69. PORT OF LONDON SANITARY COMMITTEE, ANNUAL REPORT OF THE MEDICAL OFFICER OF HEALTH To 31st Decembee, 1913. Presented 7 th May, 1914. REPORT, For the Year ended 31st December, 1913, 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, poet of london, medical inspector for purposes of the aliens act, 1905, port op 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.C. 1914. BO WATER, Mayor. A Common Council holden in the Chamber of the Guildhall of the City of London, on Thursday, the 7th day of May, 1914. 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, 1913; 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 of London Sanitary Authority by the Local Government Board, under the Public Health (London) Act, 1891, beg to submit for the information of your Honourable Court the Annual Report of Dr. Herbert Williams, the Medical Officer of Health for the Port of London, for the year ended the 31st December, 1913, which Report contains a full and detailed account of the work done in the Port during that period by the Medical Officers and Inspectors. Your Committee have had under consideration the subject of existing safeguards for the protection of this country from the introduction of Small-pox. It is a fact that there is in this country a large and increasing number of persons unprotected by vaccination, or revaccination, and in the view of your Committee, powers should be given to the Port Sanitary Authorities to visit and inspect all persons on board ships arriving from ports at which Small-pox is known or suspected to exist, and situated within 14 days steaming of ports in this country—with powers and penalties similar to those at present in existence under the Orders of the Local Government Board, relating to Plague, Yellow Fever and Cholera. Your Committee made representations accordingly to the Local Government Board, but the Board did not consider, on the evidence adduced, that the suggested course would be justified. This is a matter for regret, as at present a loophole undoubtedly exists by which Small-pox may be introduced into this country. During the year, 19 cases were reported on vessels arriving, and 9 cases were removed to and treated in the Port Sanitary Hospital. The question of Plague amongst rats in the docks has continued to receive the serious attention of your Committee, and a conference took place at the Local Government Board between the representatives of the Board, the Port of London Authority, and the Port Sanitary Authority, when suggestions were made for the better protection of premises in the docks from invasion by rats, and for other precautionary measures in connection therewith. Some interesting particulars were given of the measures taken in San Francisco, with the cost of the same in dealing with an epidemic of Plague, and the Medical Officer of Health pointed out the serious interference with the trade of London should human Plague cases occur in London. During the year, no less than 4,125 rats were examined on behalf of your Committee, for evidence of plague bacillus, and 7 rats were found to be "infected." The total number of cases of infectious disease reported and dealt with during the year is much larger than usual, due to the notification of cases of tuberculosis under the new Regulations—no less than 158 cases of tuberculosis of all kinds having been notified during the year. An outbreak of scarlet fever occurred on one of the Training Ships in the River in September. Although 27 cases of the disease occurred, the outbreak did not assume the character of an epidemic. The sanitary condition of the crews' quarters on ships continues to receive careful attention, and in the Medical Officer's Report comparisons have been drawn between the existing provisions of the Merchant Shipping Act and projected regulations on this subject by the Commonwealth Government of Australia and by the Norwegian Government. The subject of deaths of seamen from disease as shown by returns furnished by the Registrar-General of Shipping and Seamen to the Board of Trade, is also dealt with, and attention is drawn to the large proportion of deaths from diseases of the respiratory system among this class of men. The inspection of food is imposing upon your officers an increasing amount of work and responsibility, the substance of which is set out in various tables attached to this Report. The total approximate weight of goods destroyed during the year was not less than 2,458 tons. In connection with this subject, the examination of various • animal carcases and parts, from abroad, for the detection of the presence of lesions due to disease or parasites, has occupied a great deal of attention, and actinomycosis in ox-tongues has been the subject of careful consideration, and has been jointly reported upon by the Medical Officers of Health of the City and of the Port, to your Honourable Court. A fresh duty has arisen by the examination and certification of meat exported to certain foreign countries. Information is also given in the Report on the subject of the night population in the Port of London as shown by the Census of 1911. Of the steam launches, the two larger ones are continuing to work satisfactorily. The " Denton " has been disposed of, and a motor launch has been built for work in the upper reaches of the river where the shallow draught and increased speed of this type of vessel makes for greater efficiency. Your Committee have to report with regret the loss by death in November, after a long illness, of Inspector W. G. Romeril, who at the time of his death occupied the position of senior Sanitary Inspector. The Annual Report on Canal Boats required by the Canal Boats Act is appended to this Report. In accordance with the Order of your Honourable Court, an account of Receipts and Expenditure in connection with the Port of London Sanitary Authority for the year ended the 31st December last, is appended for the information of the Court. All which we submit to the judgment of this Honourable Court. Dated this fifth day of May, 1914. Edward Hughes. T. Robinson. Walter H. Key. S. David Coates. F. M. Stafford. Stephen H. M. Killik. A. Jerrold-Nathan. George Briggs. H. Percy Monckton. H. M. Gaydon. James Wann. A. C. Stanley Stone. J. W. Beningfield. Edward Ansted. W. Fortescue. OFFICES of the Poet of London Sanitary Authority and Medical Officer of Health at 51, KING WILLIAM STREET, GREENWICH, S.E. Telegraphic Address " MEDOFF, GREEN," 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 19 13. POET OF LONDON SANITARY COMMITTEE. George Bbiggs, Esq. (Chairman), Cripplegate Within. ALDERMEN. Sir Walter Wilkin, K.C.M.G. Sir John Pound, Bart. Sir William Purdie Treloar, Bart. Sir T. Vansittart Bowater, Knt. Sir Charles Cheers Wakefield, Knt. Sir William Henry Dunn, Knt. COMMONERS. Richard Green, Esq., J.P. Aldersgate. Mr. Frederick George Mellows — Aid gate. Mr. Clarence Hayden Bassishaw. Mr. Edward Ansted Billingsgate. Mr. Thomas Robinson Mr. Arthur Carlyon Stanley Stone Bishopsgate. Major Charles Clement Hodges Bread Street. Mr. Samuel Beal Bridge. Mr. Stephen Henry Molyneux Killik Broad Street. Mr. George Everest Ellis Candlewick. Mr. James Wann Castle Baynard. Col. John William Beningfield Cheap. Frank Brinsley-Harper, Esq., J.P. Coleman Street. Mr. Edward Hughes Cordwainer. Mr. Thomas Goldney Cornhill. Mr. George Thomas Sirrell Tranter . Cripplegate Without. Mr. Albion Thomas Snell Dowgate. Mr. John Brear Wild N.S. Farringdon Within. Walter Fortescue, Esq., J.P. S.S. Farringdon Within. Mr. George Lavington N.S. Farringdon Without. Mr. Alfred Jerrold-Nathan S.S. Farringdon Without. Mr. Henry Martin Gaydon Langbourn. Mr. Herbert Roper Barrett Lime Street. Lewis Michael Myers, Esq., Deputy Portsoken. Mr. Edgar Edwin Bond Queenbithe. William Walter Green Esq., J.P. Tower. Col. Vickers Dunfee 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. John Robert Pakeman (late Chairman). . Mr. James William Domoney, L.C.C. Spencer William Morris, Esq. Mr. Horace Spencer Dove. 4 INDEX. page Actinomycosis 59 Aliens Act, 1905 10 Anthrax 40 Argentina—Ox Tongues 59 Beef 47 BeriBeri 40 Canal Boats Acts 83 Chickenpox 39 Cholera 15, 17 Committee—List of Names 3 Compulsory Notification 39 Condensed Milk 50 Continued Fever 33 Crew Spaces 70, 74 Deaths of Seamen 76 Diphtheria 29 Disinfection 14 Eggs 54 Enteric Fever 31 Erysipelas 33 Fish 51 Food Inspection 41 Foreign Meat Regulations 55, 56 Fruit 52, 53 Fumigation to destroy Rats 82 German Measles 32 Glanders—Notification of 40 Grain 54 Hospital 41 Infectious Disease 11 Introductory ' 7 Launches 81 Meal and Flour 54 * Measles 32 Medical Inspection 8 Mutton and Lamb 48 Nuisances 67 page Nuts 53 Offal 49 Offensive Cargoes 69 Ox Tongues—Argentina 59 Pigs from China 48 „ Tuberculous 61 Plague 15, 18 Ditto among Rats 21 Pork48 Port, Extent of, &c. 78 ,, Population 78 Poultry and Game 51 Provisions 53 Queen borough, Food Inspection at 44 Rabbits 51 Rat Plague 19, 20, 21 Sanitary Conveniences, &c. 67 Sanitary Inspection 63 Scarlet Fever 28 Scrap Meat 55 Sheerness Boarding Station 8 Smallpox 22 Smoke Nuisances 65 Smoked and Salted Meats 51 Staff 6,82 Steam Launches, &c. 81 Sundry Food Stuffs 54 Tinned Meats 50 Tuberculosis (Pulmonary) 38 „ Regulations 37 Unsound Food 45 Veal 50 Vegetables 53 Ventilation of Crew's Spaces 71 Water Closets 72 Yellow Fever 15, 18 5 INDEX TO TABLES. table. page I. Medical Inspection—Gravesend 9 II. Ditto —Sheerness 9 III. Alien Passengers 10 IV. Do. Ships 10 V. Infectious Disease—Summary 12 VI. Compulsory Notification of Infectious Disease, with number of Deaths 13 VII. Vessels and premises disinfected 14 VIII. Effects disinfected 14 IX. Cholera 17 X. Yellow Fever 18 XI. Plague 18 XII. Rats destroyed—Return of 20 XIII. Smallpox 22 XIV. Scarlatina and Scarlet Fever 28 XV. Diphtheria 29 XVI. Enteric Fever 29 XVII. Measles 31 XVIII. German Measles 32 XIX. Erysipelas 33 XX. Continued Fever 33 XXL Pulmonary Tuberculosis 34 XXII. Tuberculosis—other kinds 37 XXIII. Chickenpox 39 XXIV. BeriBeri 40 XXV. Hospital—Admissions, Discharges and Deaths 41 XXVI. Unsound Food destroyed 45 XXVII. Unsound Meat—Weights of 46 XXVIII. Frozen Mutton and Lamb Imports 47 XXIX. Livers 50 XXX. Foreign Meat Regulations—Notices 55 XXXI. Ditto ditto Certificates 56 XXXII. OxTongues 58 XXXIII. Tuberculous Pig Carcases 61 XXXIV. Sanitary Inspection—Summary 64 XXXV. Nuisances 65 XXXVI. Ditto 66 XXXVII. Sanitary Works 67 XXXVIII. Offensive Cargoes 68 XXXIX. Deaths of Seamen from Disease 76 XL. Population of Port 79 XLI. Canal Boats 90 Appendix. Statement of Receipts and Expenditure 91 6 STAFF. List of Officers forming the Staff of the Port of London Sanitary Authority, 31st December, 1913. 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.R.Betenson,M.R.C.S.,L.R.C.P., Lond., D.P.H. Lond. July, 1907 Sheeuiiebs A. Ividd, M.R.C.S., L.R.C.P., Lond., D.P.H. 1909. E. V. Legge, M.A., M.D., B.C., B.A.0., 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. Caretaker F. Hudgell November, 1906. 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 *A. Garland, Cert.R.San.Inst. May, 1894. *W. G. Wetjen, Cert.R.San.lust. 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. C. A. Shepherd, Cert.R.San.Inst. January, 1909. DENTON HOSPITAL— (Vacant) 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 A. A. Foggo September, 1912. Ditto L. Harding September, 1911. Ditto A. Densham November, 1913. Cook E. Hutson October, 1913. Maidservant F. Ambrose October, 1913. Caretakers W. J. Wragg November, 1908. M. E. Wragg November, 1908. STEAM LAUNCHES— '' Lady Trcscott "— Master W. Jarvis April, 1911. Engineer J. A. Hardman December, 1911. Mate C. Boyd July, 1902. Stoker A. E. Howard February, 1912. 41 David Burnett "— Master C. H. Price October, 1913. Engineer G. H. Bagshaw July, 1893. Deckhand J. Baulsom March, 1913. Stoker C. Wilcox December, 1911. " Clotho " (Reserve). " George Briggs "—Motor Launch— Master C. Strange October, 1913. Engineer J. Steen Ditto. GREENWICH MOORINGS FUMIGATING BARGE "THOMAS"— Stoker, &c. W. H. Buzzel February, 1912. BARGE " COLLINGWOOD "— Watchmen W. H. Buzzel February, 1912. H. A. Clarkson May, 1912. GRAVESEND— HULK " IIYGEIA "— Shipkeeper I. Rogers April, 1893. Ditto A. Salter July, 1898. * 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 1913, being the twelfth of the series. The total number of vessels arriving in the Port of London, from "foreign" during the year, was 9,727 at Gravesend, and 324 at Sheerness, the average for the past ten years being 9,679.2 at Gravesend, and 331.9 at Sheerness. It is the largest number so arriving at Gravesend since the year 1906. Of the total arrivals, 1,948 were medically inspected at Gravesend, and 268 at Sheerness. The details of these figures are given in Tables I and II. In Tables III and IV will be found some figures relative to Alien Immigration' but these figures are subject to revision on publication of the complete official returns but the Home Office. Infectious Disease is dealt with in Tables V to XXV, with details of the cases which exhibited points of public interest. Food Inspection is now well established as an important section of the work, and in the section of this Keport in which this is specially dealt with, full particulars will be found of the work done and the quantities of material dealt with. The details of sanitary inspection are summarised in Tables XXXIV to XXXVII, and this section of the work has been well and efficiently maintained, notwithstanding the strain at times put upon these officers by the exigencies of food inspection. The working of the Canal Boats Acts is dealt with in the usual special annual report on this subject, which is appended to this Report. In relation to the Census of 1911, I have been able to extract some figures dealing with the population of the Port as expressed by the number of persons enumerated as residing within the Port on vessels, &c., at the time of taking the Census. Although, this population is personally a changing one, it is shown to be remarkably constant as to numbers. 8 A few general remarks on the Staff will be found on page 82. The Authority has suffered the loss, by death, during the year, of their senior Sanitary Inspector, W. G. Romeril. His loss is a matter for regret, as he was an intelligent, loyal, reliable and capable officer, and had been in the service since 1892. MEDICAL INSPECTION. The total number of vessels arriving at Gravesend from foreign ports was 9,727, the greatest number since 1906, the average for the past ten years being 9,679. Of these 1,948, an average of 5.6 per day, required medical inspection as coming from "infected" ports. At Sheerness, of 324 arrivals from foreign, 268 were medically inspected. The total number of cases of infectious disease reported on vessels was 447, including 151 cases of pulmonary tuberculosis. Of the cases reported, 91 or 20.3 per cent. were removed to the Port Sanitary Hospital for treatment. Short notes of these cases appear under the headings of infectious disease. SHEERNESS BOARDING STATION. Dr. Legge is the only officer of the Authority residing at Sheerness, and was originally appointed for the duty of boarding and inspecting vessels arriving from foreign. The majority of these vessels are bound for the port of Rochester, but as the entrance to that port is through the Port of London, the onus of such inspection rests upon the Port of London Sanitary Authority, and the Port of Rochester Authority contributes annually a sum of 100/. towards the expenses of such inspection and the maintenance and treatment in hospital of any persons found on vessels bound for the Port of Rochester suffering from a dangerous infectious disorder, who would be removed at Sheerness and conveyed to the Port of London Sanitary Hospital at Denton. Dr. Legge is therefore constantly on duty, and no arrangements have been made for his occasional relief ; he is liable to be called out at any hour of the day or night on week days, Sundays, and on holidays, whilst he has had to be in attendance at Queenborough on at least four nights a week from 6-10 p.m. examining meat. As it was found necessary to make arrangements for the examination of meat on every night in the week, and it was not possible to ask for this service from Dr. Legge, arrangements have been made for him to be relieved on two nights during the week by one of the assistant Medical Officers from Gravesend, whilst Dr. Legge is responsible for the examination on the other five nights. Under the heading of Food Inspection, some details are given of the results of this work at Sheerness. (Page 44.) It is now in contemplation to put into force at Queenborough, the examination of Alien Immigrants, which will mean additional work for Dr. Legge and the Assistant Medical Officers. 9 TABLE I. MEDICAL INSPECTION—GRAVESEND. From 1st January to 31st December, 1913. Jan. Feb. March April May June July Aug. Sept. Oct. Not. Dec. Total. Number of foreign arrivals 774 694 800 794 827 879 856 813 809 866 805 810 9,727 Number medically inspected 159 155 180 169 172 181 159 164 153 151 152 153 1,948 Number of passengers 1,588 791 2,183 1,817 1,763 1,460 1,059 822 856 289 376 352 13,356 Number of crew 3,379 3,569 4,561 4,889 3,792 4,143 3,416 3,776 4,019 2,825 3,764 3,886 46,019 COMPARATIVE TABLE. GRAVESEND. 1904. 1905. 1906. 1907. 1908. 1909. 1910. 1911. 1912. Mean annual number for the 10 years ending 31st December, 1913. 1913. Number of foreign arrivals 10,030 9,962 9,955 9,639 9,559 9,571 9,699 9,543 9,107 9,679.2 9,727 Number of vessels medically inspected 2,559 2,813 2,853 2,700 2,840 2,248 2,756 2,744 2,366 2,582.7 1,948 Total number medically inspected at Gravesend— From August, 1892, to December, 1912 45,412 „ 1st January to 31st December, 1913 9,727 Total 55,139 TABLE II. MEDICAL INSPECTION—SHEERNESS. From 1st January to 31st December, 1913. Jan. Feb. March April May June July Aug. Sept. Oct. Nov. Dec. Total. Number of foreign arrivals 12 14 21 28 28 50 40 23 33 26 26 23 324 Number medically inspected 10 14 16 18 21 45 37 21 27 22 21 16 268 Number of passengers — — — 5 5 10 20 6 5 — 3 — 54 Number of crew 145 197 208 312 327 636 530 299 488 334 376 239 4,091 COMPARATIVE TABLE. SHEERNESS. 1904. 1905. 1906. 1907. 1908. 1909. 1910. 1911. 1912. Mean annual number for the 10 years ending 31st December, 1913. 1913. Number of arrivals 344 349 375 376 319 337 337 292 266 331.9 324 Number of vessels medically inspected 308 292 320 325 279 285 284 259 237 285.7 268 Total number medically inspected at Sheerness— From 1st September, 1894, to 31st December, 1912 5,304 „ 1st January to 31st December, 1913 324 Total 5,628 10 ALIENS ACT, 1905. The following figures are extracted from the quarterly Parliamentary returns, and are subject to correction when the complete returns are published :— TABLE III. ALIEN PASSENGERS. LONDON. Total. Cabin. Exempt 2nd Class Passengers. Transmigrants. Other alien passengers. Proceeding to destinations out• side he United Kingdom. Holiday return tickets. Seamen. Refused leave to land. Residents returning. Balance. Totals. January 2,726 1,080 485 457 704 64 46 149 15 88 342 704 February 2,337 810 377 513 637 27 30 116 8 48 408 637 March 3,734 1,272 628 984 850 60 84 160 20 64 462 850 April 4,063 1,527 650 1,230 656 74 49 112 9 38 374 656 May 3,874 1,672 658 748 796 101 38 99 40 97 421 796 June 4,866 2,087 765 1,132 882 126 61 115 38 64 478 882 July 6,152 3,074 1,125 753 1,200 273 152 55 32 134 554 1,200 August 6,417 3,063 1,217 721 1,416 204 229 144 50 334 455 1,416 September 5,166 2,158 1,000 748 1,260 103 97 116 79 192 673 1,260 October 3,289 1,544 675 390 680 71 39 80 7 83 400 680 November 2,910 1,069 493 601 747 48 15 152 8 49 475 747 December - 2,480 937 441 463 639 50 49 70 15 47 408 639 00 © 20,293 8,514 8,740 10,467 1,201 889 1,368 321 1,238 5,450 10,467 All Ports. 12 months 546,452 217,445 111,186 153,634 64,187 8, 010 11,135 12,630 1,317 8,313 22,782 64,187 TABLE IV. Arrivals in the Port of London. Ships. Alien Passengers on NonImmigrant. Immigrant Total. Non-Immigrant Ships. Immigrant Ships. Total. January 138 18 156 1,863 863 2,726 February 122 14 136 1,543 794 2,337 March 125 30 155 1,684 2,050 3,734 April - 134 29 163 1,792 2,271 4,063 May 143 28 171 1,869 2,005 3,874 June - 155 35 190 1,878 2,988 4,866 July - 166 55 221 1,909 4,243 6,152 August 165 61 226 1,470 4,947 6,417 September 130 56 186 1,153 4,013 5,166 October 180 20 200 2,010 1,279 3,289 November 160 13 173 2,028 882 2,910 December 133 12 145 1,734 746 2,480 1,751 371 2,122 20,933 27,081 48,014 Other Ports 7,865 3,862 11,727 131,663 366,775 498,438 Total - 9,616 4,233 13,849 152,596 393,856 546,452 London. Percentage of Total 1913 18.20 8.76 15.32 13.69 6.90 8.96 Do. 1912 17.90 8.10 14.98 13.44 6.67 8.80 11 INFECTIOUS DISEASE. In Tables V. to XXV. will be found the history of the various cases of Infectious Disease reported and dealt with during the year. It will be noticed that the total—447, is largely in excess of the average for the past 10 years, and it will also be seen that this is due to the notification of cases of Tuberculosis under the new Regulations. A larger number than is usual of cases of Cholera and Yellow Fever in homeward bound ships was reported, but no case of these diseases was present in any vessel on arrival. Of 19 cases of Small-pox reported, nine were removed to the Port Sanitary Hospital, and of the 65 cases of Enteric Fever notified, 29 were removed to the same hospital. The total number of notifications made of the addresses of passengers and crews having arrived on vessels having had cases of certain Infectious Diseases, including Small-pox on board, was 439, while the number of vessels, &c., disinfected was 131. and 74 lots of personal and other effects were disinfected by the steam apparatus. 12 TABLE V.—INFECTIOUS DISEASE. Disease. 1904. 1905. 1906. 1907. 1908. 1909. 1910. 1911. 1912. Mean annual number for 10 years ending 31st December. 1913. 1913. (a) Cases reported: Cholera (including suspected cases) 4 6 3 9 5 3 5 9 2 6.5 19 Yellow Fever (ditto) ... 1 2 ... 2 ... ... ... ... 0.9 4 Plague (ditto) 6 9 9 4 1 4 6 ... 9 5.4 4 Small.pox 11 24 31 27 16 27 8 13 34 21.0 19 Scarlet Fever 11 26 82 44 23 16 21 11 10 28.4 40 Diphtheria 3 8 7 7 18 11 11 18 37 13.6 16 Enteric Fever 50 65 81 55 90 36 39 70 61 61.2 65 Measles 38 36 68 51 86 19 23 175 61 62.1 64 German Measles ... ... ... ... ... ... ... ... 3 0.7 4 Erysipelas 1 9 7 2 7 5 5 11 3 5.3 3 Typhus Fever ... ... ... ... ... ... ... ... 1 0.1 ... Continued Fever 12 11 11 11 19 10 1 5 9 10.2 13 Relapsing Fever ... ... ... ... ... 1 ... ... ... 0.1 ... Tuberculosis:— Pulmonary ... ... ... ... ... ... ... ... 71 222 151 Other kinds ... ... ... ... ... ... ... ... ... 0.7 7 Other diseases (including Chicken-pox) 17 16 35 42 41 57 25 38 42 35.1 38 Total 153 211 336 252 308 189 144 350 343 273.5 447 (b) Treated in Port Sanitary Hospital: Cholera (including suspected cases) ... ... ... 1 ... 1 2 ... ... 0.4 ... Yellow Fever (ditto) ... ... ... ... ... ... ... ... ... ... ... Plague (ditto) 4 3 1 3 ... 1 2 ... 1 1.7 2 Small.pox 5 4 ... 8 ... 4 2 6 2 4.0 9 Scarlet Fever 7. 3 28 4 6 14 ... 6 ... 7.1 3 Diphtheria ... 2 1 3 5 1 4 3 ... 2.6 7 Enteric Fever 33 23 26 27 42 11 17 22 35 26.5 29 Measles 8 13 3 14 13 5 2 7 27 11.0 18 Erysipelas ... 2 1 ... 1 1 ... ... 1 0.6 ... Typhus Fever ... ... ... ... ... ... ... ... ... ... ... Continued Fever 12 9 7 10 6 10 1 4 7 7.5 9 Other diseases (including Chicken. pox). Total 4 1 24 5 15 10 7 8 7 9.4 14 73 60 91 75 88 58 37 56 80 70.8 91 13 TABLE VI. Return of the Number of Cases of Infectious Disease Notified to the Local Government Board during the Tear 1913, and of Deaths from the Diseases Notified:— Notified. Deaths. Small-pox 5 1 Scarlatina or Scarlet Fever 38 ... Diphtheria (including Membranous Croup) 13 ... Typhus Fever ... ... Enteric or Typhoid Fever 45 2 Continued Fever 11 1 Relapsing Fever ... ... Puerperal Fever ... ... Cholera ... ... Erysipelas 3 ... Plague 2 ... Measles 40 1 Chicken-pox 27 ... Tuberculosis: Pulmonary 119 3 Other kinds 3 ... Remittent Fever ... ... 306 8 NUMBER OF NOTIFICATIONS DURING 1913. Not traced. Passengers. Crew. Passengers. Crew Small-pox 136 107 4 2 Plague (suspected) 110 69 ... ... Measles 17 ... ... ... 14 TABLE VII. Vessels and Premises Disinfected, from 1st January to 31st December, 1913. Month. Reason for Disinfection. Total Number of Disinfections. Cerebro-Spinal Meningitis. Chicken-pox. Cholera. Continued Fever. Diphtheria. Enteric Fever. Erysipelas. Measles. Plague Scarlet Fever. Small-pox. Tuberculosis. Precautionary Measure. Fumigation January ... ... ... ... ... ... ... ... ... ... ... ... 2 ... 2 February ... ... ... 2 ... 2 ... ... ... ... ... ... 3 ... 7 March ... 1 ... ... ... 2 ... ... ... 1 2 ... 2 ... 8 April ... ... ... ... ... ... ... 1 ... 1 ... 1 1 ... 4 May ... 2 ... ... 1 3 ... 2 ... 3 ... 2 2 2 17 June ... 1 ... 3 1 3 ... 4 1 ... ... 1 4 2 20 July ... 1 ... 1 ... 4 ... 1 ... ... ... 1 4 ... 12 August ... ... ... ... ... 2 ... 1 1 1 2 1 3 2 13 September ... 2 ... 1 ... 2 ... 1 ... ... 1 3 2 ... 12 October ... ... ... ... ... 4 1 3 ... ... 1 4 2 ... 15 November ... ... ... ... ... 3 ... ... ... ... ... 5 2 ... 10 December ... 1 ... ... 2 3 ... 1 ... ... ... 2 2 ... 11 Totals ... 8 7 4 28 1 14 2 6 6 20 29 6 131 TABLE VIII. Number of Disinfections of Effects, Bedding, &c., from 1st January to 31st December, 1913. 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. Plague. Scarlet Fever. Small-pox. Tuberculosis. Precautionary measure. January ... ... ... ... ... ... ... ... ... ... ... ... 1 1 1 ... February ... ... 2 ... 2 ... ... ... ... ... ... ... ... 4 3 ... March ... 2 ... ... 2 ... 1 ... 1 1 ... ... ... 7 7 ... April ... ... ... ... 1 ... 2 ... 1 ... ... ... ... 4 2 ... May ... 2 ... 1 3 ... 2 ... 3 ... 1 ... ... 12 5 ... June ... ... 3 2 2 ... 4 1 ... ... ... ... ... 12 5 ... July ... 1 1 ... 3 ... ... ... ... ... ... ... ... 5 2 ... August ... ... ... ... 3 ... 1 1 1 2 ... ... ... 8 2 ... September ... ... ... ... 3 ... 1 ... ... ... ... ... ... 4 3 ... October ... 1 ... ... 4 ... 1 ... ... 1 ... 1 ... 8 5 ... November ... ... ... ... 2 ... ... ... ... ... 1 ... ... 3 2 ... December ... ... ... 2 3 ... ... ... ... ... ... 1 ... 6 ... ... Totals ... 6 6 5 28 ... 12 2 6 4 2 2 1 74 37 ... 15 The following circular letter was sent to the owners of ships coming from ports infected with Plague, Yellow Fever and Cholera:— Port of London Sanitary Authority, 51, King William Street, Greenwich, London, S.E., 23rd April, 1913. Gentlemen, As you are aware, vessels arriving from or calling at ports infected with Plague, Yellow Fever and Cholera, are required to stop on arrival at Gravesend for the purpose of Medical inspection. In the case of vessels carrying a Surgeon, a medical certificate is furnished by him stating whether any sickness has occurred during the voyage. He usually signs a certificate similar to that enclosed herewith, and if this be satisfactory, the Medical Officer of this Authority may, at his discretion, forego the detailed examination of all persons on board, the necessity for turning round and mooring the ship when arriving at Gravesend on a flood tide is thus, in the majority of instances, obviated. It has been found that the Surgeons of ships, in some instances, have signed these certificates indicating that there had been "no sickness during the voyage," and that he had "examined all persons on board within twelve hours of arrival, and found them all in good health," but the Medical Officer of this Authority has subsequently found persons on board suffering with Small-pox and other infectious diseases. I regret to find that the importance and value of these certificates, from the shipowners' point of view, have not been appreciated, and it will, therefore, be necessary in future to accept such certificates only from the Surgeons of ships belonging to owners who can ensure that the answers given by their Masters and Surgeons can be relied upon. I would point out that under the Regulations of the Local Government Board relating to Plague, Yellow Fever and Cholera, any Master or other person is required to answer truly all such questions put to him and give all such information in pursuance of such order, and that the Master and Surgeon is required to state whether there is or has been on board during the voyage any case or suspected case of Plague, Yellow Fever or Cholera or any other fever or sickness. Neglect to comply with these Regulations entails, on conviction, a penalty not exceeding 100/. I am aware of the possible loss which may result from detaining ships for the purpose of examining all persons on board in the interest of Public Health, and before I issue instructions accordingly, I desire to know whether it will be possible for you to take such measures and give such instructions as will ensure that all cases of illness of any nature whatsoever on board on arrival or that may have occurred during the voyage, will be reported on the arrival of the vessel at Gravesend, to the Medical Officer of this Authority who accompanies the Officers of His Majesty's Customs to every vessel arriving from foreign whether by night or day. Your obedient Servant, (Sgd.) HERBERT WILLIAMS, M.D., Medical Officer of Health, Port of London. The replies received have been most satisfactory, the owners in practically every case having been most willing to co-operate with the Port Sanitary Authority. 16 (Enclosure to Circular Letter of 23rd April, 1913.) Port of London Sanitary Authority. Skip at Gravesend _19 To TheMedical Officer of health , PORT Of LONDON, Office: King William Street, GREENWICH, S.E. TELEGRAPHIC ADDRESS: "MEDOFF, GREEN, LONDON." TELEPHONE NO. new cross 36. 1 hereby certify that there has been (a) No case of Infectious or Contagious Disease. (b) No illness exhibiting Feverish Symptoms or Diarrhœa, on board this Vessel while lying in the Port of or during the voyage here (except as stated on the back hereof). I have inspected every person on board within 12 hours of arrival, and find all in good health and free from symptoms of Cholera, Yellow Fever and Plague. Signature of Ship's Surgeon. [please turn over. CASES OF INFECTIOUS OR CONTAGIOUS DISEASE. CASES OF ILLNESS WITH FEVERISH SYMPTOMS OR DIARRHCEA. DEATHS. [please turn over. 17 TABLE IX. (Cholera.) Date. Name of Vessel, Port of Registry, and Official Number. Where from. No of Cases. How dealt with. 1913. Jan. 20 s.s. " Malta," of Greenock, 102,398 Calcutta 3 Landed at Calcutta. Nov. 5 s.s. " Euphorbia," of N. Shields, 117,972 Braila 14 Landed at Braila. Six cases fatal. „ 15 s.s. "Faraday," of London; 68,535 Batavia 1 Died, and body buried at Batavia. „ 20 s.s. " Statesman," of Liverpool, 105,319 Calcutta 1 Died, and body buried at sea. Total 19 CHOLERA. The s.s. "Malta," of Greenock, 102,398, arrived at Gravesend on the 20th January, 1913, from Calcutta, having landed three cases of Cholera (one of which proved fatal) and three cases of acute Diarrhoea there on the 16th December, 1912. The cases had been ashore daily at Calcutta, and infection had been contracted there. Complete disinfection was carried out at Calcutta, and the water tanks were emptied and cleansed with Condy's fluid, and subsequently refilled. No other cases occurred, and on arrival at Gravesend all on board were found to be well. On the 10th October I received information that an outbreak of Asiatic Cholera had occurred on board the s.s. "Euphorbia" at Braila. The vessel left there on the 3rd October for London. The vessel arrived on the 2nd November, from Braila, having had 14 cases of Asiatic Cholera on board, 6 of which proved fatal. The vessel and effects were disinfected at that port. I am informed that one drinking water tank was filled with river water from alongside the ship at Braila, for the use of the Native crew. This was discontinued after sickness broke out among the Natives, and the tank was emptied and cleaned, fresh water then being taken from on shore. A sample of drinking water was taken from this vessel, and examined bacteriologically, but the result proved " negative " as regards the presence of bacilli. The vessel was carefully inspected on arrival at Gravesend, and all on board were found to be well. The cable ship "Faraday," of London, 68,536, arrived at Gravesend on the 15th November, from Batavia. On the 6th July a fireman was taken ill, and died on the 8th July, the body being landed at Batavia. The vessel and effects were disinfected at that port. No further cases occurred, and on arrival at Gravesend all on board were found to be well. The s.s. "Statesman," of Liverpool, 105,319, arrived on the 20th November from Calcutta. On the 30th October a native trimmer was taken ill. He gradually became worse, and died on the 2nd November, the body being buried at sea. The water tanks were disinfected at Suez on the 7th November, and a fresh supply taken in. The quarters were disinfected, together with effects. No fresh cases occurred, and on arrival at Gravesend all on board were found to be well. 18 TABLE X. (Yellow Fever.) Date. Name of Vessel, Port of Registry, and Official Number. Where From. No. of cases. How dealt with. 1913. Aug. 18 s.s. " Hydra," of Glasgow, 115,131 Manaos 4 3 died and were landed at Manaos, and 1 recovered. TABLE XI. Plague (suspected). Date. Name of Vessel, Port of Registry and Official No. Where from. No. of Cases. How dealt with. 1913. May 19 s.s. "Mongolia," of 117,383. Greenock, Sydney 1 Died and body buried at sea. June 14 s.s. "Gloucestershire," pool, 131,296. of Liver- Rangoon 1 Removed to Port Sanitary Hospital. July 19 s.s. "India," of 105,572. Greenock, Bombay 1 Landed at Marseilles. Aug. 12 s.s. "Derbyshire," of 106,876. Liverpool, Rangoon 1 Removed to Port Sanitary Hospital. 4 PLAGUE. On arrival of the s.s. "Mongolia," of Greenock, 117,383, at Gravesend on the 17th May, it was ascertained that a case of Plague had occurred on board. The patient, a Genoese baker, was taken ill on the 1st May with rigors, and a bubo appeared in the neck. A second bubo appeared in left armpit. The patient died on the 4th May, and the body was buried at sea the same day. The hospital where patient was isolated from the start of his disease was thoroughly disinfected, and also the native crew and effects at Suez and Marseilles. Medical inspection was done at Plymouth, and also on board before arrival in London. No further cases occurred. No disease or mortality amongst the rats on board was observed. On arrival at Gravesend all on board were found to be in good health, and the vessel was allowed to proceed to Tilbury Dock, where the ship was fumigated with Sulphur Di-oxide gas to destroy all the rats and insects on board. The patient embarked on the s.s. " Salzette " at Bombay, was transferred to the s.s. "Mongolia" at Aden, and developed the disease within 24 hours of his transferment. In my opinion he contracted the disease at Bombay before sailing thence. The s.s. "Gloucestershire," of Liverpool, 131,296, arrived at Gravesend on the 14th .June from Rangoon. A native fireman was found suffering with enlarged glands in the neck— temperature 101 degrees—and was removed to Denton Hospital with all effects. The vessel and effects were thoroughly disinfected, and the names and addresses of all passengers and persons leaving the vessel were notified to the respective Medical Officers of Health. 19 The result of bacteriological examination of fluid from enlarged gland proved to be " negative "as regards Plague. The s.s. "India," of Greenock, 105,572, arrived on the 19th July from Bombay. On the 10th June one of the crew (fireman) was taken ill with fever, and an enlarged and inflamed gland in the left groin. He was landed at Marseilles on the 13th June. All necessary disinfection was carried out at Marseilles. No dead rats were seen, and no unusual mortality among rats. On arrival at Gravesend, all on board were found to be well. The vessel was allowed to dock, and kept under observation, after being fumigated thoroughly for the destruction of rats. The s.s. "Derbyshire," of Liverpool, 106,876, arrived on the 12th August from Rangoon. A European steward was landed therefrom at Denton Hospital, with an enlarged and painful gland in the left inguinal region. There was some history of fever during the voyage, but none "on admission. The gland was punctured and a specimen of the fluid sent for bacteriological examination, the result of which proved to be "negative" as regards Plague. RETURN OF RATS EXAMINED BACTERIOLOGICALLY, 1913. Dock. No. Trapped. Pound Dead. Infected Eats: Trapped. Found Dead. Royal Albert 657 32 ... 3 Royal Victoria 1,430 176 3 1 East India 99 ... ... ... Millwall 245 ... ... ... West India 153 6 ... ... Tilbury 239 6 ... ... London 543 6 ... ... Surrey Commercial 162 5 ... ... St. Katharine 582 ... ... ... Dock Unknown 15 3 ... ... 4,125 234 3 4 Summary—Total rats examined 4,359 „ „ infected 7 During the year 7 rats were found on bacteriological examination to have' been suffering with plague. They were as follows:— Royal Albert Dock 3 Royal Victoria Dock 4 Total 7 20 TABLE XII. Return of Rats caught and destroyed during 1913. 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 164 231 203 137 237 160 191 213 228 274 221 182 2,441 Vessels during voyage 26 20 68 214 20 120 40 12 — 50 52 6 628 „ while in dock 267 257 127 172 280 200 168 211 232 253 225 205 2,597 Surrey Commercial Dk.— Warehouses 14 15 13 15 11 80 2 51 24 19 44 33 321 Vessels during voyage — — — — — — — 20 — — — — 20 „ while in dock 43 168 159 — 145 71 153 96 128 — 6 — 969 Regent's Canal Dock— Warehouses — — — — — — — — — — — — — Vessels during voyage — — — — — — — — — — — — — „ while in dock — — — — — — — — — — — — — St. Katharine's Dock— Warehouses 58 63 66 52 68 43 52 66 47 57 73 54 699 Vessels during voyage — — — — — — — — — — — — — „ while in dock — — — — — — — — — — — — — London Dock— Warehouses 38 54 87 68 73 45 52 107 139 102 117 91 973 Vessels during voyage — — — — — — — — — — — — — „ while in dock — — — — — — — — 5 — — — 5 Albert and Victoria Dks.— Warehouses 411 684 732 587 846 648 647 887 668 556 681 469 7,816 Vessels during voyage 51 320 378 703 56 88 404 373 44 148 120 1,087 3,772 ,, while in dock 642 1,039 1,057 643 552 854 700 910 483 473 624 407 8,384 West India Dock— Warehouses 64 85 125 74 199 251 236 249 164 169 162 186 1,964 Vessels during voyage 62 27 120 203 134 144 86 94 34 110 292 84 1,390 „ while in dock 170 196 369 126 341 195 158 307 268 385 442 164 3,121 East India Dock— Warehouses 47 23 33 36 42 53 48 52 54 42 49 26 505 Vessels during voyage — — — — — 20 — — — — — — 20 „ while in dock 148 154 62 11 41 33 85 113 64 84 105 191 1,091 Tilbury Dock— Warehouses 58 149 129 98 289 76 90 174 160 207 311 200 1,941 Vessels during voyage 468 572 872 460 353 700 6 169 804 405 350 159 5,318 „ while in dock 234 256 343 136 235 465 280 531 209 231 226 319 3,465 River— During voyage — — — 340 312 235 126 50 20 6 12 6 1,107 While in river — — — — — — — — — — — — — Totals 2,965 4,313 4,943 4,075 4,234 4,481 3,524 4,685 3,775 3,571 4,112 3,869 48,547 Total from February, 1901, to 31st December, 1912 - 745,634 Total from 1st January to 31st December, 1913 :— In Dock Warehouses - 16,660 On Vessels during voyage 12,255 On Vessels while in Dock and River - 19,632 48,547 Total 794,181 21 RAT PLAGUE. In previous Annual Reports, I have reported the existence of Plague amongst the rats in the Port of London and have printed the correspondence which I have had with the Port of London Authority with a view to preventing the recurrence of this danger. The Local Government Board arranged for an interview between the Port of London Sanitary Authority and the Port of London Authority at the Local Government Board on 26th September, 1913, with the idea of discussing the question. The risk of human infection arising in London owing to the existence of rat plague in London and in its docks and warehouses was mentioned. It was pointed out that if more than two cases of human plague were reported in the Port of London, it would have to be declared an infected port, and in consequence the financial loss to the shipping trade would be very large. Four sets of measures were indicated as being desirable to be carried out. First, that all the warehouses in which food is placed or stored should be made ratproof. Secondly, all refuse and waste matter that forms harbourage for rats should not be disposed of around the warehouses. Thirdly, that the present type of sanitary conveniences should be replaced by water closets with modern arrangements inaccessible to rats. Fourthly, that not only should the warehouses be made ratproof, but also the dwelling houses and offices within the dock area should be treated in a similar way. The following extracts from a Report of the Citizens' Health Committee on eradicating rats from San Francisco are interesting as showing the sort of work which might have to be done should Plague be introduced into London. The epidemic broke out in 1906, and only Chinatown where proper ratproofing measures had been taken during a previous outbreak in 1900 was exempt from Plague. The first case occurred in March, 1907, and between August, 1907, and January 31st, 1908, 159 cases occurred with 77 deaths. In the course of the epidemic, some 154,000 rats were bacteriologically examined. 400 paid Inspectors and labourers were kept at work for several months, in addition to the force maintained by the Board of Health and the Federal Government, together with a large force of voluntary Inspectors. 3,000/. was spent in rat traps and poisons alone ; cheese for bait being purchased in lots of a ton at a time. In November, 1907, the expense of anti-plague operations in San Francisco alone were 10,000/., and between August, 1907, and June, 1908, no less than 84,400/. were spent in these operations. 22 The measures which proved successful were :— 1. The destruction of rat-harbouring places. 2. Careful search for rat corpses. 3. The ratproofing of buildings. 4. Rat-trapping and poisoning. 5. The removal as far as possible of the rats' food supply. All freights leaving the City by water were inspected, and such products as grain, dried fruits, flour, hides, &c., were not allowed to be shipped unless certified as having previously been stored in rat-proof warehouses, and as having been found on examination to be free from rat infestation. Should Plague break out in London, and if foreign countries should decide to inflict similar restrictions on all food stuffs leaving the Port of London under the conditions existing at the present time, such exports would be practically prohibited. TABLE XIII. \ (Small-pox.) Date. Name of Vessel, Port of Registry and Official Number. Where from. No. of Cases. How dealt with. 1913. March 8 s.s. " Gloucestershire," of Liverpool, 181,296. Rangoon' 7 One removed to Grays Hospital, Port Sanitary Hospital, and 2 at Liverpool. ,, 17 s.s. " Egypt," of Greenock, 105,581. Bombay 1 Landed at Aden. ,, 25 s.s. " Gaea," of Christiania. Candia 1 Removed to Port Sanitary Hospital. April 12 s.s. " Bright Wings" of London, 125,786. Busreh 1 Landed at Busreh. ,, 28 s.s. " Comrie Castle," of London, 118,342. Mauritius 1 Landed at East London. May 18 s.s. " Den of Crombie," of Dundee, 123,322. Yokohama 1 Landed at Sabang June 4 s.s. " Ancona," of London, 95,205. Gibraltar 1 Landed at Lisbon. Aug. 7 s.s. " Batavier II.," of Rotterdam. Rotterdam - 1 Removed to Port Sanitary Hospital. „ 28 s.s. " Dolfyn," of Groningen. Cologne 1 Ditto. Sep. 22 s.s. "Mongolia of Greenock, 117,383. Sydney 1 Landed at Sydney. Oct. 18 s.s. "Manora," of Glasgow, 133,129. Calcutta 2 Removed to Port Sanitary Hospital. Dec. 31 s.s. " Nevassa," of Glasgow, 133,102. Calcutta 1 Landed at Colombo. Total 19 SMALL-POX. The s.s. " Egypt," of Greenock, 105,581, arrived on the 14th March, from Bombay, having landed a case suspicious of Small pox at Aden on the 26th February. The Native quarters were disinfected, and the crew were reported to have been vaccinated at Bombay. No further cases occurred, and on arrival at Gravesend all on board were found to be well. 23 The s.s. " Gloucestershire," of Liverpool, 131,296, arrived at Gravesend at 3.10 a.m. on March 8th. She sailed from Rangoon on the 5th February, calling at Colombo, February 11th, Suez, February 22nd, Port Said, February 23rd, Marseilles, February 28th, and Portland, Dorset, March 7th. The vessel was boarded at Gravesend by the Assistant Medical Officer of this Authority, in company with the Customs Preventive Officer. They were received by the Captain and the Surgeon of the vessel at the top of the ladder, and, in reply to their questions, each stated that there had been no sickness on board save that a member of the Native crew had fallen from the bridge, injuring his leg. The Assistant Medical Officer, accompanied by the Captain, inspected the Native members of the crew, looking especially for signs of Plague as the vessel had come from, and had touched at, ports where that disease existed. It was dark at the time, and artificial light had to be used for the purpose of examination. The Surgeon subsequently filled in a certificate, stating that there had been no contagious or infectious disease, or any illness exhibiting feverish symptoms or diarrhoea while lying in the Port of Rangoon or on the voyage to London. This certificate also stated that he had examined the crew within twelve hours of arrival, and found all in good health and free from symptoms of Cholera, Yellow Fever, and Plague. The vessel was in a hurry to save her tide for docking, and the vessel entered Tilbury Dock, where the passengers landed, their names and addresses having been previously furnished to the Medical Officer. In the course of the day various members of the crew departed for their homes. At 10 p.m. I received a telephone message that one of the crew, who had gone to his home at Grays, had developed Small-pox. I telephoned Dr. Willoughby, communicated the facts to him, and he proceeded at 11.30 p.m. to Tilbury Dock, and visited the vessel. The donkeyman was found to be ill, and Dr. Willoughby, on examining him, found that he was in the very earliest stage of the eruptive condition of the disease. On March 9th at 8 a.m. the launch entered Tilbury Dock, and the donkeyman and three members of the Native crew were removed to Denton Hospital suffering from Small-pox. The remainder of the Native crew with their effects were also taken to Denton Hospital, thoroughly disinfected, and returned to the vessel by 7 o'clock on the morning of the 10th, whilst the effects of the white crew were fumigated with sulphur to render them safe for handling. The members of the white crew with their effects were then removed to the Hospital and treated in a similar manner. Dr. Willoughby also vaccinated 128 members of the crew, only the chief engineer declining, as he had been successfully vaccinated by Dr. Willoughby about three years ago. I was subsequently informed that two members of the crew, who had gone to Liverpool, had developed the rash of the disease, and had been isolated in hospital. I received a call from the Surgeon of the vessel on March 10th, and he furnished the following information : — It appears that the Native crew joined the ship at Rangoon, and were signed on at Calcutta, having been previously examined for disease, and vaccinated by the Medical Officer at that port. (This vaccination was apparently done very perfunctorily) in the majority of cases only one mark being found, and all of which had been unsuccessful. At Colombo the crew were mustered and examined by the port doctor. 24 Soon after leaving Colombo, about February 12th, he was called in to see a native fireman who had a rash on his face and body, with a few spots on wrists and hands. As he was uncertain of the diagnosis, he took the precaution of isolating the man in the ship's hospital on deck, and all the crew's belongings were brought upon deck, and the crew's quarters thoroughly disinfected. The same afternoon he found two other men who had spots on the forehead and a few on the body. In his opinion this was due to "acne''—temperatures normal, and the men were sent back to work. On arrival at Suez, the man in hospital was shown to two medical officers who boarded the ship there, and they decided that the disease was not small-pox, or anything infectious. On leaving Port Said on the 23rd February, another man developed spots on his face and body, precisely similar to the man who was isolated. He also was put into hospital with the other man, and on arrival at Marseilles the whole of the crew were mustered and examined one by one, and passed by the port doctor. The first man went back to work as he was perfectly well, the other remaining in hospital until within three days of London. On March 5th, the doctor was called in to see the carpenter who complained of pains in the groin. He had an enlarged gland. Next day he had pains in his back—temperature being quite normal, and on March 7th got up and went about his work as usual. There was no sign of a rash at that time. The same day the doctor saw the donkeyman, who complained of feeling sick, with pains in the chest. There was no rash. The entire crew having been inspected at Colombo, Suez and Marseilles, and on each occasion were passed free from infectious disease of any kind. Since leaving Marseilles there was no further case of " rash," so that on arriving at Tilbury he had no hesitation in declaring that there had been no infectious disease on board. It would appear from the facts that the first man developed the disease on February 12th, and that he infected the man on February 23rd, who in turn infected the donkeyman and the others. Thus there were three generations of this disease on the vessel between Rangoon and her arrival in Tilbury Dock. The Master of the ship and the ship's Surgeon did not answer truthfully the questions which were put to them when they stated that there had been no sickness during the voyage, in view of the subsequent admission that two men had been isolated for some days during the voyage. The facts were laid before Mr. Solicitor for such action as he deemed necessary. He did not advise a prosecution. The s.s. " Comrie Castle," of London, 118,342, arrived on the 24th April, 1913, from Mauritius. The carpenter was taken ill on March 24th, and landed at East London suffering with Small-pox. All the crew were vaccinated at the time, and the cabin was disinfected with Sulphur Di-oxide gas. No further cases occurred, and all were well on arrival at Gravesend. The s.s. " Den of Crombie," of Dundee, 123,322, arrived at Gravesend on the 18th May, having landed a case of Small-pox at Sabang on the 13th April last. The patient was a native fireman. The vessel and effects were thoroughly disinfected at Sabang. 25 No further cases occurred, and on arrival at Gravesend all on board were found to be in good health. The s.s. " Gaea " (Norwegian) arrived on the 24th March from Gandia, when it was found that one of the crew was suffering from fever and headache. Although no rash was present the symptoms were so suspicious of Small-pox that the patient was landed at Denton Hospital. On the 25th the eruption came out, and the case was definitely diagnosed as one of Small-pox. The ship was fumigated and disinfected, and the names and addresses of all possible contacts were notified to the respective Medical Officers of Health. The ship left for Swansea on the 26th, and the Medical Officer of Health for that port was notified accordingly. The s.s. " Brightwings," of London, 125,786, arrived on 12th April from Busreh, having landed a case of Small-pox at that place on the 25th February. The quarters were disinfected there, and the crew vaccinated. No other cases occurred, and all were in good health on arrival at Gravesend. The s.s. "Ancona," of London, 95,205, arrived from Gibraltar on the 4th June, when it was ascertained that a man had been landed at Lisbon with a rash on face and body. The diagnosis was unknown, but was said to have been suspicious of Small-pox. All on board appeared to be well on arrival, and the vessel has been kept under daily observation during her stay in port. The names and addresses of all persons leaving the ship were notified to the respective Medical Officers of Health. The vessel left for Lisbon on the 14th June. The s.s. " Batavia II., of Rotterdam, arrived on the 7th August, from Rotterdam. In the course of examination of the alien passengers on board, it was noticed that a 2nd class passenger had spots on her face, which was very suspicious of her having suffered recently with Small-pox. The history of the case was that— She was taken ill four weeks previously with pains " all over her body,'' accompanied with shivering and vomiting. Four days later spots came out (chiefly on the face, hands and arms). She had been " out and about" in Holland for the past fourteen days, and the nature of the disease had not been diagnosed. The case was removed to Denton Hospital, and there was no doubt that she had had Small-pox recently. After thorough disinfection, together with all clothes, she was released. The ladies' cabins were thoroughly disinfected, and all infected bedding, &c., similarly treated. The patient was only discovered at the last moment, after the majority of the passengers were on the tender on their way to the shore, but no powers are possessed to delay the ship or even to take the names and addresses of the passengers in the case of small-pox. 26 Upon the subject of providing safeguards for the protection of this country from the introduction of Small-pox your Committee, on the 15th May last, addressed the following letter to the Local Government Board :— "Guildhall, E.C., " 15th May, 1913. " Sir, " The Port of London Sanitary Committee have had presented to them reports from the Medical Officer of Health dealing with cases of Small-pox on the s.s. " Gaea " and s.s. " Gloucestershire," and I am directed to enclose copies of the same. " The Committee note that there are many vessels arriving in the Port of London within 14 days of their departure from ports at which Small-pox is known to exist. " It is possible that, as in the case of the s.s. " Gaea," there may be persons on board who are incubating the disease, but who have as yet shown no signs or symptoms of Small-pox. Such persons, if members of the crew, usually are paid off and land in London, where they are lost trace of, and should they develop this disease, would form foci which might constitute the starting points of a serious epidemic of Small-pox. " The Committee are informed by the Medical Officer of Health that he has no powers to deal with these vessels should they arrive with no sickness on board, unless they have come from, or touched at ports infected with Plague, Yellow Fever or Cholera. " Having regard to the fact that there is a large and increasing number of persons in this country unprotected by vaccination or re-vaccination, they think that powers should be given to Port Sanitary Authorities to visit and inspect all persons on board ships arriving from ports at which Small-pox is known or suspected to exist and situated within 14 days steaming of ports in this country ; that all persons on these vessels should be required to give their names and addresses ; that they should be detained on board in cases where the addresses given are unsatisfactory ; and that a penalty should be imposed on such persons similar to that contained in the Local Government Board Order relating to Plague, Yellow Fever and Cholera. " I am, " Sir, "Your obedient Servant, (Signed) "JAMES BELL. " To the Secretary, " Local Government Board, " Whitehall, " S.W." 27 To this communication the following reply was received :— " Local Government Board, " Whitehall, S.W., "29th August, 1913. " Sir, " I am directed by the Local Government Board to advert to your letter of the loth May last, suggesting that certain powers should be conferred on Port Sanitary Authorities in the matter of the visitation and inspection of persons on board ships arriving from ports at which Small-pox is known or suspected to exist, and situate within 14 days' steaming of ports in this country. " In reply, I am to state that the Board have carefully considered this proposal both in regard to the administrative measures which would be needed to give effect to them, and to the question of international arrangements which would be involved, but that they do not consider, on the evidence before them that they would be justified in adopting the course suggested. " I am, Sir, " Your obedient Servant, (Signed) " THOS. PITTS, " Assistant Secretary. " The Town Clerk, " Guildhall.'' The decision of the Local Government Board is to be regretted, as a serious loop-hole exists by which it is possible for Small-pox to be introduced into this country. The s.s. " Mongolia," of Greenock, 117,383, arrived at Gravesend on the 21st September, from Sydney, having landed a European steward there with a disease suspicious of Small-pox. It was stated that he had been successfully vaccinated three weeks previously. All Europeans and native crew had been recently vaccinated. Necessary disinfection was carried out at Sydney. No further cases occurred, and all were found to be well on arrival at Gravesend. The s.s. " Manora" of Glasgow, 133,129, arrived from Calcutta on the 17th October, 1913, when a case of Small-pox was removed therefrom to Denton Hospital. All necessary disinfection was carried out—the natives were vaccinated, and vaccination was carried out in the case of all others who wished it. The names and addresses of all the persons leaving the ship were taken and notified to the respective Medical Officers of Health. The vessel was kept under strict observation, and on the 18th October another case of Small-pox was found, and removed to Denton Hospital. 28 The s.s. " Nevassa," of Glasgow, 133,102, arrived from Calcutta on the 29th December, having landed a case of Small-pox at Colombo on the 30th November last. No further cases occurred. All disinfection was carried out at Colombo, and on arrival at Gravesend all on board were found to be well. TABLE XIV. (Scarlet Fever.) Date. Name of Vessel, Port of Registry, and Official Number. Where from. Number of Cases. How dealt with. 1913. January 24 Training Ship "Exmouth," lying off Grays 2 Removed to Hospital at Homerton. Feb. 17 s.s. "Johannesburg," of North Shields, 104,829. East London 1 Landed at East London. March 18 s.s. " Omrah," of Glasgow, 108,783 Brisbane 1 Left vessel in London, convalescent. 29 s.s. "Orvieto," of Belfast, 129,628 Do. 1 Isolated on board. April 10 s.s. " Arcadia," of Belfast, 93,172 Bombay 1 Removed to Port Sanitary Hospital. May 8 s.s. " Guildford Castle," of London, 132,611. Delagoa Bay 1 Landed at Southampton. 9 s.s. " Hamlet," of Hull, 123,228 North Sea 2 1 removed to Guy's Hospital, and 1 to Port Sanitary. 30 s.s. " Highland Glen," of London, 129,139. Buenos Ayres 2 Convalescent on arrival in London. August 27 Barge " Gog and Magog " (watch barge), lying at Woolwich. 2 1 removed to hospital at Leyton, and 1 to Port Sanitary hospital. Sept. 4/12 Training Ship " Exmouth," lying off Grays 13 Removed to Ship's Hospital on shore. Sept. 29, Oct. 8, 14 and 17 Ditto Do. 4 Ditto. Oct. 27 Ditto Do. 1 Removed to North Eastern Isolation Hospital. Nov. 6 Ditto Do. 1 Ditto. 14 Ditto Do. 3 Removed to Homerton Hospital. 19 Ditto Do. 1 Ditto. 21 Ditto Do. 1 Removed to Brook Hospital, Woolwich. 26 Ditto Do. 1 Ditto. 28 Ditto Do. 1 Removed to North Eastern Isolation Hospital. Dec. 10 Ditto Do. 1 Ditto. Total 40 As will be seen from the preceding table, there was in September an outbreak of Scarlet Fever on the training ship " Exmouth" belonging to the Metropolitan Asylums Board. The outbreak did not attain the proportions of an epidemic, but was passed on from case to case until December—the total number of cases reported to me being 27. All the cases were removed to the Board's Hospitals for treatment. 29 TABLE XV. , (Diphtheria.) Date. Name of Vessel, Port of Registry, and Official Number. Where from. Number of cases. How dealt with 1913. Feb. 28 Training Ship " Arethusa," lying off Greenhithe 1 Removal to ship's Hospital on shore. April 5 s.s. " Perm," of Copenhagen Libau 1 Removed to Seamen's Hospital, Greenwich. May 14 s.s. " Suevic," of Liverpool, 113,456. Sydney 1 removed to Port Sanitary Hospital; 1 recovered. June 7 s.s. " City of Paris," of Glasgow, 124,223 Calcutta 1 Landed at Marseilles. ,, 9 s.s. "Montreal," of Liverpool, 113,373 Montreal 1 Removed to Port Sanitary Hospital. ,, 18 s.s. " Macedonia," of Belfast, 116,012 Bombay - 1 Died, and body buried at sea. Aug. 5 Training Ship " Exmouth," lying off Grays 1 Removed to Eastern Isolation Hospital. Sept. 25 s.s. " Kaga Maru, of Tokio Yokohama 1 Removed to Port Sanitary Hospital. Oct. 22 s.s. " Andania," of Liverpool, 135,481 Montreal 1 Landed at Plymouth. Not. 19 Training Ship " Arethusa," lying off Greenhithe 1 Removed to Bow Arrow Lane Hospital. Dec. 8 s.s. " Lake Michigan," of Liverpool, 115,252. Montreal 4 3 removed to Port Sanitary Hospital ; 1 recovered—left vessel in London. ,, 19 s.s, " Mantua," of Greenock, 127,544 Bombay 1 Ditto. Total 16 TABLE XVI. Enteric Fever. Date. Name of Vessel, Port of Registry, and Official Number. Where from. No. of Cases. How dealt with. 1913. Jan. 9 s.s. " Tainui," of Southampton, 124,507 Wellington 1 Left vessel in London, convalescent. Feb. 8 s.s. " Alnwick Castle," of London, 114,784. Mauritius 1 Landed at Durban. ,, 10 s.s. " Runic," of Liverpool, 113,441 Sydney 1 Ditto. March 3 s.s. " Paparoa," of Plymouth, 111,346- Wellington 1 Landed at Monte Video. ,, 12 s.s. " Montfort," of Liverpool, 110,568 St. John's 1 Removed to Port Sanitary Hospital. ,, 21 s.s. " Hurunui," of Plymouth, 132,751 Wellington 1 Ditto. „ 22 s.s. " Morea," of Glasgow, 128,235 Sydney 1 Landed at Marseilles. 26 s.s. " Dover Castle," of London, 118,409. Delagoa Bay 1 Left vessel in London, convalescent. 27 s.s. "Morea," of Glasgow, 128,235 Sydney 1 Landed at Marseilles. April 4 s.s. " Somerset," of London, 118,292 Brisbane 1 Isolated on board. ,, 9 Training Ship " Arethusa," lying off Greenlithe 1 Removed to Ship's Hospital on shore. ,, 18 Ditto ditto 1 Ditto. ,, 28 s.s. " Inkosi," of Aberdeen, 115,582 Beira 1 Died, and body buried at sea. ,, 29 s.s. " Argyllshire, of Glasgow, 129,581 Adelaide 1 Landed to Colombo. May 5 s.s."Esmeraldas," of Liverpool, 123,985 Areca - 1 Removed to Port Sanitary Hospital. Forward - 15 30 Date. Name of Vessel, Port of Registry, and Official Number. Where from. No. of Cases. How dealt with. 1913 Brought forward - 15 May 10 s.s. " Maloja," of Belfast, 132,012 Bombay 1 Landed at Port Said. „ 14 s.s. " Phoebe," of Cardiff, 98,449 Santa Fe 1 Left vessel in London, convalescent. ,, 15 s.s. " Galway Castle," of London, 132,616. East London 1 Landed at Southampton. ,, 22 s.s. "Cluny Castle," of London, 118,323 Mauritius 2 Removed to Port Sanitary Hospital. June 4 s.s. " Themistocles," of Aberdeen, 129,349. Brisbane 1 Removed to Hospital at East Ham. ,, 7 s.s. " Morayshire," of Glasgow, 108,778 Rockhampton 1 Removed to Port Sanitary Hospital. ,, 16 s.s. " Highland Scot," of London, 129,130. Buenos Ayres 1 Left vessel in London, convalescent . ,, 30 s.s. " Pomeranian," of Glasgow, 85,913 Montreal 2 Removed to Port Sanitary Hospital. July 5 Barge " Loo," of London, 87,057 Northfleet 1 Patient died at home. ,, 12 s.s, " Nore," of Greenock, 123,531 Antwerp 1 Removed to Branch Seamen's Hospital. „ 14 s.s. "Worcestershire," of Liverpool, 118,126. Rangoon 1 Landed at Port Said. ,, 20 s.s. " Balaclava," of London, 123,654 Antwerp 3 2 removed to Port Sanitary Hospital and 1 at Woolwich. ,, 25 Training Ship " Arethusa," lying off Greenhithe 1 Removed to Ship's Hospital on shore. ,, 26 s.s. " Athenic," of Liverpool, 115,239 Wellington 1 Removed to Port Sanitary Hospital. ,, 28 s.s. " Mountain Laurel," of Sandefjord Unea 1 Ditto. Aug. 6 s.s. " Stat," of Aalsund Stettin 1 Ditto. ,, 14 s.s. " Corinthian," of Glasgow, 11,257 Montreal 1 Ditto. ,, 26 s.s. " Torrinton," of Cardiff, 119,962 Bahia Blanca 1 Landed in London, convalescent. ,, 29 s.s. " Brodvale," of London, 110,136 Hankow 1 Landed at Aden. Sept. 4 s.s. "South Point," of West Hartlepool, 132,814. Philadelphia 2 Removed to Port Sanitary Hospital. ,, 6 s.s. " Ivanoe," of Trondhjem Archangel 1 Removed to Seamen's Hospital, Greenwich. ,, 15 s.s. " Atsuta Maru," of Yokohama Yokohama 1 Landed at Suez. ,, 29 s.s. "Dicky," of Liverpool, 113,939 Goole 1 Removed to Seamen's Hospital, Greenwich. ,, 29 s.s. " Hitachi Maru," of Tokio Yokohama 4 Ditto. Oct. 3 s.s. " Albatross," of London, 89,541 Genoa 1 Removed to Port Sanitary Hospital. ,, 9 s.s. " German," of Southampton, 109,290. Cape Town 1 Convalescent on arrival in London. ,, 18 s.s. " Scotian," of Glasgow, 129,547 Montreal 7 Removed to Port Sanitary Hospital. ,, 20 s.s. " Hitachi Maru," of Tokio Yokohama 1 Landed at Middlesboro'. Nov. 15 s.s. "Ionic," of Liverpool, 115,337 Wellington 1 Removed to Port Sanitary Hospital. ,, 15 s.s. " Mount Temple," of Liverpool, 113,496. Montreal 1 Removed to Hospital at Sheerness. ,, 18 s.s. " Suffolk," of London, 115,859 Sydney 1 Removed to Port Sanitary Hospital. Dec. 6 s.s. " Tyninghame," of Cardiff, 128,490 Buenos Ayres 2 Landed at Rio. ,, 10 s.s. " Kabinga," of London," 125,599 Hamburg 1 Removed to Port Sanitary Hospital. ,, 13 s.s. " Highland Brae," of London, 129,153. La Plata 1 Ditto. ,, 29 s.s. " Highland Glen," of London, 129,130. Buenos Ayres 1 Ditto. 65 31 ENTERIC FEVER. The s.s. " Stat," of Aalsund, arrived on 3rd August, 1913, from Stettin. The master, in reply to questions put to him, stated that all were well on board, and that there had been no sickness on board during the voyage. On 6th August, one of the crew was removed from the vessel at Church Hole Tier to Denton Hospital, suffering from Enteric Fever, and it would appear from the state of the man's illness that he must have been ill on the arrival of the vessel at Gravesend. I communicated with the master asking for an explanation why the case was not reported, and he stated that when the vessel passed Gravesend " none of the crew as far as he knew, were ill, the patient was on deck and performing his work." The s.s. " Scotian," of Glasgow, 129,547, arrived on the 16th October, from Montreal, and landed seven cases of Enteric Fever at Denton Hospital. The vessel left London on September 18th, arrived at Havre on the 19th. On the 20th there was an outbreak of illness among the stewards with vomiting and diarrhoea, in all—19 being affected. They all resumed duty at the end of about three or four days. The first case of Enteric Fever ailed on October 1st, and by the 8th, 7 cases (stewards) were laid up with Enteric Fever. Among the seven cases were three of the men who had suffered previously with vomiting and diarrhoea on the 20th September. The stewards had eaten food as supplied to the saloon, but none of the passengers were affected at the same time, although it is stated that some " complained " a few days later. TABLE XVII. (Measles.) Date. Name of Vessel, Port of Registry and Official Number. Where from. No. of Cases. How dealt with. 1913 January 13 s.s. " Crane," of London, 118,457 North Shields 1 Isolated at home. ,, 25 s.s. " City of Poona," of Liverpool, 131,423. Calcutta 1 Left vessel in London, convalescent. ,, 29 Training Ship " Exmouth " lying off Grays 1 Removed to North East Hospital. February 1 s.s. "Orama," of Glasgow, 132,989 Brisbane 1 Landed at Adelaide. ,, 10 s.s. "Runic," of Liverpool, 113,441 Sydney 1 Landed at Durban. March 15 s.s. " Gloucester Castle," of London, 132,592. Cape Town 1 Landed at Southampton. ,, 29 s.s. " Orvieto,"of Belfast, 129,628 Brisbane 2 Isolated on board. April 14 s.s. " Beltana," of Greenock, 131,853 Sydney 6 2 removed to Port Sanitary Hospital, 4 isolated on board. ,, 28 s.s. "Arabia," of Greenock, 105,587 Bombay 1 Left vessel in London, convalescent. May 7 s.s. " Matiana," of Glasgow, 104,588 Calcutta 1 Removed to Port Sanitary Hospital, ,, 14 s.s. " Himalaya," of Greenock, 99,776 Ditto 1 Landed at Colombo. ,, 24 s.s. " Sir Francis," of London, 129,102 Tyne 2 Landed at Tyne. Forward 19 32 Date. Name of Vessel, Port of Registry, and Official Number. Where from. No. of Cases. How dealt with. 1913. Brought forward 19 May 26 s.s. " Kasan," of Copenhagen Libau 2 Removed to Port Sanitary Hospital. June 4 s.s. " Ascania," of Liverpool, 131,342 Montreal 2 1 removed to Port Sanitary Hospital, and 1 landedatPlymouth ,, 9 s.s." Montreal," of Liverpool, 113,373 Ditto 2 Removed to Port Sanitary Hospital. ,, 14 s.s. " Kasan, ' of Copenhagen Libau 2 Ditto. ,, 18 s.s. " Mount Royal," of Liverpool, 104,498 Montreal 1 Ditto. July 15 s.s. " Shropshire," of London, 32,607 Brisbane 1 Left vessel in London, convalescent. ,, 20 s.s. " Orvieto," of Belfast, 129,628 Ditto 1 Ditto. August 5 s.s. " Himalaya," of Greenock, 99,776 Bombay 1 Landed at Aden. ,, 11 s.s. " Geelong," of London, 118,426 Sydney 1 Left vessel in London, convalescent. ,, 12 s.s. " Andania," of Liverpool Montreal 1 Removed to Port Sanitary Hospital. ,, 18 s.s. " Kasan,' of Copenhagen Libau 1 Ditto September 15 s.s. " Perm," of Copenhagen Ditto 4 Ditto October 15 s.s. " Galician," of Southampton, 113,334. Cape Town 2 Landed at Southampton. ,, 18 s.s. " Scotian," of Glasgow, 129,547 Montreal 1 Removed to Port Sanitary Hospital. ,, 22 s.s. " Guildford Castle," of London, 132,611. Delagoa Bay 18 17 allowed to leave vessel, convalescent. 1 died on board. December 9 s.s. " Dungeness," of Glasgow, 99,829, Belfast 1 Landed at Belfast. ,, 12 s.s. " Grantully Castle," of London, 129,058. East London 3 Landed at Southampton. ,, 19 s.s. " Otranto," of Belfast, 124,075 Brisbane 1 Left vessel in London, convalescent. Total 64 MEASLES. The s.s. "Guildford Castle," of London, 132,611, arrived at midnight on the 22nd October, from South Africa. There had been 18 cases of measles during the voyage, with one death ; 16 of them were convalescent on arrival, and were allowed to land after disinfection. One child, a girl aged five years, was so ill that it was deemed desirable to keep her on the vessel for two days, when the mother found lodgings, and the child's temperature then being normal, she was allowed to leave the ship. TABLE XVIII. (German Measles.) Date. Name of Vessel, Port of Registry, and Official Number. Where from. No. of Cases. How dealt with. 1913. March 19 s.s. "Neuralia," of Glasgow, 133,081 Calcutta 1 Left vessel in London, convalescent. „ 28 s.s. "Persia," of Greenock, 109,258 Bombay 1 ditto June 11 s.s. " Sicilia," of Glasgow, 113,933 Calcutta 2 Allowed to proceed home. Total 4 33 TABLE XIX. (Erysipelas.) Date. Name of Vessel, Port of Registry, and Official Number. Where from. No. of Cases. How dealt with. 1913. June 14 s.s. "Thursby," of Liverpool, 73,751 (?) 1 Removed to West Ham Infirmary. Aug. 5 s.s. " Minnewaska," of Belfast, 124,674. New York 1 Left vessel in London. Oct. 10 s.s. " Holywood," of London, 132,732. Tyne 1 Removed to Poplar Hospital. Total 3 TABLE XX. (Continued Fever.) Date. Name of Vessel, Port of Registry, and Official Number. Where from. No. of Cases. How dealt with. 1913. Feb. 15 s.s. " Arabia," of Greenock, 105,587 Bombay 1 Removed to Port Sanitary Hospital. „ 18 s.s. " Queen Eleanor," of Glasgow, 106,019. La Plata 1 Removed to Port Sanitary Hospital. „ 19 s.s. Worsley Hall," of Liverpool, 913,694. Beira 1 Ditto. May 28 s.s. " Clan Matheson," of Glasgow, 121,305. Vizagapatam 1 Removed to hospital at Tilbury. June 6 s.s. " King Howel," of London, 123,701. Buenos Ayres 1 Removed to Port Sanitary Hospital. „ 20 s.s. " Ellik," of Bergen Stettin 1 Ditto. „ 30 s.s. " Pomeranian," of Glasgow, 85,913 Montreal 1 Ditto. „ 30 s.s. "Nore" of Greenock, 123,531 Antwerp 1 Ditto. July 14 s.s. " Crown of Granada," of Glasgow, 115,724. Demerara 1 Ditto. ,, 18 s.s. " Arabia," of Greenock, 105,587 Bombay 1 Removed to Branch Seamen's Hospital. Sep. 1 s.s. " Mantua," of Greenock, 127,544 Cronstadt 1 Removed to Port Sanitary Hospital. ,, 17 s.s. " Inventor," of Liverpool, 131,287 Calcutta 1 Landed at Colombo. Oct. 20 s.s. " Argyllshire," of Glasgow, 129,581 Brisbane 1 Removed to Port Sanitary Hospital. Total 13 34 TABLE XXI. (Pulmonary Tuberculosis.) Date. Name of Vessel, Port of Registry and Official Number. Where from. No. of Cases. How dealt with. 1913. Jan. 5 (?) (?) 1 Removed to Seamen's Hospital, Greenwich. ,, 9 s.s. "Nore," of Greenock," 123,531 Yokohama 1 Left vessel in London. „ 25 s.s. " Mantua," of Greenock," 127,544 Sydney 1 Ditto. Feb. 1 s.s. "Dunluce Castle," of London, 118,490. Cape Town 1 Ditto. „ 10 s.s. " Sicilia," of Glasgow, 113,933 Yokohama 1 Ditto. „ 10 s.s. " Malwa," of Greenock, 127,543 Sydney 2 1 removed at Marseilles ; 1 died, and body buried at sea. „ 12 s.s. " Geelong," of London, 118,426 Do. 4 Left vessel in London. „ 18 s.s. "Keemung," of Liverpool, 115,327 Vancouver 1 Landed at Hong Kong. March 9 s.s. " Garth Castle,'"of London, 129,078 Cape Town 2 1 left vessel in London ; 1 died, and body buried at sea. „ 17 s.s. " Highland Rover," of London, 129,067. Buenos Ayres 1 Left vessel in London. „ 20 s.s. " Galway Castle," of London, 132,616. Cape Town 1 Landed at London. „ 23 s.s." Montezuma," of Liverpool, 110,604 St. Johns 1 Left vessel in London. „ 24 s.s. " Demosthenes," of Aberdeen, 129,362. Brisbane 1 Removed to Seamen's Hospital, Greenwich. April 4 s.s. " Grantully Castle," of London, 129,058. Cape Town 1 Landed at Southampton. „ 5 s.s. " Marmora," of Belfast, 116,011 Auckland 2 Landed at Colombo. „ 11 s.s. " Thomas," of Copenhagen St. Thomas 1 Landed at Havre. „ 12 s.s. " Orari," of Plymouth, 119,350 Auckland 1 Left vessel in London. „ 12 s.s. " Highland Corrie," of London, 129,117. Buenos Ayres 1 Ditto. „ 16 s.s. " Caledonia," of Greenock, 102,390 Calcutta 1 Died, and body buried at sea. „ 18 s.s. " German," of Southampton, 109,290. Cape Town 1 Landed at Southampton. „ 28 s.s. " Guelph," of Southampton, 104,040 Durban 1 Ditto. May 5 s.s. "Highland Warrior," of London, 132,595. Buenos Ayres 1 Left vessel in London. „ 7 s.s. "Cyclops," of Liverpool, 123,978 Vancouver 1 Died, and body landed at Hong Kong. „ 8 s.s. " Guildford Castle," of London, 132,616. Delagoa Bay 2 Left vessel in London. „ 11 s.s. "Mountford," of Liverpool, 110,568 St. Johns 1 Ditto. „ 11 s.s. " Ning Chow," of Liverpool, 115,326 Yokohama 1 Died, and body buried at sea. „ 15 s.s. " Galway Castle," of London, 132,616. East London 2 1 landed at Southampton ; 1 left vessel in London. „ 22 s.s. " Cluny Castle," of London, 118,323 Mauritius 2 1 case removed to Chatham Hospital; 1 left vessel in London. „ 27 s.s. " Limerick," of London, 109,983 Sydney 1 Died, and body buried at sea. „ 29 s.s. " Waimate," of Plymouth, 105,276 Wellington 1 Left vessel in London. „ 29 s.s. " Garth Castle," of London, 129,078 East London 1 Ditto. „ 30 s.s. "Leicestershire," of Liverpool, 127,995 Rangoon 1 Ditto. Forward 41 35 Date. Name of Vessel, Port of Registry, and Official Number. Where from. No. of Cases. How dealt with. 1913. Brought forward 41 June 9 s.s. " Persia," of Greenock, 109,258 Bombay 1 Left vessel in London. ,, 9 s.s. " Persic," of Liverpool, 110,620 Sydney 1 Died, and body buried at sea. ,, 12 s.s. "Nore," of Greenock, 123,531 Yokohama 1 Removed to Branch Seamen's Hospital. „ 14 s.s. " Malwa," of Greenock, 127,543 Sydney 1 Landed at Colombo. ,, 18 s.s. "Alnwick Castle," of London, 114,784. Mauritius 14 Removed to Herbert Hospital, Woolwich. ,, 21 s.s. " Mantua," of Greenock, 127,544 Bombay 1 Remained on board the vessel. ,, 21 s.s. '' Merton Hall, of Liverpool, 96,342 Calcutta 1 Left vessel in London. ,, 23 s.s. " Wilcannia," of London, 110,154 Sydney 1 Ditto. „ 28 s.s. " Grantully Castle," of London, 129,058. Cape Town 2 Landed at Southampton. ,, 30 s.s. " Georgian," of Liverpool, 97,816 Baltimore 1 Left vessel in London. ,, 30 s.s. " Nile," of Greenock, 123,527 Yokohama 1 Ditto. July 1 s.s. " Mooltan," of Greenock, 115,397 Sydney 1 Ditto. ,, 3 s.s. " Braemar Castle," of London 108,381. Delagoa Bay 1 Landed at Southampton. ,, 5 " s.s. " Omrah,'' of Glasgow, 108,782 Brisbane 2 1 landed at Naples, 1 left vessel in London, ,, 8 s.s. " Cayo Romano," of London, 132,614. Cuba 1 Removed to Seamen's Hospital, Greenwich. ,, 8 s.s. " Scotian," of Glasgow, 129,547 Montreal 1 Landed at Havre. ,, 9 s.s. " Demodocus," of Liverpool, 131,435. Yokohama 1 Left vessel in London. ,, 9 s.s. " Arabia," of Greenock, 105,587 Bombay 1 Ditto. ,, 9 s.s. " Ixion," of Liverpool, 135,431 Vancouver Died, and bodies buried at sea. ,, 9 s.s. " Carmarthenshire," of Southampton, 98,863. Mazagan 1 Patient remained on board the vessel. ,, 9 s.s. " German," of Southampton, 109,290. Cape Town 1 Landed at Southampton. ,, 10 s.s. " Kasan," of Libau Libau 1 Left vessel in London. ,, 15 s.s. " Palawan," of Greenock, 102,400 Yokohama 1 Removed to Haslar Hospital. ,, 16 s.s. " Shropshire," of London, 32,607 Brisbane 3 Left vessel in London. ,, 30 s.s. Minnehaha," of Belfast, 110,520 New York 1 Ditto. August 1 s.s. " Demosthenes," of Aberdeen, 129,362. Brisbane 1 Ditto. ,, 5 s.s. " Aucboria,'' of Glasgow, 129,598 Calcutta 1 Ditto. ,, 5 s.s. " Otway," of Glasgow, 128,282 Brisbane 1 Ditto. ,, 5 s.s. " Nagoya," of Greenock, 135,323 Calcutta 2 Removed to Royal Herbert Hospital, Woolwich. ,, 7 s.s. " Galway Castle," of London, 132,616. Cape Town 1 Landed at Plymouth. ,, 11 s.s. "Medic," of Liverpool, 110,573 Sydney 1 Left vessel in London. ,, 14 s.s. "Nubia," of Greenock, 102,394 Yokohama 1 Died, and body buried at ea. Aug. 16 s.s. " Otranto," of Belfast 124,675 Brisbane 1 Left vessel in London. ,, 18 s.s. " Arzila," of Liverpool, 124,097 Tangier 1 Landed at Casa Blanca. ,, 19 s.s. " Garth Castle," of London. East London 2 Left vessel in London. Forward 96 36 Date. Name of Vessel, Port of Registry, and Official Number. Where from. No. of Cases. How dealt with, 1913. Brought forward 96 Aug. 23 s.s. " Corinthic." of Liverpool, 115,296 Wellington 1 Removed to Branch Seamen's Hospital. ,, 30 s.s. " Benalla," of Greenock, 135,322 Sydney 2 1 died, and body buried at sea. 1 left vessel in London. ,, 31 s.s. " Persia," of Greenock, 109,258 Bombay 1 Left vessel in London. Sept. 1 s.s. " Benalla," of Glasgow, 135,322 Sydney 2 1 died at sea. 1 left vessel in London. ,, 1 s.s. " Mantua," of Greenock, 127,544 Cronstadt 2 Isolated on board. ,, 9 s.s. " Maloja," of Belfast, 132,012 Sydney 1 Landed at Bombay. ,, 13 s.s. " Orama," of Glasgow, 132,989 Brisbane 3 1 died and body buried at sea. 2 left vessel in London. ,, 14 s.s. " Scotian," of Glasgow, 129,547 Montreal 1 Landed at Havre. ,, 15 s.s. " Citv of Marseilles," of Liverpool, 135,436. Calcutta 1 Left vessel in London. ,, 16 s.s. " Beltana," of Greenock, 131,853 Sydney 1 ditto „ 25 s.s. " Braemar Castle," of London, 108,381. Delagoa Bay 1 Landed at Delagoa Bay. „ 29 s.s. " Ophir," of Glasgow, 98,673 Brisbane 1 Died and body buried at sea. ,, 30 s.s. " Arabia," of Greenock, 105,587 Bombay 1 Landed at Marseilles. Oct. 4 s.s. " Flintshire," of London, 105,833 Portland (Oregon) 3 Landed at Colombo. ,, 7 s.s. " Oxfordshire," of Liverpool, 131,454 Rangoon 1 Landed at Port Said. ,, 10 s.s. " Borneo," of Newcastle, 104,287 Calcutta 1 Allowed to proceed home. ,, 11 s.s. " Ballarat," of Greenock, 131,851 Sydney 1 Died, and body buried at sea. Oct. 15 s.s. " Galician," of Southampton, 113,334. Cape Town 1 Left vessel in London. ,, 18 s.s. "Nankin," of Greenock, 131,857 Yokohama 1 Landed at Colombo. ,, 18 s.s. "Manora," of Glasgow, 133,129 Calcutta 1 Landed at Calcutta. ,, 22 s.s. " Tenasserim," of Glasgow, 121,262. Rangoon 1 Landed at Port Said. „ 22 s.s. "Persic," of Liverpool, 110,620 Sydney 1 Died, and body buried at sea. ,, 25 s.s. " San Miguel " (Norwegian) Las Palmas 1 Left vessel in London. Nov. 1 s.s. "Sicilian," of Glasgow, 111,225 Montreal 2 1 case landed at Havre, 1 left vessel in London. ,, 2 s.s. " Nellore," of Greenock, 135,325 Calcutta 1 Died on board. ,, 8 s.s. " Montreal," of Liverpool, 113,373. Montreal 1 Left vessel in London. ,, 9 s.s. " Eden Hall," of Liverpool, 87,841. Smyrna 1 ditto ,, 13 s.s. "Ausonia," of Liverpool, 129,735 Montreal 2 1 case landed at Plymouth, 1 left vessel in London. ,, 13 s.s. " Nore," of Greenock, 123,531 Yokohama 3 Removed to Chatham Royal Naval Hospital. ,, 15 s.s. "Wiltshire," of London, 132,675 Sydney 1 Left vessel in London. „ 16 s.s. " China," of Belfast, 104,467 Shanghai 1 Removed to Devonport Royal Naval Hospital. „ 24 s.s. " Omrah," of Glasgow, 108,782 Brisbane 3 Left vessel in London. „ 25 s..s. "Montrose," of London, 108,351 Montreal 3 Re-shipped to Austria. Forward 144 37 Date. Name of Vessel, Port of Registry, and Official Number. Where from. No. of Cases. How dealt with, 1913. Brought forward 144 Dec. 3 s.s. "Marmora," of Belfast, 116,011 Sydney 1 Died, and body buried at sea. „ 9 s.s. " Syria," of Glasgow, 113,959 Yokohama 2 1 case landed at Port Said, 1 left vessel in London. „ 13 s.s. "Cyclops," of Liverpool, 123,978 Vancouver 1 Left vessel in London. ,, 24 s.s. "Ausonia," of Liverpool, 129,735 Portland (Maine). 1 ditto. „ 27 s.s. "Medina," of Greenock, 131,849 Sydney 1 ditto. „ 29 s.s. " German," of Southampton, 109,290. Cape Town 1 Proceeded to Germany. Total 151 TABLE XXII. Tuberculosis (other than Pulmonary). Date. Name of Vessel, Port of Registry, and Official Number. Where from. Number of Cases. How dealt with. 1913 March 18 s.s. " Talthybius," of Liverpool, 131,411. Vancouver 1 Tubercular Peritonitis. Removed to Branch Seamen's Hospital, Royal Albert Dock. July 22 Training Ship "Warspite," Greenhithe. lying off 1 Tubercular Meningitis. Removed to Ship's Hospital on shore. August 26 s.s. " Moldavia," of Greenock, 117,382. Sydney 1 Tubercular Adenitis. Remained on board the vessel. 29 s.s. Clan Macintyre," of Glasgow, 115,775. Madras 1 Tubercular Peritonitis. Ditto. Sept. 2 s.s. " Persia," of Greenock, 109,528. Bombay 1 Tuberculous elbow Left vessel in London. Nov. 16 s.s. " China," of Belfast, 104,467. Shanghai 1 Tubercle of kidney Removed to Devonport Royal Naval Hospital. Dec. 1 s.s. " Nile," of Greenock, 123,527. Yokohama 1 Tuberculous knee Left vessel in London. 7 TUBERCULOSIS. The Local Government Board have revoked the Regulations issued in 1908 and 1911 relating to Tuberculosis, and have issued a General Order dated December 19th, 1912, which came into force on the 1st February, 1913. In this General Order no specific mention is made applying it to Port Sanitary Authorities, but it is obvious that in the interests of the public health the districts of Port Sanitary Authorities should not be exempt from the provisions of this Order. Every Medical Practitioner, unless acting as a School Medical Inspector, attending on or called in to visit any person, shall within 48 hours after first becoming aware 38 that such person is suffering from Tuberculosis, send a notification to the Medical Officer of Health for the district within which the place of residence of the person is situate at the date of notification. Such notification is to apply to all cases of Tuberculosis, and not merely to those of Pulmonary Tuberculosis. This information will be supplied chiefly by the Assistant Medical Officers of this Authority, who visit incoming vessels on their arrival from " foreign." Persons from vessels, landing and coming to an Institution for treatment will be notified by the Medical Officer of such Institution, so that enquiries may be made in each case and such steps taken as are necessary or desirable for investigating the source of infection or preventing the spread of infection and for removing conditions favourable to infection. The names and addresses of persons arriving in the Port of London will be taken whenever they can be obtained, and they will be notified to Medical Officers of Health of the districts to which such persons are proceeding. No legal power is possessed under this Order to compel the supplying of correct information as to names and addresses, but it is not anticipated that much difficulty will be met with in obtaining this information. In each case steps will be taken to disinfect the quarters occupied and their contents, and to isolate whenever practicable any person remaining on the ship and suffering from this disease. PULMONARY TUBERCULOSIS. The s.s. "Montezuma," of Liverpool, 110,604, arrived on the 21st February from St. Johns. One of the stewards was landed in a moribund condition from advanced pulmonary tuberculosis. It appeared from the history that symptoms of this disease developed two years ago, and, acting on medical advice, he went to sea for the benefit of his health. He had been on various ships, and had always been under treatment by the surgeon. It used to be a not uncommon practice when a young man developed symptoms of pulmonary tuberculosis, to advice him to go to sea, generally as a steward. The steward spends most of his time below decks, sleeping in the " Glory Hole," where the ventilation and other sanitary conditions are most unsuitable for anyone suffering from this disease, and the result can only be to hasten the progress of the disease. Apart from this, there is the obvious danger of infecting his fellow-stewards, and it is desirable that such advice should no longer be given. The following figures show the difference produced by the application of the Order to Port Sanitary Authorities in the number of notifications received before and after the issue of the Order : No. of cases reported 1912 71 1913 151 Pulmonary. 7 Other kinds. 158 39 COMPULSORY NOTIFICATION OF INFECTIOUS DISEASE. Chicken-pox, also Cerebral-Spinal Meningitis, commonly known as Spotted Fever, were notifiable diseases until the 31st December, 1913. TABLE XXIII. (Chicken-Pox.) Date. Name of Vessel, Port of Registry, and Official Number. Where from. Number of Cases. How dealt with. 1913. Jan. 6 s.s. " Egypt," of Greenock, 105,581 Bombay 1 Landed at Marseilles. March 5 s.s. " China," of Belfast, 104,467 Do. 1 Removed to Port Sanitary Hospital. ,, 8 s.s. " Palawan," of Greenock, 102,400 Antwerp 1 Isolated on board. „ 19 s.s. " Neuralia," of Glasgow, 133,081 Calcutta 1 Landed at Aden. ,, 22 s.s. "Morea," of Glasgow, 128,235 Sydney 1 Isolated on board. „ 27 s.s. " Morea," of Glasgow, 128,235 Do. 1 Landed at Marseilles. ,, 28 s.s. " Persia," of Greenock, 109,258 Bombay 2 Removed to Port Sanitary Hospital. April 5 P. and O. " Go Down," Royal Albert Dock. 1 Isolated in adjoining premises. ,, 10 s.s. " Areadia," of Belfast, 93,172 Bombay 1 Landed at Bombay. May 3 s.s. " Galician," of Southampton, 113,334 East London. 1 Landed at Southampton. ,, 14 s.s. " Himalaya," of Greenock, 99,776 Calcutta 2 1 removed to Port Sanitary Hospital, 1 isolated on board. ,, 26 s.s, " Mombassa," of Glasgow, 96,082 Do. 2 Removed to Port Sanitary Hospital. June 20 s.s. "Nyanza," of Greenock, 123,529 Antwerp 1 Convalescent on arrival in London. „ 21 s.s. " Borneo," of Newcastle, 104,287 Calcutta 3 Ditto. „ 27 s.s. ''Nyanza," of Greenock, 123,529 Antwerp 6 Removed to Port Sanitary Hospital. July 15 s.s. " Inanda, of Aberdeen, 118,187 Beira 1 Isolated on board the vessel. Aug. 5 s.s. " Otway," of Glasgow, 128,282 Brisbane 1 Left vessel in London, convalescent. ,, 28 s.s. " City of Lucknow," of Glasgow, 106,040. Antwerp 1 Isolated on board the vessel. ,, 30 s.s. " City of Lucknow," of Glasgow, 106,040. Hamburg 1 Patient recovered. Sept. 1 s.s. " Mantua," of Greenock, 127,544 Cronstadt 1 Left vessel in London, convalescent. ,, 6 s.s. " Mowe, of Bremen Bremen 1 Removed to Port Sanitary Hospital. ,, 16 s.s. " Beltana," of Greenock, 131,853 Sydney 3 Left vessel in London, convalescent. Oct. 15 Training ship " Cornwall, lying off Purfleet 1 Removed to Wennington Hospital. ,, 31 s.s. " Maidan," of Liverpool, 131,241 Calcutta 1 Removed to Tilbury Hospital. Nov. 8 s.s. "Orvieto," of Belfast, 129,628 Brisbane 1 Left vessel in London, convalescent. Dec. 19 s.s. " Otranto," of Belfast, 124,075 Do. 1 Ditto. Total 38 40 TABLE XXIV. (BERI-BERI.) I herewith give a record of the cases of this disease met with. Seven vessels have reported 27 cases during the voyage :— Date of Arrival. Name of Vessel, Port of Registry, and Official Number. Where from. Number of Cases. 1913. January 24 s.s. "Nyanza," of Greenock, 123,529 Yokohama 4 March 17 s.s. "India," of Liverpool, 106,839 San Francisco 6 April 4 " Stromsbo " (Norwegian) Peru 10 June 7 "Alice A. Leigh," of Liverpool, 96,349 Iquique 2 August 5 s.s. " Jason," of Liverpool, 115,297 Hankow 3 (1 fatal) September 16 s.s. " Perseus," of Liverpool, 127,924 Yokohama 1 28 s.s. " Arabia," of Greenock, 105,587 Bombay 1 27 ANTHRAX. On 1st May, I received information respecting a case of Anthrax. The patient was reported to have been at work on the s.s. " Mantua " in Tilbury Docks. On enquiries being made it was ascertained that three days before being taken ill the patient had handled skins. On the 10th May another case of Anthrax was notified. The patient was at work in the Millwall Dock, engaged in unloading the s.s. " Perm." On or about the 26th April the patient scratched his finger, and on the 7th May became ill and was diagnosed as suffering with Anthrax. He had handled bales of horse-hair, and the ship carried horses, but no information is available that he had handled hides. Both of these cases subsequently recovered. LONDON (NOTIFICATION OF GLANDERS) ORDER, 1907. On the 28th November, I received information respecting a case of glanders in a horse at the London Dock. All necessary measures of disinfection were carried out. 41 TABLE XXV. HOSPITAL. Number of Cases Admitted, Cost oe Maintenance, &c. Patients remaining in Hospital on 31st December, 1912 8 Admitted. Discharged, Died. Remaining under treatment Cholera 0 0 0 0 Cholera (suspected) 0 0 0 0 Bubonic Plague 0 0 0 0 Ditto (suspected) 2 2 0 0 Small-pox 9 8 1 0 Scarlet Fever 3 3 0 0 Enteric Fever 29 31 1 5 Continued Fever 9 8 1 0 Diphtheria 7 6 0 1 Measles 18 18 0 0 Erysipelas 0 0 0 0 Chicken-pox 13 13 0 0 Other Diseases 1 1 0 0 Totals 91 90 3 6 Remaining in Hospital on 31st December, 1913 6 Total number of days treatment during the year 1,624 Average number of days treatment for each case 17.84 Average daily number of patients in Hospital 4.01 Average daily cost of maintenance per patient 1s. 5.7d. Average total cost of maintenance per patient £1 6s. 4.5d. The outdoor lamps at the Hospital have been replaced by new incandescent gas lamps, at a cost of 10/. FOOD INSPECTION. The work of Food Inspection in the Port of London has been carried out in accordance with the Regulations made by the Local Government Board, under the Public Health (Regulations as to Food) Act, 1907. The Public Health (Unsound Food) Regulations, 1908, came into force on the 1st October, 1908, and the Public Health (Foreign Meat) Regulations, 1908, became operative on the 1st January, 1909, and have, therefore, been in force for a period of five years. 42 The extended powers conferred by these Regulations upon Port Sanitary Authorities have enabled your officers to perform the duties of Food Inspection in a more thorough manner, and the results have proved the necessity for the additional powers under the Regulations and the importance of this branch of the work of the Port Sanitary Authority, Prior to the year 1909 the only powers of food inspection possessed by this Authority were under Section 47 of the Public Health (London) Act, 1891, and the work was carried out entirely by three Food Inspectors, who devoted the whole of their time to this work. This staff was found inadequate to carry out the provisions of the Regulations made by the Local Government Board, therefore three additional Sanitary Inspectors were appointed, and the duties of assisting with Food Inspection were added to the duties hitherto performed by the Sanitary Inspectors. The organisation for the performance of food inspection for the Port of London is as follows : The district is divided into three, to each of which a Food Inspector is allotted, and he is responsible to me for the inspection of all food stuffs within his district. The districts are as follows :— DISTRICT "A" (Inspector Spadaccini). Sub-District 1. Royal Victoria Dock. ,, 2. Royal Albert Dock. „ 3. East India Dock. DISTRICT "B" (Inspector Anderson). Sub-District 1. London, St. Katharine's and Regents Docks. ,, 2. West India and Millwall Docks. DISTRICT "C" Inspector Bailey). Sub-District 1. Surrey Commercial Docks. „ 2. "Vessels discharging in the district of the Port Sanitary Authority not within a dock. „ 3. Tilbury Dock. Each district is divided up into sub-districts which is in charge of a Sanitary Inspector whose duties are to inspect all vessels within their districts as well as all buildings, dwellings, &c., situated on the land within their district. In addition they perform routine work of food inspection under the direction of the Food Inspector. At times of pressure, the Sanitary Inspectors are engaged for portions of the day in examining food stuffs only, and during the past year it has been necessary even to utilise the services of the Assistant Medical Officers in their spare time for this purpose. 43 The five Assistant Medical Officers have been appointed by the Corporation, with the consent of the Local Government Board, to act in the execution of these regulations, either in the place of, or as Assistants to the Medical Officer of Health ; whilst the Food and Sanitary Inspectors have been similarly appointed to act under my direction in the exercise of any such powers, or in the discharge of any such duties as I may direct in the performance of these regulations. Therefore, instead of the food inspection being carried out by three Food Inspectors, as heretofore, the staff engaged upon the work now consists of— Three Food Inspectors, Ten Sanitary Inspectors, Five Assistant Medical Officers. And in spite of the increased staff engaged it is only by temporarily transferring Inspectors from one district to another that foodstuffs can be inspected so as to avoid delay in their delivery to the importers. The following figures will serve to illustrate some of the additional work carried out as regards Food inspection. During the quinquennium preceding the introduction of the before-mentioned Regulations, the annual numbers of seizures of unsound food were:— Year. Number of seizures. 1904 559 1905 469 1906 450 1907 455 1908 434 Annual average 473.4. Whereas during the succeeding quinquennium the annual numbers were :— • Year. Number of seizures. 1909 599 1910 827 1911 750 1912 705 1913 780 Annual average 732.2. Further the weight of food stuffs seized and destroyed as unfit for human food in the year preceding the introduction of the Regulations, namely 1908, was 992 tons, whereas in the year 1912 it totalled 3,758 tons, and in 1913, 2,845 tons. These figures, however, do not express the additional work performed by your officers, but simply the increase in the amount of Unsound Food seized and destroyed. Additional work by way of inspection naturally results in a corresponding increase of office work. « It has become necessary to redistribute the duties in the office in order that the First Assistant Clerk may devote his whole time to the clerical work arising from Food Inspection. 44 FOOD INSPECTION AT QUEENBOROUGH. The inspection of food at Queenborough, under the Unsound Food and Foreign Meat Regulations, during the first ten months of the year was carried out by Dr. E. V. Legge, the Assistant Medical Officer stationed at Sheerness, with the occasional assistance of an Inspector. During the last two months one of the Assistant Medical Officers attended on two nights a week. Large quantities of fresh meat from Flushing arrive at Queenborough daily, at about 6 p.m., and in order to avoid delay in forwarding same to its destination it is necessary that the inspection should be carried out immediately on arrival. The meat seized and destroyed on this station during the year was :— Pig-carcases 1 Pig-livers 610 Pig-lungs 4 Pig-spleens 1 Pig-plucks 16 Sheep-livers 363 Sheep-lungs 2 Sheep-plucks 5 Calf-livers 1 The total weight being 1 ton 0 cwts. 3 qrs. 25 lbs., all of which bore the Official Certificate of the Netherlands Government, as approved by the Local Government Board. A parcel consisting of " scrap meat" imported in contravention of the Regulations was re-exported. (See page 55.) 45 TABLE XXVI. Quantity and Description of Unsound Food Seized and Destroyed for the Year ending 31st December, 1913. Original packages. Sundry quantities by weight. Loose Articles. Approximate Total weight of Goods destroyed. MEAT— No. Description. Tons. cwts. qrs. lbs. No. Description. Tons. cwts. qrs. lbs. Fresh and Frozen— Beef- 223 quarters and crops ... ... ... ... 530 pieces 31 13 0 18 Mutton and Lamb 6,807 carcasses ... ... ... ... 227 „ 134 5 3 14 Veal, Pork and Offal 2,883 various ... ... ... ... 10,033 various 69 19 2 16 Preserved— Tinned 41 cases ... ... ... ... 113 tins 1 14 3 22 Smoked and Salted 65 casks,&c. ... 1 3 4 12 hams 14 0 0 21 Sundry 30 various ... ... ... ... ... ... 0 14 2 13 RABBITS— Frozen 80 crates ... ... ... ... 86 rabbits 2 1 0 14 Tinned ... ... ... ... ... ... 1,029 tins 0 18 1 14 POULTRY and GAME— Frozen 6 cases ... ... ... ... 10 various 0 2 2 26 FISH— Preserved, Dried 115 various ... ... ... ... ... ... 1 17 0 0 „ Tinned and Bottled 2 cases ... ... ... ... 913 tins, &c. 0 7 2 2 „ Frozen 1 cask ... ... ... ... ... ... 0 3 0 12 Wet 2,228 boxes ... ... ... ... ... ... 260 14 1 12 FRUIT— Fresh 2,874 various ... 12 2 24 ... ... 93 18 3 19 Preserved, Dried 12,085 various ... ... ... ... ... ... 449 10 0 16 „ Tinned and Bottled 49 cases, &c. 12 0 0 0 416 tins 15 11 1 16 „ Jam and Marmalade 2 cases ... ... ... ... 68 tins 0 2 2 25 VEGETABLES— Fresh 215 bags, &c. ... ... ... ... ... ... 9 0 0 0 Preserved, Dried ... ... ... 1 23 166 tins 0 9 1 19 NUTS Whole 11,380 bags ... ... ... ... ... ... 571 17 2 0 Sundry 1 case ... ... ... ... ... ... 0 1 2 0 PROVISIONS— Tea 93 cases ... ... ... ... ... ... 5 5 1 11 Coffee 34 bags ... ... ... ... ... ... 2 15 0 0 Cocoa ... ... ... ... ... ... ... ... ... ... ... ... Butter, Cheese, Lard, Margarine 3 cases 1 1 0 19 17,753 cheese 553 11 2 26 Condensed Milk 1,979 cases ... ... ... ... ... ... 40 0 3 6 Prepared Foods 100 cases ... ... ... ... ... ... 4 7 2 0 Biscuits and Confectionery 1,423 cases ... ... ... ... ... ... 27 15 1 17 Sugar ... ... ... ... ... ... ... ... ... ... ... ... GRAIN— Wheat, Maize, Barley, Rice, &c. ... ... 161 5 1 19 ... ... 161 5 1 9 MEAL and FLOUR ... ... 1 7 1 17 ... ... 1 7 1 17 CONDIMENTS and SPICES ... ... ... ... ... ... ... ... ... ... ... ... EGGS 4½ cases ... ... ... ... ... ... 0 7 0 0 DRUGS ... ... ... ... ... ... ... ... ... ... ... SUNDRIES 50 cases, &c. ... ... ... ... 228 bottles 2 0 3 10 Total 42,673 various 176 14 3 22 31,584 Various 2,458 0 2 21 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 „ „ „ 1912 3,758 7 1 2 „ „ „ 1913 2,458 0 2 21 46 TABLE XXVII. 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 cwt. qrs. 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 0 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 1912 58 3 0 3 14 3 2 3 Pork and Veal— 5 17 3 17 3 2 2 16 108 11 3 6 7 14 2 13 Offal— 19 10 0 10 1913 31 13 0 18 134 5 3 14 Pork and Veal— 1 14 3 22 14 14 3 6 252 8 1 20 0 16 1 2 Offal— 69 3 1 14 Total for nine years 2,117 17 2 . 6 787 19 0 16 341 9 2 16 37 2 2 4 121 4 3 19 3,405 13 3 5 47 TABLE XXVIII. The following Table* shows the number of carcases of Frozen Mutton and Lamb imported into the Port of London from Australia, New Zealand and South America since the commencement of the trade in the year 1880. Year. Australia. New Zealand. South America. Total No. of carcase*. 1880 400 — — 400 1881 7,275 — — 7,275 1882 57,256 8,839 — 66,095 1883 63,733 120,893 17,165 201,791 1884 111,745 412,349 108,823 632,917 1885 95,051 492,269 190,571 777,891 1886 66,960 655,888 331,245 1,054,093 1887 88,811 766,417 242,903 1,098,131 1888 112,214 939,231 169,282 1,220,727 1889 86,547 1,068,286 167,936 1,322,769 1890 207,984 1,533,393 124,413 1,865,890 1891 334,684 1,894,105 160,340 2,389,129 1892 449,488 1,505,377 166,508 2,121,373 1893 636,917 1,821,595 109,808 2,567,820 1894 939,360 1,947,609 171,802 3,058,771 1895 969,943 2,412,331 142,038 3,542,312 1896 1,565,360 2,211,895 245,573 4,022,828 1897 1,338,964 2,703,845 161,744 4,204,553 1898 1,238,653 2,784,101 201,895 4,224,649 1899 1,189,563 3,250,100 239,703 4,679,366 1900 906,766 3,157,060 271,432 4,335,258 1901 1,194,157 3,334,119 342,525 4,770,801 1902 649,929 3,668,061 411,913 4,729,903 1903 449,090 4,566,257 650,004 5,665,351 1904 413,322 3,695,088 746,096 4,854,506 1905 1,190,584 3,479,757 1,102,282 5,772,623 1906 1,839,677 3,818,506 932,986 6,091,169 1907 1,762,047 4,353,088 1,002,403 7,117,538 1908 1,214,753 3,833,012 1,435,137 6,482,902 1909 1,583,928 4,587,217 1,258,007 7,429,152 1910 2,634,274 4,842,959 1,095,555 8,572,788 1911 2,330,572 4,513,457 1,126,303 7,970,332 1912 1,545,917 4,839,401 1,305,419 7,690,737 1913 2,381,357 5,092,054 865,703 8,339,114 BEEF. 1,996,105 quarters of beef from Australia, New Zealand and South America were imported into the Port of London during the year, compared with 2,028,497 in the year 1912, and represented 35.6 per cent. of the total quantity imported into the United Kingdom from those countries. Of the total quantity landed in the Port of London 31 tons 13 cwts. 0 qrs. 18 lbs., were seized by your officers as unfit for human food, and comprised 233 quarters and crops and 53 pieces, 8 tons 10 cwts. was the largest quantity seized on any ship. * Extracted with other particulars of Colonial Imports from Meat Trade Returns published by W. Weddel and Co., Ltd., 17, St. Helen's Place, E.G. 48 MUTTON AND LAMB. The carcases of frozen mutton and lamb from Australia, New Zealand and South America, landed in the Port of London during the year, totalled 8,339,114, against 7,690,737 in 1912, and represented 64.38 per cent. of the whole quantity landed in the United Kingdom from those countries. 134 tons 5 cwts. 3 qrs. 14 lbs., comprising 6,807 carcases and 227 pieces, were seized as unfit for human food, being upwards of 120 tons in excess of the previous year's seizures. The largest quantity seized on any vessel was 102 tons 9 cwts. 1 qr. 14 lbs., representing 5,295 carcases, and sundry pieces which arrived in bad condition on a vessel which had been in collision off the coast of Spain. The s.s. "Tainui," from New Zealand, arrived in the Port of London on the 5th June, having been in collision off the coast of Spain. The contents of No. 1 Hold, which contained 22,000 carcases of mutton, were thrown overboard in the Bay of Biscay. Some water had got into No. 2 Hold, and on discharging the vessel in the Royal Albert Dock, 5,289 carcases and 36 cwts. of pieces of mutton, 94 crates of kidneys, and 6 crates of sweetbreads were found unfit for human food, and were seized and destroyed. Considerable quantities of fresh mutton and lamb also arrived from the Continent, but in no instance was it found necessary for your officers to seize any. PORK. On the whole the pork imported was found to be in good condition. Although large quantities were imported, only four carcases were seized, and they were found to be affected with tuberculosis. Particulars of these appear in Table XXXIII. In addition to the above, 6 pieces, forming part of a ship's stores, and 85 pieces on a vessel which returned to the port in a damaged condition, were seized as unfit for human food and destroyed. The total weight was 16 cwts. 0 qrs. 26 lbs. PIG-CARCASES FROM CHINA. The s.s. "Brodstone," from Hankow, arrived on the 21st March with 880 pig-carcases for delivery in London. 49 The importers decided ultimately to take the carcases to Liverpool for which port the vessel sailed, with the carcases on board, on the 2nd April, the Medical Officer of Health for Liverpool being notified of the fact. OFFAL. This class of meat imports makes great inroads upon the time of your officers. The goods arrive in considerable quantities, are usually packed in boxes, crates or bags, and much arrives in a frozen condition, which necessitates the thawing out of the meat before a thorough examination can be made. The total quantity seized amounted to 69 tons 3 cwts. 0 qrs. 14 lbs., being nearly 50 tons in excess of the quantity seized the previous year, and was made up as follows:— Tons. Cwts. Qrs. Lbs. Livers, Ox—24 boxes, 21 crates, 8 bags, 222 loose 2 5 2 15 „ Calf—1 bag, 12 loose 0 1 0 6 „ Sheep—1 crate, 19 boxes, 4,495 loose 2 5 0 8 „ Pig—610 loose 0 15 1 26 Kidneys —290 crates, 28 cases, 23 bags, 984 boxes 11 0 1 13 Sweetbreads —26 crates, 7 boxes, 1 bag 1 7 0 13 Hearts, Ox—292 cases, 10 bags, 59 loose 7 9 1 5 „ Sheep—15 bags 0 7 3 1 Plucks, Ox—2 „ 0 1 0 14 „ Sheep—626 0 17 0 4 „ Pig—16 0 0 1 20 Lungs, Sheep—11 0 0 0 12 „ Pig—4 0 0 0 9 Tongues, Ox and Calf—178 crates, 9 bags, 3,853 loose 18 11 3 0 Cheeks, Ox—509 cases, 2 baskets, 48 bags, 3 loose 14 14 2 17 Tripe —31 bags, 7 boxes 1 0 0 1 Tails, Ox—184 cases, 143 crates, 9 bags, 19 loose 8 0 2 7 Calves' Heads—5 0 0 1 23 Weasands —9 bags 0 4 2 5 Sundries —4 „ 0 0 2 1 Total weight 69 3 0 14 50 The following table shows the result of the examination of some consignments of Livers. TABLE XXIX. Date. Name of Vessel. Where from. Where lying. No. of diseased or unsound livers seized. Percentage of whole consignment 1913. OX-LIVERS. Feb. 26 s.s. "Highland Pride" Argentina Royal Albert Dock 38 47.5 March 11 s.s. "Highland Warrior" Ditto Ditto 58 72.5 24 s.s. "Niwaru" Australia Ditto 19 63.3 July 21 s.s. "Gulf of Venice " Argentina Ditto 29 boxes 18.23 Nov. 8 s.s. "Rotorua" New Zealand... Ditto 8 40 SHEEP-LIVERS. March 11 s.s. " Anglian " Boston Royal Albert Dock 587 52 24 s.s. " Cambrian " Ditto Ditto 1,007 84.62 April 29 s.s. "Kingstonian" Ditto Ditto 16 boxes 32 29 s.s. "Star of Scotland" Australia Ditto 208 29 s.s. "Suffolk" Ditto Ditto 175 28 May 9 s.s. "Argyllshire" Ditto Ditto 360 60 Oct. 21 s.s. "Argyllshire " Ditto Ditto 818 30 Nov. 18 s.s. "Pera" Ditto Ditto 517 22.4 Dec. 2 s.s. "Suffolk " Ditto Ditto 403 VEAL. Only one piece of veal, weighing 4 lbs., was seized as unfit for food. On the 23rd October, 2 calf-carcases, forming part of a consignment which arrived at Queenborough from Flushing, were found to fall below the minimum weight, namely 471/3 lbs., fixed by the Netherlands Government, for carcases of calves without the head, skin and abdominal intestines, intended for export in Great Britain and Ireland. A Notice was therefore served upon the importers, under Art. III (5) of the Public Health (Foreign Meat) Regulations, 1908, forbidding the removal of the meat for any purpose other than exportation. The meat was returned to the port of shipment. TINNED MEATS. The tinned meats seized and destroyed comprised:— Weight. Tons. Cwts. Qrs. Lbs. Beef—85 tins „ 0 0 3 19 Sausages—24 cases „ 0 12 1 8 Galantines—4 cases „ 0 3 2 4 Sundry—13 cases and 28 tins „ 0 18 0 19 Total „ 1 14 3 22 51 SMOKED AND SALTED. This class of meat, destroyed as unsound, consisted of:— Weight. Tons. Cwts. Qrs. Lbs. Salt beef—78 casks and sundry pieces „ 13 10 1 23 Hams—4 boxes and 12 loose „ 0 4 0 19 Bacon—3 boxes „ 0 5 2 7 Sundries—27 bags and 3 cases „ 0 14 2 13 Total „ 14 14 3 6 RABBITS (Frozen). The condition in which frozen rabbits arrive in this country has shown a marked improvement in recent years. Only 80 crates and cases and 86 loose rabbits, weighing 2 tons 1 cwt. 0 qrs. 14 lbs., were seized during the year under review. RABBITS (Tinned). Seizures of tinned rabbits was limited to two consignments, and resulted in 1,029 tins being found as unfit for food, and destroyed, the total weight being 18 cwts. 1 qr. 14 lbs. POULTRY AND GAME. Almost the whole of the goods seized under this heading were seized on vessels "outward bound," which had returned to the port in a damaged condition. The goods were contaminated with sea water, &c., and putrid. The weight amounted to 2 cwts. 2 qrs. 26 lbs. FISH. The considerable increase shown under this heading is due to a cargo of herrings in boxes, which arrived in bad condition. The total quantity seized and destroyed included:— Tons. Cwts. Qrs. Lbs. Wet—2,228 boxes herrings 260 14 1 12 ,, 1 cask salted salmon 0 3 0 12 Dried—79 boxes, 22 baskets, 12 bags, 11 parcels 1 17 0 1 Tinned—Lobster 304 tins 0 2 2 0 „ Salmon 387 „ 0 3 1 23 „ Herrings 19 „ 0 0 0 19 „ Sardines 187 „ 0 1 0 0 „ Sea-ears 16 „ 0 0 0 16 „ Sundries 2 cases 0 0 1 0 Total 263 1 3 27 52 FRUIT (Green). There has been a slight falling off of goods seized under this heading, which were as follows:— Apples—160 barrels, 42 boxes, 12 cwts. loose Tons. Cwts. Qrs. Lbs. 11 17 0 12 Bananas —1,819 crates 63 7 3 0 Grapes—134 barrels, 25 boxes 4 7 3 7 Lemons—3 boxes 0 3 0 0 Mangoes—4 cases 0 1 1 0 Melons—3 casks 0 2 4 0 Oranges—7 boxes, 1 case and some loose 0 7 2 24 Peaches—4 cases 0 1 0 0 Pears—14 barrels, 609 boxes and 11 trays 12 3 3 18 Plums—14 baskets, 4 cases 0 4 3 0 Tomatoes—17 crates 0 12 3 0 Sundries—2 boxes 0 1 0 0 Total weight 93 18 3 19 FRUIT (Dried). Although the quantity of these goods condemned as unfit for human food was more than three times that of the previous year, it will be of interest to know that a large proportion proved to be of some commercial value, as in the case of the dates, the greater portion were allowed to leave the district under a suitable guarantee for the manufacture of vinegar, and the Medical Officers of Health of the districts to which the goods were proceeding were duly informed of the facts. The quantities of goods condemned were:— Tons. Cwts. Qrs. Lbs. Currants—2 boxes 0 1 0 0 Dates—104 cases, 4,017 mats, 9 bags, 7,380 boxes 432 15 3 7 Figs—112 cases, 150 bags, 115 boxes 12 18 2 9 Plums—50 boxes 0 12 0 0 Raisins—10 bags, 11 boxes 0 18 2 0 Sultanas—85 boxes 1 14 1 0 Sundry—40 boxes 0 10 0 0 Total weight 449 10 0 16 FRUIT (Tinned and Bottled). Within the last few years the condition in which this class of goods has arrived has greatly improved, and of the total quantity condemned about 12 tons were rejected by the owners and seized by Officers of the Port Sanitary Authorities to prevent sale to small buyers. 53 The goods seized and destroyed included :— Tons. Cwts. Qrs. Lbs. Apple pulp—3 kegs Apricot pulp—12 cases and 171 tins 1 5 3 10 Black-currant pulp—118 tins 0 10 1 22 Orange pulp—17 cases 0 15 1 0 Strawberry pulp—41 tins 0 3 2 18 Tomatoes—14 cases and 8 tins 0 7 2 24 Sundries 12 7 0 8 Total weight 15 11 1 26 FRUIT, PRESERVED (Jam and Marmalade). Only two cases and 68 jars of jam, weighing 2 cwts. 2 qrs. 25 lbs., were destroyed as unfit for food. VEGETABLES. Fresh— Tons. Cwts. Qrs. Lbs. Onions—23 bags, 14 boxes 1 17 0 0 Potatoes—108 bags, 70 boxes 7 3 0 0 Dried— Beaus, peas, &c. 0 6 1 23 Tinned— Spinach—166 tins 0 2 3 24 Total weight 9 9 1 19 NUTS. As was the case in the previous year, the only goods appearing under this heading are: Tons. Cwts. Qrs . Lbs. Chestnuts—1,138 bags 571 17 2 0 Desiccated cocoanut—1 case 0 1 2 0 Total weight 571 19 0 0 PROVISIONS. The tea, coffee, cheese and chocolate, included in the following list were mostly rendered unfit for food owing to damage received as a result of accidents to the vessel in which they were carried. The tea was subsequently used for the extraction of caffeine. With regard to the condensed milk, 1,219 cases, weighing 23 tons 10 cwts. 1 qr., 18 lbs., were destroyed, 399 cases, weighing 8 tons 15 cwts. 1 qr. 16 lbs., were used for pig or poultry food, and 361 cases, weighing 7 tons 15 cwts. were released for confectionery purposes. 54 The milk used for pig or poultry food and confectionery purposes was only allowed to leave the district of the Port Sanitary Authority after your Medical Officer of Health had received a satisfactory guarantee respecting the same, and the Medical Officers of Health of the districts to which the goods were proceeding were furnished with full particulars:— Tons. Gwts. Qrs. Lbs. Tea—93 packages 5 5 0 11 Coffee—34 bags 2 15 0 0 Cheese—3 cases, 18,113 loose, and a quantity of trimmings 554 3 2 5 Milk, Condensed—1,979 cases 40 0 3 6 Milk, Concentrated—100 cases 4 7 2 0 Chocolate—1,423 cases 27 15 1 17 Total weight 634 7 1 11 GRAIN. The greater portion of the grain seized as unfit for human food was subsequently released under a guarantee for poultry or animal food, and notifications were sent to the Medical Officers of Health of the districts to which it was being taken. The total quantity dealt with during the year was:— Tons. Cwts. Qrs. Lbs. Wheat 119 12 1 1 Maize 7 14 1 14 Barley 2 4 1 8 Rice 17 14 0 12 Oats 3 17 0 25 Sundries 7 13 2 15 Total weight 158 15 3 19 MEAL AND FLOUR. The quantity seized was 1 ton 7 cwts. 1 qr. 17 lbs. and this was dealt with in the same way as the grain. EGGS. 6,480 eggs, contained in 4½ cases, were destroyed, the weight being about 7 cwts. SUNDRIES. Included under this heading are:— Tons. cwts. qrs. lbs. Anchovy Sauce—8 cases 0 5 0 0 Gelatine—1 case 0 1 2 0 Macaroni—5 boxes 0 1 1 0 Pickles—22 cases and 228 bottles 0 8 1 24 Tapioca—1 case 1 2 0 0 Various—3 cases 0 2 2 14 Total weight 2 0 3 10 55 SCRAP MEAT. On the arrival of the s.s. "Koningin Regentes" at Queen borough on the 17th June, the meat cargo was inspected in the usual way, when it was found that one basket (part of a consignment of 58 baskets, manifested as offal) contained scrap meat. Although scrap meat is an illegal importation, the package bore the official certificate of the Government of the Netherlands. A notice, as required by Article III. (5) of the Public Health (Foreign Meat) Regulations, 1908, was served upon the importer, and the meat was returned to the port of shipment. The facts were brought to the notice of the Consul-General to the Netherlands. TABLE XXX. 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 meat:— Date of Arrival. Name of Vessel. Where from. Where lying. Description and quantity of foreign meat in respect of which Notices were served. 1913. Jan. 15 s.s. "Anglian" Boston Royal Albert Dock 2 pig carcases. June 17 s.s. "Koningin Regentes " Flushing - Queen borough 1 basket scrap meat. Oct. 23 s.s. "Koningin Wilhelmina" Do. Do. 2 calf carcasses. The s.s. "Turakina," from New Zealand, arrived in the Port of London on the 14th May, 1913. The vessel caught fire at Rio de Janeiro, and was beached and flooded with water. The cargo comprised, inter alia, 50,000 carcases of mutton, about 900 tons of butter, and about 14,000 crates of cheese. Most of this cargo was under water. The carcases of mutton were removed from the vessel at Rio de Janeiro, taken to sea and thrown overboard. The butter and the cheese were brought to London in the vessel. Much of the butter had been melted, and had to be dug out of the ship's hold. The Port of London Authority could not take it into their warehouse, so it was allowed to proceed to two riverside wharves to be dealt with under the supervision of the Medical Officers of Health in whose districts the wharves are situated. About 5,000 crates of the cheese (3,000 of which were brought to London in the s.s. "Catalina") were sorted under the supervision of your officers, with the result that 552 tons were destroyed as unfit for human food. 56 TABLE XXXI. PUBLIC HEALTH (FOREIGN MEAT) REGULATIONS, 1908. During the year Certificates were issued under Article III. (5) of the above-mentioned Regulations in respect of the undermentioned meat:— Date. Name of Vessel. Where from. Where lying. Description and quantity of foreign meat in respect of which Certificates were issued. 1913. Jan. 4 s.s. "Pataro" Campana Royal Victoria Dock. 180 bags ox-cheeks. „ 8 s.s. " Rubis " Ostend Tilbury Dock 2 bales bacon. „ 13 s.s. " Lancastrian Boston Royal Albert Dock. 300 pig-carcases. „ 14 s.s. " Highland Glen " Argentina Ditto 100 bags ox-cheeks. „ 18 s.s. "Anglian" Boston Ditto 297 pig carcases. „ 22 s.s. "Highland Piper " Argentina Ditto 300 bags ox-cheeks. „ 29 s.s. "Pardo" Ditto Royal Victoria Dock. 200 bags ox-cheeks. „ 31 s.s. "Nerehana " Australia Ditto 132 pig-carcases. Feb. 3 s.s. "Cambrian" Boston ... Royal Albert Dock. 297 pig-carcases. 5 s.s. "Marere" New Zealand Royal Victoria Dock. 15 crates ox-cheeks. „ 12 s.s. "Highland Loch" Argentina Royal Albert Dock. 240 bags ox-cheeks. „ 13 s.s. "Topaze" Ostend Tilbury Dock 1 bale bacon. „ 18 s.s. " Highland Pride " Argentina Royal Albert Dock. 40 cases ox-cheeks. „ 26 s.s. "Highland Warrior" Ditto Ditto 120 bags and 40 cases oxcheeks. „ 26 s.s. "Otaki" New Zealand Royal Victoria Dock. 5 crates ox-cheeks. Mar. 3 s.s. "Highland Brae" Argentina Royal Albert Dock. 202 cases ox-cheeks. „ 5 s.s. "Rubis" Ostend Tilbury Dock 1 bale bacon. „ 10 s.s. "Paparoa" New Zealand Royal Victoria Dock. 4 crates ox-cheeks. „ 12 s.s. "Saphir" Ostend Tilbury Dock 2 packages bacon. „ 13 s.s. "Waiwera " New Zealand Royal Albert Dock. 23 pig-carcases. „ 15 s.s. "Highland Rover" Argentina Ditto 50 cases ox-cheeks. „ 27 s.s. "Highland Glen" Ditto Ditto 274 bags ox-cheeks. „ 27 s.s. "Highland Laddie" Ditto Ditto 80 crates ox-cheeks. „ 31 s.s. "Parana " Ditto Royal Victoria Dock. 180 bags ox-cheeks. April 1 s.s. "Parana" Ditto Ditto 200 bags ox-cheeks. „ 2 s.s. "Highland Piper" Ditto Royal Albert Dock. 427 bags and 20 cases oxcheeks. „ 8 s.s. "Highland Scot" Ditto Ditto 360 bags ox-cheeks. „ 9 s.s. "Topaze" Ostend Tilbury Dock 1 bale bacon. „ 12 s.s. "Anglian" Boston Royal Albert Dock. 400 pig-carcases. 57 Date. Name of Vessel. Where from. Where lying. Description and quantity of foreign meat in respect of which Certificates were issued. 1913. April 15 s.s. " Highland Corrie" Argentina Royal Albert Dock. 50 cases and 200 bags oxcheeks. „ 16 s.s. "Rubis" Ostend Tilbury Dock 2 bales bacon. „ 22 s.s. "Highland Loch " Argentina Royal Albert Dock. 50 cases ox-cheeks. „ 27 s.s. "Kaikoura " New Zealand Royal Victoria Dock. 11 crates ox-cheeks. „ 29 s.s. "Highland Pride " Argentina Royal Albert Dock. 440 bags and 50 cases oxcheeks. „ 30 s.s. " Topaze " Ostend Tilbury Dock 2 bales bacon. May 7 s.s. "Rubis" Ditto Ditto 1 package bacon. „ 11 s.s. "Highland Brae" Argentina Royal Albert Dock. 500 bags ox-cheeks. „ 24 s.s. " Highland Rover" Ditto Ditto 10 crates and 120 bags oxcheeks. „ 28 s.s. "Limerick" Australia Royal Victoria Dock. 84 bags ox-cheeks. June 4 s.s "Highland Glen" Argentina Royal Albert Dock. 100 bags and 183 cases oxcheeks. „ 9 s.s. "Highland Piper" ... Ditto Ditto 50 crates and 800 bags oxcheeks. „ 13 s.s. "Pardo" Ditto Royal Victoria Dock. 120 bags ox-cheeks. „ 16 s.s. "Highland Scot" Ditto Royal Albert Dock. 50 crates and 300 bags oxcheeks. „ 18 s.s. " Koningin Regentes " Flushing Queen borough 57 packages offal. „ 21 s.s. "Highland Laddie" Argentina Royal Albert Dock. 500 bags ox-cheeks. ,, 25 s.s. "Saphir" Ostend Tilbury Dock 2 bales bacon. „ 28 s.s. " Highland Corrie " Argentina Royal Albert Dock. 300 bags ox-cheeks. July 16 s.s. "Rubis" Ostend Tilbury Dock 1 bale bacon. „ 23 s.s. "Highland Warrior" Argentina Royal Albert Dock. 100 bags ox-cheeks. „ 24 s.s. " Highland Pride" Ditto Ditto 50 cases and 395 bags oxcheeks. „ 28 s.s. "Dorset" Australia Royal Victoria Dock. 84 bags ox-cheeks. Aug. 6 s.s. "Rubis" Ostend Tilbury Dock 1 package bacon. ,, 13 s.s. "Rubis" Ditto Ditto 1 package bacon. „ 18 s.s. "Shropshire" Australia Ditto 116 bags ox-cheeks. „ 19 s.s. "Durham " Ditto Royal Victoria Dock. 202 packages ox-cheeks. „ 21 s.s. "Paparoa" New Zealand ... Ditto 588 pig-carcases. Sept. 3 s.s. " Sussex " Australia Ditto 214 bags ox-cheeks. „ 17 s.s. "Topaze" Ostend... Tilbury Dock 2 bales bacon. „ 18 s.s. “Marmari" New Zealand Royal Albert Dock. 1,225 bags boned beef. Oct. 8 s.s. "Topaze" Ostend Tilbury Dock 3 packages bacon. „ 22 s.s. " Rubis " Ditto ... Ditto 3 bales bacon. „ 23 s.s. “Koningin Wilhelmina" Flushing Queen borough 21 carcases veal. „ 27 s.s. "Kumara" New Zealand Royal Albert Dock. 16 pig-carcases. 58 Date. Name of Vessel. Where from. Where lying Description and quantity of foreign meat in respect of which Certificates were issued. 1913. Oct. 28 s.s. "Saphir " Ostend Tilbury Dock 2 bales bacon. Nov. 5 s.s "Pera" Australia Royal Albert Dock. 112 bags boned beef. Dec. 1 s.s. " Cambrian" Boston Ditto 200 pig-carcases. „ 4 s.s. " Rubis " Ostend Tilbury Dock 3 bales bacon. „ 10 s.s. "Rubis" Ditto Ditto 1 basket ox-cheeks, 1 basket ox - hearts, 2 baskets sheep-plucks. „ 12 s.s. "Kingstonian " Boston Royal Albert Dock. 499 pig-carcases. „ 17 s.s. "Topaze " Ostend Tilbury Dock 2 baskets ox-hearts, 1 basket sheep-plucks. „ 18 s.s. "Saphir" Ditto Ditto 1 bale bacon. „ 24 s.s. "Anglian " Boston Royal Albert Dock. 500 pig-carcases. Special attention was also given to ox-tongues which arrived from Australia, and the following table shows the results of the examinations of various consignments:— TABLE XXXII. Date of arriyal. Name of Vessel. Number of Tongues. Percentage of Consignment. Examined. Found Diseased. 1913. Nov. 15 s.s. "Kent" 60 Nil. — „ 16 s.s. "Waimana" 662 32 4.8 „ 16 s.s. "Suffolk" 58 5 31 Dec. 7 s.s. "Demosthenes" 72 1 1.38 „ 14 s.s. "Rangatira" 120 Nil. — „ 14 Ditto 1,247 71 5.69 „ 15 s.s. "Palermo" 313 Nil. — „ 15 s.s. "Roscommon" 60 Nil. — „ 15 Ditto 120 Nil. — „ 19 s.s. "Otranto " 120 Nil. — „ 28 s.s. "Westmeath" 120 Nil. — Where two entries appear under the name of the above vessels the figures relate to consignments of different marks. 59 ACTINOMYCOSIS IN OX-TONGUES IMPORTED FROM THE ARGENTINE. At the end of July, I received information from the Local Government Board that certain tongues which had been imported from the Argentine Republic had been found to contain lesions of Tuberculosis and Actinomycosis. A preliminary examination of some imported tongues, disclosed evidence of disease which resembled Tuberculosis and Antinomycosis; this was chiefly situated in the lymphatic glands, but in some cases the blades of the tongues were found to be infected. Microscopic examination showed that the lesions were those of Antinomycosis, though they presented to the naked eye appearance similar to those of Tuberculosis. An examination was made of a number of tongues in order to ascertain whether they were infected with Tuberculosis, but in no instance could the tubercle bacillus be detected. The following tables show the number of tongues examined each month, and at the end of the year the percentage of tongues rejected:— Month. Number of Ox-Tongues Examined. Number rejected as Diseased. 1913. August 15,250 688 September 32,045 1,961 October 11,482 768 November 4,098 186 December 12,987 681 Totals 75,862 4,284 Percentage found diseased 5.64 Examination of Ox-tongues from Argentina. The following table gives details of the examination by Officers of the Port Sanitary Authority of the various consignments of ox-tongues:— Date of Arrival. Name of Vessel. Number of Tongues. Percentage of Consignment. Examined. Found Diseased. 1913. Aug. 2 "Highland Rover" 2,004 102 5.08 Ditto 2,112 116 5.48 Ditto 7,180 212 2.95 „ 8 "Highland Glen" 3,000 240 8.0 Ditto 804 75 9.32 Ditto 6,000 367 6.11 „ 16 " Highland Piper" 3,599 128 3.55 Ditto 876 87 9.93 Ditto 5,966 375 6.28 Carried forward 31,541 1,702 60 Date of Arrival. Name of Vessel. Number of Tongues. Percentage of Consignment. Examined. Found Diseased. 1913. Brought forward 31,541 1,702 Aug. 22 " Highland Scot " 2,832 171 6.03 Ditto 876 67 7.64 Ditto 8,000 436 5.45 „ 29 " Highland Laddie " 2,400 150 6.25 Ditto 468 72 13.24 Ditto 6,500 420 6.46 Sept. 6 " Highland Corrie 936 43 4.59 „ 21 " Highland Pride " 1,812 143 7.89 Ditto 720 43 5.97 „ 26 " Highland Warior " 144 13 9.02 Ditto 624 22 3.52 Oct. 11 " Highland Rover " 1,092 92 8.4 „ 25 " Highland Piper " 832 43 5.16 Nov. 1 Per rail from Liverpool 9,200 545 5.92 „ 14 "Highland Corrie" 3,698 82 2.37 „ 30 " Highland Pride " 3,011 197 6.54 Dec. 13 " Highland Brae " 1,176 53 4.5 75,862 4,284 5.64 More than one entry against various vessels refer to separate consignments of different marks. This formed the subject of a conjoint report by the Medical Officer of Health for the City of London and myself, dated October 28th, 1913, and the following information was embodied in the Report, which was forwarded to the Local Government Board:— 1. The number of instances in which evidence of disease was observed among Tongues received at the Port and City of London. 2. The conclusion therefrom, viz., that the condition chiefly observed is obviously widespread in South America, and that the supervision exercised to prevent the exportation of such affected organs is inadequate in respect of this particular matter. 3. The necessity which exists, in the interests of meat inspection work coming within your jurisdiction, that these matters should receive attention with as little delay as possible. So long as the present condition exists the time of your staff will be unduly taken up by this work to the possible detriment of inspection work in other directions, Although we have always been prepared to assist to the utmost of our powers in elucidating any new problems which 61 come under observation, we are of opinion that when once the position has been clearly defined, the work of sorting and of preventing unsound food reaching this country should be the primary duty of the exporting firms. The responsibilities of your own staff should be restored as soon as possible to normal conditions, which are to ensure that all food stuffs on arrival are sound, free from disease, and fit for human consumption. 4. The observation that a large percentage of the tongues are affected with Actinomycosis in the glands alone, and unless these glands remain attached to the roots of the tongues, it will be impossible in such cases to state whether the tongues have come from animals infected with Antinomycosis. We, therefore, feel strongly that regulations should be framed rendering the importation of tongues without the roots and glands attached liable to re-exportation. 5. The question of Actinomycosis as affecting cattle, and even the prevalence of the disease in general, does not appear to us, after a review of the literature on the subject, to have been adequately investigated, and we beg respectfully to suggest that it is a matter on which further research work might be undertaken with advantage. The tongues arrived in boxes containing 12 in each, these were frozen hard, and it was necessary to defrost them until they were soft enough. This was done by laying them out 24 to 48 hours previously. The work was extremely monotonous, and during the winter months was performed in a store, the temperature of which was about the freezing point, and the handling of the cold tongues was positively painful. Nevertheless, the examination was performed by the Inspectors and Assistant Medical Officer, loyally and willingly, and I desire to express my appreciation of the valuable services rendered by them under conditions involving, to say the least, extreme personal discomfort. TABLE XXXIII. The following is a list of pig-carcases found during the year to be affected with Tuberculosis. They were seized as unfit for food and destroyed:— Date. Name of Vessel. Where from. Where lying. Number of Carcases. 1913. Feb. 6 s.s. "Cambrian " Boston Royal Albert Dock 3 Dec. 11 s.s. "Prins Hendrik" Flushing Queenborough 1 The United States Department of Agriculture have issued the following instructions with regard to meat imported into the United States of America after transhipment in a foreign country :— "Referring to the foreign inspection certificates which are required to accompany "meat and meat food products imported into the United States, instructions are issued "as follows:— "In the case of shipment through another foreign country, with the meat "or meat food product thus transhipped there shall be presented to the Bureau "inspector the original certificate from the country of origin, or a certified copy 62 "thereof, together with a transhipment certificate signed by an authorised "official of the Government of the foreign country through which the produce "is transhipped. The transhipment certificate shall show the identity of such "meat or meat food product, and that the same has been examined and inspected "and not found to be unsound, unhealthful, unwholesome, or unfit for human "food, and that at the time of exportation from the country through which the " product was transhipped, the same contained no dye, chemical, preservative, or "other ingredient not permitted by the regulations governing the meat inspection "of the United States Department of Agriculture." During the year three consignments of foreign meat, intended for shipment to the United States of America, were examined by your Officers, namely— 12th June 40 hind-quarters of beef. 12th June 200 „ „ „ „ 13th December 1,486 quarters ,, ,, My practice on receiving a request to examine meat destined for exportation is, if possible, to see the original certificate from the country of origin, or a certified copy thereof, and to have each piece of meat examined carefully for evidence of unsoundness, disease, or other unhealthful condition. Each piece, after examination, has a piece of wire passed through it, and is clamped with an official seal, and the following is a specimen of the certificate used in respect of such consignments:— (1) FOR MEAT INTENDED FOR SHIPMENT TO THE UNITED STATES OF AMERICA. Date To I, Doctor Herbert Williams, Medical Officer of Health for the Port of London, hereby certify that quarters of beef, marked out of the s.s. from , which arrived in the Port of London on the have been this day examined and found in sound condition, and free from any appearance of disease. An official seal has been affixed to each quarter so examined, and each quarter bears the official certificate of the Government of the Argentine Republic. (Signed) Medical Officer of Health, Port of London. Four consignments were also examined for shipment to Switzerland, namely:— 29th October 150 carcases of mutton 30th „ 150 „ 4th November 100 „ „ „ 9th December 20 fore-quarters of beef and certificates issued in respect of same by your Medical Officer as follows:— 63 (2) FOR MEAT INTENDED FOR SHIPMENT TO SWITZERLAND. Certificate of Origin and Statement of Inspection of Meat for Transhipment of Fresh and Packed Meat Destined for Import into Switzerland. Country of Origin Place Name of Sender Designation of Goods Place of Destination Name of Consignee Signed for The Officer of Health charged officially with the examination of the meat in the Port of London, where the above designed goods are sent from, certifies that the are of sound condition and fit for consumption, and that this meat is of animals of the ovine or bovine species, sound and free from contagious and infectious diseases. The present truthful statement is made in London on the The Medical Officer Charged Officially with the Examination of Meat in the Port of London. (Signed), Medical Officer of Health, Port of London. SANITARY INSPECTION. The inspection of vessels and other premises by your Staff of Sanitary Inspectors has been well maintained at the customary standard. The total visits of inspection of all classes was 38,926, the average annual total for the past ten years being 37,672.9. Of the total 14,425 were of vessels from foreign ports, 20,681 of vessels coastwise, barges, &c., while 3,820 were of premises on shore within the docks. The Launches were employed on 12,939 inspections. Of the nationality of vessels inspected 56.67 per cent. of foreign arrivals were British, 14.05 per cent. Swedish and Norwegian, 10.87 per cent. German, and others in smaller proportion. (See Table XXXIV.) The total number of nuisances reported and dealt with was 3,719, involving 460 written intimations and 21 statutory notices ; in 2 cases legal proceedings were taken. The largest number of complaints was in respect of dirty crew's quarters, next in order of number being smoke nuisances. Foul bilges and peaks, defects of ventilation, lighting and heating, leaks, and insanitary conveniences form the bulk of the remainder. (See Table XXXV.) New sanitary works constructed under the supervision of your Officers is set out on Table XXXVII.) These works are carried out in accordance with plans previously deposited for the information of your Committee. There were 15 infringements of the Bye-laws reported in relation to offensive cargoes. In all cases a warning was given to the persons concerned, and in no case was any recurrence reported. (See Table XXXVIII.) 64 TABLE XXXIY. General Summary, and Analysis, of the Sanitary Inspections of Vessels, &c., in the Port of London, for the year ended 31st December, 1913. Foreign. Coastwise. Inland Navigation. Shore Premises. Sick Seamen referred to Hospital. Water Barges. Steam. Sail. Steam. Sail. Steam. Sail. Lighters (uninhabited). Canal Boats. Inspected. Defective. To be Cleaned. Inspected. Defective. To be Cleaned. Inspected. Defective. To be Cleaned. Inspected. Defective. To be Cleaned. Inspected. Defective. To be Cleaned. Inspected. Defective. To be Cleaned. Inspected. Defective. To be Cleaned. Inspected. Defective. To be Cleaned. Inspected. Defective. To be Cleaned. No. in District in good condition, 31st December, 1913. New Barges Condemned Use Discontinued No. In District Slat December, 1913. 13426 138 1394 999 1 81 3418 26 222 1343 13 78 300 2 35 12026 63 345 2491 16 187 602 52 18 3820 33 400 - 18 1 l 1 18 Total Inspections to 31st Docks and River No. Nationality. Arrived from Foreign Ports. No. of inspections Arrivals Per cent, of Total December, 1912 1,023,890 Total Inspections from 1st January to 31st December, 1913- St. Katharine's 1,227 American . 1 2 •01 Argentine - - — — London 2,085 Austrian - 25 47 •25 " Foreign" 14,425 Regent's Canal 567 Belgian - 352 375 3.61 " Coastwise " 4,762 Millwall 2,218 Brazilian _ - - - " Inland Navigation " 15,919 British† 5,512 8,496 56.67 West India 1,381 Chilian - - 1 - Premises on shore 3,820 Danish _ 303 455 3.11 Poplar 115 Dutch - 603 745 6.20 38,926 East India 674 Finnish _ 15 79 •15 Total 1,062,816 French 163 228 1.67 Victoria 2,697 German _ 1,058 1,472 10.87 Cleansing of Crew's Quarters, &c.:— Royal Albert 2,252 Greek - 3 12 •03 Italian _ 3 6 •03 Total to 31st December, 1912 67,542 Commercial 2,664 Japanese - 58 107 •59 Total No. of Vessels from 1st January to 31st December, 1913 - 2,360 Tilbury 1,884 Roumanian - — 6 — Russian - 208 293 2-13 Gravesend District 2,286 Siamese _ 5 7 •05 Total 69,902 River—*Upper District 6,380 Spanish - 49 63 •50 Swedish & Norwegian 1,367 2,031 14.05 Number of vessels inspected: — *Middle „ 4,761 - - - — In the Launches— *Lower „ 3,915 Portuguese - — — — " Lady Truscott" 2,791 " David Burnett " 2,637 Medway Nil. Uruguayan - - - - "Clotho" 3,904 Total vessels 35,106 Total vessels- 9,725 14,425 " Denton " 2,682 † Coastwise and Inland navigation 20,681 " George Briggs " 925 Shore premises 3,820 Shore premises 3,820 Total 38,926 Total 38,926 99.92 Total 12,939 In the Docks, &c. 22,167 *Upper District extends from Greenwich to Teddington. Total 35,106 *Middle „ „ „ Greenwich to Erith. •Lower „ „ „ Erith to outer limits of the Port of London. COMPARATIVE TABLE. Total number of Inspections ot vessels from— 1904. 1905. 1906. 1907. 1908. 1909. 1910. 1911. 1912. 1913. Yearly average for the 10 years ending 31st December, 1913. " Foreign " - 15,685 14,279 13,013 17,971 15,258 14,887 13,710 14,015 15,177 14,425 14,842.0 " Coastwise," " Inland Navigation," and other Inspections 19,700 19,975 22,335 19,414 20,014 25,469 24,857 24,009 28,035 24,501 22,830.9 Total 35,385 34,254 35,348 37,385 35,272 40,356 38,567 38,024 43,212 38,926 37,672.9 65 TABLE XXXV. NUMBER OF NUISANCES ON VESSELS REPORTED AND DEALT WITH during the year ending 31st December, 1913. Description of Nuisances. January. February. March. April. May. June. July. August. September. October. November. December. Totals. Smoke Nuisances:— Number of complaints received 31 16 23 14 25 48 54 4 10 22 25 32 304 Number of recurrences reported ... ... ... ... ... 1 ... ... ... ... ... 1 Offensive Cargoes (Bye-laws):— Number of Infringements reported 3 1 1 1 ... 1 1 1 2 ... •• 11 Structural and other Defects:— Ventilation 3 9 8 7 7 8 6 3 9 13 5 6 84 Lighting 9 16 8 4 6 3 4 3 6 6 3 3 61 Heating 8 10 8 4 2 ... 2 1 1 6 5 6 53 Bare iron in crew's quarters 1 3 ... 3 1 ... -••• 1 ... ... 1 1 11 Leaky decks, hawse-pipes, cable casings, &c. 11 4 8 11 5 2 8 5 2 4 4 5 69 Defective bulkheads and floors 3 4 1 1 2 3 1 1 5 ... ... ... 21 Sanitary conveniences 6 13 9 1 5 4 2 3 ... 7 4 5 59 Ship's gear or stores stowed in crew's quarters ... 1 ... 1 1 1 ... 1 ... ... ... ... 5 Foul bilges and peaks 35 6 14 7 3 8 6 ... 1 6 3 1 90 Storage of drinking water (dirty or defective tanks) 1 o o ... 1 1 ... ... ... 2 1 2 1 12 Dirty quarters 272 213 200 230 187 211 216 124 152 199 190 178 2,372 Accumulation of offensive matter 1 ... ... ... ... 1 ... ... ... ... 1 1 4 Miscellaneous Nuisances 3 10 4 1 4 3 2 3 5 12 10 9 66 Totals 387 299 283 286 250 293 302 150 194 278 253 248 3,223 Total number of vessels on which structural alterations were ordered 36 36 25 15 18 13 13 9 14 29 22 18 248 Total number of vessels on which structural alterations were reported as carried out 33 26 20 33 14 9 20 9 17 15 27 33 256 NUMBER OF NUISANCES IN THE RIVER REPORTED AND DEALT WITH during the year ending 31st December, 1913. From discharge of foul liquid, sewage, &c., into the River ... ... ... ... 2 ... 1 1 ... ... 1 1 6 Offensive condition of River water ... ... ... ... ... ... ... ... ... ... ... ... ... Totals ... ... ... ... 2 ... 1 1 ... ... 1 1 6 66 TABLE XXXYI. NUMBER OF NUISANCES ON SHORE PREMISES REPORTED AND DEALT WITH during the year endiDg 31st December, 1913. Description of Nuisances. January. February. March. April. May. June. July. August. September. October. November. December. Totals. Smoke Nuisances:— Number of complaints received 1 6 2 2 1 ... 1 1 ... 4 5 3 26 Number of recurrences reported ... ... ... ... ... ... ... ... ... ... ... ... ... Structural and other Defects:— Ventilation ... ... ... ... ... ... ... . . . ... ... ... ... ... Lighting ... ... ... ... ... ... ... ... ... ... ... ... ... Heating ... ... ... .... . . ... ... ... ... ... ... ... ... ... Dilapidations ... ... ... ... ... ... ... ... 1 1 1 1 3 Sanitary conveniences 4 ... 1 ... 1 1 2 1 1 2 5 ... 18 Water supply ... ... ... ... ... ... ... 1 2 ... 2 5 Dirty premises 55 38 26 43 44 29 42 13 12 38 57 16 413 Accumulation of offensive matter 3 ... ... ... ... ... ... ... ... 1 2 ... 6 Drainage 1 ... ... ... ... 1 ... ... ... ... 1 ... 3 Foul cesspits, latrines, &c. 3 ... 1 ... ... ... 1 ... ... 2 1 ... 8 Miscellaneous nuisances 4 ... ... 1 ... ... 1 ... 1 ... 1 ... 8 Totals 71 44 30 46 46 31 47 15 16 50 72 22 490 Number of shore premises on which structural alterations were ordered 6 1 1 1 1 3 1 2 3 6 3 28 Number of shore premises on which structural alterations were reported as carried out 2 ... 1 1 3 ... 1 ... 2 1 2 2 15 SUMMARY. Smoke. Structural. Offensive Cargoes. Sewage, Drainage, &c. Miscellaneous, Totals. Number of Nuisances reported— (a) On vessels 304 363 11 ... 2,545 3,223 (b On shore 26 26 3 435 490 (c) On the River ... ... ... 6 ... 6 Totals 330 389 11 9 2,980 3,719 Number of written Intimations— (a) On vessels 107 206 11 ... 105 429 (b) On shore 7 18 ... 2 ... 27 (c) On the River ... ... ... 4 ... 4 Totals 114 224 11 6 105 460 Number of Statutory Notices— (a) On vessels 14 5 I ... 1 21 (b) On shore ... ... ... ... ... (c) On the River ... ... ... ... ... ... Totals 14 5 1 ... 1 21 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 ... ... 1 ... ... 1 ... ... ... ... ... ... 2 Total number of cases in which legal proceedings were taken ... ... ... ... ... ... ... ... ... ... ... ... ... 67 TABLE XXXVII. Part I. Date completed. Works. 1913. Jan. 16 St. Katharine's Dock—Erection of water closets, &c., on Top Floor "C" Warehouse. April 24 East India Dock (Import)—Erection of water closet and urinal in South-East corner of No. 5 Warehouse, South Quay. May 6 West India Dock—Erection of new Labourers' Shelter and "Calling On " place, with sanitary conveniences in connection therewith. „ 10 Royal Albert Dock—Erection of water closets for Messrs. H. Grreen, Siley, Weir and Co., Ltd. „ 23 Poplar Dock—Construction of new drain from capstan pit, and roof rain water to existing main water drainage. June 25 St. Katharine's Dock—Alterations to convenience at No. 4a Yard. Oct. 23 Surrey Commercial Dock—Erection of additional sanitary accommodation in Steel Yard. Nov. 28 Surrey Commercial Dock—Erection of additional closets, &c., at Principal Office. Part II. Sanitary Works and alterations, not yet reported as completed:— Date Plan submitted. Works. 1913. Jan. 3 London Dock—Proposed new conveniences at Western Dock, North Quay. „ 24 Regent's Canal Dock—Proposed rain-water arrangements for Weighbridge Office at Lion Wharf. Feb. 21 Royal Albert Dock—Proposed erection of sanitary conveniences at the rear of Dockmaster's Office. April 4 Surrey Commercial Dock—Proposed conveniences at Swedish Yard. July 2 Surrey Commercial Dock (New Shod, Swedish Yard)—Proposed connection of rain-water drains with existing 18-inch brick drain, and ventilation of drain. „ 30 Millwall Dock—Proposed drain and latrine, North side of Boilerhouse. Aug. 2 St. Katharine's Dock (No. 2 Yard)—Proposed re-arrangement of sanitary conveniences. Sept. 2 Royal Albert Dock (Basin, North)—Proposed construction of two private closets, and seven closets for Lascars. „ 2 London Dock—Proposed construction of sanitary conveniences and drainage at New Jetty, Western Dock. „ 20 Royal Albert Dock—Proposed sanitary accommodation for women. Nov. 19 Royal Victoria Dock—Proposed sanitary conveniences at Messrs. Cory's New Offices, Pier Head. „ 21 Surrey Commercial Dock—Proposed drainage in connection with Railway Yard. Dec. 23 Royal Albert Dock—Proposed alteration to latrines at Albert Dock Engine Works, Ltd. „ 30 Royal Albert Dock—Proposed erection of earth closets at the New Zealand Shipping Co.'s Boat Shed. NUISANCES. On the 18th November, 1913, I received from the River Department, Port of London Authority, a report which had reached them from the Metropolitan Police, Thames Division, of the discharge of oil into the river from a vessel lying in the vicinity of Woolwich Reach. 68 There seems to have been no doubt as to the facts. Section 92 of the Thames Conservancy Act, 1894, Sub-Section 4, forbids any person without lawful excuse to "wilfully cause or suffer any offensive matter, whether solid or fluid, to flow or pass into the Thames or into any tributary," but the final paragraph of the same section is as follows:— "Provided always that the Sub-Section (4) of this Section shall not extend or apply to any vessel within the limits of the Port of London and under the jurisdiction of the Port Sanitary Authority thereof." This was the reason for passing the report of the police on to your Medical Officer, but it does not appear that the discharge of oil from vessels lying in the river, in the manner described in the report, would or could constitute a nuisance which should be dealt with by your Committee under the Public Health Act. In view, however, of the probability, in the near future, of an increased number of vessels using or importing liquid fuel coming into the river, the question generally was referred to Mr. Solicitor for his views upon the point raised. TABLE XXXVIII. BYE-LAWS—OFFENSIVE CARGOES. Fifteen cases of infringement of the above-mentioned bye-laws were reported during the year. In each case written notice was sent to the owners of the barges concerned:— Date. Name of Vessel. Infringement. 1913. Jan. 1 Dumb barge "Petunia" Laden with a cargo of refuse matter which was not properly and securely covered so as to prevent any nuisance arising therefrom. „ 24 Barge "Hawthorn " Permitting the barge laden with an offensive cargo to remain within the district for a longer period than 48 hours. „ 29 Lighter " Robert" Laden with a cargo of fish offal which was not properly and securely covered so as to prevent any nuisance arising therefrom. Feb. 7/8 Dumb barge " Daffodil" Laden with a cargo of dung which was not properly and securely covered so as to prevent any nuisance arising therefrom, and also remained within the district for a longer period than 48 hours. April 18 Lighter " Extension " Laden with a cargo of road sweepings, &c., which was not properly and securely covered so as to prevent any nuisance arising therefrom. May 9 Lighter " Emma " Laden with a cargo of house refuse, road sweepings and dung, which was not properly and securely covered so as to prevent any nuisance arising therefrom. „ 9 Lighter "Walter" Ditto Ditto. „ 31 Lighter " Exe " Ditto Ditto. July 24 Lighters " George " and " Wandsworth." Ditto Ditto. Aug. 15 Lighters " John and Sarah " and “Harry." Loaded with a cargo of sewage screenings which was not properly and securely covered so as to prevent any nuisance arising therefrom. Sept. 11 Lighter "John and Sarah." Ditto Ditto. Oct. 17 Lighter " Beaconsfield " Failing to have the lighter thoroughly cleansed and deodorized within 6 hours after the discharge therefrom of an offensive cargo. „ 21 Lighter " Sloop " Laden with a cargo of refuse matter which was not properly and securely covered as to prevent any nuisance arising therefrom. 69 OFFENSIVE CARGOES. On the 7th May I received information that the master of the barge "Agreement," of Rochester, official number 78,529, on the 23rd April last, went into the fore cabin to defœcate. The mate, becoming alarmed at his long absence, went down into the cabin and found that the master had fallen from the bucket, face downwards, and was black in the face—apparently dead. He was taken to St. Thomas' Hospital and found to be dead. The man's father is of opinion that he was overcome by foul gases from a cargo of manure, which had been in the barge for two days. An inquest was held at Lambeth Mortuary on the 26th April, and a verdict was returned to the effect that he had either been asphyxiated or choked. Such cargoes occasionally generate a lethal gas which passes into the cabin, and several deaths have occurred from this cause. The barge was inspected on May 13th. The bilges were in a muddy condition, and smelling, but there was no cargo on board. On the 15th December I received a complaint from a resident of Greenhithe respecting the offensive condition of a barge named "Kingcup," lying off Greenhithe, and loaded with dung. The Inspector for the Gravesend District was immediately notified, and a written notice was sent to the owners of the barge, the result being that the unloading of the cargo was hastened, and the barge was removed on the 17th December. In November, two ships arrived in the Port laden with cargoes of cotton seeds. Four men employed in unloading these vessels experienced, a few hours after they had commenced working, symptoms of severe itching all over their bodies. They attended at the London School of Tropical Medicine, where they were found to be suffering with a papular eruption over the whole body except the face and hands. There was no danger to life, but the symptoms were extremely disagreeable and irritating. On examination of the cotton seed it was found to be heavily infested with a maggot, or caterpillar, which appeared to be the larva of a small moth named Gelechia Gossypiella, that has been found very destructive in granaries. On the maggots, mites were found in great numbers. These were identified as Pediculoides Ventricosns. The creature is like a louse but much smaller, and has long hair-like bristles attached to the legs. It has been known to attack man in the tropics and in America. It is supposed that these mites had been introduced into the country of origin with a view to its attacking the caterpillar and moth described above, and so preventing them from doing damage to the cotton seed. I am indebted to Col. A. Alcock, I.M.S., F.R.S., LL.D., &c., and Dr. F. W. O'Connor, of the London School of Tropical Medicine, for particulars of the cases and for the identification of the caterpillars and mites. 70 CREW SPACES. It is gratifying to note that this subject is receiving more favourable consideration in responsible quarters, and it may be assumed therefore that the reiterated comments by, amongst others, Port Sanitary Authorities on the inadequate provisions of existing legislation, relating to the hygiene of vessels from the point of view as dwellings, is beginning to take effect, and there are at least signs of some attempt at an international levelling up of standards in this respect. The Commonwealth of Australia in the Navigation Bill of 1912 deals with the subject in much greater detail than the British Merchant Shipping Act, in reference to vessels (a) Registered in Australia (b) engaged in the Coast trade. I have also been privileged to peruse certain Regulations drafted by the Director of Shipping for the Government of Norway on the same subject. The Board of Trade have also revised and re-issued the Instructions to their Surveyors, which will take effect in February, 1914. These instructions do not, of course, enlarge any provisions of the Merchant Shipping Act, but merely instruct Surveyors as to the terms in which, in the opinion of the Board, those provisions should be translated in practice. In all legislation dealing with the accommodation on vessels for seamen, the first question that presents any difficulty is the minimum of space to be afforded each man. It must be expressed in two dimensions, (a) cubic or general breathing space, and (b) floor area. It has been pointed out by all who have handled the subject with a view to reform, that the legal minimum does usually in practice become the maximum. This should not be so, but it is of course only natural that builders should consider the official minimum as sufficient. The British Merchant Shipping Act offers, by way of inducement to the shipowners, to deduct from the tonnage of the ship, upon which he pays dues, the tonnage expressed by the space devoted entirely to the use of the crew. This Act also regulates the measurement of vessels for the purposes of the Australian Navigation Bill. It is therefore interesting to note that the Commonwealth Government by the Bill do not regard the minimum space provided by the Imperial Act as being adequate, and a similar view would appear to be taken by the Norwegian Government, thus:— Merchant Shipping Act. Australia. Norway. Cubic space (in feet) 120 140 140 Floor area (in square feet) 15 18 18 It is a peculiarity of the Merchant Shipping Act that the allowance of space mentioned may be taken to include any special accommodation provided, such as separate mess rooms, &c., save that the space allotted for sleeping must not be less than 71 72 cubic feet, and 12 square feet of floor space respectively. In the Colonial and Swedish regulations the minimum of 140 and 18 is for the space set apart for berthing or sleeping, and space appropriated for messing, washing, &c., would appear to be additional. Such a step would be a great advance on existing conditions. In the Colonial regulations certain local trade vessels, and in the Swedish vessels of less than 200 tons register, are exempt from those provisions. • The Colonial regulations make a departure in legislating specially for officers, allotting in ships of 300 tons and upwards to each officer up to at least four, a separate room with not less than 180 cubic feet of space, and in the case of a limited class of vessels of less than 300 tons gross register for each two officers a separate room with a content of not less than 350 cubic feet. Another striking provision is found in the Norwegian regulations where in vessels oE 800 tons and upwards two bunk cabins and separate mess rooms shall be provided for the crew. But on passenger vessels of 3,000 tons and upwards (where the crew would of course run to large numbers) this arrangement may be modified, subject to the preliminary deposit and approval by the appointed officers, of a plan of the proposed cabin arrangement. The Australian regulations prohibit crew's quarters below the winter load line, and the Swedish, below the main deck unless the ports are 2½ feet above winter load line. Ventilation.—With reference to this much discussed, and in regard to crew's quarters, admittedly difficult question—the Australian Regulations alone adopt a volumetric standard. They provide that "Every place in a ship appropriated to the berthing "accommodation of seamen or apprentices shall be ventilated in such a "manner as to ensure a flow of not less than 3,000 cubic feet of fresh air every hour for "each seaman or apprentice, evenly diffused by means approved by a qualified medical "inspector with an intake and outtake of such size and so arranged as to "prevent such draught as would in the opinion of the medical inspector be likely to be "prejudicial to the health of the seamen or apprentices." The Norwegian Regulations follow the broader lines of the British, except that favour seems to be given to doors, skylights, and the like as primary means of ventilation ; whereas a secondary position is given to this by our Merchant Shipping Act, which recognises such means only as auxiliaries—ventilation to be as effective as possible independently of doors, &c. But the two countries appear to agree on this point that each case should be decided on its merits by competent authority. They further agree in stipulating that deck ventilators must not have their termination immediately over or near a bunk. The British Regulations add, in view of the fact that the deck site of the ventilators is often arbitrarily defined by the position of other gear, &c., that in that case, a trunk way should be fitted below in the cabin or berth to direct the inflowing air away from the occupants of the bunk. 72 Head Room.—Under the British Merchant Shipping Act, 5 ft. 6 in. is regarded as a practical minimum, permitting a man to get about without serious inconvenience. It probably requires practice to achieve this. The Swedish Regulations require on vessels of 200 tons and upwards a minimum of 6 ft. 3 in. and on vessels of 300 tons and upwards 6 ft. 9 in., a very different thing, and an immense improvement. Mess Rooms.—Australia requires separate mess rooms where practicable, if not, then tables must be of a folding or sliding type. Norway requires separate mess rooms in vessels of 800 tons upwards. Food Lockers.—The storage of food in lockers in the crew's quarters is not absolutely prohibited on British ships, but is discouraged, and can generally be dealt with as a nuisance. The Norwegian Regulations, however, absolutely prohibit the keeping of food, damp clothes, and other things likely to become offensive in sleeping compartments. This is a most excellent provision. Baths and Lavatories.—These are of course found nowadays provided for crews on many British vessels of the best class, but the custom is not general. The Australian Government require such to be provided to the satisfaction of their Medical Inspector. Norway requires on steam vessels of 1,500 tons and upwards in addition to lavatories a bath for the crew with warm water supply when required. On smaller vessels the bath only is dispensed with, separate washing accommodation, one washing apparatus to every two men in one watch is required. Water Closets.—The standard of one closet for each ten men of the ship's company, recognised by the Board of Trade, is also accepted by the Norwegian Government, while the Australian regulations leave the extent of accommodation to be decided or approved by the Medical Inspector. Hospital (Sick Berth) Accommodation.—This on British ships may be provided, and if so, and there is compliance with the regulation, it "should" be certified as "Crews' Hospital" and be included with the deductions made on account of Crews' space from the tonnage of the vessel. The Commonwealth Regulations require:— "(271) HOSPITAL ACCOMMODATION. 1. Every (a) Foreign-going ship trading regularly with the Commonwealth, or (b) Australian-trade ship on a voyage between consecutive ports which exceeds a prescribed distance and having 100 persons or more on board, shall be provided with hospital accommodation of such a character and so placed and arranged as to afford proper means of isolation for cases of communicable disease which may arise during the voyage, and for any persons attending to such cases. 73 2. The accommodation shall include the necessary lavatory and sanitary accommodation and such other accommodation as is prescribed. 3. The hospital shall, wherever practicable, be placed on the top deck aft or on the boat deck as far alt as practicable. 4. The master of a vessel who fails to comply with this Section and who suffers his vessel to enter any port or place in Australia shall be guilty of an offence. Penalty (on master or owner) 100l." The Norwegian regulations provide that in vessels with a crew of 12 men and upwards there shall be a "special sick ward," properly lighted and ventilated, and with bunks as follows:— Crews 12-17 men 1 bunk „ 18-30 „ 2 bunks „ 31-45 „ 3 „ „ 46 and upwards 4 „ but this regulation does not apply to fishing, whaling and sealing vessels below 200 tons register nor to the Coasting and European short sea routes. Other minor requirements by way of improvement on existing standards may be mentioned as:— Metal bunks Australia. Bunks not to be against ship side Norway. Separate lockers outside sleeping berth for oilskins, boots, &c. do. Galley not in crew's quarters (except in Arctic vessels) do. Daily cleaning and ventilating of quarters, by watch on duty do. In this review—necessarily condensed and abbreviated—it is merely sought to show that a decidedly active movement is taking place in the right direction as regards the seaman. The difference is that the two Governments quoted are seeking powers to make these various sanitary improvements compulsory in their vessels, while the British Merchant Shipping Act does nothing of the kind except to a very limited degree. The method adopted by other authorities of classifying vessels by their tonnage is good. It gives some idea, in the first place, of the probable amount of space at disposal. The placing of vessels engaged on short sea routes and coasting trades as a separate class is also wise, as conditions here often differ widely from vessels in the overseas trade. Progress on similar lines should certainly be made with British shipping. It would not be difficult to transform or modify the existing "Instructions" into definite Regulations to be enforced under penalty and by summary proceedings. Under existing circumstances, a nuisance may exist during a whole voyage, and, only be abated when in a port in this country after inspection and an intimation had been served on the owners: e.g., overcrowding may have existed for a long period and the nuisance abated by forthwith discharging the crew after the vessel's arrival. 74 It would appear that Proceedings under the Merchant Shipping Act can only be taken by the Board of Trade for this, but I do not know of any instance in which such proceedings have been instituted. This question partakes of an international character, and, in my opinion, it is worthy of consideration by an Official International Convention at which all the nations interested in maritime commerce should be represented. Regulations, based upon the decision of the Convention should then be issued, and they should be enforced summarily by the Port Sanitary Authorities of the United Kingdom. CREW SPACES. Comparison of Regulations, &c., by the Governments of the Commonwealth of Australia, Norway (in draft), and the United Kingdom. AUSTRALIA. NORWAY. UNITED KINGDOM. Officers, per head— Cubic space 180 cub. feet Under 300 tons gr. 175 cub. feet 110 cub. feet 120 c. ft. For all purposes Floor area ... 18 sq. feet 15 sq. ft. Seamen and Apprentices, per head— 72 c. ft. Minimum for sleeping Cubic space 140 cub. feet Floor area 18 sq. feet 12 sq. ft. Ventilation 3,000 cub. feet per hour per head No standard No standard Head room ... Under 200 tons gross 6 feet 3 inches, Above 200 tons 6 feet 9 inches 5 feet 6 inches minimum Mess room Separate, or folding, or sliding tables in quarters Separate for 800 tons up • •• Food lockers, &c. ... Not in sleeping quarters Not in sleeping quarters Bathrooms and lavatories, h. & c. water. q. S. Over 800 tons, separate washing for each two men of watch Over 400 tons, ditto for long voyages and to tropics 1,500 tons and up, add bath Optional Hospital - Minimum 100 persons carried On vessels above 200 tons and carrying crew of 12 persons and upwards. 1 to every 10 persons Optional. W.C's, &c. q.s. 1 to every 10 persons Position Not below winter load line Not below main deck unless ports 2½ feet above winter load line Optional 75 SLEEPING ACCOMMODATION ON BOARD SHIP. The following Table gives particulars of the sleeping accommodation in the crew's quarters found on certain vessels inspected by your Officers. Date. Quarters (Native). Occupied by Sleeping accommodation provided. Number of men for whom no sleeping accommodation is provided. Bunks. Cots, Gunny Bags and Hammocks. 1913. September 29 Firemen 101 men 29 27 45 October 3 Firemen 101 „ 20 40 41 Seamen 48 „ 18 13 17 „ 7 Firemen 55 „ 29 17 9 Seamen 42 „ 17 11 14 „ 29 Firemen 101 „ 23 16 62 Seamen 51 „ 21 7 23 November 3 Firemen 101 „ 30 32 39 Seamen 50 „ 24 16 10 „ 11 Firemen 81 „ 17 20 44 Seamen 45 „ 14 3 28 „ 19 Firemen 101 „ 44 20 37 Seamen 47 „ 22 11 14 „ 20 Firemen 87 „ 11 24 52 Seamen 42 „ 11 12 19 „ 25 Firemen 101 „ 52 7 42 Seamen 47 „ 33 10 4 December 4 Firemen 101 „ 30 26 45 Seamen 47 „ 21 10 16 „ 8 Firemen 80 „ 17 18 45 Seamen 41 „ 14 10 17 „ 16 Firemen 101 „ 19 29 53 Seamen 47 „ 20 16 11 „ 30 Firemen 101 „ 30 36 35 Seamen 47 „ 28 5 14 Totals 1,766 men 594 436 736 This Table shows that the crew's quarters were occupied by 1,766 seamen, for whom only 594 bunks were provided, and a few cots and hammocks. Many of the hammocks were improvised out of gunny bags, the remainder of the occupants had to sleep on the floor or on their boxes. 76 The facts were reported in the first instance to the Board of Trade, and representations were made to the owners, and hammocks sufficient in number have been supplied to each vessel, but as they are only issued to the men on request, the deficiency of sleeping accommodation continues. The crews in these vessels are natives of India, whose standard of comfort is usually lower than that possessed by Europeans, but the fact that rough wooden cots were erected in some of the vessels by the crew, and also that gunny bags had been improvised as hammocks, would indicate that if the proper number of hammocks were hung in the quarters, the crew would make use of them. DEATHS OF SEAMEN FROM DISEASE. I have extracted the following information from the official returns issued by the Board of Trade, of the deaths from all causes of seamen belonging to merchant vessels registered in the United Kingdom, which were reported to the Board of Trade during the year ended the 30th June, 1913. As to the sources of information, the Report states that:— The particulars relating to deaths of seamen are obtained from depositions and formal inquiries in respect of wrecks and casualties, inquiries held by Superintendents of Mercantile Marine Offices, Consuls and Colonial Officers, entries in official log books, &c. but the classification of deaths from disease necessarily depends in some cases on opinions and inferences of persons who have had no special medical training. It is not, therefore, proposed that the figures relating to deaths from disease should be accepted as exact statistics, but it is considered that they are sufficiently accurate to be of use when questions arise relating to the origin or prevalence amongst seamen of particular maladies. TABLE XXXIX. Causes of Deaths. Total Deaths of all Seamen, British and Foreign, on Sailing and Steam Vessels. Deaths after Discharge. Grand Total. Zymotic— Enteric Fever 45 18 63 Small-pox 3 1 4 Yellow Fever 1 — 1 Cholera 17 5 22 Plague 5 — 5 Plague (bubonic) 2 — 2 Other Zymotic Diseases 10 4 14 Simple and Ill-defined Fevers 10 2 12 Remittent and Intermittent Fevers 3 — 3 Malarial Fever and Malaria 51 5 56 Blood Poisoning 11 5 16 Beri-Beri 25 2 27 Venereal Diseases 10 3 13 Constitutional Diseases— Tuberculosis (General) 22 12 34 Rheumatism and Rheumatic Fever 3 . 3 Cancer 12 5 17 Forward 230 62 292 77 Causes of Deaths. Total Deaths of all Seamen, British and Foreign, on Sailing and Steam Vessels. Deaths after Discharge. Grand, Total. Brought forward 230 62 292 Diseases of the Nervous System— Apoplexy 29 1 30 Inflammation of the Brain 11 1 12 Heat Apoplexy and Heat Stroke 20 1 21 Sunstroke 1 1 2 Other Diseases of the Brain 5 3 8 Paralysis 4 1 5 Other Diseases of the Nervous System 6 2 8 Lunacy and Insanity 8 4 12 Alcoholism 6 — 6 Opium 8 — 8 Diseases of the Circulatory System— Diseases of the Heart 142 20 162 Other Diseases of the Circulatory System 5 2 7 Diseases of the Respiratory System— Phthisis 79 18 97 Pneumonia 92 21 113 Bronchitis 14 2 16 Pleurisy 10 2 12 Other Diseases of the Respiratory System 21 6 27 Diseases of the Digestive System— Diseases of the Stomach (Gastritis, &c.) 24 2 26 Diseases of the Intestines (Enteritis, Peritonitis, Appendicitis, &c.) 56 10 66 Diseases of the Liver (Jaundice, Hepatitis, Cirrhosis, &c.) 17 6 23 Diarrhœa and Dysentery 29 5 34 Other Diseases of the Digestive System 1 1 2 Diseases of the Urinary System— Diseases of the Kidneys (Nephritis, Uræmia, &c.) 23 4 27 Bright's Disease 4 1 5 Other Diseases of the Urinary System 5 1 6 . Dropsy 7 — 7 Debility, Other Ill-defined and Unknown Diseases— Debility 22 2 24 Other and Ill.defined Diseases 37 1 38 Unknown Diseases 4 3 7 920 183 1,103 From the above figures it will be seen that the causes accounting for the largest number of deaths from disease, are as follows:— Per cent. of Total Deaths from Disease. Diseases of the Heart 162 14.6 Pneumonia 113 10.2 Tuberculosis and Phthisis 131 11.8 Total from Diseases of the Respiratory System 265 24.0 Total from Diseases of the Digestive System 151 13.6 Total from Zymotic Diseases 238 21.5 78 Excluding diseases of the heart, it will be seen that the number of deaths attributed to tuberculosis and phthisis, is larger than that of any other disease—pneumonia coming next with 113, while the total deaths from diseases of the respiratory system were 265, or 24 per cent. of total deaths from disease. This proportion of deaths in a class of men which are leading an open-air life is striking, and the prevalence of such diseases amongst them is no doubt largely encouraged by the want of ventilation in the quarters in which many of them are compelled to sleep and live, when not actually on deck. The total number of deaths from "zymotic diseases," under which heading is included the generally known infectious fevers, &c., is 238, or 21.5 per cent. of the total. Of these diseases, enteric fever accounts for 63 deaths, and malaria for 56. The number of deaths from venereal disease is only 13, as men rarely die from this disease on board ship, and the figure gives no indication as to the number of cases which have occurred amongst seamen during the year. Diseases of the digestive system which account for a total of 151 deaths, or l3.6 per cent., include all the well-known diseases of the digestive tract, a discussion of which would be beyond the limits of space in this Report. PORT OF LONDON. The limits of the Port of London as at present defined commence at High Water Mark in the River Thames at Teddington Lock, in the County of Surrey, and extend down both sides of the River Thames to an imaginary straight line drawn from the Pilot Mark at the entrance of Havengore Creek, in the County of Essex, to the Lands End at Warden Point, in the Isle of Sheppey, in the County of Kent, such point being the North-Western limit of the Port of Faversham, and shall extend up and include both sides of the River Medway to an imaginary straight line drawn from the South-East point of land Westward of Coalmouth Creek, thence across the said River Medway to the Westernmost point of the piece of land which forms the Eastern side of the Stangate Creek, or, in other words, the North-West point of Fleet Marsh, and from thence in a Southerly direction to Iwade Church, in the said County of Kent, and thence in a North-easterly direction to Elmley Chapel, in the said Isle of Sheppey, a supposed direct line from Elmley Chapel, to Iwade Church, being the Western limit of the Port of Faversham, and the said Port of London shall include the Islands of Havengore Creek aforesaid, called Potton and Rushley Islands, and so much of the said Creek and watercourse as extends from it to the town of Rochford, and shall also include all other islands, rivers, streams, creeks, waters, watercourses, channels, harbours, docks and places within the before-mentioned limits contained. (See page 83.) POPULATION OF THE PORT. The number of persons actually living within the Port, on vessels, is always ot interest, and the opportunity afforded by the Census 1911 has been taken, with a view to furnishing your Committee with some information as to the resident population of the Port, as distinct from the larger working population which flows and ebbs daily. 79 According to the Census returns, the number of persons enumerated on board sea-going and coasting merchant vessels, and on inland barges and boats, in the counties of London, Middlesex, Surrey, Essex and Kent, but within the district of the Port of London Sanitary Authority, was 9,710 on 1,296 vessels. At the previous Census in 1901, the numbers were 9,166 persons on 1,299 vessels The close comparison, not only with regard to the number of vessels, but the number of persons in occupation, is interesting, and as I pointed out in discussing the Census of 1901, that in 1874 soon after the Authority was constituted, the then Medical Officer of Health (Dr. Leach) estimated that the average number of vessels in Port at any one time was 1,000, and the population probably 9,000—a very close estimate. The figures tend to show that the number has not fluctuated very greatly during the past fifty years, either in the number of vessels in the Port at any one time, or of the number of persons resident on the same. On the last occasion I was able to give some information of the proportion of British, Foreign, Colonial and other classes of vessels, and of the number of females living on board vessels, but on this occasion the method of tabulation adopted does not furnish these particulars. I append a list showing the counties, parishes and administrative areas abutting upon the district of the Port of London Sanitary Authority, and the number of vessels and persons enumerated in each. The figures quoted here do not include any persons on His Majesty's ships. The Port, like the City of London, represents a huge day working area, and a day Census, showing the number of persons employed would, if practicable, be of interest and value. TABLE XL. Port of London Population. Number of persons enumerated on Vessels within the limit of the Port of London. Extracted from Census Returns, 1911. County. Parish. Vessels. Persons. Middlesex Brentford U.D.— New Brentford 34 150 Old Brentford 2 4 Chiswick U.D. and C.P. 4 8 Heston and Isleworth U.D.—Isleworth 24 81 Twickenham U.D. and C.P. 1 2 Surrey Ham U.D. and C.P. 1 3 Richmond M.D.—Kew 2 2 Barnes U.D.—Mortlake 2 4 London Left Bank— Hammersmith 1 3 Fulham 5 8 Chelsea 3 7 Carried forward 79 272 80 County. Parish. Vessels. Persons. Brought forward 79 272 London (continued) Westminster— St. George's, Hanover Square 6 11 St. Margaret and St. John 8 13 City of London 20 190 Stepney— St. George in the East 22 168 St. Botolph (Without), Aldgate 26 321 Shadwell 17 141 Wapping 22 310 Ratcliff 14 122 Limehouse 30 157 Poplar M.B. 149 1,005 Right Bank— Wandsworth 7 13 Battersea 15 32 Lambeth 15 30 Southwark M.B.— Christchurch 11 19 St. Saviour's 6 11 Bermondsey 105 692 Camberwell 8 16 Deptford 1 2 Greenwich M.B.— Charlton and Kidbrooke 19 163 Greenwich 42 140 St. Nicholas, Deptford 12 57 Woolwich M.B.— Woolwich 67 363 Plumstead 7 45 Essex West Ham 69 711 East Ham 43 438 Romford R.D.— Dagenham 8 81 Rainham 4 10 Barking 20 51 Grays Thurrock 25a 732a Orsett R.D.— Chadwell 21 579 Corringham 12 22 East Tilbury 6 21 Fobbing 2 3 Little Thurrock 2 96 Mucking 1 2 Stanford-le-Hope 4 12 Stifford 3 14 West Thurrock 16b 433b Billericay R.D.—Pitsea 2 3 Rochford R.D.— Canvey Island 7 40 Great Stainbridge 1 1 Great Wakering 2 4 Hadleigh 2 2 Carried forward 978 6,548 (a) Includes Training Ship "Exmouth," 663 persons. (b) Includes Reformatory School Ship "Cornwall," 295 persons. 81 County. Parish. Vessels. Persons. Brought forward 978 6,548 Essex (continued) Rochford R.D. (continued)— Little Stambridge 3 6 Paglesham 4 4 South Benfleet 5 10 South Fambridge 1 1 Sutton 1 2 Leigh 10 23 Southend-on-Sea M.B.— Prittlewell 40 127 Southchurch 2 4 South Shoeburyness 3 6 Kent - Dartford R.D.— Dartford 1 1 Crayford 2 4 Stone 19c 299c Swanscombe 33d 483d Erith 30 153 Northfleet 21 96 Gravesend M.B.— Gravesend 25 184 Milton 27 78 Strood R.D.— Chalk 4 9 Cliffe 10 27 Denton 6 27 Frindsbury Extra 14 75 Hailing 5 8 Higham 3 3 Hoo R.D.— Allhallows 2 4 Hoo 4 8 Isle of Grain 7 14 Stoke 1 1 Sheppey R.D.— Emley 3 6 Minster in Sheppey 3 4 Queenborough 17 408 Sheerness 32 87 Census 1901 1,299 9,166 LAUNCHES. The new motor launch "George Briggs" was delivered in October, and has done good work since in inspection of vessels lying in the Upper District. The launch fulfils all requirements in that district, is easily handled and speedy. Being of shallow draught the advantages in this respect over the old steam launches have already been proved. Creeks can now be visited, also vessels lying in shallow water during the ebb tide. The steam launch "Denton" has been sold, and the "Clotho" is at present, pending sale, being used as a reserve. For this the old launch is very useful, being a good sea-boat, can be used even in bad weather on the Gravesend Station when the larger launches have to lay-by for overhaul. (c) Includes Training Ship "Warspite," 209 persons. (d) Includes Training Ships "Arethusa" and "Chichester," 240 persons. 82 BARGE "THOMAS." FUMIGATING APPARATUS. The fumigating plant was used on eight occasions during the year, the largest ship fumigated being one of 10,750 tons, with a cubic capacity of 652,000 cubic feet. Date. Name of Vessel. Capacity in Cubic Feet. 1913. April 19 th s.s. "Themistocles" 551,573 May 27th s.s. "Mongolia" 186,688 „ 29th s.s. "Ixia" 128,000 June 14th s.s. "Norseman" 652,800 „ 17th s.s."Persia" 154,730 Aug. 2nd s.s. "India" 126,620 „ 14th s.s. "Stag" 121,370 Sept. 4th s.s. "Paris" 43,500 I have received a letter from the Port of London Authority, dated 30th July, 1913, in which it is stated that the Dock and Warehouse Committee have authorised that, until further notice, the fumigating craft of the Port of London Sanitary Authority shall be exempt from dock dues when entering the docks for the sole purpose of fumigating vessels. STAFF. The following short remarks deal with the principal changes and modifications that have occurred in the Staff during the year. Medical Officers.—Dr. Legge, Sheerness, who had been ill and off duty, was able to resume duty in April, and has since continued to perform the usual duties carried out by him, some special remarks on which will be found in that section of the Report dealing with medical inspection at Sheerness. Inspectors.—1 have to report with regret the loss in November, by death, after a long illness, of Inspector W. G. Romeril. He was the senior Sanitary Inspector, and had been in the service of the Corporation since 1892, being 54 years of age at the time of his death. He was an exceptionally intelligent, capable, loyal and industrious officer, and took an active interest in all matters appertaining to his duties—and was a contributor to current literature on the subject of sanitation on board ships. Some years ago he published a work entitled "Sanitation in the Mercantile Marine," which was a useful addition to literature on this subject. Office.—James G. Godden, Junior Clerk, resigned his position in December in order to take up an appointment abroad. He had been in the service three years, having joined in 1910. 83 Launches.—A. E. Topping, deckhand of the "Denton," resigned his position in March, and the vacancy was filled by J. Baulsom at commencing wages of 16s. per week. Owing to the acquisition of a motor launch, the services of W. Shaw, deckhand, were dispensed with in November. Hospital.—Miss Hoare, Senior Assistant Nurse, resigned her position in March, and Miss G. G. Jones was appointed to fill the vacancy. Miss Jones resigned in September, and Miss A. A. Foggo was appointed to the vacancy. Miss F. Cork, Junior Assistant Nurse, who contracted Enteric Fever in November, 1912, returned to duty in February. She resigned her position in November, and Miss A. Densham was appointed to fill the vacancy. Emma Accleton and Ethel Harling were appointed in January, as Cook and Housemaid respectively. They resigned their positions in October, and the vacancies were filled by Ellen Hutson and Florence Ambrose. CANAL BOATS ACTS. In accordance with Section 3 of the Canal Boats Act, 1884, I beg to present herewith my 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, 1913. 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 right bank from Teddington downwards:— Wandsworth Creek (River Wandle). Part of the Grand Surrey Canal within the Surrey Commercial Docks. Hay's Dock. St. Saviour's Dock. Deadman's Dock. River Ravensbourne (Deptford Creek). Rivers Cray and Darenth (Dartford Creek). The entrance to the Gravesend Canal. Cliffe Creek. Yantlet and Coalmouth Creeks. Part of the river Medway, and of the Swale. 84 On the left bank from Teddington downwards:— The entrance to the River Brent. Chelsea Dock. Grosvenor Dock. Limekiln Creek. Part of the River Lea. Barking Creek. Rainham Creesk. 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 Greenwich. Inspector Burr 208l. per annum. Middle District. Greenwich to Erith. Inspector Elward 175l. 10s. per annum. Lower District. Erith to seaward limits of the Port of London (including part of the River Medway). Inspector Shepherd 148l. 4s. 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. Millwall Dock. Inspector Lambe 20ll. 10s. per annum. Eastern District. Royal Victoria Dock. East India Dock. Inspector Garland 208l, per annum. Royal Albert Dock. Inspector Wetjen 208l. per annum. 85 Western District. London Dock. St. Katherine's Dock. Regent's Dock. Inspector Hopkins 208l. per annum. Surrey Commercial Dock. Inspector Rolfe 201l. 10s. per annum. Gravesend District. Tilbury Dock. Left Shore, from Purfleet down. Right Shore, from Erith down. Inspector Massie 169l. per annum. (2) The total number of inspections for the year was 576, representing a net number of 451 boats. The remainder, 125, represents repeated visits by Inspectors of this Authority. The number of the boats not conforming to the Acts and Regulations was 53, or 9.20 per cent. of the total, the percentage for the previous five years being 6.96 per cent. In addition to the above, 26 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) Unregistered Boats. The following boats were found, on. inspection, to be unregistered within the meaning of the Act,:— Date. Name of Boat. Registration Authority. Reason for Registration or Re-registration. 1913. J an. "William" Jane "William" March "John" Birmingham New Boat. Aug. "Industry" Port of London Ditto. The "Industry" was registered with this Authority, and the "John" is under registration by the Birmingham Registration Authority. In the case of the "William," the boat has not been met with since June. The owner states that it is not used as a residence. An opportunity will be taken of inspecting the boat when next in the port and ascertaining whether there is any evidence of occupation. 86 (b) Notification of Change of Master. None. (c) Certificates. Absence of certificate was found in the following cases, a complaint being sent to the owners. In the case of the boats marked * information was received that the Certificates were subsequently placed on board:— 1913. Jan. 5 * "Mole" registered Berkhamsted, No. 334. 11 * "Crawford" „ Uxbridge, No. 412. „ 30 * "Grace" „ Brentford, No. 315. April 17 * "Franklin" „ Berkhamsted, No. 338. May 2 * "Stanley" „ Port of London, No. 271. „ 20 * "Henley" „ Uxbridge, No. 458. „ 22 * "Don" „ Port of London, No. 357. June 23 †"Caledonia" „ „ „ No. 420. „ 23 † "Britannia" „ „ „ No. 418. 23 † "Wales" „ „ „ No. 410. „ 25 * "Henley" „ Uxbridge, No. 458. July 14 * "Grantham" „ Birmingham, No. 1259. „ 30 * "Sarah" Berkhamsted, No. 408. Oct. 16 * "Sarah „ „ No. 408. „ 30 * "Sarah and Eliza" „ Uxbridge, No. 382. Nov. 22 *"Henley" „ „ No. 458. Dec. 6 "Wandle" „ Berkhamsted. † Under re-registration by this Authority. In the following cases, the Certificates produced did not identify the owner with the boat:— Jan. 31 ‡ "John" registered Brentford, No. 59. June 23 § "England" „ Port of London, No. 409. Sept. 2 ‡ "Jane" „ Reading, No. 41. Dec. 1 "Brimo" „ „ No. 20. ‡ Remedied. § Under re-registration by this Authority. (d) Marking. The following boats were found infringing in this respect:— March 10 "James" registered Brentford, No. 322. April 26 "Joseph" „ „ No. 363. June 23 §§ "Caledonia" „ Port of London, No. 420. Sept. 2 "Jane" „ Reading, No. 41. Oct. 14 "Sarah" „ Stepney, No. 4. Nov. 14 "Sarah" „ Berkhamsted, No. 408. Dec. 6 "Wandle" „ Berkhamsted. ‡‡ Remedied subsequently. §§ Under re-registration by this Authority. (e) Overcrowding. This was found in the case of one boat, as follows:— The canal boat "Samuel," registered Brierley Hill, No. 190, was inspected on the 21st October. The fore cabin, which is registered for two persons, was in a very leaky condition and quite unfit for habitation. The after cabin, registered for two adults, was occupied by two adults and three children. A complaint was sent to the owners. 87 The boat has since been met with, but I have received a letter from the owners stating that the boat is "laid up" and uninhabited. The complaint with regard to overcrowding is thus remedied. (f) Separation of Sexes. The following case was met with:— The canal boat "Albert," registered Berkhamsted, No. 314, was inspected on the 27th October, when the after cabin was found to be occupied by a man and his wife, and a female person over the age of 12 years. A complaint was sent to the owners on the 1st November, and on the 17th December I received information that the infringement had been duly remedied. (g) Cleanliness. The following boats were found to require cleansing, and those on which the necessary improvement was made are marked * accordingly:— Jan. 5 *"Mole" registered Berkhamsted, No. 334. „ 30 *"Sarah and Eliza" „ Uxbridge, No. 382. „ 31 *"John" „ Brentford, No. 59. April 22 "Warwick" „ Wolverhampton, No. 917. May 1 *"Mary Ann" „ Port of Loudon, No. 458. „ 2 *"Stanley" „ No. 271. „ 9 *"Twaddell" „ Brentford, No. 227. July 31 *"Hilton" „ Ware, No. 53. Sep. 30 *"Livingstone" „ Berkhamsted, No. 325. Oct. 27 *"Albert" „ „ No. 314. Dec. 8 *"Humber" „ „ No. 433. (h) Ventilation. The following boats were found to require better ventilation, or some repair. Those in which the alterations have been made, are noted*:— 1913. Jan. 27 "Joseph" registered Berkhamsted, No. 363. „ 28 "Nellie" „ Brentford, No. 192. „ 30 "William" (unregistered). Feb. 6 *"Cicero" registered Reading, No. 21. „ 25 *"Warwick" „ Wolverhampton, No. 917. March 18 *"Colne" ,, Berkhampsted, No. 333. „ 18 *"Rose" „ Wolverhampton, No. 966. April 22 *"Warwick" „ „ No. 917. „ 28 *"Andree" „ Berkhamsted, No. 255. May 2 *"Stanley" ,, Port of London, No. 271. „ 2 *"Rhodes" „ „ No. 203. „ 9 *"Twaddell" „ Brentford, No. 227. „ 14 *"Albert" „ Berkhamsted, No. 314. ,, 16 *"Alice" „ Port of London, No. 5. „ 16 "Humber" „ Berkhamsted, No. 433. „ 28 "Wales" ,, Port of London, No. 410. June 5 " George and James" „ Brentford, No. 42. „ 6 *"Andree" „ Berkhamsted, No. 255. „ 9 *"Rhodes" „ Port of London, No. 320. „ 9 "Brimo" „ Reading, No. 20. „ 16 "Rebecca" „ Brentford, No. 66. „ 23 *" Britannia" „ Port of London, No. 408. „ 23 "Wales" „ No. 410. „ 25 Henley" „ Uxbridge, No. 458. 88 1913. July 8 "Diligent" registered Brentford, No. 65. „ 10 "Glendower" „ Port of London, No. 457. Sept. 2 *"Jane" „ Reading, No. 41. „ 30 "Livingstone" „ Berkhanuted, No. 325. Oct. 3' *"Prudence" „ Ware, No. 38. 7 *"Eric" „ Brierley Hill, No. 231. „ 14 "Sarah" „ Stepney, No. 4. „ 21 "Samuel" „ Brierley Hill, No. 190. „ 22 *"Providence" „ Ware, No. 46. „ 27 "Diligent" „ Brentford, No. 65. Oct. 27 *"Albert" „ Berkhamsted, No. 314. 29 *"Dufferin" „ „ No. 347. ,, 31 *"King" „ Reading, No. 39. Nov. 6 *"Sarah" „ Berkhamsted, No. 408. 14 "Sarah" „ „ No. 408. „ 24 "Alice" „ Brentford, No. 305. Dec. 1 "Brimo" „ Reading, No. 20. „ 3 "Livingstone" „ Berkhamsted, No. 325. „ 17 "Kuroki" „ Port of Loudon, No. 428. (i) Painting. 17 boats were found to require painting with regard to the interior of the cabin, which was done in the cases marked *:— 1913. Jan. 27 "Joseph" registered Berkhamsted, No. 363. April 22 "Warwick" „ Wolverhampton, No. 917. „ 26 "Joseph" „ Berkhamsted, No. 363. May 2 *"Stanley" „ Port of London, No. 271. „ 9 *"Twaddell" „ Brentford, No. 227. June 5 "George and James" „ „ No. 42. „ 16 "Rebecca" „ „ No. 66. July 31 *"Hilton" „ Ware, No. 53. Sept. 2 *"Jane" „ Reading, No. 41. „ 30 "Livingstone" „ Berkhamsted, No. 325. Oct. 3 *"Prudence" „ Ware, No. 38. „ 14 "Sarah" „ Stepney, No. 4. ,, 21 "Samuel" „ Brierley Hill, No. 190. Nov. 6 *"Sarah" „ Berkhamsted, No. 408. „ 24 "Alice" „ Brentford, No. 305. Dec. 3 "Livingstone" „ Berkhamsted, No. 325. ,, 12 "Leslie" „ Brierley Hill, No. 229. (j) Provision of Water Cask. The following boats were not provided with proper water vessel for containing water for drinking. In 4 cases I received information that this has been done:— 1912. Jan. 5 *"Mole" registered Berkhamsted, No. 334. March 18 *"Colne" „ „ No. 333. April 15 *"Walter" „ Daventry, No. 296. „ 15 *"Friendship" „ Birmingham, No. 1,280 May 16 "Humber" „ Berkhamsted, No. 433. Sept. 30 "Livingstone" „ „ No. 325 Dec. 6 "Wandle" „ „ No. 327 „ 12 "Leslie" „ Brierley Hill, No. 229 89 (k) Removal of Bilge Water. In the following 4 cases, the bilges were found to be in a filthy condition. * Reported to be remedied:— 1913. Jan. 5 *"Mole" registered Berkhamsted, No. 334. March 18 *"Colne" „ „ No. 333. May 28 *"Wales" „ Port of London, No. 410. June 5 "George and James " „ Brentford, No. 42. (l) Notification of Infectious Disease. No case of infectious disease was notified to me during the year, on board any canal boat. (m) Admittance of Inspector. No difficulty has been experienced in regard to the visits of the Inspector of this Authority. (4) No legal proceedings were necessary during the year. (5) The total number of infringements found was 119 on 53 boats. Formal notice of each infringement was at once given to the owners, and in many cases were remedied without further complaint. The number of written notices was 59, and the number which has been certified as attended to was 55. This number includes 19 orders made in 1912 and reported remedied in 1913. Of the complaints issued in the year now under review, 61.00 per cent. were remedied. (6) 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, 1913, there were 254 boats on the Register:— Propelled by Tug and Oars 237 „ „ Steam 15 „ „ Motors 2 254 (9) Three boats were registered in 1913. These were new boats. Table of Canal Boats Carrying Children on Board. Year. No. of boats. No. of boats with children. No. of children. Average No. of children per boat, Average No. of boats with children. 1908 1,168 206 459 2.18 17.63 1909 1,432 219 495 2.26 15.29 1910 908 172 354 2.05 18.94 1911 926 173 400 2.31 18.03 1912 841 197 409 2.07 23.42 1913 451 61 196 3.21 13.52 I have the honour to be, Gentlemen, Your obedient Servant, Medical Officer of Health, Port of London. 90 TABLE XLI. SUMMARY OF CANAL BOATS FOR THE YEAR ENDING 31ST DECEMBER, 1913. January. February. March. April. May. June. July. August. September. October. November. December. TOTAL. TOTAL FOR THE YEAR 1908. 1909. 1910. 1911. 1912. New boats registered ... 1 ... ... 1 ... ... ... 1 ... ... ... 3 ... ... 2 6 2 Registration owing to structural alterations ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Registration for other purposes ... ... ... ... ... ... ... ... ... ... ... ... ... 1 1 1 ... ... Inspected 51 44 53 55 56 57 70 12 25 66 48 39 576 1,110 1,379 878 889 817 Conforming to Acts and Regulations 43 42 49 49 46 46 65 11 23 55 44 33 506 1,066 1,289 807 800 692 Infringements in respect to:— Registration 1 ... 1 ... ... 1 ... 1 ... ... ... ... 4 2 ... 4 8 9 Notification of change of master ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 2 Absence of certificate 3 ... ... 1 3 4 2 ... ... 2 1 1 17 22 9 20 44 34 Certificate not identifying owner with boat 1 ... ... ... ... 1 ... ... 1 ... ... 1 4 13 5 ... 2 5 Marking, &c. ... ... 1 1 ... 1 ... ... 1 1 1 1 7 14 20 9 18 11 Overcrowding ... ... ... ... ... ... ... ... ... 1 ... 1 5 3 2 5 5 Partition separating sexes ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 ... 2 Males over age ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 2 Females over age ... ... ... ... ... ... ... ... ... 1 ... ... 1 ... ... ... ... ... Cleanliness 3 ... ... 1 3 ... 1 ... 1 1 ... 1 11 30 20 14 12 23 Painting 1 ... ... 2 2 2 1 ... 2 3 ... 2 17 2 ... 9 19 17 Ventilation 1 ... ... ... 1 3 1 ... ... ... ... . . . 6 1 2 3 5 8 Dilapidation 2 ... 2 2 6 7 1 ... 2 9 3 3 39 31 46 27 33 68 Removal of bilge water 1 ... 1 ... 1 1 ... ... ... ... ... ... 4 ... ... ... 1 3 Without pump ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Refusal to admit Inspector ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... No proper water vessel ... ... 1 2 1 ... ... 1 ... ... 2 8 10 6 5 9 9 Without double bulkhead ... ... ... ... ... ... ... ... ... . . . ... ... ... ... ... ... ... ... Notification of infectious disease ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Detained for cleansing ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Proceedings taken ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 ... Cautions given 6 2 3 5 8 9 4 1 2 9 4 6 59 76 80 33 70 97 „ attended to 4 4 9 7 4 5 3 3 1 5 5 5 55 71 80 46 49 74 Total registered by Port Sanitary Authority since 1887 461 Cancelled 207 Actual number on the Register, 31st December, 1913 254 Registered for 2,154 persons. Carrying 926 men. 205 women. 196 children. 91 ADMINISTRATION OF THE PORT OF LONDON (PUBLIC HEALTH ACT, 1891). REVENUE ACCOUNT for the Year ended 31st December,1913. Dr. Cr. £ s. d. £ s. d. £ s. d. £ s. d. To Salaries, viz.:— By Proceeds of Sale of Unsound Food (see contra) 1,900 10 7 Dr. H. Williams, Medical Officer of Health 1,000 0 0 „ Sundry Fees, viz.:— Assistant Medical Officers:— Health Certificates 106 6 8 Dr. W. M. Willoughby £400 0 0 Metropolitan Asylums Board, under 1891 Act 0 3 6 „ J. S. Warrack 400 0 0 Canal Boat Registration 1 7 6 „ W. M. Willoughby 109 4 0 Disinfections 135 4 0 „ W. D. Betenson 400 0 0 243 1 8 „ E. V. Legge 350 0 0 „ Grant from Home Office in respect of Medical Officer under the Aliens „ A. Kidd 370 0 0 Act, 1905 753 17 0 Locum Tenens 133 17 6 „ Refund of proportion of Medical Officer's Salary, &c., by Rochester 2,163 1 6 Port Sanitary Authority 100 0 0 W. J. Albrow, Clerk 295 0 0 „ Ditto, forwarding Telegrams 0 11 3 3,458 1 6 100 11 3 „ Uniforms 128 13 8 „ Fidelity Guarantees 1 16 0 „ Sundry Reimbursements 4 3 4 „ National Health Insurance 18 11 3 „ Wages, per Dr. Williams, viz.:— 3,002 3 10 Offices 478 10 0 „ Excess of Expenditure over Income 12,322 2 11 Inspectors 2,795 15 10 Launch Crews 1,377 0 9 Hospital Staff 289 6 9 4,940 13 4 „ Workmen's Compensation 15 8 4 „ Contributions to Officers' Pension Fund No. 1 £ 94 17 1 „ Ditto No. 2 No. 2 233 3 8 328 0 9 „ Contributions to Officers' Pension Fund re Pensions 169 8 8 „ Pensions 52 0 0 549 9 5 „ Disbursements, per Dr. Williams, viz.:— Petty Cash Expenses, Inspectors and others 336 10 8 Postage Stamps 54 0 0 Sundry Office Expenses 35 11 8 426 2 4 „ Offices at Greenwich, viz.:— Rent 55 0 0 Rates and Taxes 19 11 0 Fire and Boiler Insurance 1 0 2 Telephone Rent 20 10 0 Gas 8 6 6 Furniture 11 2 3 Coal 7 13 3 Water 2 6 0 125 9 2 „ Expenses of Steam Launches, Hulk, &c., viz.:— Insurance 152 0 0 Coal and Coke 432 14 1 Repairs £200 16 2 Less Reimbursements for Damage 92 4 2 108 12 0 Skiff and Moorings 7 12 6 Stores 220 4 1 Petrol 41 16 8 Purchase of new Launch £837 17 6 Less Sale of old one 135 0 0 702 17 6 1,665 16 10 „ Hospital at Denton, viz.:— Expenses of extra Nurses 170 14 4 Rent of Causeway, &c. 18 5 0 Rates and Taxes 77 10 5 Fire and Boiler Insurance 11 8 6 Telephone Rent 18 5 0 Gas 51 7 8 Coal 54 4 1 Stores 69 5 2 General Repairs 183 9 6 Maintenance of Patients 134 17 8 784 7 4 „ Printing and Stationery 68 0 6 „ Telegrams and Maintenance of Private Wire 21 18 7 „ Examination of Rats, &c. 384 3 0 „ Condemning Unsound Food, Expenses 24 14 10 „ Proceeds of sale of Unsound Food returned to Consignees (see contra) 2,071 12 4 „ Disinfectants 31 11 10 „ Subscriptions 10 16 0 „ Advertisements 9 19 9 „ Medical Examinations re new Appointments 2 2 0 „ Miscellaneous 15 3 0 ,, Law Charges, viz.:— Mr. Comptroller 1 0 10 Mr. Solicitor 3 16 0 4 16 10 „ Parliamentary Expenses 190 11 7 „ Mr. Hallkeeper, Disbursements 0 2 4 „ Delegation Expenses 74 5 0 „ Committee's Allowance 150 0 0 „ Ditto re Inspection of River 150 0 0 300 0 0 £ 15,324 6 9 £15,324 6 9 Chamber of London, 31st March, 1914. ADRIAN POLLOCK, Chamberlain.