelas 32 Food Inspection 43 Foreign Meat Regulations 47 Hospital 68 Infectious Disease 12 Introductory 7 Livers 55 Measles - 30 Medical Inspection 8 page Notifications of Infectious Disease 34 Nuisances 62 Offensive Cargoes 64, 66 Pig Carcases 58 Plague 15 Police Court Proceedings 69 Pork 60 Pulmonary Tuberculosis 36 River Thames 64 Sanitary Inspection 11 Scarlet Fever or Scarlatina 26 Small-pox 17 Smoke Nuisances 62-64 Staff 6, 71 Steam Launches 70 Unsound Food 54 Unsound Meat 52 Water Barges 61 Yellow Fever 17 5 INDEX TO TABLES. table. page I. Medical Inspection—Gravesend 8 II. Ditto —Sheerness 8 III. Sanitary Inspection—Summary 10 IV. Sanitary Works 11 V. Infectious Disease—Summary 12 VI. Cholera 13 VII. Rats destroyed—Return of 16 VIII. Small-pox 17 IX. Scarlet Fever or Scarlatina 26 X. Diphtheria 27 XI. Enteric Fever 28 XII. Measles 31 XIII. Erysipelas 32 XIV. Continued Fever 32 XV. Chicken-pox 33 XVI. Beri-Beri 34 XVII. Compulsory Notification of Infectious Disease, with number of Deaths 34 XVIII. Vessels and premises disinfected 35 XIX. Effects disinfected 35 XX. Pulmonary Tuberculosis—Disinfections recommended 41 XXI. Foreign Meat Regulations—Notices 47 XXII. Ditto ditto Certificates 48 XXIII. Unsound Meat—Weights of 53 XXIV. Unsound Food destroyed 54 XXV. Livers (Unsound) 55 XXVI. Tuberculous Pig Carcases 60 XXVII. Nuisances 62 XXVIII. Ditto 63 XXIX. Offensive Cargoes 66 XXX. Aliens Act, 1905 67 XXXI. Ditto 67 XXXII. Hospital—Admissions, Discharges and Deaths 68 XXXIII. Police Court Proceedings 69 XXXIV. Steam Launches 70 XXXV. Canal Boats 76 6 STAFF. List of Officers forming the Staff of the Port of London Sanitary Authority, 31st December, 1911. 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 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. Lond. July, 1907. A. Kidd, M.R.C.S., L.R.C.P., Lond., D.P.H. 1909. Sheehness E. V. Legge, M.A., M.D., B.C., B.A.O., L.M.Dublin. 1909. GREENWICH OFFICES— Clerk W. J. Albrow March, 1890. 1st Assistant E. A. Sorrell October, 1894. 2nd ditto W. C. Barham June, 1903. Junior ditto J. G. Godden July, 1910. Ditto T. J. S. Cotterell July, 1910. 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. *J. H. Rolfe, Cert.R.San.Inst. September, 1901. *W. Elward, Cert.R.San.Inst. March, 1909. *F. J. Massie, Cert.R.San.Inst. March, 1909. DENTON HOSPITAL— C. A. Shepherd, Cert.R.San.Inst. January, 1909. Medical Officer W. M. Willoughby, B.A., M.D., B.C., D.P.H. Camb. November, 1908. Nurse Matron J. Jackson February, 1910. Assistant Nurse M. Mummery November, 1910. Ditto L. Harding September, 1911. Ditto F. Cork December, 1911. Cook E. Dack December, 1911. Maidservant E. Harvey May, 1911. W. J. Wragg November, 1908. Caretakers M. E. Wragg November, 1908. STEAM LAUNCHES— " Lady Trcscott "— Master W. Jarvis April, 1911. Engineer J. A. Hardman December, 1911. Mate C. Boyd April, 1911. Stoker J. Steen April, 1911. " David Burnett "— Master J. G. True October, 1911. Engineer G. H. Bagshaw December, 1911. Deckhand W. Shaw October, 1911. Stoker C. Wilcox December, 1911. " Clotho "— Master C. Strange October, 1911. Engineer Deckhand A. E. Topping October, 1911. " Denton "—Relief Launch (laid by). GREENWICH MOORINGS— Watchmen W. Howell April, 1897. W. Stanley November, 1911. HULK " HYGEIA"— Shipkeeper I. Rogers April, 1893. Ditto A. Salter July, 1898. BARGE "THOMAS"— Stoker, &c. W. H. Buzzel December, 1910. OFFICE CARETAKER F. Hudgell November, 1906. * These Inspectors possess the Special Certificate of the Royal Sanitary Institute for Inspectors of Food. 7 PORT OF 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 1911, being the tenth of the series. A general view of the work of your officers, as shown by the tables accompanying this Report, shows that the number of vessels arriving from foreign ports, which last year showed a slight increase, has again lessened. (Tables I.-II.). All of these vessels were visited by your Assistant Medical Officers. The efficiency of the work of your Sanitary Inspectors, as shown by Tables III., IV., XXXI. and XXXII., has been maintained. With regard to Infectious Diseases (Table V.), the number of cases reported is larger than in any year of the previous decade—due to outbreaks of measles. The number admitted to the Hospital also shows an advance in all the usual classes of infectious diseases. Cholera and Plague are dealt with in special articles, with particulars of the precautions adopted in the Port of London. The principal Infectious Diseases have also been separately dealt with. The development of Food Inspection under the Regulations relating to the Inspection of Foreign Meat and Unsound Food is an important matter, and I have dealt with the subject at some length with a view to showing not only the enormous amount of material to be dealt with, but also the necessity for the frequent attendance of your Officers at all hours, day or night, and on Sundays, together with some of the difficulties which arise from the continuous and simultaneous discharge of cargo from several vessels in the same dock. Some special features in connection with parasitical disease in foreign meat are also described. With reference to alien immigrants, I have set out as in previous years, in table form, figures relating to the number of such immigrants entering the Port of London. The Staff, except for minor changes, remains the same. There have been no additions to the executive during the past year, and it is proper to record that the willing co-operation of all concerned has been fully maintained. A short account of such changes as have taken place will be found on page 71. To this Report is appended, as usual, my Annual Report on the working of the Canal Boats Acts, and a statement of General Income and Expenditure. During the year, 192 cases of dangerous and infectious disorders have been notified to the Authority. 8 TABLE I. MEDICAL INSPECTION—GRAVESEND. From 1st January to 31st December, 1911. Jan. Feb. March April May June July Aug. Sept. Oct. Not. Dec. Total. Number of foreign arrivals © 800 700 829 778 858 827 878 736 762 840 783 752 9,543 Number medically inspected 238 199 224 222 246 248 255 205 210 254 239 204 2,744 Number of passengers 501 779 976 671 994 1,198 1,393 1,777 1,369 977 781 714 11,130 Number of crew 4,672 4,166 4,762 6,626 4,617 4,678 6,108 5,108 4,919 5,526 5,777 5,637 62,596 COMPARATIVE TABLE. GRAVESEND. 1902. 1903. 1904. 1905. 1906. 1907. 1908. 1909. 1910. Mean annual number for the 10 years ending 31st December 1911. 1911. Number of foreign arrivals 10,520 10,711 10,030 9,962 9,955 9,639 9,559 9,571 9,699 9,919 9,543 Number of vessels medically inspected 1,668 2,522 2,559 2,813 2,853 2,700 2,840 2,248 2,756 2,751.5 2,744 Total number medically inspected at Gravesend— From August, 1892, to December, 1910 40,302 „ 1st January to 31st December, 1911 2,744 Total 43,046 TABLE II. MEDICAL INSPECTION—SHEERNESS. From 1st January to 31st December, 1911. Jan. Feb. March April May June July Aug. Sept. Oct. Nov. Dec. Total. Number of foreign arrivals 23 20 28 22 41 25 32 13 23 24 21 20 292 Number medically inspected 17 17 27 19 37 22 28 11 22 23 20 16 259 Number of passengers 2 — 1 7 10 13 62 5 106 7 1 — 214 Number of crew 199 221 332 242 531 268 395 136 304 281 305 223 3,437 COMPARATIVE TABLE. SHEERNESS. 1902. 1903. 1904. 1905. 1906. 1907. 1908. 1909. 1910. Mean annual number for the 10 years ending 31st December, 1911. 1911. Number of arrivals 387 402 344 349 375 376 319 337 337 346.2 292 Number of vessels medically inspected 244 342 308 292 320 325 279 285 284 290.6 259 Total number medically inspected at Sheerness— From 1st September, 1894, to 31st December, 1910 4,808 „ 1st January to 31st December, 1911 259 Total 5,067 9 MEDICAL INSPECTION—GRAVESEND.* The total number of vessels medically inspected during the year was 2,744, which approximates very closely to the mean annual number for the past ten years. This medical inspection involved the examination of passengers and crews to the total number o£ 73,726. The total number of vessels arriving from "foreign" ports, at Gravesend, was 9,543, a number which is somewhat lower than that for the four preceding years, and below the average for the preceding ten years. The total number of vessels medically inspected at Gravesend since the inauguration of medical inspection in 1892 is 43,046. The Russian steamship "Maimaxa," of Archangel, arrived from Riga on the 6th December, 1910, and was visited by the Assistant Medical Officer, on the Customs launch, in Gravesend Reach. The master was informed that the medical officer would require to inspect all persons on board. The master, however, proceeded with the vessel, took his pilot on board, and went to the Millwall Dock. On arrival there, not having been granted " pratique," the vessel was sent back to Gravesend, where the crew were inspected, and the certificate of pratique was issued. A breach of the regulations had occurred, but the additional cost incurred in bringing the vessel from the Millwall Dock to Gravesend and back, as well as the inconvenience, was—in my opinion—ample punishment on this occasion. The Port Sanitary Committee agreed, and did not think it necessary to institute legal proceedings against the master. MEDICAL INSPECTION—SHEERNESS. The total number of vessels visited by your Assistant Medical Officer (Dr. E. Y. Legge) stationed at Sheerness during the year was 259 of a total of 292 foreign arrivals. In those cases where a vessel cannot be reached in time to inspect at Sheerness, a telegram is sent to Rochester, and the vessel is examined there. The number of passengers and crews carried by the vessels examined was 3,651. The total number of vessels medically inspected at Sheerness since a medical officer was stationed there in 1894, is 5,067. The arrangements for boarding vessels arriving from foreign ports have for many years past been carried out by His Majesty's Coastguard, for whom a room was provided in Garrison Point Fort, and a look-out was kept from the top of the fort. The arrangements for boarding vessels have now been taken over by His Majesty's Customs, and the Military Officer Commanding at Sheerness did not approve of anyone unconnected with armaments entering Garrison Point Fort. I arranged for the telephone to be removed from the interior of the fort and placed outside in a convenient position. His Majesty's Customs have placed a steam launch on the station, and communication with Dr. Legge is, for the present, made from the temporary telephone situated near the Gun Wharf. Negotiations are being made by His Majesty's Customs with a view to obtaining a piece of ground in a suitable position where a watch-house can be built, and from which a look-out can be kept. When this has been done the telephone will be moved there, and Dr. Legge will be summoned when required. In accordance with the Local Government Board regulations, the Customs' Officers will detain any vessel arriving from a port infected with Plague, Yellow Fever or Cholera, but they are unable to do this in the event of vessels arriving from other ports. I am pleased, however, to report that the medical inspection of vessels passing through the Port of London for the Port of Rochester, has been carried out quite as efficiently as heretofore. * See also Staff—Medical Officers—page 71. 10 TABLE III. General Summary, and Analysis, of the Sanitary Inspections of Vessels, &c., in the Port of London, for the year ended 31st December, 1911. Foreign. Coastwise. Inland Navigation. Shore Premises. Sick Seamen referred to Hospital | Water BaRGEI. 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 (food condition, 3l8t December, 1911. Now Barffea Condemned. Use Discontinued. No. in Dlatriet ales Doormember 1911  12655 75 1795 1360 6 233 2699 •26 235 1 134 4 87 504 5 29 14139 92 426 1611 4 87 926 56 21 2996 29 320 4 18 - - - Total Inspections to 31st December, 1910 942,054 Docks and River. No. Nationality. Arrived from Foreign Ports. No. of in spections Arrivals Per cent, of Total Total Inspections from 1st January to 31st December, 1911 — St. Katharine's 1,195 American - — — London 2,296 Argentine 2 3 .02 Austrian 26 44 .27 "Foreign" 14,015 Regent's Canal 700 Belgian 353 371 3.71 " Coastwise " 3,833 Brazilian - - - " Inland Millwall 2,335 British† 5,533 8,398 58.22 gation " 17,180 West India 1,699 Danish 325 501 3.41 Premises on shore 2,996 Poplar 30 Dutch 577 759 6.07 38,024 Finnish 16 45 .16 Total 980,678 East India 691 French 151 187 1.58 German 936 1,204 9.84 Victoria 2,532 Greek 8 40 .08 Cleansing of Crew's Quarters, &c. :— Royal Albert 1 3,278 Italian 4 8 .04 Japanese 55 112 .57 Total to 31st December, 1911 61,675 Commercial 3,032 Roumanian — — — Total No. of Vessels from 1st January to 31st December, 1911 2,913 Tilbury 1,779 Russian 168 272 1.76 Siamese 5 9 •05 Gravesend District 3,245 Spanish 73 107 •76 Total 64,588 River—*Upper District 4,375 Swedish & Norwegian 1,268 1,949 13.34 Number of vessels inspected *Middle „ 3,795 Mexican - 2 - Portuguese - 1 3 •01 " Lady Truscott" 1,602 *Lower „ 4,056 Uruguayan - 1 1 •01 Medway - Nil. Chilian 1 — •01 " David Burnett " 2,806 "Clotho" 4,217 Total vessels - 35,028 Total vessels- 9,503 14,015 t Coastwise and Inland navigation 21,013 " Denton " 3,844 Shore premises 2,996 Shore premises 2,996 Total 38,024 Total 38,024 99.91 Total 12,469 In the Docks, &c. - 22,559 *Upper District extends from Limehouse to Teddington. Total 35,028 *Middle „ „ „ Limehouse to Erith. *Lower „ „ „ Erith to outer limits of Port of London. COMPARATIVE TABLE. Total number of Inspections of vessels from— 1902. 1903. 1904.' 1905. 1906. 1907. 1908. 1909. 1910. 1911. Yearly average for the 10 year" ending 31st December,1911 "Foreign" 16,336 15,989 15,685 14,279 13,013 17,971 15,258 14,887 13,710 14,015 15,114.3 " Coastwise," " Inland Navigation," and other Inspections 17,270 19,496 19,700 19,975 22,335 19,414 20,014 125,469 24,857 24,009 21,254.1 Total 33,606 35,485 35,385 34,254 35,348 37,385 35,272 40,356 38,567 38,024 36,368.4 11 SANITARY INSPECTION. In Table III. will be found a general summary of the work of sanitary inspection carried out by the staff of Sanitary Inspectors in the docks and on the river. It will be seen that the total number of inspections of all classes made in the docks was 22,559, and in the launches 12,469. The inspections in the dock comprised 35,028 visits to vessels, and 2,996 to premises on shore. The cleansing of crew's quarters was necessary in 2,913 cases. This cleansing is often found necessary on newly arrived vessels, and is carried out without resort to statutory measures. The total number of vessels from foreign ports inspected was 9,503, and of these 5,533, or 58 per cent., were under the British flag, Swedish and Norwegian coming next in order with 1,268 vessels. German vessels number 936, or 9"84 per cent., Dutch and Belgian coming next in order with 557 and 353 respectively, while other nationalities entering the Port are given in the Table. TABLE IV—PART I. Date completed. Works. 1911. Jan. 31 Millwall Dock—Construction of new closet and soil pipe at Wheatslieaf Mills. Feb. 10 St. Katherine's Dock—Alterations to lavatories at " A " warehouse, occupied by J. Travers and Sons, Ltd. Mar, 24 London Dock—Diversion of main drain and construction of new drain at North Quay, Western Dock. „ 27 Royal Albert Dock—Temperance Catering Company's new premises near Central Station—New 4-inch drain connecting on to an old drain. April 20 Royal Victoria Dock—Diversion of drains at No. 1 Customs Offices. June 21 East India (Export) Dock—Construction of a new water closet at the South-east corner. Aug. 26 St. Katherine's Dock—Provision of a new urinal at West side of main entrance. Oct. 21 Royal Albert Dock—Drainage for office and mess-room, Scrutton's, Ltd. Dec. 9 St. Katherine's Dock—Erection of conveniences for Fitters' Shops at Wood Yard. Part II. Sanitary Works and alterations, not yet reported as completed :— Date Plan submitted. Works. 1911. May 12 London Dock, West Gardens Yard—Provision of new conveniences to replace existing ones. 26 London Dock, South Quay—Proposed alteration to drains. July 19 London Dock—Nos. 7 and 8 warehouses on the Wool Show Floor. New roof water pipes. Aug. 11 London Dock—Alteration to drainage of the West Gardens Yard, Eastern Dock. Sept. 26 Royal Victoria Dock—Proposed new closets at General Office. DRAINAGE WORK. Royal Albert Dock.—Temperance Catering Company's new premises near Central Station.—New 4-inch drain. I have to report that this work was done without any notice from the owners of the premises, or any opportunity given for the supervision of the work by an Inspector of this Authority. The owners were informed that the drain has not been approved by the Port of London Sanitary Authority. 12 DRAINAGE AND SANITARY WORKS. In Table IV. will be seen a list of various works which have come under the supervision of the Sanitary Inspectors in relation to the construction or alteration of drainage, public conveniences, &c. As I have before pointed out, this is a growing and important section of the work, and one in which it is advisable that the powers of the Authority should be strengthened. TABLE V.—INFECTIOUS DISEASE. Disease. 1902. 1903. 1904. 1905. 1906. 1907, 1908. 1909. 1910. Mean annual number for 10 years ending 31st December, 1911. 1911. (a) Cases reported : Cholera (including suspected cases) 20 9 4 6 3 9 5 3 5 7.3 9 Yellow Fever (ditto) ... ... ... 1 2 ... 2 ... 0.5 ... Plague (ditto) 10 6 6 9 9 4 1 4 6 5.5 ... Small-pox 93 13 11 24 31 27 16 27 8 26.3 13 Scarlet Fever 13 11 11 26 82 44 23 16 21 25.8 11 Diphtheria 26 7 3 8 7 7 18 11 11 11.6 18 Enteric Fever 66 88 50 65 81 55 90 36 39 64.0 70 Measles 36 14 38 36 68 51 86 19 23 54.6 175 Erysipelas 2 4 1 9 7 2 7 5 5 5.3 11 Typhus Fever ... 1 ... ... ... ... ... ... ... 0.1 ... Continued Fever 2 13 12 11 11 11 19 10 1 9.4 5 Relapsing Fever ... ... ... ... ... ... ... 1 ... 0.1 ... Other diseases (including Chickenpox). 14 9 17 16 35 42 41 57 25 29.4 38 Total 282 175 153 211 336 252 308 189 144 239.9 350 (b) Treated in Port Sanitary Hospital : Cholera (including suspected cases) ... ... ... ... ... 1 ... 1 2 0.4 ... Yellow Fever (ditto) ... ... ... ... ... ... ... ... ... ... ... Plague (ditto) 4 3 4 3 1 3 ... 1 2 2.1 ... Small-pox 29 11 5 4 ... 8 ... 4 2 6.9 6 Scarlet Fever 2 5 7 3 28 4 6 14 ... 7.5 6 Diphtheria 2 4 ... 2 1 3 5 1 4 2.5 3 Enteric Fever 27 55 33 23 26 27 42 11 17 28.3 22 Measles 11 7 8 13 3 14 13 5 2 8.3 7 Erysipelas 1 1 ... 2 1 ... 1 1 ... 0.7 ... Typhus Fever ... ... ... ... ... ... ... ... ... ... Continued Fever 4 13 12 9 7 10 6 10 1 7.6 4 Other diseases (including Chickenpox). 8 4 4 1 24 5 15 10 7 8.6 8 Total 88 103 73 60 91 75 88 58 37 72.9 56 13 One of the principal duties of a Port Sanitary Authority is [the prevention of the introduction of certain exotic diseases, which are regulated by International Convention. These are Cholera, Yellow Fever, and Plague, and during the latter part of the year an International Sanitary Conference, which was attended by delegates from various parts of the world, assembled in Paris, with a view to revising the national arrangements agreed to at the Paris Conference in 1903 for the control of the above mentioned diseases. CHOLERA. This disease is endemic in Calcutta, and has been prevalent in Europe, especially in certain ports on the Mediterranean Sea. During the year 1910 it was very prevalent in the Russian Baltic Ports, especially in St. Petersburg, but in 1911 very few cases have occurred there. Italy has been specially affected, and from there it has spread to certain ports in Spain, France, and Northern Africa, and it is said that no less than 25 cases of Cholera were conveyed to the United States of America by vessels carrying immigrants from Italian ports. It has been stated that persons apparently in good health may contain the specific organisms of Cholera within their bodies, and though they present no symptoms of Cholera, yet are liable to infect drinking water, food, &c., and so communicate the disease to other persons after landing. This is an unpleasant prospect, as the ordinary process of medical inspection can only distinguish those persons who are apparently in good health and free from symptoms of Asiatic Cholera. The only way of detecting these so-called "carriers" is by bacteriological examination of each person arriving from an infected port. It is not necessary to point out that this would entail a vast amount of hard and unpleasant work, and would impose severe restrictions upon incoming passengers. The conveyance of Enteric Fever by human " carriers " has been well established, but further investigations are necessary before deciding whether Asiatic Cholera is spread in this way, and whether it will be necessary to examine in minute detail, and bacteriologically, all persons arriving from Cholera infected ports. Special regulations will require to be issued by the Local Government Board before this procedure can be adopted. TABLE VI. (Cholera.) Date. Name of Vessel, Port of Registry, and Official Number. Where from. No. of Cases. How dealt with. 1911. July 20 s.s. " Antinoe," of London, 125,605 Smyrna 1 Died (buried at sea). Aug. 5 s.s. "Raven," of London, 87,144 Genoa 1 Ditto. Sept. 1 s.s. " Armanistan," of Swansea, 128,920 - Persian Gulf. 2 One landed at Bussorah, and one at Bushire. „ 30 s.s. "City of Bombay," of Liverpool, 131,286 Calcutta 1 Landed at Suez. Oct. 1 s.s. "Anatolia," of Liverpool, 110,525 Bussorah 1 Died (buried at sea). Nov. 9 s.s. " Griqua," of London, 115,933 - Ditto 1 Removed to hospital at Mohamrah. 13 s.s. " Gloamin," of Leith, 104,733 - Bushire 2 One case died, one recovered. Total 9 14 The s.s. " Antinoe" arrived at Gravesend on the 19th July from Pandema and Smyrna. On July 4th, a coal trimmer, after coming off watch at 6 p.m., was attacked with violent cramps in the legs. He had no vomiting, some diarrhoea, but no rice water stools. He was very weak, and died the next day. He was buried at sea. Water was taken on board at Smyrna, and all persons, after inspection, were found well on arrival at Gravesend. I regarded this as a suspicious case, and carried out the necessary measures of disinfection. The s.s. " Raven," of London, arrived at Gravesend on the 5th of August from Genoa. On the 12th July a man was taken ill with abdominal pains, cramps, and rice water stools. He died in 13 hours, and body was buried at sea. The vessel was quarantined at Naples, and disinfected throughout. Clothing and bedding thrown overboard. On the 1st September, the s.s. " Armanistan," of Swansea, from the Persian Gulf, arrived in the Port of London, and reported having had two cases of Cholera on board during the voyage. Both patients were Arab firemen. The first patient was taken ill on the 23rd July, while the vessel was lying at Bussorah ; he was seen by a local doctor, who diagnosed the case as one of Cholera, and the patient was removed to hospital. The second patient was taken ill on the 30th July, and was removed to hospital at Bushire. The ship was thoroughly disinfected at Bussorah and Bushire, and again on arrival at Suez. No other cases occurred. The s.b. "City of Bombay," of Liverpool, 131,286, arrived on the 30th September, 1911, from Calcutta. On the 11th September a Lascar fireman was taken ill with severe diarrhoea. He was removed to hospital at Suez on the 12th. All necessary disinfection was carried out, and the tanks were emptied and cleaned. No further illness occurred, and on an inspection of the crew at Gravesend, all were found well. The s.s. "Anatolia" of Liverpool, 110,525, arrived on the 1st October from Bussorah. On the 27th August a first-class passenger was taken ill, and died on the 28th August, being buried at Mahomrah. All clothing, bedding, &c., were burnt, and the necessary disinfection of vessel was carried out. The water tanks were emptied and cleaned out. No further suspicious cases occurred. The s.s. "Griqua," of London, 115.933, arrived from Bussorah on the 9th November, 1911. On the 12th September one of the crew became ill Avith vomiting, pain, diarrhoea and collapse. He was moved to hospital at Mahomrah, where he died on the 18th September. All necessary disinfection of vessel and effects were carried out there. No further case occurred. On arrival at Gravesend all were found well on board. The s.s. "Gloaming," of Leith, 104,733, arrived from Bushire on the 10th November. On the 29th August two Asiatic firemen were taken ill with Cholera. One died, and the other one, who recovered, was paid off at Bushire. The ship was disinfected at IVlahomrah, and again at Bushire. No further case occurred. On arrival at Gravesend all were found well on board. 15 PLAGUE. Plague, which during the year 1910 showed some sign of abatement in India, has become more prevalent during the year 1911, and it is estimated that by the end of the year the deaths from plague there will amount to nearly one million. Serious outbreaks occurred in Manchuria, which resulted in 50 thousand deaths. This outbreak was pneumonic in form, that is, the lungs were principally infected. This is the most infective and dangerous form of the disease, scarcely any person ever recovering from it. Plague has occurred in South America and in certain ports in Europe, but principally those in Southern Russia. Plague has also occurred in Egypt, Algeria, Morocco, and Mauritius. During the year a systematic bacterological examination has been made of rats from various docks within the jurisdiction of the Port Sanitary Authority. 1,250 rats have been so examined, but only one was found infected with Plague, and that early in February. In addition, five rats were found infected with Plague in a warehouse bordering on the river at Wapping, but not within the district of the Port Sanitary Authority. This was an isolated outbreak, and the measures adopted appear to have been successful in preventing the spread of this disease amongst rats. Had an outbreak of plague occurred amongst the rats in the docks, it would probably have been at once detected, and measures taken to prevent it spreading. Only one rat was found infected with plague during the year, viz., in February, and there was some suspicion that it had possibly been found on a vessel and thrown ashore. The Port Sanitary Committee readily agreed to have the rats bacteriologically examined, and the sum of 1561.5s. was spent on the work ; they took the view that it was of the first importance to be able, not only to recognise an early outbreak of plague amongst rats, but to be able definitely to say that after a systematic examination, that there was no plague found existing amongst rats in the Port of London. In a recent report on plague investigations in India, particulars are given of some experiments on the natural increase of rats. It appears that one pair of rats may produce about 36 young in the course of 12 months, and as they breed at the age of 4.5 months, from a pair of rats no less than 858 may be produced in the course of 16 months. The Commonwealth of Australia requires vessels coming from or touching at ports which have been declared to be infected with Plague, to be fumigated with Sulphur Di-oxide Gas at the port of departure and when empty, with a view to the destruction of rats on board. During the year 23 vessels have been fumigated by the apparatus of this Authority in the Port of London, so as to comply with the requirements of the Australian Commonwealth. The apparatus worked satisfactorily, and it is now practicable to fumigate any one of the largest vessels entering the port within a period of 24 hours. No case of plague or of suspected plague has been reported during the year on any vessel arriving in the Port of London. 16 TABLE VII. Return of Rats caught and destroyed during 1911. 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. Millwall Dock— Warehouses 143 169 132 230 169 136 119 180 298 202 151 234 2,163 Vessels during voyage 40 — 14 12 34 12 121 82 76 240 22 12 665 „ while in dock- 248 227 128 311 323 388 357 113 296 314 377 257 3,33y Surrey Commercial Dk.— Warehouses 15 8 88 28 20 13 95 2 — 3 — — 272 Vessels during voyage — — — — — — — — — 2 — — 2 ,, while in dock 272 224 129 274 313 226 203 191 217 185 231 152 2,617 Regent's Canal Dock— Warehouses Vessels during voyage „ while in dock St. Katharine's Dock— Warehouses 41 44 42 53 33 29 53 27 63 47 58 66 556 Vessels during voyage — — — — — — — — — — — — — „ while in dock - - - - - - - - - - - - - London Dock— Warehouses 88 93 102 94 92 78 118 37 133 104 76 78 1,093 Vessels during voyage — — — — — — — — — — 2 — 2 „ while in dock - - - - - - - - - - 22 — 22 Albert and Victoria Dks.— Warehouses 389 342 435 529 401 339 487 307 605 591 375 323 5,123 Vessels during voyage 328 795 568 714 — 51 170 363 842 258 40 402 4,531 „ while in dock 734 578 966 1,066 927 396 746 470 1,033 511 470 652 8,549 West India Dock— Warehouses 30 11 34 49 40 71 86 26 12 58 6 48 471 Vessels during voyage 23 111 92 30 80 — — 76 18 128 50 50 658 „ while in dock 475 223 261 444 462 733 652 425 457 363 306 376 5,177 East India Dock— Warehouses 78 72 62 78 73 42 89 71 45 21 36 54 721 Vessels during voyage — — — — — — — — — — — — — „ while in dock 18 29 57 565 208 55 207 37 — 32 128 216 1,552 Tilbury Dock— W arehouses 46 93 169 126 70 62 97 46 201 160 145 226 1,441 Vessels during voyage 140 373 430 571 66 521 510 170 150 226 356 412 3,925 „ while in dock 325 142 43 126 116 125 499 194 178 253 179 237 2,417 River— During voyage - - - - - - - 2 - - - - 2 While in river - - - - - - - - 9 - - - 9 Totals 3,433 3,534 3,752 5,300 3,427 3,277 4,609 2,819 4,633 3,698 3,030 3,795 45,307 Total from February, 1901, to 31st December, 1910 649,975 Total from 1st January to 31st December, 1911 :— In Dock Warehouses - 11,840 45,307 On Vessels during voyage 9,785 On Vessels while in Dock and River - 23,682 Total 695,282 17 YELLOW FEVER. Yellow Fever has been chiefly found in Central and South America. This disease is chiefly conveyed by a species of mosquito which practically cannot exist in this country, and although cases have occurred on ships coming from South America to this country, there is little or no danger of this disease obtaining a foothold here. The dangerous infectious disorders notifiable in the Port under the Public Health Act are as follows :— Small-pox. Diphtheria. Membranous Croup. Scarlatina or Scarlet Fever. Typhus Fever. Typhoid Fever. Enteric Fever. Relapsing Fever. Continued Fever. Measles. In addition to these the following diseases have been made notifiable with the sanction of the Local Government Board :— Chicken-pox. Cerebro-Spinal Fever (Epidemic Cerebro-Spinal Meningitis). Acute Polio Myelitis or Acute Polio Encephalitis. SMALL-POX. There was a small outbreak of Small-pox in London early in the year, some 70 or 80 cases having occurred. This disease occurs epidemically at certain well-recognised intervals, and one is now due. It was feared, therefore, that the outbreak in the early part of the year would be followed by a recurrence of the disorder at the end of the year. It is pleasing to record, however, that no case had occurred in London in the latter part of the year endine- 31st December. TABLE VIII. (Small-pox.) Date. Name of Vessel, Port of Registry and Official Number. Where from. No. of Cases. How dealt with. 1911. Mar. 20 s.s. " City of Calcutta," of Glasgow, 115,759. Calcutta 1 Removed to Hospital at Port Said. „ 21 Steam Tug " Diligence," of London, 123,848. Towing in River Thames. 1 Removed to Orsett Isolation Hospital. April 12 P. and O. " Go Down," Royal Albert Dock. - 1 Removed to Port Sanitary Hospital. 21 s.s. " Gloucestershire," of Liverpool, 131,296. Rangoon 1 Ditto. May 2 s.s. " Derbyshire," of Liverpool, 106,876. Do. 1 Landed at Dover. June 3 s.s. " Sargasso," of London, 87,117. Lisbon 1 Remoyed to Port Sanitary Hospital. 10 s.s. " Egypt," of Greenock, 105,881. Bombay 1 Landed at Plymouth. 10 s.s. "Albania," of Gothenburg Quebec 1 Landed at Quebec. 13 s.s. " Ruapehu," of Plymouth, 111,357. New Zealand 1 Landed at Rio de Janeiro. 14 s.s. " Foyle," of London, 115,800. Odessa, &c. 1 Landed at Port Said. Sept. 3 s.s. " Persia," of Greenock, 109,258. Bombay 1 Removed to Port Sanitary Hospital. 4 s.s. " Araby," of Liverpool, 118,070. La Plata 1 Ditto. 21 s.s. " Achilles," of Liverpool, 113,405. Yokohama - 1 Ditto. Total 13 18 The s.s. "Omrah" arrived from Australian ports, via Naples, on June 10th, 1911. All persons on board were reported well, with the exception of a case of Enteric Fever which was landed at the hospital of this Authority at Denton. The surgeon's certificate stated that he had examined all persons on board within twelve hours of the vessel's arrival, and that there was no person on board with any symptoms of fever. The vessel proceeded to dock, where the persons on board landed, and subsequently sailed for Australia. On July 6th I received a letter from the Medical Officer of Health of the Gloucestershire County Council, informing me that a case of Small-pox had occurred within that county, in the case of a boy who had been a passenger on the s.s. " Omrah." It was stated that he had been a passenger in a cabin containing ten berths, and that six passengers had been berthed in the cabin who had joined the vessel at Port Said, and two at Naples. It appears that a man, D. C., joined the ship at Naples as a Distressed British Seaman. Enquiry was made of the Orient Steam Navigation Company, and it appears that D. C. consulted the surgeon of the ship on the 4th and 6th June; he complained of pains in the stomach and back on the first occasion, and on the second occasion also had some pain in the back and neck. He was given some medicine and told to come again if no better. He did not consult the surgeon again. No other signs or symptoms were noticed, and there does not appear to have been any rash noticed at the time of his consulting the ship's surgeon, and there was nothing in the man's case that caused the surgeon to suspect any infectious disease. On July 4th 1 heard from the Medical Officer of Health, South Shields, that there was a man suffering there with Small-pox, who had been infected by D. C. Another man on board, S., went to Folkestone and there died of malignant Smallpox which appears to have been undiagnosed. A man, however, who assisted with the post-mortem examination of S. subsequently developed a mild attack of Small-pox. It is therefore obvious that D. C. must have developed a slight attack of Small-pox on the vessel, and that he infected the boy who went to Gloucestershire, and subsequently a person who went to Folkestone, whilst he went to South Shields and infected another person there. This seems to have been the whole extent of the outbreak, and it is fortunate that no other cases occurred. The s.s. " Derbyshire" of Liverpool, 106,876, arrived at Gravesend at 11.10 p.m. on May 5th, 1911, from Rangoon, via Suez and other ports. There were 132 passengers, 59 European crew, and 93 Asiatic crew. No case of sickness was reported by the master, and the surgeon furnished a certificate which stated that there were no cases of infectious disease on board, and no one suffering with any feverish symptoms, and that he had inspected every person on board within 12 hours of arrival and all were found in good health. The Asiatic crew were carefully examined by the Assistant Medical Officer of this Authority, and with the exception of one case of Orchitis in the person of an Asiatic, they were all apparently in good health. On May 9th I received a letter 19 from the Medical Officer of Health for the East Kent Joint Committee which informed me that F. N. J., aged 20, a steward on the s.s. " Derbyshire," who had left the vessel at Tilbury on Saturday, May 6th, was then in Sandgate Small-pox Hospital suffering from typical Small-pox. Enquiries were made on the vessel that day, which was then lying in Tilbury Dock. The surgeon was interviewed, and he stated that the man had complained to him on the day of arrival, May 6th, that he had a rash. This was Scarlatiniform in parts and itched; there was no fever; the man appeared in good health and sang at a concert on the evening of May 5th. The doctor obviously thought it was nothing in particular, and certainly nothing of an infectious nature, and F. N. J. proceeded on May 6th to his home at Hythe, Kent, where on arrival he went straight to bed, and the next day was examined by a doctor and certified to be suffering from Small-pox. On arrival at Hythe he was met on the station by his sister, who became infected, and subsequently developed Small-pox, and on his journey home he must have travelled in the trains of at least two railway companies, and it is probable that many persons must have been exposed to the risk of infection with this disease. The vessel having touched at infected ports, a list of the names and addresses of all persons on board was supplied to the Medical Officer who boarded the ship on arrival. These were notified to the Medical Officers of the districts to which they were proceeding. Amongst them was a man, A. G., who gave an address at Liverpool, and who was subsequently found to have developed Small-pox, and was removed to hospital. Several members of the crew live in the Borough of Wallasey, Lancashire, This comprises districts which are generally known as Poulton, Seacombe, Egremont, Liscard, New Brighton, and Wallasey. Amongst the passengers were persons who gave addresses in Wallasey, Egremont, Birkenhead, and Liscard; W. G. gave an address in Liscard and proceeded to his home. His name and address was notified to the Medical Officer of Health for Liskeard, in Cornwall, as it was thought that that was the place to which he was proceeding. This appears to have been a mistake, and as the notification form was not returned to me by the Medical Officer of Health for Liskeard it was assumed to be correct. On June 28th, the Medical Officer of Health for Wallasey was called to see in consultation, D. G., whom he examined and found to be suffering from Small-pox. The examination of the other inmates of the house revealed that the sister showed marks of having recovered from Small-pox which had been diagnosed as Chicken-pox, and that her father, W. G., showed similar evidence of recent Small-pox, and he had been a steward on board the s.s. " Derbyshire," and had developed an eruption on or about May 20th, and had not been attended by a doctor. Neither of these people had been properly isolated, and had been mixing promiscuously with many people in public places. I append particulars of the outbreak in the Borough of Wallasey that have been furnished to me by the courtesy of Dr. T. W. N. Barlow, Medical Officer of Health for the Borough. 20 Small-pox Cases, 1911. 1. W. G. Landed at Tilbury May 6th, steward on the s.s. "Derbyshire," from which vessel some cases of Small-pox were removed to London. This man's name NOT included in list of contacts forwarded to Medical Officer of Health. Rash about May 20th. Is said not to have left house until June 5th, afterwards walked about freely. No visitors. No doctor in attendance. 2. Miss G. Rash June 10th or 11th. Diagnosed by medical attendant as Chicken- pox. Did not leave house for five or six days. Afterwards no isolation. 3. Miss D.G. Rash June 25th. Medical Officer of Health called in consultation ; found Small-pox. FIRST KNOWN CASE. 4. Mrs. T. Died June 26th. Death registered as due to Peritonitis. Spots June 9th. Washing sent to laundry in Union Street; managed by husband throughout illness. Husband and doctor at first denied eruption. Both afterwards acknowledged that the woman "was covered with scabs when she died." No doubt this case infected cases 5 to 12. 5. E. J. Rash appeared about June 29th. Manageress of laundry. 6. A. 0. „ „ „ July 2nd. Engineer at laundry. 7. M. D. „ „ „ July 4th. 8. A.L. „ „ „ July 4th. 9. M. McD. „ „ „ July 6th. Workers at laundry, Union Street. Discovered by Medical Officer of Health when he visited the premises. 10. A. C. Maid at Mrs. T's. Rash appeared about July 4th or 5th. Discovered by Medical Officer of Health. 11. Mrs. W. Sister-in-law of Mrs. T. Rash appeared about July 6th. Visited T's June 21st and 23rd. 12. E. A. Lived next door to Mrs. T. Rash appeared about July 6th. Knew the T's. Mr. T. slept with him on day of wife's death. Had made enquiries at house. Discovered by Medical Officer of Health. 13. T. W. Lived at 5, St. Mary's Street, five doors away from Mrs. T. No known contact. Rash appeared about July 5th. Source of infection not accurately determined. The connection between the first three cases and the remainder has not been traced, but since the G. family and Mrs. T. lived about 50 yards apart (though not in the same street), and since cases 1 and 2 were never isolated, properly speaking, and after a short period mixed promiscuously with other people, and no other cases were known in the Borough or vicinity, it is only reasonable to suppose that these cases are associated, though the exact association is not clear. The cases on the s.s. "Derbyshire "and" Omrah" afford striking illustrations of the manner in which the infection of Small-pox may be introduced to this country by a person either suffering from Small-pox, which is either not recognised or who is 21 in the incubation period of that disease. Thus in three counties Small-pox arose in connection with each of these vessels from which a man had landed whilst suffering from unrecognised Small-pox. In the case ex s.s. "Derbyshire," out of the persons who left the vessel, 185 were notified, and of these only seven could not be traced, but it was unfortunate that the notification of the man G. should have been sent to the wrong place, as he developed the disease, was not medically attended, and infected other persons. It was fortunate that owing to the routine practice of taking the names and addresses of all persons arriving on vessels coming from infected ports that so many names and addresses were available for notification. Had the vessel not come from an infected port there would have been no list of names and addresses forthcoming, and had there been a case of Small-pox on such a vessel, there would have been no power to compel persons to give their names and addresses or even to punish them if they gave names and addresses which were incorrect. There is, moreover, no power to compel vaccination or segregation of contacts. Sailors generally refuse to be vaccinated, and unless they voluntarily submit to control, there is no power to prevent them going where they will, and when they do land, they generally go amongst a class of people who are indifferent to the protective properties of vaccination. In a country adequately protected by vaccination and re-vaccination—e.g., Germany, there would be little risk of an outbreak of Small-pox occurring, but with a largely increasing number of persons in this country who do not avail themselves of the protective properties of vaccination, it is probably only a question of time when an epidemic of Small-pox will again occur in this country. In the Commonwealth of Australia there are parts of the country where, I am informed, no less than 80 per cent. of the people are unprotected by vaccination against Small-pox, and the Commonwealth Government have issued regulations under their Quarantine Act, 1908, for preventing the introduction of Small-pox. In the Commonwealth of Australia, Small-pox is a quarantinable disease, and every vessel arriving from overseas, and every vessel on which any quarantinable disease has broken out or been discovered, shall be subject to quarantine. I append a few extracts from the Commonwealth Quarantine Act of 1908, which will indicate the restrictions found to be necessary and desirable in a country where the population contains a large number of unvaccinated persons. Section 34.—(1) Where a vessel has arrived at any port from a proclaimed place, or is subject to quarantine, and the quarantine officer is satisfied that no person on board is actually suffering from a quarantinable disease, but is not satisfied that the vessel is free from infection, he may, subject to this Section:— (a) Refrain from giving a certificate of pratique. (b) Permit the vessel to proceed on her voyage without performing quarantine at a quarantine station. (c) Permit any passengers for that port and their effects to be landed. (d) Permit any cargo on the vessel for that port to be landed. (2) The vessel shall continue to be subject to quarantine until pratique is granted. 22 (3) All persons landed in pursuance of this Section shall continue subject to quarantine until such period as is prescribed, and, while so subject, shall be under quarantine surveillance, and shall comply with the regulations relating to quarantine surveillance. Penalty for non-compliance: One hundred pounds. (4) All cargo and passengers' effects landed under this Section shall be subject to treatment and disinfection as described. Section 35.—(1) A quarantine officer may, by order in writing, order in to quarantine any vessel, person, or goods (whether subject to quarantine or not), being, or likely to be, in his opinion, infected with a quarantinable disease, or a source of infection with a quarantinable disease. (2) If a vessel has arrived in Australia from a proclaimed place, the quarantine officer shall (except as prescribed) order her into quarantine. (3) The order may:— (a) In the case of any vessel, and all persons and goods on board the vessel be served on the master of the vessel; or, (b) In the case of any person, be served on the person ; or (c) In the case of any goods, be served on the owner or consignee, or any person having possession or custody of the goods. (4) When the order has been served in accordance with this Section, the vessel, and all persons and goods on board the vessel, or the person or goods, as the case may be, shall be deemed to be ordered into quarantine. The procedure would therefore be on the arrival of a vessel subject to quarantine, to order the vessel into quarantine. No persons but those willing to remain in the State for the full quarantine period are to be allowed to land. Infected and suspected persons should be removed from vessels as soon as it is possible. In the case of Small-pox on a vessel on which vaccination has already been carried out on board, arrangements must be made without delay for the disinfection of the persons on board, especially those more directly exposed to infection. A vaccinated person means: successfully vaccinated with active vaccine over a total area of not less than one-half of a square inch, which area shall, when healed, show distinct foveation. 13. Properly vaccinated means: vaccinated not less than 14 days nor more than 7 years prior to examination. 14. The period during which persons landed in quarantine under the provisions of section 34, sub-section (1), paragraph (c), or ordered into quarantine under the provisions of section 35, or during which persons released under quarantine surveillance under the provisions of sections 34 and 45, sub-section (4) of the Act, remain subject to quarantine, shall be not less than 18 days, if the disease in regard to which infection is suspected is Small-pox. The period of quarantine or quarantine surveillance shall be reckoned from the last day on which, in the opinion of the quarantine officer, there has been exposure to infection from a quarantinable disease. 23 In the case of quarantine for Small-pox, any person who has been properly vaccinated under the observation or to the satisfaction of the Chief Quarantine Officer may, as soon as practicable, be released under quarantine surveillance or released from quarantine. Any person to be released under this regulation shall, if so required, submit himself with his goods and effects to disinfection as prescribed or to the satisfaction of the quarantine officer. 15. Any person eligible under these regulations for release under quarantine surveillance, may, subject to the concurrence of the Chief Quarantine Officer, and to any conditions as to disinfection imposed by these regulations, be released under surveillance on application in accordance with the following form:— Quarantine Act, 1908. Sections 34 and 35 (4) To the Chief Quarantine Officer, State of (a) Name of ship or station. (b) Give intended address. I hereby request that I (and the undernamed members of my family being under the age of twenty-one years, and under my control*), may be permitted to leave (a) under quarantine surveillance, and I hereby undertake to comply with all the regulations relating to quarantine surveillance. My address will be (b) Signature Date Note.—It will be sufficient if this undertaking is signed by the head of the family, in cases where more than one member of the family desires to leave under quarantine surveillance, and where they are. less than twenty-one years of age. Every member of a family above twenty-one years of age must give a separate undertaking. 16. Any person released under quarantine surveillance shall, as frequently and at such tunes as the Chief Quarantine Officer directs, present himself for inspection and examination to a quarantine officer, or to a medical officer of health when available, or to a duly qualified medical practitioner as the Chief Quarantine Officer directs, and shall, if required by the Minister, pay such fee as may be fixed for the inspection or examination. 17. Any person released under quarantine surveillance shall, immediately on the appearance in himself of any symptoms or signs of illness or disease, report the facts, or cause them to be reported, to the quarantine officer or other person to whom he has been directed to present himself under the provisions of the last preceding regulation. The parent or guardian signing the application for the release of any child under surveillance shall be responsible for the observance by the child of the provisions of the regulations relating to release under surveillance. 18. No person under quarantine surveillance shall leave the port where he is released or change his residence without the permission of the Chief Quarantine Officer. 19. No person under quarantine surveillance shall leave the State in which he has been released without permission of the Director of Quarantine, on the recommendation of the Chief Quarantine Officer, subject to such conditions as may be imposed by the former. 24 20. Any person contravening any of the regulations relating to quarantine surveillance, shall be liable to the penalty fixed generally for any breach of these regulations, and shall also forfeit all the privileges and advantages of release under quarantine surveillance, and may be removed by any constable or authorised person to a quarantine station. It would be difficult to enforce such strict regulations in this country, and they certainly would interfere with our maritime commerce. There are two things necessary for an explosion. (a) An accumulation of explosive material. (b) An agent, such as fire, which, when brought into contact with such explosive material, will cause it to explode. There is a growing accumulation of "explosive material" in this country in the shape of persons who are insufficiently protected by vaccination against Small-pox, and when this has increased it will only need the introduction of the infection to cause an epidemic of Small-pox. In my opinion, powers are desirable for compelling possible contacts with Small-pox to give their names and addresses, so that after landing they may be found and kept under reasonable medical supervision. The s.s. "Persia," of Greenock, from Bombay, arrived at Gravesend on the 3rd September, and reported a case of Small-pox on board. The patient was taken ill on the 30th August, and the rash appeared on the 2nd September. He was removed to the Denton Hospital. All necessary disinfection was carried out. The whole of the crew had recently been vaccinated. No further cases occurred. The s.s. "Araby," of Liverpool, from La Plata, arrived at Gravesend on the 4th September, and reported one of the crew, a carpenter, to be suffering from Chicken-pox. An examination of the patient by the Boarding Medical Officer, proved him to be suffering from Small-pox, and he was accordingly removed to the Denton Hospital. All necessary disinfection was carried out. Vaccination was offered to the crew and refused. The names and addresses of the passengers were notified to the Medical Officer of Health of the districts to which they were proceeding. The s.s. "City of Calcutta," of Glasgow, 115,759, arrived at Gravesend on the 20th March, 1911. A passenger who had embarked at Madras on the 20th February— ailed on the 5th March, and was diagnosed as suffering from Small-pox. He was landed at Port Said on the 7th March, where I am informed he subsequently died. Some of his effects were on board the vessel on arrival, and they were removed to Denton Hospital for disinfection. All persons on board were found free from the disease, and were subsequently kept under observation. No illness of a suspicious nature has since occurred, and the vessel sailed for Glasgow, the Medical Officer of Health for that Port being duly informed of the facts. The engineer of the steam tug "Diligence," of London, 123,848, was removed from his home at Purfleet on March 20th, 1911, suffering from Small-pox. He had been at work from March 7th to the 17th on board the tug "Jane," of London, 68,400, on which date he returned on board the "Diligence," but not feeling well, he returned to his home, where, on the 20th, a rash appeared. He was seen by a doctor, and the complaint was diagnosed as Small-pox. 25 The two tugs, with their crews, were taken to Denton, where they were thoroughly disinfected. Vaccination was offered to all the men, but it was refused. Their names and addresses were notified to the Medical Officer of Health of the districts in which they resided. No further cases occurred. The s.s. "Gloucestershire," of Liverpool, 131,296, arrived in the Port on the 21st April, 1911, when one of the crew—a Lascar named Yassan—was removed to Denton Hospital suffering from Small-pox. The vessel came from Rangoon, and the patient is stated not to have been on shore since leaving that place. The names and addresses of the passengers were furnished, and were duly notified to the Medical Officers of Health for the districts to which they were proceeding. The crew remained on board the vessel, and were kept under observation. The vessel proceeded to Liverpool, and the Medical Officer of Health for that port was duly notified of the facts. All necessary disinfection of the vessel and effects was carried out, also vaccination of the crew. Amongst the passengers were a lady and gentleman who gave an address within the City of London. They were allowed to land, but on enquiry at the address by the Medical Officer of Health for the City of London, it was ascertained that it was an address for the receipt of letters only, and the private address of the passengers was refused. The vessel came from a Plague-infected port, and the Regulations of the Local Government Board, dated September 9th, 1907, as to Cholera, Yellow Fever, and Plague Ships arriving from Foreign Ports, Article XXVI. provide that :— "The Master of a ship, or any other person, shall answer truly all such "questions put to him by, and give all such information to, any Officer of "Customs or Medical Officer of Health as are necessary for any purpose of this "Order; and a person who is required in pursuance of this Order to give to the "Medical Officer of Health or to notify to any Local Authority the name and "intended place of destination and the address of the said person shall not "knowingly give or notify a false or fictitious name, place of destination or "address, and shall not refuse or neglect to give or notify as aforesaid the true "name, intended place of destination and address of the said person. In this case the passengers failed to comply with Article XXVI. of the Regulations, as the address given was not such as is required by the Regulations. I recommended that the facts be reported to Mr. Solicitor for such action as he might deem desirable. On April 12, I received a telephone message that there was a Lascar in the Royal Albert Dock, who was ailing and had developed a rash. I at once proceeded to the dock, and the case being Small-pox, I ordered the removal of the patient to Denton Hospital. All contacts were vaccinated and are being kept under observation. It was ascertained that the patient formed one of the crew of a troop ship, and had come from Southampton to the Royal Albert Dock by rail. A suspicious case of Small-pox was found on the vessel on arrival at Southampton. No further case occurred amongst the contacts. The s.s. "Egypt," of Greenock, 105,881, arrived at Gravesend on the 9th June, 1911, from Bombay, having landed a case of Small-pox at Plymouth. Vaccination was offered to all the crew, and performed in the case of those accepting. The names and addresses of all the passengers were taken, and notified to the various Medical Officers of Health. 26 The s.s. "Ruapehu," of Plymouth, 111,357, arrived on the 10th June, 1911, from New Zealand, having landed a case of Smallpox at Rio de Janeiro, on May 21st last. The 3rd class passengers, stewards, and crew were vaccinated. On the 7th June, 1911, I received information that the s.s. "Albania," of Goteborg, had a case of Smallpox on board, on the outward voyage, the case being landed at Quebec. The s.s. "Foyle," of London, 115,800, arrived on the 14th June, having landed a case of Small pox at Port Said on the 17th April last. In the case of each of the above vessels, all necessary disinfection was carried out to my satisfaction, and no further cases occurred. The s.s. "Sargasso," of London, 87,117, arrived on the 26th May, 1911, from Lisbon, and proceeded to the London Dock. On the 1st June, I received information that the chief officer was ill on board, with a disease suspicious of Smallpox. The case was therefore removed to Denton Hospital, where it was diagnosed to be one of typical Smallpox. All necessary disinfection of the vessel was carried out—and vaccination was offered to the crew, and performed in the case of several who accepted it. The vessel touched at Malaga, Gibraltar, and Lisbon. The patient did not go ashore at any of the ports touched at, but labourers from the shore came off to work the cargo in and out. The source of infection was probably Lisbon. The vessel sailed for Lisbon on June 3rd, and all on board appeared to be in good health. TABLE IX. (Scarlet Fever or Scarlatina.) Date. Name of Vessel, Port of Registry, and Official Number. Where from. Number of Cases. How dealt with. 1911. January 11 s.s. "Flintshire," of London, 105,833 Yokohama 1 Removed to Branch Seamen's Hospital, Royal Albert Dock. Februar 7 s.s. "Highland Brae," of London, 129,153. Buenos Ayres 1 Removed to Plaistow Fever Hospital. April 7 Training ship "Exmouth," lying off Grays 1 Removed to Eastern Hospital, Homerton. „ 22 s.s. "Kiapara," of Plymouth, 114,630 Wellington 1 Convalescent on arrival of vessel in London. May 15 s.s. "Minnewaska," of Belfast, 124,674 New York 1 Removed to Port Sanitary Hospital. June 30 s.s. "German," of Southampton, 109,290. East London 1 Ditto. July 7 Training ship "Worcester" lying off Greenhithe 1 Removed to Ship's Hospital on shore. August 1 s.s. "Intaba," of Aberdeen, 129,345 Beira 1 Removed to Port Sanitary Hospital. Sept. 27 s.s. "Tintagel Castle," of London, 105,900. Delagoa Bay 1 Ditto. October 12 s.s. "Dover Castle," of London, 119,400. Do. 1 Ditto. „ 81 s.s. "Themistocles," of Aberdeen, 129,349. Brisbane 1 Ditto. Total 11 27 TABLE X. (Diphtheria. ) Date. Name of Vessel, Port of Registry, and Official Number. Where from. No. of Cases. How dealt with. 1911. Jan. 23 s.s. "Stephen Furnes," of Newcastle Newcastle 1 Removed to Brook Hospital, Shooter's Hill. March 23 Training ship "Arethusa," lying off Greenhithe I Removed to ship's sanatorium on shore. „ 27 Ditto ditto ditto 1 Removed to Bow Arrow Lane Hospital. April 10 London Dock, No. 1, Dock Cottages 1 Removed to hospital at Homerton. „ 26 s.s. "Dover Castle," of London, 118,409. Delagoa 1 Landed at Southampton. May 3 s.s. "Namur," of Greenock, 123,528 Calcutta 1 Removed to hospital at Marseilles. „ 22 Training ship "Exmouth," lying off G rays 1 Removed to ship's hospital on shore. June 1 s.s. "Galeka," of Southampton, 110,265. Cape Town 1 Removed to Port Sanitary Hospital. „ 11 s.s. " Agadir," of Liverpool, 124,092 Las Palmas 2 Ditto. „ 24 Training ship "Warspite," lying off Gr eenhithe 2 Removed to ship's hospital on shore. „ 26 Ditto ditto ditto 2 Ditto. July 17 Training ship "Arethusa," lying off Greenhithe 1 Ditto. Aug. 4 Training ship "Exmouth," lying off Grays 1 Removed to Eastern Hospital, Homerton. Oct. 26 s.s. "Gloucester Castle," of London Delagoa Bay 1 Landed at Las Palmas. Dec. 20 s.s. "Avondale Castle," of London, 108,160. Antwerp 1 Removed to hospital at Hamburg. Total 18 28 TABLE XI. Enteric Fever. Date. Name of Vessel, Port of Registry, and Official Number. Where from. No. of Cases. How dealt with. 1911. Jan. 23 s.s. "Normand," of Bayonne Marseilles 1 Removed to Branch Seamen's Hospital, Royal Albert Dock. „ 28 s.s. "Highland Brae," of London, 129,153. Buenos Ayres 1 Removed to Port Sanitary Hospital. Feb. 2 s.s. "Intaba," of Aberdeen, 129,345 Beira 1 Ditto. „ 21 s.s. "City of Sparta," of Glasgow, 106,082. Calcutta 1 Ditto. „ 25 s.s. "China," of Belfast, 104,467 Sydney 1 Removed to Hospital at Marseilles. March 14 s.s. "Runic," of Liverpool, 118,441 Ditto 2 Removed to Hospital at Cape Town. „ 15 s.s. "Andora,” of Christiania Charente 1 Removed to Port Sanitary Hospital. April 1 s.s. " Siva," of Grangemouth, 90,921 Gandia 1 Patient remained on board. „ 7 s.s. "Berwick Castle," of London, 114,822. Mauritius 1 Removed to Hospital at Las Palmas. „ 7 s.s. "Sardinian," of Glasgow, 71,695 St. John's 1 Removed to Port Sanitary Hospital. „ 8 s.s. " Conisciiffe," of Sunderland, 114,637. Bahia Blanca 1 Removed to Hospital at Las Palmas. „ 15 s.s. "Persia," of Greenock, 109,258 Bombay 1 Removed to Hospital at Port Said. „ 18 s.s. "Waipara," of Glasgow, 119,128 Brisbane 2 Removed to Hospital at Brisbane. „ 18 Training ship "Cornwall," lying off Purfleet 1 Removed to Hospital at Wennington. „ 20 s.s. "Syria," of Glasgow, 113,959 Yokohama 1 Removed to Hospital at Shanghai. „ 29 s.s. " Umsinga," of London, 114,777 Bombay 1 Isolated at own residence. „ 29 s.s. "City of Paris," of Glasgow, 124,233. Calcutta 1 Removed to Hospital at Port Said. May 4 s.s. "Caledonia," of Greenock, 102,390 Bombay i Removed to Hospital at Marseilles. „ 4 s.s. "Inyoni," of Aberdeen, 98,544 Beira 1 Died—buried at sea. „ 4 s.s, "Drumcree," of Liverpool, 120,909 Buenos Ayres 1 Removed to Port Sanitary Hospital. „ 5 s.s. “Zoroaster," of London, 112,740 Bombay 1 Patient died on vessel in dock. „ 11 s.s. " Tongariro," of Plymouth, 111,356 Wellington 1 Removed to Middlesex Hospital. „ 11 Training ship " Cornwall," lying off Purfleet 1 Removed to Ship's Hospital on shore. „ 11 s.s. "Montezuma," of Liverpool, 110,604. St. John's 3 Died—buried at sea. „ 12 s.s. "Vostizza," of Andros Braila 1 Removed to Port Sanitary Hospital. 29 Date. Name of Vessel, Port of Registry, and Official Number. Where from. No. of Cases. How dealt with. 1911. May 13 s.s. '' Inveric," of Glasgow Buenos Ayres 1 Removed to Hospital at Las Palmas. „ 15 s.s. " Golden Cross," of Whitby, 99,146 Bussein 1 Landed at Gibraltar. „ 31 Training ship " Cornwall," lying off Purfieet Removed to Ship's Hospital June 2 s.s. " Borneo," of Newcastle, 104,287 Yokohama 1 Removed to Port Sanitary Hospital. „ 10 s.s. "Egypt," of Greenock, 105,881 Bombay 1 Landed at Plymouth. „ 10 s.s. " Omrah," of Glasgow, 108,782 Brisbane 1 Removed to Port Sanitary Hospital. „ 14 s.s. " Foyle," of London, 115,800 Odessa, &c. 1 Landed at Alexandria. „ 20 s.s. '' Sergei," of Riga Riga 1 Removed to Seamen's Hospital, Greenwich. „ 24 s.s. " Vasconia," of Solvesborg Savannah 1 Ditto. „ 28 s.s. " Gulf of Suez," of London, 81,799 Cyprus 1 Removed to Port Sanitary Hospital. „ July 4 "John Gill," of Mariehamn 1 Removed to Port Sanitary Hospital. „ 7 Steam Tug " Woodcock," of London, 87,949. Employed on River Thames. 1 Isolated at home. „ 8 s.s. " Southend Belle," of London, 105,824. Employed on excursion trips. 1 Removed to Poplar Hospital. „ 9 s.s. "Caledonia," of Greenock, 121,218 Bombay 1 Removed to Port Sanitary Hospital. „ 13 s.s. " Flintshire," of London, 105,833 Yokohama Landed at Port Said. „ 31 s.s. " Hurona," of Dundee, 99,214 Montreal 1 Removed to Seamen's Hospital, Greenwich. Aug. 10 s.s. "City of Madrid," of Glasgow, 113,965. Calcutta 1 Landed at Calcutta. „ 16 s.s. " Montana," of London, 94,344 Antwerp 1 Removed to Seamen's Hospital, Greenwich. „ 26 s.s. " Matheran," of Liverpool, 120,046 Calcutta 1 Removed to Hospital at Gibraltar. „ 31 Training ship " Exmouth," lying off Gr eenhithe 1 Removed to Eastern Hospital, Homerton. Sept. 4 s.s. " Bohemia," of Glasgow, 98,622 Calcutta 1 Removed to Port Sanitary Hospital. „ 8 Training ship " Arethusa," lying off Gr eenhithe 1 Removed to Bow Arrow Lane Hospital. „ 9 s.s. " Orchis," of Liverpool, 63,327 Antwerp 1 Removed to Seamen's Hospital, Greenwich. „ 16 s.s. " Orvieto," of Belfast, 129,628 Brisbane 1 Removed to Port Sanitary Hospital. „ 18 s.s. " Denewell," of Newcastle, 129,761 1 Removed to Seamen's Hospital, Greenwich. „ 23 s.s. " Mobile," of Liverpool, 97,855 Baltimore 1 Removed to Port Sanitary Hospital. 30 Date. Name of Vessel, Port of Registry, and Official Number. Where from. No. of Cases. How dealt with. 1911. Oct. 1 s.s. Marathon," of Aberdeen, 118,184 Cape Town 2 Removed to Branch Seamen's Hospital, Royal Albert Dock. „ 1 s.s. "Oceana," of Belfast," 93,170 Bombay 1 Died—buried at sea. „ 3 Pier Head Cottage, St. Katheriue's Dock 1 Removed to Homerton Hospital. „ 6 s.s. "Albania," of Liverpool, 11Q,797 Montreal 2 Removed to Port Sanitary Hospital. „ 17 s.s. "Radiance," of Sunderland, 119,222. Rosario 1 Landed at Las Palmas. „ 24 s.s. "Eda," of London, 120,684 Smyrna 1 Removed to Port Sanitary Hospital. Nov. 14 s.s. "Egyptian," of Glasgow, 98,618 Odessa 1 Ditto. „ 16 s.s. "Westhampton," of Hartlepool, 124,324. Savannah 1 Ditto. Dec. 1 s.s. “Ausonia," of Liverpool, 129,735 Montreal 1 Ditto. „ 2 s.s.Inventor," of Liverpool, 131,287 Calcutta 1 Removed to Hospital at Port Said. „ 5 s.s. "Derbyshire," of Liverpool, 105,876. Rangoon 1 Removed to Tilbury Hospital. „ 6 s.s. "Senator," of Liverpool, 102,078 San Francisco 1 Removed to Hospital at St. Vincent. Total 70 Measles has been a notifiable disease in the Port of London since 1890. This disease was made notifiable for the following reasons:— 1. It is a very infectious disease with a high death rate in children. 2. In its early stage the rash of Smallpox somewhat resembles Measles. 3. Masters of vessels were accustomed, in order to avoid delay to their vessels, of assuming any rash to be Measles, and so did not think it necessary to mention it on arrival at Gravesend. 4. Members of the crew and passengers of vessels infected with this disease are generally landed at Denton Hospital. Many passenger lines carry numbers of children on their vessels, and it is obviously desirable that this disease should not break out on the voyage. 5. Passengers arriving from " Foreign " and who are suffering with Measles, are generally unable to go to a hotel, and have no other place to which they can go where they will not communicate the disease. Moreover, they generally travel by rail from the docks and may infect a large number of persons en route. It is therefore desirable that passengers suffering from Measles, unless they can be removed to some place where they can be isolated and proper precautions taken, should be removed to the hospital at Denton when there is sufficient accommodation available, and kept there till they are free from any risk of infecting other persons. 31 The following cases were reported on incoming vessels : — TABLE XII. (Measles.) Date. Name of Vessel, Port of Registry and Official Number. Where from. No. of Cases. How dealt with. 1911. January 7 s.s. "Otranto," of Belfast, 124,675 Brisbane 1 Patient isolated on board until well. „ 20 Training ship “Exmouth," lying off Grays 9 Removed to Hospital at Homerton. „ 21 s.s. "Otway," of Glasgow, 128,282 Sydney 6 4 cases landed at Fremantle and 1 at Marseilles. 1 isolated on board. „ 27 Training ship " Exmouth," lying off Grays 1 Removed to Brook Hospital, Shooter's Hill. February 22 H.M.S. "Worcester," lying off Greenhithe 9 Removed to Ship's Sanatorium Greenhithe. „ 24 s.s. " Sardinian," of Glasgow, 71,695. St. John's, N.B. 1 Removed to Port Sanitary Hospital. March 4 s.s. " Osterley," of Glasgow, 128,287 Brisbane 4 1 case landed at Fremantle, 1 at Plymouth, 1 at Port Sanitary Hospital, and 1 landed in London well. „ 18 s.s. " Ophir," of Glasgow, 98,673 Brisbane 1 Removed to Metropolitan Asylums Board Hospital. „ 624 Training ship "Worcester," lying off Greenhithe 67 Removed to Ship's Sanatorium on shore. „ 27 Ditto Ditto 2 Ditto. April 8 s.s. "Macedonia," of Belfast, 116,012 Auckland 1 Removed to Hospital at Port Said. „ 10 Training ship "Worcester," lying off Greenhithe 1 Removed to Ship's Sanatorium on shore. „ 18 s.s. " Moravian," of Aberdeen, 108,662. Brisbane 1 Patient remained on board, well. May 3 s.s. " Tortona," of Newcastle, 129,735 Portland (Maine) 2 Ditto. „ 8 s.s. "Highland Scot," of London, 129,130. Buenos Ayres 1 Ditto. „ 12 s.s. " Mantua," of Greenock, 127,544 Bombay 8 2 cases landed at Aden, 1 at Plymouth, 1 died and was buried at sea, and 4 recovered. „ 13 s.s. " Ansconia," of Liverpool, Portland (Maine) 1 Removed to Hospital at Islington. „ 28 s.s. " Sardinian," of Glasgow, 71,695. Quebec 1 Removed to Port Sanitary Hospital. June 1 s.s. " Galeka," of Southampton, 110,265. Cape Town 20 Removed to Hospital at South ampton. „ 3 s.s. " Comrie Castle," of London, 118,342. Ditto 1 Removed to Hospital at Lisbon. „ 10 s.s. " Montreal," of Liverpool, 113,373. Montreal 1 Landed at Montreal. „ 10 s.s. " Braemar Castle," of London, 108,381. Cape Town 16 Landed at Southampton. „ 15 s.s. " Themistocles," of Aberdeen, 129,349. Brisbane 4 Patients recovered. August 10 s.s. " Turakina," of Plymouth, 114,620. Wellington 4 Landed at Plymouth. „ 16 s.s. "Norseman," of Liverpool, 110,633. Brisbane 1 Landed at Sydney. „ 29 s.s. "Medic," of Liverpool, 11,984 Sydney 2 Removed to Port Sanitary Hospital. October 11 s.s. "Osterley," of Glasgow, 128,287 Brisbane 4 3 recovered, 1 proceeded to private residence. „ 23 s.s. "Commonwealth," of London, 115,903. Sydney 1 Allowed to land in London. November 17 s.s. " Geelong," of London, 118,426 Ditto 2 None. Patients recovered. December 9 s.s. "Avon," of Grangemouth, 90,917. Grangemouth 1 Removed to Port Sanitary Hospital. „ 9 s.s. "Orsova," of Glasgow, 128,278 Brisbane 1 Removed to Hospital at Sydney. Total 175 32 TABLE XIII. (Erysipelas.) Date. Name of Vessel, Port of Registry, and Official Number. Where from. No. of Cases. How dealt with. 1911. January 9 Barge " Verdict," of London, 95,473 1 Removed to Seamen's Hospital, Greenwich. „ 30 s.s. " Prince Charles," of London, 120,546. Brussels 1 Ditto. February 6 s.s. " Pomeranian," of Glasgow, 85,193. St. John's 1 Ditto. March 2 s.s. " Durham Castle," of London, 118,387. Cape Town 1 Removed to Hospital at Plymouth. „ 6 s.s. " Tuskar," of Glasgow, 98,598 Glasgow 1 Isolated on board. July 22 s.s. " Umhloti," of London, 98,168 Natal 1 Removed to Seamen's Hospital, Greenwich. Aug. 16 s.s. " Durham Castle," of London, 118,387. Cape Town 1 Landed at Southampton. Oct. 17 s.s. " Ausonia," of Liverpool, 129,735 Montreal 1 Removed to Bermondsey Infirmary. „ 30 s.s. " Rossmore," of Glasgow, 124,166 Kirkcaldy 1 Isolated on board. Dec. 15 s.s. " Highland Ghillie," of London, 98,081. La Plata 1 Removed to Seamen's Hospital, Greenwich. „ 18 s.s. " Bonoventa," of Larvik Chile 1 Removed to Port Sanitary Hospital. Total 11 TABLE XIV. (Continued Fever.) Date. Name of Vessel, Port of Registry, and Official Number. Where from. No. of Cases. How dealt with. 1911. March 14 s.s. "Sutton Hall," of Liverpool, 120,853. Vizagapatam 1 Removed to Port Sanitary Hospital. June 29 s.s. "Ayrshire," of Glasgow, 119,066 Adelaide 1 Ditto. July 19 s.s. "Sergei," of Riga Riga 1 Ditto. Sept. 6 s.s. "San Antonio," of London, 125,790. Texas City 1 Ditto. Dec. 23 s.s. "Otway," of Glasgow, 128,252 Brisbane 1 Patient recovered. Total 5 33 TABLE XV. (ChickenPox.) Date. Name of Vessel, Port of Registry, and Official N umber. Where from. Number of Cases. How dealt with. 1911. Feb. 8 s.s. " Palma," of Belfast, 116,009 Antwerp 1 Isolated on board. „ 24 s.s. " Grantully Castle," of London, 129,058. Cape Town 2 Landed at Southampton convalescent. March 22 s.s. " Mahronda," of Liverpool, 120,868 Calcutta 2 Remained on board. „ 22 s.s. " Mombassa," of Glasgow, 96,082 Ditto 3 Removed to Port Sanitary Hospital. April 9 s.s. " Umgeni," of London, 108,314 Durban 2 Convalescent on arrival of vessel in London. „ 11 s.s. " Tintagel Castle," of London, 105,900. Delagoa Bay 4 Removed to Port Sanitary Hospital. „ 20 s.s. "Syria,"of Glasgow, 113,959 Yokohama 4 Convalescent on arrival of vessel in London. „ 29 s.s. "City of Paris," of Glasgow, 124,233. Calcutta 2 Ditto. May 8 s.s. " Moldavia," of Greenock, 117,382 Auckland 1 Removed to Hospital at Aden. „ 31 Training ship "Warspite," lying off Greenhithe 1 Removed to Ship's Hospital on shore. June 2 s.s. "Morea," of Greenock, 128,235 Auckland 1 Patient recovered before vessel arrived in London. „ 14 s.s. "Suevic," of Liverpool, 113,456 Sydney 1 Ditto. July 7 s.s. "Persic," of Liverpool, 110,620 Ditto 4 Patients well on arrival of vessel in London. „ 20 s.s. "Inkosi," of Aberdeen, 115,582 Durban 1 Ditto. „ 29 s.s. "Umvoti," of London, 105,857 Natal 1 Ditto. „ 31 s.s. "Kasan," of Copenhagen Libau 2 Ditto. Aug. 20 s.s. "Orsova," of Glasgow, 128,278 Brisbane 1 Removed to Port Sanitary Hospital. Sept. 13 s.s. "Otranto," of Belfast, 124,675 Stockholm 1 Landed at Stockholm. „ 27 s.s. “Tintagel Castle," of London, 105,900. Delagoa Bay 1 Landed at Southampton. Oct. 29 s.s. " Commonwealth," of London, 115,903. Sydney 3 Allowed to land in London. Total 38 34 TABLE XVI. (BeriBeri.) I herewith give a record of the cases of this disease met with. Ten vessels have reported 44 cases during the voyage:— Date of Arrival. Name of Vessel. Where from. Number of Cases. 1911. January 3 " Dorothea,'' of Louisa Leychelles 13 February 10 s.s. "Peshawur," of Glasgow, 121,223 Sydney 1 May 24 " Sylfid" Peru 7 August 3 s.s. "Dalblair" Calcutta 2 „ 10 s.s. "Clan Sutherland " Mauritius 4 „ 19 Go Down, Royal Albert Dock — 1 (fatal) October 15 s.s. "Glenroy " Antwerp 2 „ 26 s.s. "Tango Mani" Yokohama 4 November 11 s.s. "Hebe " Lillesand 3 „ 30 s.s. "Bendoran " China 1 December 29 s.s. "Candia Yokohama 6 44 TABLE XVII. Return of the Number of Cases of Infectious Disease Notified during the Year 1911, and of Deaths from the Diseases Notified:— Notified Deaths Smallpox 5 1 Scarlatina or Scarlet Fever 9 1 Diphtheria (including Membranous Croup) 10 1 Typhus Fever ... ... Enteric or Typhoid Fever 38 1 Continued Fever 3 ... Relapsing Fever ... • • • Puerperal Fever ... ... Cholera ... ... Erysipelas 8 ... Plague ... ... Measles 98 ... Chickenpox 9 ... Pulmonary Tuberculosis 12 2 192 6 The above Table shows the number of cases of infectious disease notified under the compulsory notification provisions of the Public Health Act. Enquiry has been made as to the mortality amongst the cases notified, with the result that this is shown to be about 3'1 per cent., but the figures are obviously too small to be of any value. NOTIFICATIONS OF NAMES AND ADDRESSES DURING THE YEAR. Smallpox.—Passengers 500 Crew 22 Total 522 35 TABLE XVIII. Vessels and Premises Disinfected, from 1st January to 31st December, 1911. Month. Reason for Disinfection. Total Number of Disinfections. CerebroSpinal Meningitis. Chickenpox. Cholera. Continued Fever. Diphtheria. Enteric Fever. Erysipelas. Measles. Plague (Suspected). Scarlet Fever. Smallpox. Tuberculosis. Precautionary Measure. January ... ... ... ... ... 1 ... I ... ... ... ... 3 5 February ... 1 ... ... ... 2 ... 1 ... ... ... ... 3 7 March ... 3 ... 1 ... 1 2 ... ... 2 ... 6 15 April ... 3 ... ... ... 4 ... 2 ... ... 2 5 16 May ... ... ... ... ... 5 ... 4 ... 1 1 1 3 15 June ... 2 ... 1 2 4 ... 1 ... 1 1 ... ... 12 July ... 1 ... ... ... 4 1 ... ... ... ... ... 2 8 August ... 1 ... ... ... 1 ... 1 ... 1 ... ... 1 5 September ... 1 ... 1 ... 3 ... ... ... 1 2 ... 2 10 October ... ... ... ... ... 3 ... 1 ... 2 ... ... 3 9 November ... ... ... ... ... 2 ... 1 ... ... ... ... 4 7 December ... ... ... ... 3 1 1 ... ... ... ... 5 10 Totals ... 12 3 2 33 2 15 ... 6 8 1 37 119 TABLE XIX. Number of Disinfections of Effects, Bedding, &c., from 1st January to 31st December, 1911. Month. Reason for Disinfection. Hospital Bedding, &c. Total Effects. Number of times Steam Disinfector was used. Disinfected by Fumigation. Cholera. Chicken-pox. Continued Fever. Diphtheria. Enteric Fever. Erysipelas. Measles. Suspected Plague. Scarlet Fever. Smallpox. Precautionary measure. January ... ... ... ... 1 ... 1 ... ... ... ... 3 5 6 ... February ... 1 ... ... 3 ... 1 ... ... ... ... 3 8 5 ... March ... 1 1 ... 1 ... 2 ... ... 3 ... 1 9 4 ... April ... 3 ... 1 5 ... ... ... ... 2 ... 1 12 5 ... May ... ... ... ... 4 ... 3 ... 1 1 ... 1 10 6 ... June ... 2 1 2 4 ... ... ... 1 1 1 2 14 7 ... July 1 1 ... ... 5 ... ... ... ... ... ... 1 8 5 ... August ... 1 ... ... 1 ... 1 ... 1 ... 1 1 6 5 ... September ... 1 1 ... 2 ... ... ... 1 2 ... 1 8 4 ... October ... 1 ... ... 4 ... 1 ... 2 ... ... 1 9 6 ... November .. ... ... ... 2 ... 1 ... ... ... ... 2 5 2 ... December ... ... ... ... 1 1 1 ... ... ... ... ... 3 3 ... Totals 1 11 3 3 33 1 11 ... 6 9 2 17 97 58 ... 36 PULMONARY TUBERCULOSIS. This disease has received considerable attention during the past few years. The following Regulations have been issued:— 1. The Public Health (Tuberculosis) Regulations, 1908. 2. The Public Health (Tuberculosis in Hospitals) Regulations, 1911. 3. The Public Health (Tuberculosis) Regulations, 1911. (1) These Regulations (1908) provide for the notification of cases of this disease occurring amongst the inmates of Poor Law Institutions or amongst persons in the care of District Medical Officers. Very few notifications have been received under these Regulations, and only in those cases where destitute persons have landed from a vessel suffering from this disease, and subsequently have entered a Poor Law Institution, giving the name of the vessel as the last address from which they came. (2) Those of May, 1911, provide for the notification of cases of this disease occurring amongst the in-patients or out-patients of those hospitals supported wholly or in part by voluntary contributions. Several cases were notified from the Seamen's Hospital. Sailors suffering from this disease went there for treatment, and were either admitted or treated as out-patients; in each case the notification was sent to me. (3) Those issued in November, 1911, and which came into force on January 1st, 1912, provide for the notification of every case of this disease by any Medical Practitioner attending on, or called in to visit any person ; he shall, within 48 hours of first becoming aware that such person is suffering from Pulmonary Tuberculosis, complete, sign, and transmit a notification of the case to the Medical Officer for the area within whose district the place of residence of the person is situated. Under this order, the name of any person landing from a ship and being attended by any Medical Practitioner will be notified to me. Article VIII.—Upon the receipt of a notification under these Regulations, or under the Poor Law Regulations, or under the Hospital Regulations, the Medical Officer of Health shall make such enquiries and take such steps as may appear to him to be necessary or desirable for preventing the spread of infection, and for removing conditions favourable to infection: Provided that nothing in this Article shall be deemed to authorise a Medical Officer of Health or other Officer to take any of the steps herein mentioned at any Poor Law Institution or any Hospital. Article X.—Nothing in these Regulations shall apply to or impose any duty or obligation upon any Medical Practitioner acting in his capacity as:— (a) Medical Officer of a Poor Law Institution or District Medical Officer. (b) Medical Officer of a Hospital. 37 (c) Medical Officer of one of His Majesty's Prisons or of a Certified Reformatory School. (d) Medical Officer of an Institution for Lunatics. (e) Medical Examiner of Candidates for some office or appointment. ( f) Medical Examiner on behalf of an Insurance Company of a person proposing to insure his life at the risk of that Company ; or (g) Medical Examiner of the passengers and crew of an emigrant ship. Article XI.—Nothing in these Regulations or in the Hospital Regulations shall have effect so as to require a notification to be transferred to a Medical Officer of Health in respect of any person whose place of residence is not situated in England and Wales. Article XII.— Nothing in these Regulations shall have effect so as to require a notification to be transmitted to a Medical Office of Health in respect of any inmate of any building, ship, vessel, boat, tent, van, shed, or similar structure belonging to His Majesty the King. Article XIII.—Nothing in these Regulations shall have effect so as to apply, or so as to authorise or require a Medical Officer of Health or a Council, or any person or authority, directly or indirectly, to put in force with respect to any patient in relation to whom a notification in pursuance of these Regulations has been transmitted to a Medical Officer of Health, any enactment which renders the patient, or a person in charge of the patient, or any other person, liable to a penalty, or subjects the patient to any restriction, prohibition, or disability affecting himself, or his employment, occupation, or means of livelihood, on the ground of his suffering from Pulmonary Tuberculosis. The prevalence of Pulmonary Tuberculosis amongst seamen is much greater than is supposed. A sailor's life is supposed to be particularly healthy, but the conditions under which sailors live and to which attention has been drawn repeatedly in my Annual Reports, are such as favourably pre-dispose to the dissemination of this disease. By the courtesy of Dr. Murdock McKmnon, Medical Registrar and late Medical Superintendent of the Seamen's Hospital at Greenwich, I am enabled to give some tables which show the total number of admissions, to the Dreadnought Hospital, of patients suffering from this disease. "These tables have been compiled to show the total number of admissions to the Dreadnought Hospital, of patients suffering from Pulmonary Tuberculosis in 21 years (1890-1910 inclusive) ; the annual number of admissions under each class, and the death-rate, also the percentage death-rate from phthisis, calculated from the total number of deaths from all causes. In Table I. is given the total annual admissions under each rating ; in Table II., the total annual admissions of phthisis cases with the percentage death-rate ; and in Table III., the total deaths from all causes, and the death-rate from phthisis calculated from such total." 38 TABLE I.—Total number of Admissions under each Rating. Year. Ablebodied Seamen. Firemen. Engineers. Cooks. Stewards. Officers. Various. Totals, 1890 41 13 13 8 2 2 3 82 1891 45 24 8 6 9 3 4 99 1892 47 24 2 3 6 0 7 89 1893 39 30 9 4 8 0 2 92 1894 41 25 5 7 3 2 0 83 1895 39 23 10 8 7 2 3 92 1896 42 28 9 10 8 1 4 102 1897 41 31 7 7 9 0 3 98 1898 47 33 13 6 10 1 2 112 1899 38 34 15 13 7 2 5 114 1900 32 29 17 5 10 0 2 95 1901 36 24 5 8 6 2 3 84 1902 41 23 3 3 9 1 3 83 1903 40 26 4 5 3 0 4 82 1904 39 21 2 4 10 3 8 87 1905 35 14 5 2 9 1 10 76 1906 28 29 1 5 10 0 4 77 1907 38 21 4 2 4 1 4 74 1908 21 24 3 3 5 0 7 63 1909 29 21 6 3 7 0 8 74 1910 23 17 3 9 5 1 5 63 Total 782 514 144 121 147 22 91 1,821 Per cent. 42.9 28.2 7.9 6.6 8.1 1.2 5 — 39 TABLE II.—Total Annual Admissions of Phthisis cases, with percentage Death Rate. Year. Admissions. Deaths. Percentage Death Rate. Year. Admissions. Deaths. Percentage Death Rate. 1890 82 35 41.6 1901 84 31 35.7 1891 99 33 33.3 1902 83 30 36.1 1892 89 31 34.8 1903 82 31 37.6 1893 92 28 30.4 1904 87 37 42.5 1894 83 32 38.5 1905 76 17 22.3 1895 92 32 34.7 1906 77 30 38.9 1896 102 39 38.2 1907 74 35 47.2 1897 98 28 28.5 1908 63 28 44.4 1898 112 35 31.2 1909 74 20 27.0 1899 114 37 32.4 1910 63 22 34.7 1900 95 37 38.9 TABLE III.—Total Deaths from all causes, with Death Rate from Phthisis. Year. Total Deaths from all Causes. Percentage Death Rate from Phthisis. Year. Total Deaths from all Causes. Percentage Death Rate from Phthisis. 1890 122 31.2 1901 130 23.8 1891 127 25.9 1902 142 21.1 1892 119 26.0 1903 113 27.4 1893 116 24.1 1904 125 29.6 1894 134 23.8 1905 116 14.5 1895 130 24.6 1906 136 22.0 1896 155 25.1 1907 144 24.3 1897 116 24.1 1908 127 22.0 1898 126 27.7 1909 100 20.7 1899 121 30.5 1910 123 17.8 1900 136 27.2 40 The effects of these Regulations as affecting the Port of London Sanitary Authority, are as follows:— Every person suffering with Pulmonary Tuberculosis who has been on a vessel and who forthwith comes under the care of a Medical Practitioner either in his private or official practice, shall be notified to me. This will enable enquiries to be made on the vessel to ascertain whether there are any effects, &c., remaining there which are liable to retain infection, and will also enable the quarters inhabited by the patient to be inspected, and if necessary thoroughly cleansed and disinfected. The Local Government Board in the circular issued with the Order state that:—" Apart from the actual "treatment of cases, the Board would again urge on Local Authorities the great "importance of their making full use of their powers of preventing overcrowding, “and of securing the removal of any conditions tending to injure the health of persons "residing in their districts." It may be stated that the crews' quarters on vessels are habitually overcrowded, when judged by the lowest standard of accommodation which exists or is permitted on shore, which cubic capacity is, in the case of common lodging-houses occupied by day and night, 400 cubic feet, whereas seamen may only have 72 cubic feet per head. The conditions under which seamen on vessels live are particularly favourable for the dissemination of Pulmonary Tuberculosis, and it would seem that until the legislature takes some more practical interest in the welfare of seamen, Pulmonary Tuberculosis will continue to be a cause of much mortality amongst this class of men. I have pointed out before, that the conditions of life on vessels for seamen can be much improved especially in new vessels without much addition to the prime cost of construction. The crews' quarters should be situated above deck, preferably in the after part of the ship. This position will enable their quarters to be provided with skylights and adequate means of ventilation. Ventilation means the regular supply of fresh air to the inhabited spaces, without the creation of a draught, and the extraction of the foul air so that the carbonic acid gas, &c., shall be constantly removed and the quantities not allowed to increase beyond a recognised low percentage, whilst the relative quantity of oxygen in the air may be as high as possible. The present Regulations of the Board of Trade merely insist on the provision of a ventilator, which is often situated over a berth, and is generally stopped up from below, or the external opening is covered up with canvas. Complaints are made of the degeneracy of the seamen found on board British ships. They can, indeed, do little else but degenerate under the present conditions. Persons who travel by steamer and are enabled to sleep in State Rooms below deck are often only too cognisant of the imperfect ventilation found in ordinary steamers even under such favourable circumstances where the State Room is inhabited usually for only a few hours at night—they can easily imagine the condition of the seamen shut up in quarters below deck which are practically in constant use as a sleeping, living and dining room, generally dark, dirty, damp, and encumbered with clothing. In some of the smaller vessels the men have even to provide and to keep their food in their quarters. 41 The Regulations discourage, and rightly so, any action which would interfere with the occupation or means of livelihood of persons suffering from Pulmonary Tuberculosis. The position of a Port Medical Officer under these conditions is particularly difficult. There is little doubt that if the crews of vessels could be medically examined, there would generally be found some member of the crew suffering from Pulmonary Tuberculosis in a more or less degree. The following example was met with recently:—A sailor had been on a ship for about eight months, had been ailing for about two months with general debility—off duty at various periods, and finally laid up for three weeks with cough and general weakness, suffering from Pulmonary Tuberculosis. He died at sea, and was buried at Perim. This man had been capable of spreading the disease amongst the other occupants of the forecastle for at least two months. Seafaring men are not generally very particular in their habits. They expectorate wherever it is convenient, and are thus, when affected with Pulmonary Tuberculosis, a source of great danger to the other occupants of the quarters. If the Medical Officer should report to the Captain that a man was suffering with Pulmonary Tuberculosis, it would mean that he would probably be discharged, in which case he would take a situation on another vessel and so continue the danger of spreading the disease. The master might, on the other hand, decide to take no action, the man would then remain on the vessel and continue to be a source of danger to his companions. Some good, however, will be done if these men seek treatment in recognised hospitals. They can be educated so that when they leave the hospital and join a vessel, the habits of precaution which they have learned in the hospital can be continued when on board ship, and so the danger will to a certain extent be minimised. TABLE XX. (Pulmonary Tuberculosis.) Vessels in respect of which Disinfection was Recommended and Performed. Date. Vessel. Disease. Dock. 1911. Jan. 12 s.s. “Arawa" Tuberculosis Royal Albert. April 10 s.s. "Highland Rover " Ditto Ditto. May 16 s.s. "Afric" Ditto Tilbury. „ 23 s.s. "Mongolia" Ditto Ditto. June 21 s.s. "Cluny Castle" Tuberculosis West India. July 10 s.s. "Umhloti" Ditto East India. „ 10 s.s. "Persic " Ditto Tilbury. Sept. 30 s.s. "Perseus " Ditto Royal Albert. Oct. 26 s.s. “Palermo " Ditto Ditto. „ 30 s.s. "Highland Laddie Ditto Ditto. Nov. 6 s.s. "Sardinia" Ditto Ditto. Dec. s.s. "Palma" Ditto Victoria. 42 COMPULSORY NOTIFICATION OF INFECTIOUS DISEASES. I received from the Clerk to the London County Council a copy of an Order made by the Council requiring—for a period of three months as from and including 22nd March, 1911—the notification of cases of Chicken-pox in the administrative County of London. By an Order of the Port of London Sanitary Authority, Chicken-pox has been a notifiable disease within the district of the Port of London since the 3rd November, 1910, and such Order remained in force until the 30th April, 1911. The importance of this notification lies in the fact that each case of Chicken-pox is seen, and it is ascertained whether the patient is suffering from a mild form of Small-pox or not. By an Order of the Port of London Sanitary Authority, Chicken-pox and Cerebro-Spinal Fever (Epidemic Cerebro-Spinal Meningitis) and Acute Polio Myelitis or Acute Polio Encephalitis, were made notifiable for twelve months from January 1st, 1912. CORPORATION OF LONDON. Port of London Sanitary Authority. COMPULSORY NOTIFICATION OF INFECTIOUS DISEASES. NOTICE IS HEREBY GIVEN, that the Mayor, Commonalty, and Citizens of the City of London, as the Port Sanitary Authority of the Port of London, do hereby, by virtue of the power vested in them by Section 56 of the Public Health (London) Act, 1891, order that as from the 1st January next, the provisions of the said Act with respect to Infectious Diseases shall apply in the district of the said Port Sanitary Authority to Cerebro-Spinal Fever (Epidemic Cerebro-Spinal Meningitis) and Acute Polio Myelitis or Acute Polio Encephalitis, in addition to the Diseases specifically mentioned in Section 55 of the said Act, or any Order extending or amending the same, and that such Order shall remain in force until the 31st December, 1912. By Order of the Port Sanitary Authority, Guildhall, London, 30 November, 1911. JAMES BELL, Town Clerk. Telegrams— "medoff, london," Telephone— 36 new cross. Notifications should be addressed to— The Medical Officer of Health, Port of London, 5.1, King William Street, Greenwich, S.E. 43 CORPORATION OF LONDON Port of London Sanitary Authority. COMPULSORY NOTIFICATION OF INFECTIOUS DISEASES. NOTICE IS HEREBY GIVEN, that the Mayor, Commonalty, and Citizens of the City of London, as the Port Sanitary Authority of the Port of London, do hereby, by virtue of the power vested in them by Section 56 of the Public Health (London) Act, 1891, order that as from the 1st January next, the provisions of the said Act with respect to Infectious Diseases shall apply in the district of the said Port Sanitary Authority to CHICKEN-POX, in addition to the Diseases specifically mentioned in Section 55 of the said Act, or any Order expending or amending the same, and that such Order shall remain in force until the 31st December, 1912. By Order of the Port Sanitary Authority, Guildhall, London, 30th November, 1911. JAMES BELL, Town Clerk. Telegrams— "medoff, london." Telephone— 36 new cross. Notifications should be addressed to— The Medical Officer of Health, Port of London, 51, King William Street, Greenwich, S.E. FOOD INSPECTION. The Regulations issued by the Local Government Board, under the Public Health (Regulations as to Food) Act, 1907, have been carried out strictly in the Port of London. They have added considerably to the work, but the additional powers conferred on this Authority have enabled the officers to exercise a stricter supervision on all Foodstuffs entering the Port of London. 1. The Unsound Food Regulations specially deal with Unsound Food, and practically extend those Clauses of the Public Health (London) Act, 1891, dealing with Unsound Food, so that they shall apply to ports and enable foodstuffs in larger quantities to be examined, a contingency which was not definitely provided for in the Public Health Act. 2. The Foreign Meat Regulations deal chiefly with the following subjects:— (а) To prohibit the importation of Scrap Meat. (b) To regulate the importation of Pork. Thus, Pork can only be imported:— 1. In the form of the whole carcass, with all the glands present. 2. In the form of bacon, salted and pickled. 3. Contained in packages, bearing an Official Certificate which states that the pig in question has been examined, both ante and post-mortem, and found free from any appearance of disease. Such Official Certificates have to receive the approval of the Local Government Board, and were only so recognised, on the Board being satisfied as to the conditions and method of inspection in the certifying country. 44 (c) To prohibit Tongues, &c., imported in pickle, provided such pickle contains any of the following substances:— Formalin. Salicylic Acid. Formic Aldehyde. Formic Acid. Fluorine. Sulphurous Acid. Boron. Benzoic Acid. During the year 1910, the fore-quarters of Beef coming from certain Australian ports were found to be extensively infected with "worm." This was practically confined to certain parts of the fore-quarters, and during the year 1911, the exporters in Australia have removed the briskets and those portions of the fore-quarters which were found to be particularly liable to be attacked by the "worm." Hind-quarters have been found also to be more or less affected, and this has necessitated the careful examination of every hind-quarter of Beef arriving from Australia by the Inspectors of this Authority. It was found that certain marks and consignments were more extensively affected than others. Thus, some marks were found to contain "worm" to the extent of 70 per cent., whilst in others, it was so small as to be practically negligible. The Commonwealth of Australia have appointed Veterinary Inspectors to examine quarters of Beef before they are exported. It has been found, however, that such Inspectors were apparently not very expert in the examination of hind-quarters, for several consignments bearing certificates, stating that that had been examined, were found on inspection here to be affected to the extent of 50 per cent. The results have from time to time been reported to the High Commissioner for the Commonwealth of Australia in London, and he has made stringent representations to the Commonwealth Goverment as to the necessity of a thorough and reliable examination being made of the meat, &c., before it is exported to this country. A Veterinary Inspector has been appointed who will be attached to the office of the High Commissioner in London. Similar inspectors have been appointed by the Dominion of New Zealand and the Argentine Republic. If these inspectors will co-operate with the Sanitary Authorities of this country, the standard of meat inspection in the exporting country will be kept high, and will ensure that meat will arrive from those countries which is quite sound and free from disease. Pigs imported in the form of whole carcasses have been carefully examined. Those arriving from Holland and Belgium have been found to bear evidence of careful examination, and speaking generally, to be free from disease. Those arriving from Australia, however, often require careful examination. On one occasion 50 pigs arrived from Tasmania, bearing a label that they had undergone both ante and post-mortem examinations. It was found, however, that the lymphatic glands in the neck had not been exposed, or even examined. It was found that five of the pigs contained deposits of tubercle in the glands of the neck. 45 The more thorough examination of meat in Australia and other countries of export should lessen the work of your staff, and if the results of inspection show that the inspection in Australia is reliable and satisfactory, it may not be necessary to examine all the meat arriving in this country, but only a percentage, merely to check the efficiency of the examination in Australia. The following Instructions have been Issued in Australia bt the Commonwealth regarding the supervision and inspection of meat for export. Animals are to be inspected both ante and post-mortem. No carcass of beef or pork shall be examined if the visceræ of the same are not dentifiable. Any carcass submitted for inspection with any lymph glands removed, or the pleura or peritoneum stripped, shall be rejected. Condemnation of the whole carcass is necessary in the presence of any of the following conditions:— (a) Any general disease such as anthrax, blackleg, pyaemia, septicaemia, or tetanus. (b) Definite emaciation. (c) Anaemia, if pronounced (flesh pale, soft, watery). (d) Signs of marked fevering of flesh. (e) Cloudy swelling or fatty degeneration (unless definitely localized). (f) Redwater —if the flesh is in any way abnormal. (g) Jaundice. (h) Uraemia—Urinus odour or strong sexual odour. (i) Cystic parasites (cysticercus cellulosae or trichina spiralis). (j) Immaturity. (k) Very advanced pregnancy or parturition (within 10 days). (l) Inflammation of the lungs, pleura, peritoneum, intestines, uterus, pericardium or endocardium. (m) Swine fever or hog cholera. (n) Malignant catarrh. (o) Multiple abscess (in sheep). Condemnation for Tuberculosis. (1) The condemnation of the whole carcass is necessary in the presence of any of the following conditions:— (a) Tuberculosis in any degree in a pig. (b) Any emaciated carcass showing tuberculosis in any degree. 46 (c) Any tuberculous animal found before slaughter to be suffering from fever or evidently ailing. (d) If the disease is generalized (miliary). (e) If the lesions, wherever situated, are extensive as well as caseous or purulent or surrounded by active hyperemia. (f) If the miliary tuberculosis is present in both lungs ; or if disease of the lungs is accompanied by adhesions between lung and pleura ; or if the pleura or peritoneum is effected. (g) If the miliary tuberculosis is present in the liver, along with a tubercular lesion in some other part of the carcass. (h) If tuberculosis is present in two or more places (organs, glands, membranes or tissues) not directly connected by lymph vessels. (2) Local condemnation of the quarter or part affected is sufficient in the case of cattle in the presence of the following conditions:— In a well-nourished carcass if the disease is definitely localized (calcified or encapsuled) and of limited extent, that is when the disease is limited to one organ and its related glands, or to one distinct group of glands, such as :— (a) The pharyngeal lymph glands ; (b) The thoracic (visceral) lymph glands ; (c) The pharyngeal and thoracic (visceral) lymph glands ; (d) The lungs and related lymph glands ; (e) The liver and related abdominal lymph glands. Worm Nests in Cattle.—After freedom from other Diseases had been proved, the carcass, other than the briskets, is to be specially examined for worm nests, which, if found, and if superficial and few in number, are to be removed ; if numerous and scattered, the carcass is to be condemned. In the hind-quarters, the nodules are to be specially looked for on the flank and on the outer side of the stifle joint; occasionally they are to be found well back on the outer surface. In fore-quarters, nodules must be specially looked for at the lower edge of the latissimus dori, but other parts must also receive attention. The briskets are to be removed from all carcasses by the cut shown in an accompanying print. The cut is to be made from the reflexion of the diaphragm on the eleventh rib, upwards in a line parallel to the edge of the back of the quarter. The separation of the brisket must not be effected until the carcass has set. The brisket is to be examined by the Inspector subsequently, by careful slicing into thin layers. Any brisket (from a carcass otherwise free from disease) may, if found free from worm nodules, be preserved (corned or canned) under supervision. 4 7 No affected briskets are to be used for canning or corning for export. The management is responsible for the maintenance of cleanliness and other sanitary conditions throughout any approved premises. The Veterinary Inspector in charge is, however, authorised to suspend slaughtering or preparation for export on any premises or any place not maintained in a proper condition, and he may, if necessary to secure efficient supervision and inspection, fix the hours of slaughter. At the close of each day's operations, he must ascertain the time of resumption of work, in order that arrangements may be made for proper supervision. In order to facilitate thorough inspection, the work of inspection has been standardised, as to the maximum number of animals to be examined daily by each inspector. The number of animals of the various kinds, which it is considered may be properly examined by a competent Inspector, is as follows :— Cattle 100 or Pigs 200 or Sheep 2,500 The certificates to be attached to canned meat and carcasses passed for export, are in charge of the Veterinary Inspector, who is responsible for their proper use, and for the stamping of each certificate with his signature. TABLE XXI. PUBLIC HEALTH (FOREIGN MEAT) REGULATIONS, 1908. During the year Notices were served under Article III. (5) and VI. of the above-mentioned Regulations, requiring the exportation of the following foreign meat :— Date of Arrival. Name of Vessel. Where from. Where lying. Description and quantity of foreign meat in respect of which Notices were served. 1911. Jan. 23 " Devon," of London, 108,171. Townsville Royal Victoria Dock. 2 cases boneless meat.| Mar. 28 " Somerset," of London, 118,292. Melbourne Ditto 160 sides pork. May 16 " Prins Hendrik," of Amsterdam. Flushing Queenborough Pier 1 pig carcass. July 7 " Osterley," of London, 128,287. Australia Tilbury Dock ... 3 pig carcasses.* „ 12 " Persic," of Liverpool," 110,620. Ditto Ditto 1 pig carcass.* Sept. 15 "Somerset," of London," 118,292. Brisbane Royal Victoria Dock. 3 pig carcasses.| „ 19 " Koningen Regentes," of Amsterdam. Flushing Queenborough Pier 28 pig livers. „ 19 " Koningen Regentes," of Amsterdam. Ditto Ditto 28 pig livers. „ 21 " Koningen Regentes," of Amsterdam. Ditto Ditto 22 pig livers. „ 22 " Koningen Regentes," of Amsterdam. Ditto Ditto 22 pig livers. * Goods lying at Royal Victoria Dock. † These goods were lying at Poplar Cold Air Store, and were subsequently destroyed at the request of the consignees, ‡ These goods were destroyed at the request of the consignees. 48 TABLE XXII. PUBLIC HEALTH (FOREIGN MEAT) REGULATIONS, 1908. During the year Certificates were issued under Article [II. (5) of the above-mentioned Regulations in respect of the undermentioned foreign meat :— Date. Name of Vessel. Where from. Where lying. Description and quantity of foreign meat in respect of which Certificates were issued. 1911. Jan. 6 " Ruahine," of Plymouth New Zealand Victoria Dock 12 crates ox cheeks, 195 pig carcasses, 16 cases pork. „ 6 "Kia Ora," of Southampton. Ditto Royal Albert Dock. 124 pig carcasses. „ 10 Ditto Ditto Ditto 247 pig carcasses. „ 10 " Whakarua," of London Melbourne Victoria Dock 20 bags ox cheeks. „ 14 " Kaikoura," of Plymouth New Zealand Ditto 16 crates ox cheeks. „ 16 Ditto Ditto Ditto 22 pig carcasses. „ 16 " Rippingham Grange," of London. Melbourne Royal Albert Dock. 28 bags ox cheeks, 44 pig carcasses. „ 16 " Rangatira," of Southampton. Brisbane Ditto 64 pig carcasses. 17 " Pal ma," of Belfast Melbourne Ditto 50 pig carcasses. „ 19 "Rubis," of Anvers Ostend Tilbury Dock 4 sides bacon. „ 25 " Ayrshire, of London Australia Victoria Dock 256 pig carcasses. „ 25 " Devon," of London Ditto Ditto 52 pig carcasses. „ 26 " Topaz," of Anvers Ostend Tilbury Dock 1 case sheep kidneys. „ 27 " Aki Maru," of Tokio Tientsin Royal Albert Dock. 2 casks intestines. „ 27 "Devon," of London Australia Victoria Dock 122 bags ox cheeks. Feb. 1 " Topaz," of Anvers Ostend Tilbury Dock 3 bales bacon. „ 2 " Highland Brae," of London. Argentina Royal Albert Dock. 1,000 cases ox cheeks. „ 3 " Nerehana,"of London ... New Zealand Victoria Dock 27 pig carcasses. „ 3 " La Blanca," of London Zarate Ditto 146 bags ox cheeks, 171 clods beef. „ 6 '' Ruapehu," of Plymouth New Zealand Ditto 25 crates ox cheeks. „ 7 " Morayshire," of Glasgow Australia Ditto 102 pig carcasses, 35 bags ox cheeks. „ 11 ''Geelong," of London ... Sydney Ditto 111 pig carcasses. „ 13 " Paparoa," of Plymouth Lyttelton Ditto 271 pig carcasses, 11 boxes pig kidneys. „ 13 " Dorset," of London Brisbane Ditto 132 pig carcasses. „ 15 " Peshawur," of Glasgow Melbourne Royal Albert Dock. 12 pig carcasses. „ 16 " Mimiro," of London Australia Victoria Dock 203 pig carcasses. „ 22 " Highland Corrie," of Liverpool. Argentina Royal Albert Dock. 700 crates ox cheeks. „ 23 " El Argentino," of London Ditto Victoria Dock 367 bags ox cheeks. „ 23 " Rubis," of Anvers Ostend Tilbury Dock 5 sides bacon. „ 25 " Star of Canada," of Belfast. Wanganui Victoria Dock 6 pig carcasses. 49 Date. Name of Vessel. Where from. Where lying. Descripton and quantity of foreign meat in respect of which Certificates were issued. 1911 Mar. 2 " Banffshire," of Glasgow New Zealand Victoria Dock 15 pig carcasses. „ 1 " Poona," of Glasgow Australia Royal Albert Dock. 95 bags ox cheeks. 9 „ " Opawa," of Plymouth New Zealand Victoria Dock 243 pig carcasses. „ 4 " Opawa," of Plymouth Ditto Ditto 49 crates ox cheeks, 16 boxes „ 4 ''Poona," of Glasgow Australia Royal Albert pig kidneys. 56 pig carcasses. „ 6 " Banffshire," of Glasgow Brisbane Dock. Victoria Dock 43 bags ox cheeks. ,, 8 " Rotorua," of Penang Lyttelton Ditto 10 crates ox cheeks, 73 pig carcasses. „ 9 " Highland Scot," of Liverpool. Argentina Royal Albert Dock. 400 crates ox cheeks. „ 10 " Otaki,'' of Plymouth Lyttelton Victoria Dock 3 cases ox cheeks, 10 pig carcasses. „ 15 " Star of Scotland," of Belfast. New Zealand Ditto 15 pig carcasses. „ 17 " Ionic," of Liverpool Ditto Royal Albert Dock. 32 pig carcasses. „ 18 " Pakeha,'' of Southampton Ditto Ditto 211 pig carcasses. „ 18 " Montfort," of Liverpool St. John's, N.B. Millwall Dock 28 barrels pork and beef casings. „ 18 " Saphir," of Anvers Ostend Tilbury Dock 1 cask salted pigs' " guts." „ 22 " Runic," of Liverpool Sydney Victoria Dock 46 bags ox cheeks. „ 22 '' Perthshire," of Glasgow Melbourne Ditto 80 bags ox cheeks, 32 pig carcasses. „ 23 " Aeneas," of Liverpool Ditto Royal Albert Dock. 291 pig carcasses. „ 23 " Hitachi Maru," of Tokio Shanghai Ditto 4 casks sausage casings. „ 27 " Marere," of London New Zealand Victoria Dock 33 pig carcasses. „ 29 " Somerset," of London Melbourne Ditto 377 pig carcasses. „ 29 " Topaze," of Anvers Ostend Tilbury Dock 2 bales bacon. April 11 " Highland Rover," of Liverpool. Argentina Royal Albert Dock. 200 bags ox-cheeks. „ 13 " Waimate," of Plymouth New Zealand Victoria Dock 540 pig carcasses, 9 crates ox cheeks, 36 crates pig kidneys. „ 18 " Guardiana," of London Argentina Ditto 300 crates and 342 bags ox cheeks, 80 bags weasands, 704 cases ox cheeks. „ 21 " Moravian," of Aberdeen Sydney Royal Albert Dock. 26 pig carcasses, 10 crates kidneys. „ 21 " Wakool," of London Australia Victoria Dock 153 pig carcasses. „ 21 '' Palermo," of Glasgow Sydney Royal Albert Dock. 447 pig carcasses. ,, 22 " Star of India," of Belfast New Zealand Victoria Dock 35 pig carcasses. „ 24 " Mamari," of Southampton Auckland Royal Albert Dock. 71 pig carcasses. „ 24 " Medic," of Liverpool Melbourne Victoria Dock 172 pig carcasses, 144 bags ox cheeks. „ 24 " Kaipara,'' of Plymouth Auckland and Lyttelton. Ditto 13 crates ox cheeks. 33 pig carcasses. „ 29 Ditto Ditto Ditto 79 pig carcasses. May 3 " Tongariro," of Plymouth Lyttelton Ditto 16 crates ox cheeks. „ 4 " Cufic," of Liverpool Brisbane Ditto 182 pig carcasses. „ 8 '' Rimutaka," of Plymouth Lyttelton Ditto 18 crates ox cheeks, 32 cases ox skirts, 1,384 pig carcasses. 50 Date. Name of Vessel. Where from. Where lying. Description and quantity of foreign meat in respect of which Certificates were issued. 1911. May 9 " Wilcannia," of London . Melbourne Victoria Dock 133 pig carcasses, 36 bags ox cheeks. „ 16 " Prins Hendrik," of Amsterdam. Flushing Queenborough Pier. 23 pig carcasses. „ 18 " Muratai," of London New Zealand Victoria Dock 8 pig carcasses. „ 23 " Ruahine," of Plymouth Ditto Ditto 62 pig carcasses. „ 30 " Orari," of Plymouth Ditto Ditto 283 pig carcasses. „ 31 " Rubis," of Anvers Ostend... Tilbury Dock 6 sides bacon. June 2 " Durham," of London New Zealand Victoria Dock 242 pig carcasses, 65 pig kidneys, 4 crates ox cheeks. „ 3 " Commonwealth," of London. Australia Royal Albert Dock. 15 pig carcasses. „ 7 " Highland Brae," of London. Argentina Ditto 800 cases ox cheeks. „ 13 " Highland Rover," of London. Ditto Ditto 500 cases ox cheeks. „ 16 " Oswestry Grange," of London. Australia Victoria Dock 101 bags ox cheeks, 100 cases ox cheeks, 57 pig carcasses. „ 24 " Suevic," of Liverpool Ditto Ditto 111 pig carcasses. „ 24 ''Whakarua," of London New Zealand Ditto 20 pig carcasses. „ 26 " Highland Corrie," of London. Argentina Royal Albert Dock. 500 cases ox cheeks. July 5 " Kaikoura," of Plymouth New Zealand Victoria Dock 101 pig carcasses. „ 19 Ditto Ditto Ditto 23 crates ox cheeks. „ 5 " Whakatane," of Plymouth. Ditto Ditto 155 pig carcasses. „ 5 " Saphir," of Anvers Ostend Tilbury Dock 2 bales bacon. „ 7 " Osterley," of London Brisbane Ditto 95 pig carcasses. „ 12 " Persic," of Liverpool Australia Victoria Dock 97 pig carcasses. 12 " Ophir," of Glasgow Ditto Ditto 122 pig carcasses. ,, 14 " Miltiades," of Aberdeen Ditto Royal Albert Dock, 118 bags ox cheeks. „ 14 " Geelong," of London Ditto Ditto 257 pig carcasses. „ 19 " Malwa," of Greenock Ditto Victoria Dock 99 pig carcasses. „ 26 "Dorset," of London Ditto Ditto 385 pig carcasses. Aug. 10 " Rubis," of Anvers Ostend Tilbury Dock 2 bales bacon. ,, 17 " Topaze," of Anvers Ditto Ditto 1 bale bacon. „ 18 " Macedonia," of Belfast Australia Victoria Dock 130 pig carcasses. „ 18 "Naming," of London Adelaide Ditto 15 pig carcasses. „ 18 " Runic," of Liverpool Sydney Tilbury Dock ... 56 pig carcasses. ,, 23 Ditto Ditto Ditto 94 pig carcasses. 24 " Saphir," of Anvers Ostend Ditto 3 bales bacon. „ 28 " Runic," of Liverpool Sydney Ditto 400 pig carcasses. „ 30 " Opawa," of Plymouth New Zealand Victoria Dock 304 pig carcasses, 73 boxes kidneys. „ 30 " Paparoa," of Plymouth Ditto Ditto 12 crates pork, 1,592 pig carcasses, 16 boxes kidneys. „ 31 " Tokomaru," of Southampton. Ditto Royal Albert Dock. 161 pig carcasses. „ 31 " Highland Glen," of London. Argentina Victoria Dock 1,201 cases ox cheeks, 36 cases calf cheeks. 51 Date. Name of Vessel. Where from. Where lying. Description and quantity of foreign meat in respect of which Certificates were issued. 1911 Aug. 31 " Marmora," of Belfast Australia Victoria Dock 515 pig carcasses. Sept. 6 '' Rubis," of Anvers Ostend Tilbury Dock 3 bales bacon. „ 11 " Aeneas," of Liverpool Australia Victoria Dock 287 pig carcasses. „ 12 "Matatua," of Southampton. New Zealand Royal Albert Dock. 18 pig carcasses. „ 14 " Saphir," of Anvers Ostend Tilbury Dock 2 packages bacon. „ 15 " Wakool," of London Australia Victoria Dock 64 pig carcasses. ,, 21 Ditto Ditto Ditto 279 pig carcasses. „ 19 " Koningen Regentes," of Amsterdam. Flushing Queenborough Pier. 21 tongues, 5 calf livers, 2 sheep livers, 1 sheep pluck. „ 20 " Somerset," of London Australia Victoria Dock 298 pig carcasses. „ 21 '' Koningen Regentes," of Amsterdam. Flushing Queenborough Pier. 6 calf livers, 2 sheep livers, 7 tongues. ,, 23 " Somerset," of London Australia Victoria Dock . 43 pig carcasses. „ 26 " Corinthic," of Liverpool New Zealand Ditto 175 pig carcasses. ,, 27 " Star of Scotland," of Belfast. Australia Ditto 103 pig carcasses. ,, 27 " Star of Canada," of Belfast. Sydney Ditto 460 pig carcasses. „ 27 " Rubis," of Anvers Ostend Tilbury Dock 1 bale bacon. Oct. 10 " Ruahine," of Plymouth Wellington Victoria Dock 30 pig carcasses. „ 10 " Highland Loch," of London. Argentina Royal Albert Dock. 200 cases ox cheeks. „ 10 '' Highland Mary," of London. Ditto Victoria Dock 226 cases ox cheeks. „ 21 " Thule," of Sweden Gothenborg Millwall Dock 19 pig carcasses. „ 21 " Carmarthenshire," of Southampton. Shanghai Victoria Dock 22 pig carcasses. „ 29 " Cornwall," of London Australia Ditto 276 bags ox cheeks. „ 30 " Thorsten," of Sweden Gothenborg Millwall Dock 2 pig carcasses. Nov. 2 " Highland Laddie," of Liverpool. Argentina Royal Albert Dock. 300 cases ox cheeks. „ 2 " Thule," of Gothenborg Gothenborg Millwall Dock 3 pig carcasses. „ 8 " Rubis," of Anvers Ostend Tilbury Dock 6 sides bacon, 3 crates veal. „ 11 " Thorsten," of Sweden Gothenborg Millwall Dock 14 boxes offal. „ 14 " Ruapehu," of Plymouth Lyttelton Victoria Dock 232 pig carcasses. „ 14 "Essex," of London Melbourne Ditto 45 pig carcasses. „ 14 " Highland Glen," of London. Argentina Royal Albert Dock. 600 cases ox cheeks. „ 17 " Thule," of Sweden Gothenborg Millwall Dock 2 bales pig carcasses, 3 cases offal. „ 28 " Topaze," of Anvers Ostend Tilbury Dock 9 sides bacon. „ 29 " Minnewaska," of Belfast New York Ditto 53 pig carcasses. ,, 30 " Highland Piper," of Liverpool. Argentina Royal Albert Dock. 700 cases ox cheeks. Dec. 6 " Saphir," of Anvers Ostend Tilbury Dock 8 sides bacon. „ 13 "Highland Pride," of Liverpool. Argentina Royal Albert Dock. 592 crates ox cheeks. „ 15 " Palma," of Greenock Sydney Victoria Dock 135 pig carcasses. „ 20 " Rangatira," of Southampton. Australia Royal Albeit Dock. 3 pig carcasses. „ 20 " Rubis," of Anvers Ostend Tilbury Dock 1 bale bacon. ,, 27 " Topaze," of Anvers Ditto Ditto 4 sides bacon. „ 29 " Anchises," of Liverpool Australia Royal Albert Dock. 145 pig carcasses. 52 UNSOUND MEAT. With regard to unsound meat seized and destroyed, the quantities are set out in Table XXIII., and total 462 tons 11 cwts. It will be noticed that the Beef amounts to only 341 tons, compared with 1,100 tons in 1910. This difference in quantities is easily accounted for, inasmuch as the largest quantity seized on any one vessel during 1911 was only 90 tons, whereas in the year 1910 nearly 500 tons were seized on one vessel. Further, during 1910, most of the fore-quarters of Beef imported from Australia were whole, and it was found that they were much affected with "worm" ( Onchocerca), chiefly in the briskets and flanks. The briskets and flanks were, therefore, removed and destroyed. During the past year the fore-quarters imported from Australia have had the briskets and flanks removed before importation. With regard to Mutton, 25 tons were seized and destroyed, as compared with 50 tons in the previous year. The maximum weight of any single seizure during the year 1911 was about 5 tons, compared with 20 tons in 1910. About 4½ tons of Pork and Veal were seized and destroyed. The amount of Offal seized and destroyed constituted a record for any one year, and totalled 80 tons, 19 cwts., 1 qr., 8 lbs., this being made up as follows:— Tons. Cwts. Qrs. Lbs. Ox-livers - 32 16 0 11 Sheep-livers — 11 3 14 Pig-livers — 1 0 26 Kidneys 37 3 0 15 Sweetbreads 4 7 2 21 Sundries, including Heads, Hearts, Plucks, Tails, Tripe 5 19 1 15 80 tons. 19 cwts. 1 qr. 8 lbs. There was an increase in the amount of tinned meats seized and destroyed, chiefly due to a very bad consignment which arrived about the end of the year, and from which nearly 2½ tons was destroyed. An average quantity of smoked and salted meat was seized. 53 TABLE XXIII. Description of Meat Destroyed. Year. Beef. Mutton. Veal, Pork, Offal. Tinned. Smoked and Salted, &c. Total. Tons cwts. qrs. lbs. Tons cwts. qrs lbs. Tons cwts qr s. lbs. Tons cwts. qrs. lbs. Tons cwts. qrs. lbs. Tons cwts. qrs. lbs. 1905 335 16 0 27 361 14 1 5 8 17 3 24 2 0 0 12 0 4 1 4 708 12 3 16 1906 136 5 3 24 94 15 0 8 22 7 0 10 9 0 0 26 0 0 3 14 262 9 0 26 1907 47 5 2 16 63 6 2 24 8 11 1 6 2 14 4 5 63 8 0 22 185 6 3 17 1908 47 14 2 6 22 12 2 10 1 3 0 8 3 12 2 8 2 19 1 13 78 2 0 17 1909 19 11 3 7 21 3 1 17 Pork and Veal— 2 10 2 19 0 2 3 22 113 9 1 19 4 14 7 23 Offal— 65 4 2 15 1910 1,100 0 0 27 50 8 1 13 Pork and Veal— 3 2 2 2 32 13 1 6 1,234 1 3 24 3 5 0 13 Offal— 44 12 1 19 1911 341 6 3 18 25 9 1 6 Pork and Veal— 6 8 2 5 3 18 2 0 462 11 0 0 4 8 1 19 Offal— 80 19 1 8 Total for seven years 2,028 1 1 13 639 9 2 27 244 5 1 5 29 9 2 21 103 7 1 25 3,044 13 2 7 54 TABLE XXIV. Quantity and Description of Unsound Food Seized and Destroyed for the Year ending 31st December, 1911. 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 MEAT— Fresh and Frozen— Beef 2,815 quarters ... ... ... ... 4,519 pieces 341 6 3 18 Mutton and Lamb 1,325 carcasses ... ... ... ... 543 55 25 9 1 6 Veal, Pork and Offal 5,731½ packages ... ... ... ... 2,696 loose 85 7 2 17 Preserved— Tinned 3 cases ... ... ... ... 3,410 tins 6 8 2 5 Smoked and Salted - 40 55 ... ... ... ... 51 sundry 3 18 2 0 Sundry 252 packages 0 19 2 22 ... ... 1 6 0 7 RABBITS— Frozen ... ... 0 17 0 19 ... ... 0 17 0 19 Tinned 47 cases ... ... ... ... ... ... 1 10 0 19 POULTRY and GAME— Frozen 2 packages ... ... ... ... 25 loose 0 0 1 0 FISH 20 cases ... ... ... .... ... 0 4 2 0 Preserved, Dried ... ... 0 4 0 0 ... ... 0 4 0 0 „ Tinned and Bottled 50 cases ... ... ... ... 9,312 tins 5 8 3 5½ „ Frozen ... ... ... ... ... ... ... ... ... ... ... ... FRUIT— Fresh 7,498½ packages ... ... ... ... ... ... 150 14 3 8 Preserved, Dried 4,046 „ 1 11 0 8 ... ... 92 4 0 11 „ Tinned and Bottled 107 „ ... ... ... ... 29,425 tins 52 9 0 19 „ Jam and Marmalade 17 cases ... ... ... ... 15 jars 1 17 2 19 VEGETABLES— Fresh 220 bags ... ... ... ... ... 17 2 0 22 Preserved, Dried ... ... 107 15 0 0 5,859 tins 112 19 0 4 NUTS- Whole ... ... ... ... ... ... ... ... ... ... ... ... Ground 77 bags ... ... ... ... 24 tins 10 12 1 12 Sundry 53 55 ... ... ... ... ... ... 5 1 0 27 PROVISIONS— Tea ... ... 2 16 0 7 ... ... 2 16 0 7 Coffee 4 cases 5 ... ... ... ... ... 5 3 0 26 Cocoa 24 55 ... ... ... ... ... ... 2 0 0 25 Butter, Cheese, Lard, Margarine ... ... 64 10 0 27 2,737 sundry 70 4 0 27 Condensed Milk 133 cases ... ... ... ... ... ... 1 8 0 27 Prepared Foods 3 „ 0 6 0 0 12 tins 4 13 1 7 Biscuits and Confectionery 53 „ ... ... 36 55 14 19 1 6 Sugar ... ... ... ... 1 24 ... ... 0 0 1 24 GRAIN— Wheat, Maize, Barley, Rice, Ac. ... ... 267 6 3 0 ... ... 267 6 3 0 MEAL and FLOUR 231 bags ... ... ... ... ... ... 25 3 2 19 CONDIMENTS and SPICES 213 packages ... ... ... ... ... ... 20 16 2 26 EGGS ... ... ... ... ... ... 14,400 ... 0 13 1 7 Dried 5 cases ... ... ... 2 tins 0 0 2 8 Liquid ... ... ... ... ... ... ... ... ... ... ... ... SUNDRIES 4,159 packages ... 2 2 0 1,015 tins 87 6 0 22 Total 27,129 packages 183 5 0 4 74,081 sundry loose 1,408 4 3 1½ Approximate Total weight of Goods destroyed during the year 1909 1,415 7 0 22 „ „ „ 1910 2,483 6 2 13 „ „ „ 1911 1,408 4 3 1½ 55 LIVERS. In my reports for the years 1909 and 1910, reference was made to the number of diseased and unsound livers which arrived in the Port. During the year 1909 the number seized and destroyed reached nearly 11,000. In 1910 it fell to less than 2,000, while in 1911 the total was only a few short of 7,000. The following table shows the results of the examination of certain consignments of livers. TABLE XXV. Date. Name of Vessel. Where from. Where lying. No. of diseased or unsound livers seized. Percentage of whole consignment 1911. Jan. 20 s.s. " Ayrshire " Brisbane Tilbury Dock 31 55.35 „ 31 s.s. " Paparoa " Lyttelton Victoria Dock 31 27.7 Feb. 9 s.s. "Dorset" Brisbane Tilbury Dock 196 63.6 Mar. 4 s.s. " Highland Scot " Argentina Royal Albert Dock 4 100 „ 26 s.s. "Thorpe Grange" Ditto West India Dock 90 21.12 „ 27 s.s. " Somerset" Brisbane Victoria Dock 24 35.29 Apr. 20 s.s. " Highland Glen " Argentine Royal Albert Dock. 12 100 „ 28 s.s. " Tongariro " New Zealand Victoria Dock 4 22.2 May 8 s.s. " Kaipara " Ditto Ditto 2 50 „ 6 s.s. " Rimutaka " Ditto Ditto 31 36.04 ,, 18 s.s. " Carpentaria " Australia Royal Albert Dock 74 5606 June 6 s.s. "Durham" New Zealand Victoria Dock 69 80.23 „ 19 s.s. '' Oswestry Grange " Australi Ditto 141 78.33 „ 30 s.s. " Kaikoura " New Zealand Ditto 8 80 July 18 s.s. " Rippingham Grange " Australia Royal Albert Dock 320 100 „ 21 s.s. " Highland Loch " Argentine Ditto 362 90.5 Aug. 22 s.s. " Highland Glen " Ditto Victoria Dock 912 42.24 Oct. 2 s.s. " Perthshire'' Australia Ditto 267 88.85 „ 7 s.s. "Highland Mary " Argentina Ditto 126 100 „ 7 s.s. " Highland Loch " Ditto Royal Albert Dock 621 43 „ 17 s.s. '' Waipara " Australia Ditto 208 54.16 „ 21 s.s. "Cornwall " Ditto Victoria Dock 2,393 65.04 Dec. 9 s.s, "Highland Pride" Argentina Royal Albert Dock 698 74.05 56 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 to the 31st December, 1911. Port of London Authority. Capacity. Victoria Dock 316,000 carcasses. Victoria Dock Extension 181,000 „ West India Dock 89,000 „ Surrey Commercial Dock 68,000 „ London Central Markets Cold Storage Co., Ltd. Poplar 150,000 „ Total Capacity in 56 lb. Sheep 804,000 „ Summary. Route. Ships. Carrying capacity. Australia to United Kingdom, &c. - 58 2,565,600 carcasses. New Zealand 51 4,810,500 „ Australasia and/or South America to United Kingdom, &c. 21 1,920,100 „ South America to United Kingdom, &c- 75 4,857,200 „ 205 14,153,400 „ The importation of Frozen Mutton and Lamb (in carcasses) into the United Kingdom began approximately about the year 1880, when 400 carcasses were imported into London. The following figures will show how the importations into London have increased. Carcasses Carcasses Carcasses Year. from Australia. from New Zealand. from South America. TOTAL. 1881 - 7,275 Nil. Nil, 7,275 1891 - 334,684 1,894,105 160,340 2,399,129 1901 - 1,194,157 3,234,119 342,525 4,770,801 1911 - 2,330,572 4,513,457 1,126,303 7,970,332 The total importations of Mutton, Lamb, and Beef into the United Kingdom, from Australia, New Zealand, and South America, in 1911, were as follows :— BEEF. Mutton Carcasses. Lamb Carcasses. Frozen Quarters. Chilled Quarters. From Australia 1,962,048 1,650,231 520,073 1,309 From New Zealand 1,795,259 3,427,236 165,546 — From South America 3,058,943 1,066,666 1,523,706 2,151,170 Totals 6,616,250 6,144,133 2,209,325 2,152,479 Of these quantities, there were landed in the Port of London :— 3,740,360 carcasses or 56.53 per cent, of the Mutton. 4,229,972 „ or 68.84 „ „ Lamb. 1,827,803 quarters or 41.90 „ „ Beef. For the foregoing figures relating to cold storage and the frozen meat trade, I am indebted to the Annual Reviews issued by Messrs. W. Weddel and Co. 57 A few figures relating to the quantities of meat discharged from one ship in one dock alone, may be of interest. This particular ship discharged in the Royal Albert Dock—Chilled Beef 27,396 quarters, Frozen Beef 2,113 quarters, Sheep 9,442 carcasses, and Offals 269 packages. This ship was one of a line of several steamers regularly trading with the dock, and all carrying approximately similar quantities. The vessels arrive weekly, and the rate would represent by this one line alone, and at one warehouse only, in the course of the year—384,880 oxen, 490,984 sheep, or without counting sheep, the carcasses of 7,000 bullocks a week, or 1,000 per day, to be inspected. It is very obvious from this, that if any defect is discovered in the meat necessitating detailed inspection, the demand upon your officers is considerable, as it means a concentration of inspectors upon the ship on which defective meat happens, and at the same time the maintenance of supervision over all other ships which may be discharging meat and other foodstuffs at the same time, in addition to the ordinary work of sanitary inspection. During the year several experimental consignments of Rabbits from Australia, arrived in the Port of London. The methods of "preservation" were novel, and the idea was to be able to ship rabbits to London in bulk, and so save the expense of carriage in refrigating chambers. Altogether four consignments arrived. The first consisted of seven barrels, each containing about one hundred skinned rabbits embedded in tallow, the whole forming a solid block. The second comprised five casks packed in a similar manner. The third and fourth comprised six cases and eight cases respectively. The cases were about two feet long, one foot wide and the same depth, the interior being divided into sections filled with fat, in which the rabbits were embedded. These cases each weighed 118 lbs., made up as follows : fat 73 lbs., rabbits 29 lbs., tare 16 lbs. The tallow and fat in all the consignments were rancid, and the rabbits putrid and unfit for human food. They were, therefore, seized by your officers and destroyed. The result of these experiments proved so costly and unsatisfactory, that they have been discontinued. On the 7th January, a consignment of 85 casks of Beef from Australia, arrived in the Port of London. On examination, the casks were found to contain flanks and briskets which had been cut off fore-quarters of Beef, in Australia. As experience, gained by inspection here, proved that the majority of flanks and briskets on fore-quarters of Australian Beef contained Onchocerca ("worm''), a 10 per cent. examination of the contents of the casks was made, and it was found that the pieces of Beef were considerably infected with " worm." The importers were communicated with, and they asked to be allowed to re-export it to Australia. As this was an early consignment, the request was acceded to, but the 58 importers were informed, that if any similar consignments were imported in the future, and found to contain " worm," the meat would be seized and taken before a magistrate, with a view to obtaining an order for its condemnation and destruction, and they would be dealt with subsequently in accordance with the provisions of the law. No further consignments of this character arrived in the Port during the year. On the 16th May, one of your Food Inspectors, while examining a consignment of Chilled Beef from the Argentine Republic, found a hind-quarter on which the scrotum fat was very much beyond the normal size, and full of pus. The fat was removed and sent to Dr. F. A. Andrewes, at St. Bartholomew's Hospital, for pathological examination, and he reported that:— " The specimen of scrotum fat from a hind-quarter of Beef, left with me " yesterday, by your Inspector, is tuberculous. I find large cavities full of " semi-fluid pultaceous material, which contains tubercle bacilli in large numbers. " I think it probable that a tuberculous abscess has arisen in the lymphatic glands " of the region in question, but if so, the glands are now practically destroyed." On the 18th May, the Inspector discovered seven casks of salted Beef (ship's storer.) which had been sold by the master of a vessel to a " dealer." The meat was putrid, and was accordingly seized and destroyed. On the 12th June, the s.s. " Oswestry Grange" arrived from Brisbane, via Liverpool, having on board three bags of neck beef (scrap meat). This was Foreign Meat of Class 1, and a notice had been served upon the importers, by the Medical Officer of Health at Liverpool, forbidding the removal of the meat from the vessel for any purpose other than exportation, in accordance with the provisions of Articles III. (5) and IV (1) of the Public Health (Foreign Meat) Regulations, 1908. The importers decided to have the meat destroyed instead of incurring the expense of exporting it, and this was done under the supervision of your Officers. On an inspection of the schooner "Reward," of Chester, 76,180, on the 9th November, it was found that about 8 lbs. of salt beef (stored in one of the vessel's harness casks) was in an offensive condition, and quite unfit for food. The condition was brought to the notice of the Mate, and the meat was destroyed by burning in the furnace. The s.s. "Anglian," from Boston, U.S.A., arrived on the 8th November, when it was found that amongst the cargo there were 100 tubs marked " Imitation of Currant Jelly," composed of apple juice, maple syrup, phosphoric acid, and colouring matter. There was no infringement of the Merchandise Marks Act, and no action could be taken by this Authority under the Food and Drugs Acts. It is stated that this substance is sold largely to confectioners, where it doubtless masquerades, and is consumed as, currant jelly. PIG CARCASES. Special attention was paid to pig-carcases imported during the year, with the result that 57 carcases were found to be affected with tuberculosis, as compared with 52 in the previous year. 59 Table XXVI. shows that these were imported as follows :— From Australia 52 carcases „ New Zealand 2 „ „ New York 1 „ „ Holland - 1 „ „ Russia - 1 „ Total 57 „ The carcases arriving from Australia generally have attached to them an "Official Certificate" of the Commonwealth of Australia, which states: "That this meat has been examined, and by ante-mortem and post-mortem veterinary inspection is found free from disease, and suitable in every way for human consumption." With a view to checking the efficiency of the examination in Australia, a careful examination of pig-carcases from Australia during the year was made, and the two following cases go to prove that such consignments must be carefully examined :— The s.s. " Essex," from Melbourne, arriving on the 9th November, having on board 50 pig-carcases, each of which bore the Official Certificate of the Commonwealth of Australia. The carcases were examined in dock, and five were found to be affected with tuberculosis and were seized and destroyed. The s.s. " Anchises," from Australia, arrived on the 21st December, with a consignment of 149 pig-carcases, four of which your officers found to be affected with tuberculosis, of which, three bore the Official Certificate. They were seized and destroyed. In each case the facts were reported to the High Commissioner for the Commonwealth of Australia, and I am informed that the services of the Inspectors who examined the carcases found, ex s.s. " Essex," have been dispensed with. Pig-Carcases from Russia. The s.s. " Carmarthenshire," from Vladivostock, arrived in the Port of London, on the 27th April, with a consignment described as " thirteen sides of frozen pork." On examination the consignment was found to consist of 13 pig-carcases of the " razor-back" variety, each one bearing a medical certificate from Vladivostock. The carcases were not frozen hard, they were badly butchered, wet, flabby, and very unsightlv. They were all putrid and unfit for human food. Only one carcase was examined for evidence of disease, and that was found to be badly infected with tuberculosis in the throat glands. Chinese characters were stamped on the legs of the carcases. All the carcases were seized and destroyed. Pig-Carcases from China. The s.s. "Carmarthenshire," from Yokohama, arrived in the Port of London on the 14th October, with 22 pig-carcases from China. Each carcase was carefully examined, and found to be fit for human food. This was the only consignment from China which arrived during the year. 60 TABLE XXVI. The following is a list of pig-carcases found during the year to be affected with tuberculosis. These were seized as unfit for food and destroyed :— Date. Name of Vessel. Where from. Where lying. Number of Carcasses. 1911. Jan. 19 " Koningen Regentes " Flushing - Queenborough Pier 1. „ 20 " Ayrshire " Australia - Victoria Dock - 1. April 27 " Carmarthenshire " Vladivostock Ditto 1. June 26 "Osterley" Australia - Ditto 2. July 12 ''Geelong" Ditto Ditto 2- „ 12 ''Ophir" Ditto Ditto 1. „ 19 "Malwa" Ditto Ditto 4. „ 25 " Orontes " Ditto Ditto 12. „ 29 "Runic" Ditto Ditto 2. Aug. 31 " Marmora " Ditto Ditto 15. Sept. 4 "Aeneas" Ditto Ditto 2. „ 16 " Somerset" Ditto Ditto 2. Not. 5 " Ruapehu " - New Zealand - Ditto 2. „ 8 "Essex'' Australia - Ditto 5. „ 28 "Minnewaska" New York- Tilbury Dock 1. Dec. 21 " Anchises" Australia - Royal Albert Dock 4. Total - 57. PORK. The s.s. " Somerset," from Melbourne, arrived on the 28th March, with a consignment of 160 sides of pork. The Public Health (Foreign Meat) Regulations, 1908, Article 2 (i) (C) state that:— " The expression " Foreign Meat of Class I." means foreign meat in the form " of severed parts of the carcase of a pig, or of other edible parts of a pig, which " have not, before importation, been salted cured, pickled, dried, or smoked, or " otherwise prepared as bacon or ham, and which are not contained in a box, case, " receptacle, or package with an official certificate impressed thereon, or affixed or " attached thereto." These sides of pork therefore clearly came within the description of Foreign Meat, Class I. Article V., of the Foreign Meat Regulations, provides that " The Medical Officer of Health in determining whether, in the case of any " foreign meat to which these Regulations apply, he shall give a certificate or a " notice in pursuance of these Regulations, shall observe and comply with the " following rules, that is to say :— " He shall not give a certificate and shall give a notice as regards Foreign " Meat of Class I., and Foreign Meat of Class II." 61 Accordingly a Notice was served under Article V. of the Regulations, upon the importers, forbidding the removal of the pork for any purpose other than exportation. The importers applied for permission to export the meat, via Liverpool. Permission was given for this to be done, provided the importers made the necessary arrangements with the Medical Officer of Health for Liverpool. These having been completed, the meat was despatched to Liverpool in sealed railway waggons, the numbers of which were reported to the Medical Officer of Health for Liverpool. The organisation of the Staff for carrying out Food Inspection has been found to work satisfactorily, i.e., the formation of three districts, each under the control of a Food Inspector, who is responsible for the food inspection in his district with the assistance of the Sanitary Inspectors. The work at times has been very hard, and has frequently necessitated the Inspectors working overtime. It was found impossible to allow more than one Inspector to be away at a time on holiday, and even the absence of one Inspector made it difficult at times to carry out the work expeditiously. Fortunately, the health of those remaining was good, so that no man was absent from ill-health. The question of appointing additional Inspectors has been under consideration during the year, but it has not yet been found necessary to add to the staff. The duties of meat inspection at Queensboro' have been performed by Dr. Legge, with the assistance of Inspector Bailey. It has been found there that the meat and offal from certain Dutch slaughterhouses is not so carefully inspected as that from others ; speaking generally, the results have been satisfactory. During the suspension of work in the Port of London owing to the " strike " in the month of August, many vessels with cargoes of foodstuffs on board were unable to be discharged. The refrigerating engines were able to be kept going, so that the cargoes were ultimately discharged generally in good condition. WATER BARGES. The water supply to many vessels in the Port, is obtained by means of water barges. These barges are either specially constructed for the purpose of iron, or wooden barges containing large iron tanks, from which the water is pumped into the ship's tanks. Vessels entering the docks can in most cases obtain a water supply from the shore mains, so that the water barges are employed principally in the conveyance of drinking water to vessels lying in the river. The regular inspection of these vessels is of importance, and forms one of the duties of your Sanitary Inspectors. It is necessary that the tanks, when empty, shall be thoroughly cleansed and lime or cement washed. The number of water barges at present plying in the Port is 18, and all of these are reported to be in good condition. It might be added that the water which these barges supply is in all cases drawn from the public mains, and is therefore of satisfactory purity and quality. 62 TABLE XXVII. NUMBER OF NUISANCES ON VESSELS REPORTED AND DEALT WITH during the year ending 31st December, 1911. Description of Nuisances. January. February. March. April. May. June. July. August. September. October. November. December. Totals. Smoke Nuisances :— Number of complaints received 23 12 12 17 17 1 19 ... 15 24 20 2 162 Number of recurrences reported ... ... ... ... ... ... ... ... ... ... ... ... ... Offensive Cargoes (Bye-laws) :— Number of Infringements reported 1 ... 1 ... ... ... 2 23 2 ... 2 ... 31 Structural and other Defects :— Ventilation 1 1 7 6 3 1 4 5 4 5 6 4 47 Lighting 4 9 16 15 2 3 7 6 11 18 11 8 110 Heating 4 3 8 7 2 4 1 ... 4 10 8 5 56 Bare iron in crew's quarters 2 2 ... ... ... ... ... 1 ... 1 ... ... 6 Leaky decks, hawse-pipes, cable casings, &c. 4 2 6 6 3 5 6 5 4 10 15 4 70 Defective bulkheads and floors ... 1 10 2 3 1 2 ... 2 2 1 2 26 Sanitary conveniences 1 1 ... 4 ... 1 2 1 2 3 2 2 19 Ship's gear or stores stowed in crew's quarters ... ... 1 ... ... ... ... ... ... ... ... ... 1 Foul bilges and peaks 7 9 6 9 8 1 ... ... 2 5 3 3 53 Storage of drinking water (dirty or defective tanks) ... ... 1 2 ... 1 1 ... 2 ... 2 1 10 Dirty quarters 269 258 296 252 263 239 275 273 231 174 199 184 2,913 Accumulation of offensive matter ... ... ... ... 2 ... ... ... 1 2 •• ... 5 Miscellaneous Nuisances 1 ... 2 6 3 8 2 4 1 4 5 5 41 Totals 317 298 366 326 306 265 321 318 281 258 274 220 3,550 Total number of vessels on which structural alterations were ordered 12 14 31 27 11 10 14 16 18 32 29 20 264 Total number of vessels on which structural alterations were reported as carried out 3 13 10 9 27 14 11 13 9 14 31 24 178 NUMBER OF NUISANCES IN THE RIVER REPORTED AND DEALT WITH during the year ending 31st December, 1911. From discharge of foul liquid, sewage, &c., into the River 1 ... ... ... 1 ... ... ... ... ... ... 1 3 Offensive condition of River water ••. ... ... ... ... ... ... ... ... ... ... ... Totals ... ... ... ... ... ... ... ... ... ... ... ... ... 63 TABLE XXVIII. NUMBER OF NUISANCES ON SHORE PREMISES REPORTED AND DEALT WITH during the year ending 31st December, 1911. Description of Nuisances. January. February. March. April. May. June. July. August. September. October. November. December. Totals. Smoke Nuisances:— Number of complaints received 3 1 1 ... 2 ... 2 ... 2 2 1 1 15 Number of recurrences reported ... ... ... ... ... ... ... ... ... ... ... ... ... Structural and other Defects :— Ventilation ... ... ... ... ... ... ... ... ... ... ... ... ... Lighting ... ... ... ... ... ... ... ... ... ... ... ... ... Heating ... ... ... ... ... ... ... ... ... ... ... ... ... Dilapidations ... ... ... ... 2 1 ... ... ... ... ... ... 3 Sanitary conveniences 1 ... ... 2 1 ... 1 1 2 ... ... ... 8 Water supply ... ... ... 1 ... ... 1 1 ... ... ... ... 3 Dirty premises 30 18 26 31 35 35 37 36 35 16 9 12 320 Accumulation of offensive matter 2 3 1 1 ... 1 1 2 ... ... ... ... 11 Drainage ... ... ... ... ... ... ... ... 1 ... ... 1 Foul cesspits, latrines, &c. 2 ... ... ... 1 1 5 ... 1 ... ... 3 13 Miscellaneous nuisances 2 ... 1 8 2 4 3 1 2 1 ... 1 25 Totals 40 22 29 43 43 42 50 41 43 19 10 17 399 Number of shore premises on which structural alterations were ordered 2 3 1 4 4 1 2 1 3 1 ... ... 22 Number of shore premises on which structural alterations were reported as carried out... 2 3 1 1 1 2 2 2 3 2 1 ... 20 SUMMARY. Smoke. Structural. Offensive Cargoes. Sewage, Drainage, &e. Miscellaneous, Totals. Number of Nuisances reported— (a) On vessels 162 335 31 ... 3,022 3,550 (b) On shore 15 14 ... 1 369 399 (c) On the River ... ... ... 3 ... 3 Totals 177 349 31 4 3,391 3,952 Number of written Intimations— (a) On vessels 59 185 31 • • • 90 365 (b) On shore 1 12 ... 1 10 24 (c) On the River ... ... ... ... ... ... Totals 60 197 31 1 100 389 Number of Statutory Notices— (a) On vessels 3 ... 1 ... • • • 4 (b) On shore ... ... ... ... 2 2 (c) On the River ... ... ... ... ... ... Totals 3 ... 1 ... 2 6 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 ... ... ... ... ... ... 2 ... ... ... ... 1 3 Total number of cases in which legal proceedings were taken ... ... ... ... ... ... 2 ... ... ... 1 3 64 NUISANCES. By the preceding Tables it will be seen that a total number of 3,952 nuisances were dealt with during the year—this involving the sending of 389 intimations, whilst 6 statutory notices were served. By far the largest proportion of nuisances reported were of a minor character on vessels, which did not involve other than verbal instructions in order to bring about their abatement. Of smoke nuisances, 162 complaints were received with regard to vessels, and 15 with regard to premises on shore. Formal warning was sent in each case, with the result that in no instance was there any recurrence of the nuisance. RIVER THAMES. On August 2nd, the water between Barking and Crossness was discoloured and gave forth offensive odours. The condition was probably due to the hot weather and drought, which led to a diminished flow of water over Teddington Weir, and through the other tributaries of the Thames below Teddington. On July 28th, a complaint was received from the Medical Officer of Health for Barnes Urban District Council, of a nuisance arising from quantities of dead fish upon the foreshore of the river. The place was at once inspected, when it was found that a very large nnmber of dead fish had been washed up on the banks of the river, and that a nuisance existed. The removal of this fish was a matter for the Port of London Authority to deal with, and on being communicated with they at once took steps to have this done, and the nuisance was accordingly abated. The dock water has remained in good condition, and there has been no recurrence of the offensive condition noticed in the Millwall and West India docks in former years. I have to report that the s.s. "Nimrod," of London, 55047, arrived from Siberia on the 8th October, having on board two dogs and a live deer. One of the dogs subsequently died and caused a nuisance on board ; the carcass was burnt in the ship's furnace. I might add that these animals were kept in the quarters formerly occupied by the crew, and their presence there created a nuisance. I communicated with the owners of the vessel respecting this matter, and on the 19th October, it was found that the animals had been removed to the upper deck. The quarters were also thoroughly cleansed and disinfected. The reindeer died on the 5th November, and the body was burnt in the ship's furnace on the 6th. The live dog was removed and placed in quarantine in accordance with the requirements of the Board of Agriculture. BYELAWS.—OFFENSIVE CARGOES. Nineteen cases of infringement of the above-mentioned Bye-laws were reported during the year. A written Notice was sent to the owners of the barges. The barge "Serapis" arrived at Greenhithe on July 1st, loaded with manure, which at the time was securely covered. The barge was allowed to remain there until the 6th, when the process of discharging began. 65 At the time of the Inspector's visit on the 6th July, he found the barge loaded with stable manure in a decomposing state, and that there were no covers of any description to cover the refuse, and that no person was in charge of the barge at the time. The Bye-laws require that :— 2. Every person who shall load or carry in any ship, boat or vessel within the district aforesaid any dust, ashes, rubbish, offal, carrion, fish or filth, or other matter or thing liable to become offensive or to cause a nuisance if exposed to the open air, shall, except while actually engaged in loading or discharging the same, at all times keep all such dust, ashes, rubbish, offal, carrion, fish or filth, or other such matter or thing properly and securely covered, so as to prevent any nuisance arising therefrom, and no such dust, ashes, rubbish, offal, carrion, fish or filth, or other such matter or thing, shall be loaded above the coamings or hatches of any such ship, boat or vessel. 3. Where, for the purpose of removal within, or carriage through the District of the Port Sanitary Authority, any cargo, load, or collection of faecal or offensive or noxious matter or liquid has been put into or upon any ship, boat or vessel, the owner or consignee, or any person who has undertaken to deliver such cargo, load, or collection, or who is in charge of the same, or of such ship, boat or vessel, shall not without a reasonable excuse, permit or allow or cause such ship, boat or vessel containing such cargo, load or collection, or any undischarged portion thereof, to remain within the said district for a longer period than forty-eight hours. 5. If any faecal or offensive or noxious matter or liquid shall have been dropped or spilt in any ship, boat or vessel while being loaded thereon, or removed or carried in or through such Port Sanitary District, the Master of such ship, boat or vessel shall within six hours of the discharge of such matter or liquid so being removed or carried, cause such ship, boat or vessel to be thoroughly cleansed of and from such matter or liquid so dropped or spilt. On the 6th July, a telegram was received by the Dartford Rural District Council, which read as follows :—" Please viewr barge here putrid dung everybody complaining." The sender of the telegram complained to the Sanitary Inspector of the Dartford Council, that the barge had been alongside the " Hard," at Greenhithe, since the 5th, the contents had not been covered, and the stench filled the house; his son was suffering from a sore throat caused by the stench, and other people were complaining. It was ascertained that the cargo was being unloaded and placed in carts which were covered with cloths. During the process of unloading the cargo, the carts had to proceed some distance to the farm, and in the intervals of unloading the cargo was not properly covered. The usual notice was sent to the owner on the 6th July, and a message was received from him in reply, that the barge (although belonging to him) was out on hire to a market gardener at Greenhithe. It was stated, that owing to the excessive heat, all hands were engaged on fruit-picking, and therefore the cargo had to wait. On the 7th July it was found that the remaining cargo had been covered—but there was a most obnoxious smell coming from the cargo. 66 The barge was moored in close proximity to dwellings, and the inhabitants were obliged to keep the windows closed. The infringement was reported to your Worshipful Committee in September, 1911, and the facts were duly placed in the hands of the City Solicitor for such action as he might deem necessary. It is most objectionable that, such cargoes should be discharged in the vicinity of dwelling-houses, but no action can be taken so long as the offensive cargo is kept properly and securely covered except while actually engaged in discharging the same, and the barge containing such cargo is not allowed to remain within the district of this Authority for a longer period than 48 hours. The consignee has promised in future to discharge such cargoes either expeditiously or at some other place. The locality will, however, be kept under careful observation. TABLE XXIX. BYE-LAWS.—OFFENSIVE CARGOES. Nineteen cases of infringement of the above-mentioned Bye-laws were reported during the year. A written Notice was sent to the owner of the barge :— Date. Name of Vessel. Infringement, 1911 Jan. 10-13 Lighter " Jonan " Permitted to remain within the district for a longer period than forty-eight hours while loaded with an offensive cargo, to wit, manure. Loaded with a cargo of stable manure totally uncovered. Loaded with a cargo of refuse totally uncovered. July 6 " Serapis " „ 19 " Hose," and a lighter name unknown Aug. 17 and 18 "Blue Bell" Ditto. 17,18 and 19 "Saker" Ditto. „ 17,18 and 19 " May " Ditto. „ 17 " Phlox " Ditto. „ 17 " Magnolia " Ditto. „ 17 "Foxglove" Loaded with a cargo of refuse partly uncovered, and loaded above the coamings. „ 17,18 and 19 "Jasmine" Ditto. 17,18 and 19 "Fuchsia" Ditto. „ 17,18 and 19 "Myrtle" Ditto. „ 17,18 and 19 " Shem " Ditto. Sept. 4 Lighter " Roger Leigh " Laden with a cargo of offensive refuse, which was wholly uncovered. „ 20 Lighter " Coronation " Ditto. Nov. 13 Lighter " Olive " Laden with a cargo of refuse matter not properly and securely covered. „ 13 Lighter " May " Ditto. „ 13 - - Lighter " Gloxinia " Ditto, and loaded above the coamings. The majority of these offences occurred during the month of August, when there was a "strike" of labour in the Port of London, and it was decided to take no legal action. 67 ALIENS ACT, 1905. The following figures are extracted from the quarterly Parliamentary returns, and may be subject to correction when the complete returns are published :— TABLE XXX. ALIEN PASSENGERS. LONDON. Total. Cabin. Exempt 2nd Class Passengers. Transmigrants. Other alien passengers. Proceeding to destinations outside the United Kingdom. Holiday return tickets. Seamen. Refused leave to land. Residents returning. Balance. January 3,882 2,242 976 221 443 34 28 61 — 61 259 February 3,016 1,665 714 287 380 47 25 70 — 24 214 March 3,935 2,025 985 434 491 43 26 51 — 47 324 April - 4,809 2,754 1,330 242 483 60 5 69 3 54 292 May - 3,449 1,769 607 418 655 95 26 66 3 65 400 June - 3,809 2,003 672 429 705 121 123 73 — 77 311 July - 5,282 3,036 912 508 826 224 87 47 11 78 379 August 4,885 2,545 1,038 308 994 153 189 64 21 245 322 September 4,311 2,225 790 386 910 138 26 135 14 227 370 October 3,191 1,517 667 350 657 80 11 178 — 86 302 November 2,226 908 337 374 607 63 27 134 10 44 329 December 2,086 867 398 285 536 69 20 140 2 60 245 44,911 23,556 9,426 4,242 7,687 1,127 593 1,088 74 1,068 3,747 All Ports. 12 months -448,531 191,013 106,941 89,202 56,375 7,394 8,998 11,325 944 8,858 18,856 TABLE XXXI. Arrivals in the Port of London. Ships. Alien Passengers on NonImmigrant. Immigrant Total. Non-Immigrant Ships. Immigrant Ships. Total. January - - 176 17 193 2,740 1,142 3,882 February - - 155 11 166 2,495 551 3,046 March - - 158 21 179 2,702 1,233 3,935 April - - - 178 34 212 2,455 2,354 4,809 May - - - 164 27 191 2,003 1,446 3,449 June - - - 163 28 191 2,096 1,713 3,809 July - - - 218 44 262 2,125 3,157 5,282 August - - 160 49 209 1,667 3,218 4,885 September - - 152 41 193 1,733 2,578 4,311 October - - 171 26 197 1,778 1,413 3,191 November - - 152 14 166 1,570 656 2.226 December - - 135 11 146 1,616 470 2,086 1,982 323 2,305 24,980 19,931 44,911 Other Ports 7,811 3,527 11,338 117,236 281,384 398,620 Total - 9,793 3,850 13,643 142,216 301,315 443,531 London. Percentage of Total 1911 20.23 8.39 16.96 17.56 6.61 10.25 Do. 1910 21.34 13.02 18.89 19.52 10.96 13.50 68 Immigrant hip. Non- Immigrant ships. Cabin passengers. Explanatory Notes. Section 8 (2) of the Act provides that the expression " immigrant ship " means " a ship which brings to the United Kingdom more than 20 alien steerage passengers who are to be landed in the United Kingdom, whether at the same or different ports, or such number of those passengers as may be for the time being fixed by order of the Secretary of State, either generally, or as regards any special ships or ports " ; and in this return " immigrant ship " means a ship which brings to be landed in the United Kingdom more than 20 alien steerage passengers. For the purposes of the Act all alien passengers, except first class or "cabin" passengers, are " steerage passengers." Ships bringing to be landed not more than 20 alien steerage passengers are described as "non-immigrant ships." By an Order, dated December 19th, 1905. and made under Section 8 (3) of the Act, the Secretary of State declared " all such passengers as are entitled to use the cabins, state rooms, or saloons, where the accommodation is superior to that provided in any other part of the ship devoted to the carrying of passengers, to be cabin passengers for the purposes of the Act." Under Section 1 (4) the Secretary of State has power, in certain circumstances and subject to such conditions as he thinks fit to impose, to exempt immigrant ships from the provisions of that Section. The Secretary of State has in a number of instances granted such exemptions conditioned so as to relieve the second-class passengers from inspection, on the owners of the ships giving security by bond that they will not land, from amongst those passengers, undesirable immigrants. This expression means alien passengers (other than first-class or cabin passengers) who have in their possession on arrival prepaid through tickets, and in respect of whom security has been given under Section 8 (1) (b) of the Act, that they will proceed to places outside the United Kingdom. Alien passengers who come within this category are not regarded as immigrants under the Act. Proceeding to Under this heading are placed those alien passengers who come within the ontside the united provisions of Section 8 (1) (a) of the Act, to the effect that " any passenger who shows Kingdom. to the satisfaction of the immigration officer or board concerned with the case that he desires to land in the United Kingdom only for the purpose of proceeding within a reasonable time to some destination out of the United Kingdom." Exempted second-class passengers. Transmigrants. TABLE XXXII. HOSPITAL. Number of Cases Admitted, Cost of Maintenance, &c. Patients remaining in Hospital on 31st December, 1910 Admitted. Discharged , Died. ning under treatment Cholera 0 0 0 0 Cholera (suspected) 0 0 0 0 Bubonic Plague 0 0 0 0 Ditto (suspected) 0 0 0 0 Small-pox 6 5 1 0 Scarlet Fever 6 5 1 0 Enteric Fever 22 18 1 3 Continued Fever 4 4 0 0 Diphtheria 3 2 1 0 Measles 6 5 0 1 Erysipelas 1 1 0 0 Chicken-pox 8 8 0 0 Other Diseases 0 0 0 0 Totals 56 48 4 4 69 Remaining in Hospital on 31st December, 1911 .... 4 Total number of days treatment during the year .... 942 Average number of days treatment for each case .... 16*82 Average daily number of patients in Hospital .... 2*58 Average daily cost of maintenance per patient - - -2s. 1*75d. Average total cost of maintenance per patient £1 16s. 1*1$. The total number of patients admitted to the Hospital during the year was 56. Of these the largest number were cases of Enteric Fever, numbering 22. Of the total number of patients admitted, all recovered with the exception of four—there being one death from Enteric Fever, one from Scarlet Fever, one from Small-pox, and one from Diphtheria. The total number of days treatment was 942, the average number of days treatment for each case being 16*82, whilst the average daily number of patients in Hospital was 2*58. The average daily cost of maintenance per patient will be seen to amount to 2s. 1 %d. per head. The exterior of all the buildings has been painted, and two boilers heated by gas provided in the laundry. The boiler of the disinfecting apparatus was examined in December, and it was found that the boiler tubes were wasted and required replacing. The work was carried out at a cost of 17/. 10s. TABLE XXXIII. Police Court Proceedings. Date. Name of Vessel. Offence. Police Court. Result. 1911. July 20 s.s. " Registan," of Swansea. Master failed to comply with precautions to prevent the landing of rats. Tower Bridge Summons dismissed for technical reasons. 21 55 61 s.s. " Ayrshire," of Glasgow, 119,066 Master failed to answer truly questions put to him by Officer of H.M. Customs and Assistant Medical Officer of Port of London Sanitary Authority as regards a case of illness on board. Gravesend Fined 51., with costs 71. Is. 6<2. Dec. 19 Canal boat" Mole," registered Berkhampsted, No. 334. Overcrowded and uninhabitable condition of boat. Tower Bridge Adjourned for owner to do the necessary work. POLICE COURT PROCEEDINGS. At the Gravesend Police Court on the 21st July, 1911, William John Page, Master of the s.s. " Ayrshire," was summoned for a breach of the Regulations of the Local Government Board relating to Cholera, Yellow Fever and Plague. The vessel arrived on June 27th, and in answer to questions put by an Officer of H.M. Customs, and also subsequently by an Assistant Medical Officer of this Authority, the Master stated that all were well on board, and that there had been no sickness during the voyage. It was subsequently found that there was a man on board who had been suffering for several days with symptoms of Enteric Fever, and he had to be removed to the Port Sanitary Hospital at Denton. 70 Article XXVI. of the Regulations of the Local Government Board as to Cholera. Yellow Fever and Plague, dated September 9th, 1907, states that:— "The Master of a ship, or any other person, shall answer truly all such "questions put to him by, and give all such information to, any Officer of Customs "or Medical Officer of Health as are necessary for any purpose of this Order." The offence of the Master consisted in not answering truly the questions put to him by an Officer of Customs, and by an Assistant Medical Officer of the Port of London Sanitary Authority. The penalty for the breach of these Regulations is one not exceeding 100/. The magistrate considered the case proved, and inflicted a fine of 10/. and 61. 0s. 6d. costs. The Master appealed, and the fine was reduced to 5l. and 71. 1s. 6d. costs. Table XXXIV. STEAM LAUNCHES. Number of working days for the three years ended 31st December, 1911, and the number of vessels visited. Launch. Total No. of working days. No. of days laid by. Total No. of vessels visited. Average daily No. of vessels visited. 1909 1910 1911 1909 1910 1911 1909 1910 1911 1909 1910 1911 "Lady Truscott" — — 112 — — 253 — — 1,602 — - 143 "David Burnett" 246 242 217 129 123 148 4,558 4,838 2806 18.5 19.9 129 "Clotho" 268 276 291 97 89 74 4,880 4,399 4.217 18.2 15.9 148 "Denton" 275 265 213 90 100 152 5,476 5,163 2,844 19.9 19.4 133 Cost of upkeep for year ended 31st December, 1911, with average daily cost for 3 years. 1911. Wages. Coals. Stores. Repairs &c. Total. Average daily cost.* £ s. d. £ s. d. £ s. d. £ s. d. £ s. d. 1909 1910 1911 £ s. d. £ s. d. £ s. d. "Lady Truscott" 134 8 0 100 12 6 70 5 8 6 19 6 312 5 8 - - 2 15 9 "David Burnett'' 414 3 0 120 1 6 51 4 6 39 2 9 624 11 9 2 11 4 2 11 5 2 17 6 "Clotho" 297 7 4 86 15 6 31 4 8 45 8 5 460 15 11 1 11 4 1 9 1 1 11 8 "Denton" 225 8 6 31 17 6 21 10 11 36 14 7 315 11 6 1 6 1 1 6 10 1 9 7 Total 1,071 6 10 339 7 0 174 5 9 128 5 3 1,713 4 10 5 8 9 5 7 4 8 14 6 * Calculated on the number of "working" days The s.s. "Lady Truscott" has worked satisfactorily during the year, and haproved a good and safe sea boat in rough weather; the "David Burnett" is in fair condition, but the two smaller launches show signs of age and wear, and during the year the question of repairing one and replacing the other should receive the careful consideration of your Worshipful Committee. 71 STAFF. Medical Officers.—I regret to have to reprot that Dr. A. Kidd, one of the Hoarding Medical Officers at Gravesend, met with an accident while on duty on the 25 th Octolier, which necessitated his absence from duty for three weeks. The s.s. "Callisto" arrived from La Plata on the 25th October, 1911. Being from an "infected port," the vessel was boarded by one of the Medical Officers (Dr. A. Kidd) of this Authority, at Gravesend. He proceeded to inspect the crew who were lined up on deck. Having occasion to step behind one of the crew, he tripped against the coaming of the hatch which was left uncovered, and he fell. Fortunately he was able to save himself from falling to the bottom of the hold, by clutching hold of the side of the hatch. It was, however, found that he had dislocated his finger, besides sustaining other damage which necessitated his being off duty for several weeks. The master and the mate were both present at the inspection, and no warning was given to the Medical Officer that the hatch was off. It was quite dark at the time, and it was gross carelessness that the hatch was left off, and the Medical Officer should have been informed. Sanitary Inspectors.—Sanitary Inspectors Elward and Massie, having obtained the Certificate of the Royal Sanitary Institute, as Inspectors of Meat and other Foodstuffs, were appointed as First Class Inspectors, as follows :— Inspector Elward, from 1st February, 1911, and Inspector Massie, from 1st December, 1911. Both of these Inspectors were approved as Assistant Officers under the Public Health (Regulations as to food) Act, 1907, by the Local Government Board. Hospital Nurses.—Miss M. Johnson, Assistant Nurse, resigned her appointment on May 14th. Miss Lily Harding was, with the approval of your Chairman, appointed to the position of Assistant Nurse, and took up her duties on the 24th July. Miss M. E. Parr, Assistant Nurse, also resigned her appointment on December 5th. Miss F. E. Cork was appointed to the position, in December, at a salary of 20l. per annum, rising by 2l. annually to a maximum of 26l. per annum. Domestic Staff.—C. Tarrant (cook) resigned her appointment on the 14th November. Eva Mary Dack was appointed in her place, and commenced on the 16th November, at a salary of 20l. per annum, rising by 1l. annually to a maximum of 51. per annum. Steam Launches.—C. Wilcox was appointed as stoker on the launch "David Burnett." Jonas A. Hardman was appointed as engineer of the launch "Lady Truscott," in place of George H. Bagshaw, at 50s. per week. The launch "David Burnett" was transferred to the Greenwich Station in October. W. Shaw, watchman on the barge "Collingwood," terminated his appointment on the 17th October, and W. Stanley was appointed by the Port of London Authority in his place, on the same terms as his predecessor. I have to report that Engineer Lane, of the "Denton," was absent from duty ill, from August 11th. He furnished a medical certificate which stated that he was suffering from heart disease and dropsy. William H. Buzzel, the stoker of the "Thomas," performed his duties temporarily. 72 CANAL BOATS ACTS. In accordance with Section 3 of the Canal Boats Act, 1884, I beg to present herewith ray Annual Report on the working of the Canal Boats Acts and Regulations within the district of the Port of London Sanitary Authority, during the year ending 31st December, 1911. The Acts and Regulations apply within the whole of the district under the jurisdiction of the Port of London Sanitary Authority, including the river and docks —as a "canal," for the purposes of the Act, 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. The navigation in addition to the enclosed docks, includes the following navigable tributary waters and creeks of the River Thames:— On the South side from Teddington downwards:— Part of the Grand Surrey Canal within the Surrey Commercial Docks. Hay's Dock. St. Saviour's Dock. Deadman's Dock. Deptford Creek (River Ravensbourne). Dartford Creek (Rivers Cray and Darenth). The entrance to the Gravesend Canal. Cliffe Creek. Yantlet and Coalmouth Creeks. Part of the river Med way, and of the Swale. On the North side from Teddington downwards:— The entrance to the River Brent. Chelsea Dock. Grosvenor Dock. Limekiln Creek. Bow Creek (River Lea). Barking Creek (River Roding). Rainham Creek (River Ingesbourne). Mucking Creek. Thames Haven, Hole Haven. Potton and Rushley Creeks. River Roach as far up as Rochford. The whole of this area is divided into three districts, known as the Upper, Middle and Lower, each district being in charge of an Inspector, as follows :— RIVER. Upper District. Teddington to Liinehouse. Inspector Massie 156l. per annum. 73 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 Shepherd 136l. 10s. per annum. The Docks are divided into four districts, known as the Central, Eastern, Western and the Gravesend district. It has been found advisable to sub-divide these districts, and instead of one Inspector to each, two have been appointed to the Western, and two to the Eastern district, as follows:— Central District. West India Dock. South West India Dock. Poplar Dock. Mill wall Dock. Inspector Lambe 188l. 10s. per annum. Eastern District. East India Dock. Royal Victoria Dock. Inspector Garland 208l. per annum. Royal Albert Dock. Inspector Wetjen 208l. per annum. Western District. London Dock. St. Katherine's Dock. Regent's Dock. Inspector Hopkins 208l. per annum. Surrey Commercial Dock. Inspector Elward 162/. 10s. per annum. Gravesend District. Tilbury Dock. North Shore, from Purfleet down. South shore, from Erith down. Inspector Rolfe 188l. 10s. per annum. The address of each Inspector for official purposes is the office of the Authority, at No. 51, King William Street, Greenwich, S.E. (2) The total number of inspections for the year was 889, representing a net number of 583 boats. The remainder, 306, represents repeated visits by Inspectors of this Authority. 74 The number of the boats found not conforming to the Acts and Regulations was 89, or 10.0 percent. of the total, the percentage for the previous five years being 7.95 per cent. In addition to the above, 37 boats were at the time of visit found with the cabin doors locked, there being no person on board. Inspection was therefore impossible, and these visits are not included in the number of boats inspected. (3) With reference to the various infringements of the Act:— (a) Eight unregistered boats were found, and six of these were subsequently registered. (b) No notifications were received with regard to change of master, although two cases were found where the master was not the person named on the Certificate. (c) Certificates—These were absent in 44 cases, and in 20 of these cases the Certificates have subsequently been placed on board and the infringement remedied. In two cases Certificates were found which did not identify the owner with the boat. (d) Marking and Numbering—18 boats were found to be incorrectly marked and numbered. (e) Overcrowding occurred on five occasions on three boats. The canal boat "Enterprise," registered Uxbridge, No. 366, was found to have one child in the fore cabin in excess of the number for which the boat was registered. The boat was subsequently met with, and the infringement found to be remedied. The canal boat "Stone," registered Birmingham, No. 1,010, was found to have one lad in the fore cabin in excess of the registered number. It was stated that this lad was on the boat for the one trip only. The canal boat "Mole," registered Berkhamsted, No. 334, which is registered for four adults aft, or two adults and three children, was found to be occupied by a man and wife and five children. (f) Partition separating sexes—No case of infringement was found during the year. (g) 12 boats were found infringing with regard to want of cleanliness, and of these, 10 have been since reported as cleansed. (h) Insufficient ventilation was found on five boats, and 33 were found to require some repair. In 25 cases these alterations have been since certified as carried out. (i) Painting was found to be required in 19 cases. (j) Nine Boats were found without proper water vessels. This has been provided in the case of four boats. (k) Removal of bilge water—Nil. (l) Notification of Infectious Disease—Nil. (m) Admittance of Inspector—Nil. No difficulty was experienced in regard to the visits of the Inspector. (4) Legal proceedings were necessary in one case. 75 The canal boat "Mole," registered Berkhamsted, No. 334, was inspected in May, when the following defects were found :— After cabin—Registered for four persons, but occupied by man, wife and five children; cabin to be painted. Fore cabin—Very damp, sides wet and dirty; stove to be fixed. The boat was again inspected in August, and the following infringements still existed:— After cabin—Still occupied by man, wife and five children. Fore cabin— Damp and dirty, flooring and stove defective. The boat was inspected in September, when there was no overcrowding. On a further inspection of the boat in November, the following infringements were found to exist :— After cabin—Occupied by man, wife and five children; cabin top leaky, floor broken and stove funnel defective; paintwork dirty. Fore cabin— Damp, floor broken. Notices were sent to the owner. In November I recommended to the Port Sanitary Committee that the matter should be placed in the hands of the City Solicitor. This was done. The Solicitor decided to apply for summonses against the owner and the master, the former in respect to the structurally defective and uninhabitable conditions of the cabins—the primary cause of the trouble—and the master in respect of the overcrowding. The summonses were granted, returnable at the Tower Bridge Police Court in December, and the hearing was adjourned to the 19th January in order that the owner might carry out his undertaking to remedy the defects.* (5) The total number of infringements found was 277 on 89 boats. Formal notice of the serious infringements was given to the owners, and in many cases they were remedied without further action. The number of such notices was 70, and the number which has been certified as attended to was 49. Of the complaints issued in the year now under review, 64.2 percent.were remedied. (6) Infectious Disease—No case of infectious disease has been reported on any canal boat in the Port of London during the year. Double Bulkheads—There were no infringements with regard to the provision of these. (7) No boats have been detained for cleansing. (8) On December 31st, 1911, there were 258 boats on the Register. (9) Six boats were registered in 1911. These were all new boats. I have the honour to be, Gentlemen, Your obedient Servant, Medical Officer of Health, Port of London. * The work necessary to remedy the defects was subsequent ly carried out, and the owner paid the legal costs of the proceedings. 76 TABLE XXXV. SUMMARY OF CANAL BOATS FOR THE YEAR ENDING 31ST DECEMBER, 1911. January. February. March. April. May. June. July. August. September. October. November. December. TOTAL. total for the year 1906. 1907. 1908. 1909. 1910. New boats registered ... ... ... ... 4 ... ... ... 1 ... 1 ... 6 2 ... ... ... 2 Registration owing to structural alterations ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 ... ... ... Registration for other purposes ... ... ... ... ... ... ... ... ... ... ... ... ... 3 3 1 1 1 Inspected 61 79 105 89 89 73 61 58 53 62 91 68 889 1,502 1,294 1,110 1,379 878 Conforming to Acts and Regulations 55 73 101 85 75 66 56 54 46 53 78 58 800 1,377 1,188 1,066 1,289 807 Infringements in respect to:— Registration ... ... ... 1 3 1 ... 1 1 1 ... ... 8 10 6 2 ... 4 Notification of change of master 1 ... ... ... ... ... ... ... 1 ... ... ... 2 ... ... ... ... 1 Absence of certificate 1 3 1 1 8 4 3 2 2 5 4 10 44 29 24 22 9 20 Certificate not identifying owner with boat ... ... ... ... ... ... ... ... ... ... 2 ... 2 5 3 13 5 ... Marking, &c. 1 ... ... ... 6 2 1 1 2 3 1 ... 18 28 18 14 20 9 Overcrowding ... 1 1 ... 1 ... ... 1 ... ... 1 ... 5 8 8 5 3 2 Partition separating sexes . . . ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 Males over age ... ... ... ... ...... ... ... ... ... ... ... ... ... 2 ... ... ... ... Females over age ... ... ... ... ...... ... ... ... ... ... ... ... ... 3 ... ... ... ... Cleanliness 1 1 ... ... 3 3 1 ... ... 1 1 ... 12 36 35 30 20 14 Painting 3 1 2 2 4 4 2 ... ... 1 ... ... 19 2 2 2 ... 9 Ventilation ... ... ... ... 1 ... 1 ... 1 2 ... ... 5 2 4 1 2 3 Dilapidation 1 1 1 ... 6 4 1 ... ... 5. 7 ... ... ... 29 ... ... 27 Removal of bilge water ... ... ... ... ... ... ... ... ... ... ... ... 1 ... ... ... ... 27 Without pump ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Refusal to admit Inspector ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... No proper water vessel 0 1 1 ... ... ... 1 1 1 1 ... ... ... 1 ... 10 6 5 Without double bulkhead ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Notification of infectious disease ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Detained for cleansing ... ... ... ...... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Proceedings taken ... ... ... ... ... ... ... ... ... ... ... 1 1 ... ... ... ... ... Cautions given 6 6 3 3 11 6 4 3 2 7 11 8 70 113 82 76 80 33 „ attended to 1 6 1 2 1 7 2 3 3 7 3 13 49 107 85 71 80 46 Total registered by Port Sanitary Authority since 1887 456 Cancelled 198 Actual number on the Register, 31st December, 1911 258 Registered for 3,268 persons. Carrying 1,989 persons. 77 APPENDIX. ADMINISTRATION OF THE PORT OF LONDON (PUBLIC HEALTH ACT, 1891). Dr. REVENUE ACCOUNT for the Year ended 31st December, 1911. Cr. £ s. d. £ s. d. £ s. d. £ s. d. To Salaries, viz.:— By Sundry Fees, viz. :— Dr. 11. Williams, Medical Officer of Health 800 0 0 Disinfection of Vessels 500 3 0 Assistant Medical Officers :— Health Certificates 5 5 0 Dr. W. M. Willoughby £400 0 0 Metropolitan Asylums Board, under 1891 Act 1 13 6 „ J. S. Warrack 400 0 0 Canal Boat Registration 2 2 6 ., W. M. Willoughby 109 4 0 Vaccination Act 0 0 9 „ W. D. Betenson 365 0 0 509 4 9 „ E. V. Legge 350 0 0 ,, Grant from Home Office in respect of Medical Officer under the Aliens Act, 1905 750 0 0 „ A. Kidd 330 0 0 Locum Tenens 94 10 0 ,, Refund of proportion of Medical Officer's Salary, &c., by Rochester 2,048 14 0 ,, Port Sanitary Authority 100 0 0 W. J. Albrow, Clerk 275 0 0 ,, Ditto, forwarding Telegrams 0 13 11 3,123 14 0 100 13 11 „ Uniforms 124 11 1 „ Fine inflicted re Breach of Local Government Board Regulations 5 0 0 „ Fidelity Guarantees 1 16 0 „ Sundry Reimbursements 7 12 0 ,, Wages, per Dr. Williams, viz.:— Offices 428 10 0 1,372 10 8 Inspectors 2,696 16 8 ,, Excess of Expenditure over Income 2.838 3 6 Launch Crews 1,350 12 7 0 ' * ! Hospital Staff 262 2 11 4,738 2 2 ,, Workmen's Compensation 22 10 4 „ Contributions to Officers' Pension Fund No. 1 £91 18 5 Ditto No. 2 247 19 2 339 17 7 „ Contributions to Officers' Pension Fund re Pensions 169 8 8 ,, Pensions 55 0 0 564 6 3 ,, Disbursements, per Dr. Williams, viz.: — Petty Cash Expenses, Inspectors and others 375 1 11 Postage Stamps 54 0 0 Sundry Office Expenses 49 17 9 478 19 8 ,, Offices at Greenwich, viz. :— Rent 55 0 0 Rates and Taxes 19 0 4 Fire and Boiler Insurance 1 0 2 Telephone Rent 21 8 3 Gas 10 1 9 Repairs 49 12 1 156 2 7 „ Expenses of Steam Launches, Hulk, &c., viz.:— Insurance 194 9 4 Coal and Coke 371 17 8 Repairs £314 5 6 Less Reimbursements for Damage 39 2 11 275 2 7 Stores 324 12 6 Final Repayment of Outlay for New Launch " Lady Truscott" 1,653 11 1 2,819 13 2 .. Hospital at Denton, viz. :— Expenses of extra Nurses 148 9 11 Rent of Causeway, &c. 4 5 0 Rates and Taxes 72 5 7 Fire and Boiler Insurance 11 8 6 Telephone Rent 13 5 0 Gas 51 2 1 Coal 83 11 0 Stores 163 1 0 General Repairs 221 14 6 Maintenance of Patients 114 1 5 883 4. o „ Printing and Stationery 99 4 2 ,, Telegrams and Maintenance of Private Wire 18 7 8 „ Amount Paid to Consignees of Unsound Food £3,283 8 2 Less Proceeds of Sale of Ditto 2,720 19 11 562 8 3 ,, Analysis of Samples of Food, &c. 183 10 0 745 18 3 „ Disinfectants 29 17 3 „ Subscriptions 22 8 0 „ Advertisements 10 12 11 ,, Medical Examinations re new Appointments 3 13 6 ,, Miscellaneous 10 16 0 ,, Law Charges, viz. :— Mr. Comptroller 1 0 0 Mr. Solicitor 6 2 7 7 2 7 „ Mr. Hallkeeper, Disbursements 2 9 7 ,, Delegation Expenses 47 5 0 „ Committee's Allowance 150 0 0 ,, Ditto re Inspection of River 150 0 0 300 0 0 £14,210 14 2 £14,210 14 2 Chamber of London, JOSEPH C. DIMSDALE, 27th March, 1912. Chamberlain.