80m PORT OF LONDON SANITARY COMMITTEE. ANNUAL REPORT OF THE MEDICAL OFFICER OF HEALTH, • To 31st December, 1924. Presented 23rd April, 1925. REPORT, For the Year ended 31st December, 1924, OF THE MEDICAL OFFICER OF HEALTH FOR THE PORT OF LONDON. BY WILLOUGHBY MASON WILLOUGHBY, B.A., M.D B.C., Cantab., D.P.H.Camb., Medical Officer of Health, Port of London. LONDON: Printed by Drake, Driver & Leaver, Ltd., Rosebery Avenuf, E.C. 1. BOWER, Mayor. A Common Council holden in the Chamber of the Guildhall of the City of London, on Thursday, the 23rd day of April, 1925. THE Port of London Sanitary Committee did this day deliver into this Court a Report in writing under their hands, of their proceeding's, and submitting the Annual Report of the Medical Officer of Health of the Port to the 31st December, 1924; which was read. 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. 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, beg to submit for the information of your Honourable Court the Annual Report of Dr. Willoughby Mason Willoughby, the Medical Officer of Health of the Port of London, for the year ended the 31st December, 1924, which Report contains a full and detailed account of the work done in the Port during that period by the Medical Officers and Inspectors. An Account of Receipts and Expenditure in connection with the Port of London Sanitary Authority for the year ended the 31st March, 1925, is appended, in accordance with the Order of your Honourable Court, for the information of the Court. 2 All which we submit to the judgment of this Honourable Court. Dated this 7th day of April, 1925. G. W. Young. Wm. H. Thomas. T. J. Harrowing. Arthur Bedford. C. S. Giddins. Edw. C. Weston. J. S. Pearse. W. Fortescue. J. H. White. Leo Taylor. C. A. Batho. John S. Hixdley. J. G. Howell. H. J. Doree. E. L. J. Durant. J. R. Brough. G. J. Nicholls. OFFICES OF THE Port of London Sanitary Authority AND Medical officer of health AT 5, CHURCH PASSAGE, GUILDHALL, LONDON, E.C.2. Telegraphic Address - " MEDOFF, CENT, LONDON." Telephone No. - - - LONDON WALL 6400. BOARDING STATIONS. RIVER THAMES ... Hulk " Hygeia," Gravesend. RIVER MEDWAY - Garrison Point, Sheerness. Telephone No. (Hulk " Hygeia ") - - GRAVESEND 325. HOSPITAL FOR INFECTIOUS DISEASES AT DENTON, near GRAVESEND. Telephone No. (Hospital) - GRAVESEND 257. Ditto (Medical Officer of Health) „ 86. LIMITS OF THE 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. A 4 INDEX. PAGE Anthrax 23 Actinomycosis 44 Analysis of Foodstuffs 47 Aliens 56 Beef 45 Biscuits and Confectionery 47 Bye-laws, Offensive Cargoes 55 „ House-boats 58 Cholera 9 Continued Fever 16 Chickenpox 22 Canned Spinach 51 Canal Boats Act 61 Diphtheria 13 Dysentery 22 Dengue Fever 23 Drugs 47 Enteric Fever 14 Erysipelas 16 Effects Disinfected 30 Eggs 47 Egg Yolk 47 Form " A " 40 „ " B " 40 „ " C" 41 „ ' D" 41 Food Inspection 44 Fish 45 Fruit 46 Formaline in Beef 48 German Measles 16 Grain 47 Grant-aided Public Health Services 60 Hospital 41 Introductory 6 Infectious Diseases 8 Influenza 21 Illness, declaration of 28, 29 Jam, Marmalade and Honey 46 Legal Proceedings 57 Limits of Port 3 Launches, &c 60 PAGE Medical Inspection—Gravesend and Sheerness 6, 7 Measles 15 Malaria 19 Miscellaneous Diseases 28 Meat Destroyed 43 Mutton and Lamb 45 Meat (canned, smoked and salted) 45 Meal and Flour 47 Nuts 46 Nuisances 53 Offices 3 Ox-tongues 45, 48 Offal 45 Plague 9 Pulmonary Tuberculosis 16 Pneumonia 21 Public Health (Foreign Meat) Regulations 44-50 Pork 45 Poultry and Game 45 Provisions Prepared Foods 47 Public Health (Shellfish) Regulations 56 Rats destroyed 31 „ examined 32 Rat Fumigations 35 „ Precautions 40 Rabbits 45 Staff 5, 60 Smallpox 11 Scarlet Fever 13 Sausages 45 Sundries (food) 47 Spinach, canned 51 Sanitary Inspections 52 Sanitary Works, &c. 55 Tuberculosis 18 Unsound Food Destroyed 42 Venereal Diseases 24 Vessels and Premises Disinfected £0 Vegetables 46 INDEX TO TABLES. TABLE PAGE I. Medical Inspection 6 II. Infectious Disease-Summary 8 III. Compulsory Notification of Infectious Disease, with number of Deaths 9 IV. Cholera 9 V. Plague 9 VI. Smallpox 11 VII. Scarlet Fever 13 VIII. Diphtheria 13 IX. Enteric Fever (Typhoid and Paratyphoid Fever) 14 X. Measles 15 XI. German Measles 16 XII. Erysipelas 16 XIII. Continued Fever 16 XIV. Pulmonary Tuberculosis 16 XV. Tuberculosis, other kinds 18 XVI. Malaria 19 XVII. Pneumonia 21 XVIII. Influenza 21 XIX. Dysentery 22 XX. Chickenpox 22 XXL Venereal Diseases 24 XXII. Miscellaneous Diseases 28 XXIII. Vessels and Premises fected 30 XXIV. Effects Disinfected 30 XXV. Rats Destroyed 31 TABLE PAGE XXVI. Analysis of Rats Examined 32 XXVII. Returns of Rats Examined 33 XXVIII. Rat Fumigations 35 XXIX. Rat Precautions, U.S.A. Requirements 40 XXX. Shipping Entering the Port, Form A 40 XXXI. Rats Destroyed and Examined, Form B (See Tables XXV. and XXVII 40 XXXII. Precautions against Plague, FormC 41 XXXIII. Vessels Subjected to Measures of Rat Destruction, Form D 41 XXXIV. Hospital Cases 41 XXXV. Unsound Food Seized, &c 42 XXXVI. Unsound Meat Destroyed, Weights, &c. 43 XXXVII. Sanitary Inspections, mary 52 XXXVIII. Sanitary Inspections, ances on Vessels 53 XXXIX. Sanitary Inspections, ances on Shore Premises 54 XL. Sanitary Works and Alterations 55 XLI. Bye-laws, Offensive Cargoes 55 XLII. Aliens, Medical Inspection 56 APPENDICES. Summary of Canal Boats. Revenue Account. 5 STAFF. List of Officers forming the Staff of the Port of London Sanitary Authority, 31st December, 1924. Office. Name of Officer. Date of entering the Service. Date of Appointment to present position. MEDICAL OFFICER OF HEALTH W. M. Willoughby, B.A., M.D., B.C., D.P.H.Camb. May, 1901 February, 1916. DEPUTY Col. J. S. Warrack, R.A.M.C., T.D., M.A.,M.D., C.M.Aberdeen, D.P.H.Camb., Barrister-at-Law. April, 1903 February, 1916. ASSISTANT MEDICAL OFFICERSGravesend W. D. Betenson, M.R.C.S., L.R.C.P., D.P.H.Lond. July, 1907 July, 1907. Sheerness A. Kidd, M.R.C.S., L.R.C.P., D.P.H.Lond. (Vacant.) October, 1908 October 1908. OFFICES— Chief Clerk E. A. Sorrell October, 1894 July, 1924. 1st Assistant W. C. Barham March, 1901 July, 1924. 2nd „ J. A. Gillis March, 1914 luly, 1924. Junior A. W. Moore January, 1920 July, 1924. Charwoman Mrs. E. Kail November, 1922. November, 1922. FOOD INSPECTORS *A. Garland May, 1894 December, 1917. *W. G. Wetjen August, 1898 July, 1921. *J. H. Rolfe September, 1901 March, 1922. *W. W. Burr August, 1898 October, 1924. ASSISTANT FOOD INSPECTOR *H. R. Hopkins February, 1899 October, 1924. SANITARY INSPECTORS *P. R. Lambe January, 1900 January, 1900. *W. El ward March, 1809 March, 1909. *F. J. Massie March, 1909 March, 1909. *W. J. Berry February, 1914 February, 1914. *W. Gray September, 1921 September, 1921. P. W. Coombe December, 1924 j On Probation. W. E. Smith December, 1924 DENTON HOSPITAL— Medical Officer in Charge Col. J. S. Warrack, R.A.M.C., T.D., M.A., M.D., C.M. Aberdeen, D.P.H. Camb., Barrister-at-Law. April, 1903 February, 1916. Matron J. Jackson February, 1910 February, 1910. Charge Nurse M. C. Raggio November, 1924 November, 1924. Assistant Nurse fE. J. Pearson December, 1924 December, 1924. „ ,, S. Rees August, 1924 August, 1924. ,, ,, A. Dawes December, 1924 December, 1924. Probationer Nurse H. Prior April, 1923 April, 1923. Cook-General (Vacant) Maid A. Chapman August, 1924 August, 1924. Wardmaid M. Edwards October, 1924 October, 1924. Handyman, &c. R. W. Rutland March, 1924 March, 1924. Laundress Mrs. Rutland Gardener S. Waterman April, 1919 April, 1919. LAUNCHES— " Lady Truscott Master W. Jarvis July, 1893 April, 1911. Engineer J. A. Hardman July, 1893 December, 1911. Mate A. F. Rough November, 1914 November, 1914. Fireman A. E. Howard February, 1912 February, 1912. "James Howell"—Motor LaunchMaster C. H. Price May, 1912 February, 1923. 'George BRiGGs"-Motor LaunchMaster C. Strange December, 1898 October, 1913. Engineer J. J. Steen May, 1908 October, 1913. GREENWICH MOORINGS— Barge " Ella Vicars "— Watchmen H. A. Clarkson May, 1912 May, 1912. E. Ditch. January, 1915 November, 1917. GRAVESEND—Hulk "Hygeia"— Shipkeepers A. Salter July, 1898 July, 1898. J. H. Salter February, 1919 February, 1919. * These Inspectors possess the Special Certificate of the Royal Sanitary Institute for Inspectors of Food, t An addition to the Staff due to the absence of Nurse Prior, under treatment in hospital. a 2 6 5, Church Passage, Guildhall, E.C. 2. January, 1925. TO THE WORSHIPFUL THE PORT OF LONDON SANITARY COMMITTEE. Gentlemen, I have the honour to present herewith my Annual Report for the year ending 31st December, 1924. The total number of vessels medically inspected during the year was 899, and the total number of cases of illness reported to your Medical Officers was 578, of which number 60 cases were removed to Denton Hospital. Temporary arrangements were made for carrying on the duty at Sheerness Boarding Station, owing to the retirement of Dr. Legge. Aliens arriving in the Port have been found to be clean, healthy and louse-free. No plague, cholera, typhus or smallpox case was dealt with in Port. No plague infected rat has been found in the Port during the year. Food and Sanitary Inspections have been carried out in a satisfactory manner. One Sanitary Inspector was promoted to the duties of Food Inspection. Two new Sanitary Inspectors were appointed on probation. The question of canned spinach was before your Worshipful Committee. Bye-laws in connection with house-boats came into force on the 12th June 1924. On April 9th a number of Foreign Medical Officers were shown the Port and some of the working of the Authority in connection with infectious disease. Legal proceedings were taken in two cases in connection with recurring smoke nuisances. An order was placed for a new motor launch for use on the Gravesend Station. The annual report on the working of the Canal Boats Acts and Regulations is appended to this report. TABLE I.—MEDICAL INSPECTION. From 1st January to 31st December, 1924. (a) Gravesend. Jan. Feb. March April May June July August Sept. Oct. Nov. Dec. Total. No. Medically inspected 85 64 74 68 74 44 62 68 77 86 94 103 899 No. of Passengers 386 345 422 951 886 252 919 2,604 1 ,252 359 667 318 9,361 Number of Crews 4,909 ; 3,450 4,177 4,222 4,176 3,390 3,302 5,500 3,493 3,822 4,152 5 i,106 49,699 Number of Foreign Arrivals 824 643 786 851 990 955 1,143 1,020 994 1,015 1,005 976 11,202 (b) Sheerness. Jan. Feb. March April May June July August Sept. Oct. Nov. Dec Total. No. Medically Inspected – – – – – – – – – – – – – No. of Passengers – – – – – – – – – – – – – No. of Crews – – – – – – – – – – – – – No. of Foreign Arrivals 13 20 20 29 31 52 45 43 40 45 39 35 412 7 MEDICAL INSPECTION AT SHEERNESS. The following report, dated 2nd October, 1924, was made to your Worshipful Committee, on the question of medical inspections at Sheerness :— " THE SHEERNESS BOARDING STATION AND DUTIES OF A MEDICAL OFFICER AT SHEERNESS." " The termination of Dr. Legge's services at Sheerness is a convenient time for examination of the whole position with regard to the question of retaining the services of a wholetime Medical Officer stationed at this point. Before the war, a regular Flushing—Queenboro' passenger and cargo service afforded daily and constant work for a Medical Officer in examination of passengers, meat and aliens. Queenboro' as a landing place appears now to be beyond special consideration for some time to come. For one year ending September 5th, 1924, the total arrivals from foreign ports at the mouth of the Medway were 424, i.e., one ship, sometimes two, a day. Their nationalities are British, 180 ; Foreign, 244. Vessels from ports in Europe lying North of the Dover Straits, 279. Vessels from ports on which routine watch for infectious disease is usually kept, 20 (Petrograd, 3 ; Riga, 1 ; Finland, 7 ; British India, 2 ; Mexico, 1 ; Malta, 2 ; Black Sea, 2 ; Gibraltar, 1 ; Gambia, 1). Though, from time to time, in the past 20 years, cases of illness have been investigated by the Medical Officer, infectious cases have been extremely few—one scarlet fever and two enteric fever. These have each been duly declared before examination. The trades in which the ships are engaged present no special infectious disease problems, such as the Plague rat. The visit to each arrival would of itself occasion no great work, and the visit to each ship on which illness is declared, much less still. But to keep a launch under way or waiting day and night for the sole purpose of transporting a Medical Officer to one, perhaps two, boats a day—the great majority being boats of small tonnage and small crew—seems to be materially out of perspective with the necessities, and latterly no such facility for the regular transport of a Medical Officer has been available. The Customs launch with a ' quarantine ' officer on board may be anywhere between Chatham and Sheerness at the moment when the vessel from ' foreign ' rounds Garrison Point. The Customs ' quarantine ' officer puts his questions to the master; if the replies are satisfactory there is no law for his detention of the vessel or turning her round on tide or sending her back to Garrison Point. Thus the Medical Officer may have been ready and waiting on the quayside only to see the ship pass up without his visit. The difficulty of boarding at Sheerness would not be surmountable unless with a launch always at the disposal of the Medical Officer and a ' quarantine ' officer constantly and solely detailed to ' quarantine ' work, or with a Medical Officer on duty night and day and constantly on board the Customs launch. The first of these alternatives would strain the equipment and staff of the Customs and the second that of the Port Sanitary Authority. The district of the Port of London ends at a line joining the mouth of the River Swale with Goalmouth Creek at the Isle of Grain and includes Ridham Dock in the Swale. Analysis for the year shows that the number of ships entering the Medway bound for the Port of Rochester is 235 as against 188 remaining in the Port of London district. For Rochester—Chatham, 11 ; Rochester, 207 ; Upnor, 10 ; Strood, 4; Gillingham, 2; Maidstone, 1 ; equals 235. For London—Port Victoria, 9 ; Ridham Dock, 136 ; Queenboro', 38 ; Sheerness, 5 ; equals 188. For Faversham—1. The ships for the London district can easily be examined from Sheerness within a short time of arrival by a Medical Officer overland, or in ships for Port Victoria, by boat, information of arrival being given by the Customs. At present the Port of Rochester contributes to the Port of London Sanitary Authority £100 per annum for ' quarantine ' work. It will thus be seen that the Customs, The Rochester Port and the Port of London Sanitary Authority are jointly concerned in the boarding arrangements. The Ministry of Health is obviously interested. It appears to your Medical Officer that any routine work having such small practical effect as that at the Sheerness boarding station tends to become a secondary consideration and would certainly not be attractive work to a whole-time officer of any merit. A part-time Medical Officer could be as effective. The 188 ships for the London district can be reached at any time within an hour or so of arrival and inspection made. The Customs would, no doubt, give information as at present ; whenever illness is declared information would be immediate and the visit and inspection of the Medical Officer hastened. 8 The inspection of the 235 ships for Rochester district would in that case remain for that Authority's consideration. Where infectious disease on ships bound for either district is declared at Sheerness the Medical Officer acting for the Port of London Sanitary Authority could, with information and assistance from the Customs officer, board and make arrangements for dealing with cases as at present. So few cases have occurred in twenty years that no routine in this matter has been established, but the Port of London Sanitary Authority has always been prepared to deal with the cases and the infection on the ship arriving. I recommend that your Medical Officer be authorised to approach the Ministry of Health, the Rochester Port Sanitary Authority and His Majesty's Customs for exploring a satisfactory arrangement by which a part-time Medical Officer can carry on the work efficiently." It is obvious in matters of Public Health that any arrangement made before the etiology of plague and other infectious diseases had had elucidation in the fruitful years, 1902—1920, should be closely re-examined at this date. TABLE II.—INFECTIOUS DISEASE. disease. 1915. 1916. 1917. 1918. 1919. 11)20. 1921. 1922. 1923. Mean Annual No. for 10 years ending 31st Dec., 1924. 1924. (a) Cases Reported: Cholera (including suspected cases). 2 5 2 — 9 10 – 1 3 3.3 1 Yellow Fever (ditto) – – – – – 2 – – – .2 – Plague (ditto) 4 – 18 12 20 6 8 9 4 8.2 1 Smallpox 47 15 2 16 43 27 9 17 12 20.5 17 Scarlet Fever 18 5 – 8 4 11 28 11 6 9.9 8 Diphtheria 18 7 9 23 25 21 20 44 29 21.9 23 Enteric Fever 64 61 43 26 77 51 44 29 49 48.6 42 Measles 337 836 168 256 52 513 60 20 82 237.0 46 German Measles 10 8 33 4 7 12 8 – 19 11.9 18 Erysipelas 9 1 – 3 3 1 — 2 2.4 5 Typhus Fever – — 1 – – 1 1 1 – .4 – Continued Fever 7 5 2 2 – 1 4 2 4 2.9 2 Relapsing Fever – – – 19 – – – – 2 2.1 – Tuberculosis:— Pulmonary 96 53 45 38 51 67 54 44 83 62.1 90 Other kinds 6 19 26 20 35 2 2 4 6 12.6 6 Other diseases (including Chickenpox). 48 44 166 2,552 1,887 766 310 348 336 677.6 319 Total 666 1,059 515 2,976 2,213 1,493 549 530 637 1,121.6 578 (b) Treated in Port Sanitary Hospital: Cholera (including suspected cases). – – – – 1 – – – – 1 – Yellow Fever (ditto) – – – – – – – – – – – Plague (ditto) – – 9 12 10 2 1* – – 3.4 – Smallpox 10 2 – 1 13 10 – – 3 3.9 – Scarlet Fever 10 2 – 5 1 3 13 2 – 4.2 6 Diphtheria 3 1 1 – 1 4 3 3 1 1.8 1 Enteric Fever 17 34 15 7 42 11 13 9 10 17.1 13 Measles 33 4 3 2 – 35 6 5 1 9.7 8 Erysipelas 1 – 1 – – 1 – – 2 6 1 Typhus Fever – – – – – – – – – – – Continued Fever 5 4 8 6 – 1 3 – 2 2.9 – Other diseases (including Chickenpox) 11 6 24 24 22 13 9 14 10 16.4 31 Total 90 53 61 57 90 80 48 33 29 60.1 60 * Plague negative. 9 TABLE III. Return of the number of cases of Infectious Disease notified to the Ministry of Health during the year 1924, and of deaths from the diseases notified. This Table includes all cases actually introduced or occurring within the Port, but does not include cases reported as having occurred on vessels during the voyage, but which had either recovered or been removed from the vessel before arrival at Gravesend. Notified. Deaths. Notified. Deaths. Smallpox – – Brought forward 51 4 Scarlet Fever 5 1 Continued Fever — — Diphtheria (including Membranous Croup) 17 _ Trench Fever — — Dysentery 6 — Enteric Fever (Typhoid and Paratyphoid) 18 3 Ophthalmia Neonatorum – – Erysipelas 4 – Pneumonia 11 — Tuberculosis:— Cholera — — Respiratory 66 1 Plague — — Other Forms 5 — Puerperal Fever — — Malaria 50 1 Cerebro-spinal Fever — — Chickenpox 28 — Acute Poliomyelitis — — Measles (excluding German Acute Polio-encephalitis — — Measles 10 — Encephalitis Lethargica — — Whooping Cough — — Typhus Fever — — Other Diseases 42 — Relapsing Fever — — Total 262 6 Carried forward 51 4 TABLE IV.—Cholera. Date. Name of Vessel, Port of Registry and Official No. Where from. No. of Cases. How dealt with. 1924. Sept. 15 ss. " Argalia," Glasgow, 142,474. Cuba l Landed at Bassein. CHOLERA. ss. " Argalia " arrived from Cuba, 15th September, 1924. This vessel was loading at Bassein, where there was epidemic cholera. The patient, a donkeyman, became suddenly ill on the 14th May, 1924, and was landed immediately. The case proved fatal, and was diagnosed as cholera there. There were no other cases, and the vessel left for Durban, subsequently. Fumigation of infected quarters was carried out, and effects destroyed. The case occurred previous to the present voyage, and was reported on arrival at Gravesend. All on board were well on arrival, and the vessel proceeded to West India Docks. TABLE V.—Plague. Date. Name of Vessel, Port of Registry and Official No. Where from. No. of Cases. How dealt with. 1924. Dec. 23 ss. " Atlanticos," Syra. New Orleans l Landed New Orleans. PLAGUE. The ss. " Atlanticos " arrived at Gravesend, December 23rd. Warning of her history had been received from the Ministry of Health through the United States Public Health Service, previously. A stowaway from Oran (4th Oct., 1924) worked as coal trimmer till the ship reached New Orleans, 27th October. On this day he was ill of fever and swelling in the groin. On October 28th he was sent to hospital and the diagnosis of plague was made 5 days later. The ship left New Orleans, 27th November ; during the month's stay the crew were under observation—no further case of plague occurred. The vessel went from Barcelona to Oran for bunker coal and thence to New Orleans in ballast, but had shipped 2,000 tons of cargo before the final fumigation. The cargo thus shipped was timber, rice and carbon black. On the 30th October there was a cyanide fumigation of the ship. 10 On the 3rd November the ship was again fumigated with cyanide and 35 dead rats were recovered, 9 of which were plague infected. Since this disinfestation, 6 rats were trapped, all free from plague. The cargo, about 6,000 tons, from New Orleans and Newport News, consisted of timber, lubricating oil, spelter, oyster shell, rice and carbon black. There was rice in bags in all holds. The trapping of rats after disinfestation is a suspicious circumstance but there is a possibility that these boarded the vessel at New Orleans between November 3rd, the date of final disinfesting, and the 27th November, the date of leaving. In the dock the ship was boomed off, 15 feet from the quay, during non-working hours. Every mooring rope was guarded with tarred trapping and discs properly fitted. One gangway only was permitted and this was whitened. No barge was allowed to be alongside during non-working hours or from dusk to dawn. A watch was kept for rats alive or dead during discharge of cargo. The assumption of a difficulty of complete efficacy in disinfesting with cyanide in the presence of cargo made the close examination of this ship as to rats on discharge a matter of interest. Recent evidence (ss. " Trevanion ") as well as a past experience (ss. " Hector ") shows that a history of only small numbers of rats on board is quite compatible with human outbreak in the presence of rat plague infection, particularly where the manifest shows no particular attraction to rats in the holds. No sign of rats was found on board ; the American fumigations appear to have been absolute. In order to secure a certificate of disinfestation and thus clear the ship of any stispicion a further sulphur disinfestation was carried out in the Port. On the 14th October, 1924, information was received from the Ministry of Health that a case (or two cases) of plague had occurred on the ss. " Trevanion," which arrived at Port Said from Cardiff on the 21st September. The movements of the vessel were as follows :— May, 1924, on voyage from Cardiff to Rio de Janeiro. June 9, arrived Rio de Janeiro. June 18, left Rio de Janeiro for Bahia Blanca. June 26, arrived Bahia Blanca. July 8, left Bahia Blanca for St. Vincent. June 28, left St. Vincent for London. August 13, arrived London. Left London (in ballast) for Barry. August 22, arrived Cardiff. September 4, sailed from Cardiff. September 5, passed Lundi Islands. September 21, arrived Port Said. This vessel arrived at Gravesend, 7-25 p.m., on the 13th August. Close enquiries were made with regard to rats, the vessel having come from a plaguesuspected port with a grain cargo. The answers given by the master were not completely satisfactory, and instructions were given for further enquiries to be made. The vessel proceeded to Bellamy's Wharf where a thorough examination was carried out ; no trace of rats was found. The vessel was reported to have been fumigated at Dunkirk in May, by " sulphur pump." About 40 rats were then found as a result of fumigation. The ss. " Osterley " which arrived from Brisbane on the 20th November, brought back several distressed British seamen from Port Said, amongst whom was H.D. He contracted plague on the ss. " Trevanion " and was landed at Port Said. He had buboes in both groins and fever. Both buboes were opened and healed. The scars showed that these were femoral buboes. The Surgeon of the " Osterley " had no knowledge of these cases and did not report them until questioned as to the illness of several distressed British seamen. Documents were then produced and their details obtained. H.D. was questioned by the boarding Medical Officer and supplied the following interesting details. He was a mess-room boy and was affected two days later than the steward. He, a steward and a cabin boy berthed together in the poop. Next to their cabin was a storeroom. He saw numerous rats during the outward voyage from Cardiff. 11 Questioned as to dead rats he said there were smells in the alleyway adjoining the cabin and one or more dead rats were found in the alleyway on the voyage from Bahia Blanca to London. The place of infection of the " Trevanion " was probably Bahia Blanca, on the evidence of the mess-room boy. The circumstances under which a rat plague infested ship can freely deliver a cargo in the port in spite of (I.) Definite questioning of the Master as to rats. (II.) Regulated searching of the ship during discharge, leading to a conclusion of non-rattiness, indicate the difficulty of any absolute protection in the matter of the plague rat unless aided by the rat-prevention campaign throughout the country. The proprietors of the wharf, to which this ship went for discharge, are to be congratulated on the state of their wharf and warehouses and on the efforts they make to secure freedom from rats. TABLE VI.—Smallpox. Date. Name of Vessel, Port of Registry and Official No. Where from. No. of Cases. How dealt with. 192 Jan. 9 4. ss. " Nyanza," Greenock, 123,529. Kobe i Landed at Colombo. „ 11 ss. " Machaon," Liverpool, 143,674. Taku Bar i . Landed at Singapore. „ 24 ss. " Braunfels," London, 139,050. Basra and Liverpool l Landed at Koweit. Feb. 12 ss. " Glenapp," Glasgow, 144,230. Kobe i Landed at Suez. „ 29 ss. " Macedonia," Belfast, 116,012. ,, 2 Kobe, 1 ; Shanghai, 1. Mar. 16 ss. " Mentor," Liverpool, 137,408. ,, 1 Landed at Colombo. April 4 ss. " Caledonia," Greenock, 102,390. Bombay 1 Landed at Aden. „ 29 ss. " Manela," Glasgow, 144,250. Karachi 2 1 landed Karachi, 1 Bombay. „ 30 ss. " Devanha," Greenock, 117,400. Bombay 2 Landed at Port Said. May 4 ss. " Rhexenor," Liverpool. Dairen 1 Removed to hospital at Glasgow. „ 28 ss. " City of Cairo," Liverpool, 137,423. Tsingtao 1 Landed at Marseilles. June 12 ss. " Caledonia," Greenock, 102,390. Bombay 1 Landed at Gibraltar. Sept. 9 ss. " Peleus " Dalny 1 Landed at Dalny. Dec. 31 ss. " Nevasa," Glasgow, 133,102. Calcutta 1 Landed at Aden. SMALLPOX. ss. " Nyanza " arrived from Kobe on the 9th January. On the 25th November, a fireman from thess. "Nellore,''left in hospital at Hong Kong, with fever and cough, was sent on board the " Nyanza " for passage home. On the 1st December patient was ill, smallpox rash appeared on the 6th December and patient was landed at Colombo on the 10th. Crew were vaccinated. Infected quarters on the vessel were disinfected at Colombo. ss. " Machaon " arrived from Taku Bar on the 11th January. On the 2nd December an assistant steward was taken ill with headache, backache and vomiting. Rash appeared on the 5th December. Case was diagnosed as smallpox. Isolated and landed at Singapore. All on board were vaccinated. Bedding and blankets were removed for steam disinfection at Gravesend, and the infected cabin fumigated and washed down. ss. " Braunfels " arrived from Basra and Liverpool on the 24th January. The third mate was taken ill on December 2nd, taken to hospital at koweit with smallpox on the 7th, and died there on the 14th December. All crew were vaccinated, and cabin disinfected, at koweit. B 12 ss. " Glenapp " arrived from Kobe, 12th February. On January 15th, a sailor (Chinaman) complained of feeling unwell; no rash. On the 16th a pimple was noticed on his forehead. Patient was at once isolated ; general rash developed later, and he was landed at Suez on the 27th. Bedding, &c., was destroyed ; cabin and forecastle fumigated. No other case occurred. The ss. " Macedonia " arrived from Kobe on the 29th February. On January 12th a European steward was landed at Kobe with smallpox. Another case (a native) occurred in Shanghai. The crew were vaccinated, and thorough disinfection of vessel carried out in Kobe. No other case occurred. The ss. " Mentor " arrived from Kobe on the 16th March. On February 16th a stewardess developed smallpox, was isolated and landed at Colombo on the 22nd. Probable place of infection Shanghai on February 3rd. Patient vaccinated at birth and not since. All passengers and crew were vaccinated at Colombo ; effects were also landed, bedding destroyed, and vessel disinfected. No further case occurred. ss. " Caledonia " arrived from Bombay on the 4th April. On March 17th a saloon steward was taken ill with fever ; rash came out on March 20th, with severe headache, backache and vomiting. Patient landed at Aden as a case of smallpox. Disinfection of infected quarters on the vessel was carried out at Aden ; clothing thrown overboard. Four persons were also vaccinated. A suspicious case was landed at Denton Hospital on arrival of this vessel. This case turned out to be one of skin rash. Hospital quarters were fumigated ; effects were removed to Denton Hospital. A native attendant was taken ashore for disinfection, and returned to the ship. ss. " Manela " arrived from Karachi on 29th April. On 28th March a Lascar was taken ill with smallpox and sent to hospital at Karachi the same day. On the 30th March, the third cook was taken ill and sent to hospital at Bombay on the 31st. The whole crew were vaccinated at Karachi, and the vessel disinfected. The crew's quarters were again disinfected at Bombay, all the crew being landed and their clothing and bedding put through a steam disinfector. ss. " Devanha " arrived from Bombay on 30th April. A baker reported ill on the 15th April—case diagnosed as smallpox and landed at Port Said on the 18th April. On the 12th April a passenger who had been a smallpox contact ashore, reported sick—rash came out 15th April. Case landed at Port Said on the 18th. At Port Said all cabins were fumigated ; contents taken ashore to Isolation Hospital. Personal effects landed with patients. All contacts were vaccinated. Contents of the Isolation Flospital were landed at Gravesend for disinfection ; the Hospital was also fumigated. ss. " Rhexenor " arrived from Dairen at 8 a.m., on May 4th. Vessel reported all well on arrival, with the exception of one death from broncho-pneumonia and one case beri-beri. On May 6th information was received from Glasgow that a passenger (D.B.S.) per this vessel had there been removed to hospital recovering from smallpox. The names and addresses of the crew were at once notified to the various Medical Officers of Health, and the living quarters on the vessel disinfected. This vessel reported all well and no sickness during the voyage, and the Surgeon certified accordingly. The man had been put on board the " Rhexenor " by the Consul. The master produced his Board of Trade certificate whereon was written " Illness suspected smallpox proved negative." In reply to my enquiry, the ship's Surgeon reported his observations on the case wherein it was now obvious that, at Suez, a misdiagnosis had been made. On May 8th, Glasgow reported that the diagnosis of smallpox had been confirmed, and gave details of a history of two former cases (one fatal) on the ship 13 on the previous homeward voyage as also of the present case which were perfectly conclusive as to diagnosis. The infection, which remained in this case, though slight, was capable of setting up an epidemic. Happily there were no developments. ss. " City of Cairo " arrived from Tsingtao on the 28th May. On the 20th May a case of smallpox was landed from this vessel at Marseilles. All passengers and crew, except native firemen, were vaccinated. Cabins and contents disinfected at Marseilles ; bedding taken ashore and disinfected with steam. The names and addresses of all passengers and crew, leaving the ship, were notified to the various Medical Officers of Health. ss. " Caledonia " arrived from Bombay on the 12th June. On the 8th June a passenger was removed at Gibraltar suffering from smallpox ; patient's husband (contact) also landed. All the 2nd saloon staff and contacts were re-vaccinated. Isolation Hospital and infected cabin were fumigated. On arrival at Gravesend, fumigation was again carried out, and clothing and bedding removed to Denton Hospital for steam disinfection. The names and addresses of all passengers and crew were notified to the various Medical Officers of Health. ss. " Peleus " arrived from Dalny, on the 9th September. On the 30th June the carpenter was taken ill and the case was diagnosed as smallpox—landed at Dalny, 25th June. Patient remained in hospital over a fortnight and was put on board the ss. " Rhexenor " and landed at Port Said ; patient rejoined the " Peleus " on the 26th August, and is now on duty. The vessel was disinfected at Dalny and effects were landed or destroyed. All crew were vaccinated. No further case occurred. ss. " Nevasa " arrived from Calcutta, 31st December, 1924. On the 6th December a native fireman was taken ill ; rash appeared on the 8th. Patient was immediately isolated with all infected clothes and bedding. The quarters occupied were disinfected. The patient was landed at Aden on the 12th. All infected bedding, &c., was then burnt, and the hospital cabin disinfected. The vessel was kept under daily observation while in the Port. No other case occurred. TABLE VII.—Scarlet Fever. Date. Name of Vessel, Port of Registry and Official No. Where from. No. of Cases. How dealt with. 1924. Jan. 2 ss. " Highland Pride," London, 129,086. Buenos Aires l Landed at Buenos Aires. Apl. 10 South-West India Dock — 1 Removed to hospital at Poplar. May 7 ss. " Albania," Liverpool, 143,704. New York 2 Removed to Port Sanitary Hospital. June 5 ss. " Gascon," Southampton, 106,907. London 1 ,, ,, July 1 ss. " Antonia," Liverpool, 145,937. Montreal 2 ,, ,, Nov. 19 ,, ,, ,, 1 ,, ,, TABLE VIII.—Diphtheria. Date. Name of Vessel, Port of Registry and Official No. Where from. No. of Cases. How dealt with. 1924. Jan. 30 H.M.S. " Alert," lying off Woolwich l Removed to Park Hospital (M.A.B.) Feb. 1 ss. " Persic," Liverpool, 110,620. Brisbane 2 Landed at Southampton. June 4 Training Ship " Warspite " – 1 Removed to hospital at Dartford. July 12 ,, ,, – 1 Removed to Port Sanitary Hospital. Carried forward 5 B 2 14 Diphtheria—continued. Date. Name of Vessel, Port of Registry and Official No. Where from. No of Cases. How dealt with. 1924. Sept. 3 S/tug " Southampton," London, 129,132. Brought forward 1 Removed to Tilbury Hospital. Oct. 31 Training Ship " Exmouth " – 7 Removed to Eastern Hospital (M.A.B.) Nov. 1 " – 3 (Carriers). ,, ,, „ 13 " – 4 (Carriers). ,, ,, „ 21 ,, ,, – 2 (Carriers). ,, ,, Dec. 31 ss. " Salerno," Hull Christiania 1 Landed Christiania. 23 TABLE IX.—Enteric Fever. Date. Name of Vessel, Port of Registry and Official No. Where from.' No. of Cases. How dealt with. 1924. Jan. 31 ss. " Highland Rover," London, 129,607. B. Aires 1 Removed to Port Sanitary Hospital. Mar. 7 ss. " City of Benares," Glasgow, 114,004. Calcutta 1 ,, ,, 27 ss. " Morea," Glasgow, 128,235. Kobe 1 Landed at Marseilles. „ 29 m/s. " Loch Katrine," London, 146,228. N. Pacific Coast 1 Landed at Colon. Apl. 13 ss. " Karmala," Liverpool, 135,590. Yokohama 1 Landed at Colombo. „ 24 ss. " Nevasa," Calcutta 1 Removed to Port Sanitary Mav 9 Glasgow, 133,102. ss. " Maloja " Sydney 1 Hospital. ,, ,, „ 26 ss. " Nore," Greenock, 123,531. Calcutta ,, ,, June 19 ss. " Marquesa," Liverpool, 140,586. La Plata 1 ,, ,, „ 20 ss. " Rapot," Bremen Chili 1 ,, ,, „ 23 ss. " Ethelwolf," Whitby, 118,859. Buenos Aires 1 ,, ,, „ 28 ss. " Kaisar-I-Hind," Greenock, 128,653. Bombay 1 ,, ,, July 17 ss. " Egyptian Transport," W. Hartlepool, 135,900. Buenos Aires 1 Convalescent on arrival. „ 19 ss. " Kosmo," London, 145,192. Hankow 1 Landed Hong Kong. „ 24 ss. " Morvada," Glasgow, 136,319. Calcutta Landed Madras. „ 24 ss. " El Uruguayo," W. Hartlepool, 132,817. Buenos Aires 1 Removed to hospital at Liverpool. Aug. 10 ss. " Mandala," Glasgow, 137,806. Calcutta 1 Landed Marseilles. „ 15 ss. " Rygja," Bergen Montreal 1 Admitted to Royal Albert Dock Hospital. „ 18 ss. " Karmala," Liverpool, 135,590. Yokohama 1 landed Port Said. 1 died on board. „ 29 ss. " Aviemore," Ibrail 1 Removed to Port Sanitary „ 31 Liverpool, 143,675. ss. " City of Tokio," Vladivostock Hospital. Convalescent on arrival. Sept. 1 Liverpool, 145,886. ss. " Minnewaska," Belfast, 145,433. New York 1 Landed New York. „ 1 ss. " Nevasa," Beira 1 Landed Aden. „ 13 Glasgow, 133,102. ss. " Selandia," Copenhagen. Bangkok 1 Landed Colombo. „ 21 ss. " City of Dunkirk," Liverpool, 131,464. Moji 1 Landed Hong Kong. Oct. 7 ss. " Kitano Maru," Tokio. Yokohama 2 Admitted to Seamen's Hospital, Greenwich. Carried forward 30 15 Enteric Fever—continued. Date. 1924. Name of Vessel, Port of Registry and Official No. Where from. Brought forward No. of Cases. 30 How dealt with. Oct. 10 ss. " Mahratta," Liverpool, 140,545. Calcutta 1 Landed Colombo. Nov. 5 ss. " Port Macquarie," London, 135,132. •> 1 „ 6 ss. " Hardwicke Grange," London, 146,177. La Plata 1 Well on arrival. Nov. 20 ss. " Osterley," Glasgow, 128,287. Brisbane 1 Put on board at Gibraltar free from infection. .. 21 ss. " Nore," Greenock, 123,531. Calcutta 1 Hospital for Tropical Diseases, Euston. „ 23 ss. " Clan Murdoch," Glasgow, 141,911. Marmagon 1 Landed Cochin. „ 26 ss. " Saxonia," Liverpool, 110,648. New York 1 Removed to Port Sanitary Hospital. „ 28 ss. " Paris Maru," Osaka Y okohama 1 Removed to Royal Albert Dock Hospital. „ 29 ss. " Minnewaska," Belfast, 145,433. New York 1 it ti Dec. 2 ss. " Morea," Glasgow, 128,235. Yokohama 1 it it „ 29 ss. " City of Venice," Glasgow, 147,890. Calcutta 1 Admitted to hospital at Glasgow. „ 31 ss. " Madura," Glasgow, 146,268. Beira 1 Landed Marseilles. 42 TABLE X—Measles. Date. 1924. Name of Vessel, Port of Registry and Official No. Where from. No. of Cases. How dealt with. Feb. 29 ss. " Macedonia," Belfast, 116,012. Kobe 4 Patients well on arrival. Mar. 9 ss. " Macharda," Liverpool, 140,593. Calcutta 1 Treated on board. „ 17 ss. " Novara," Greenock, 131,860. ,, 8 6 well; 2 to Port Sanitary Hospital. Apl. 9 ss. " Andania," Liverpool, 145,934. New York 1 Proceeded home. May 22 ss. " Longships," Glasgow, 141,869. Glasgow 1 Removed to Port Sanitary Hospital. „ 28 ss. " Nellore," Greenock, 135,235. Yokohama 3 Well on arrival. June 2 ss. " Lapland," Liverpool, 137,398. New York 1 ,, ,, „ 3 ss. " Ausonia," Liverpool, 145,970. Montreal 1 Removed to Port Sanitary Hospital. „ 17 ss. " Andania," Liverpool, 145,934. ,, 1 ,, ,, „ 24 ss. " Dunluce Castle," London, 118,490. Beira 1 Convalescent on arrival. „ 28 Training Ship " Warspite " — 1 Removed to Ship's hospital. „ 30 ss. " Lapland," New York 2 1 landed New York ; 1 to Aug. 1 Liverpool, 137,398. ss. " Merkara," Rangoon 2 ' Port Sanitary Hospital. Proceeded home. „ 3 Glasgow, 136,332. ss. " Morea," Kobe 3 Convalescent on arrival. „ 15 Glasgow, 128,235. ss. " Ballarat," Greenock, 145,596. Sydney 1 ,, ,, Sept. 28 ss. " Jervis Bay," Sydney, 150,187. ,, 1 ,, ,, Oct. 10 ss. " Medic," Liverpool, 110,573. Brisbane 2 Landed Southampton. „ 29 ss. " Durham Castle," London, 118,387. Beira 10 9 landed Plymouth ; 1 to Port Sanitary Hospital. Nov. 6 ss. " Baradine," Belfast, 145,419. Sydney 1 Removed to Port Sanitary Hospital. „ 14 ss. " Garth Castle," London, 129,078. Beira 1 Well on arrival. 46 16 TABLE XI.—German Measles. Date. Name of Vessel, Port of Registry and Official No. Where from. No. of Cases. How dealt with. 1924. Apl. 14 ss. " Guildford Castle," London, 132,611. Beira 2 Well on arrival. „ 24 ss. " Nevasa," Glasgow, 133,102. Calcutta 1 ,, May 2 ss. " Malwa," Greenock, 127,543. Bombay 1 Proceeded home. June 4 Training Ship " Warspite " — 1 Removed to Ship's hospital on shore. „ 18 July 9 ss. " Ausonia," Liverpool, 145,970. Montreal 1 1 Well on arrival. Oct. 17 ss. " Ruahine," Plymouth, 124,582. Auckland 8 Landed Southampton. Nov. 10 ss. " Moldavia," Liverpool, 145,973. Sydney 2 Landed Port Said. Dec. 7 ss. " Minnetonka," Belfast, 145,438. New York 1 Convalescent on arrival. 18 TABLE XII.—Erysipelas. Date. Name of Vessel, Port of Registry and Official No. Where from. No. of Cases. How dealt with. 1924. Jan. 13 ss. " Malancha," Liverpool, 140,567. Calcutta l Died on board. May 27 ss. " Antonia," Liverpool, 145,937. Montreal l Removed to St. Thomas's Hospital. July 9 ss. " Oddvar," Christiania. – l Removed to Seamen's Hospital, Greenwich. Aug. 25 West India Docks (Tobacco Warehouse) l Removed to Poplar Hospital. Dec. 17 ss. " Andania, Liverpool, 145,934. New York 1 5 Removed to Port Sanitary Hospital. TABLE XIII.—Continued Fever. Date. Name of Vessel, Port of Registry and Official No. Where from. No. of Cases. How dealt with. 1924. Apl. 23 ss. " Prometheus," Liverpool, 105,387. Manila 1 Landed at Batavia. June 28 ss. " Kaisar-1-Hind," Greenock, 128,653. Bombay 1 Landed Marseilles. 2 TABLE XIV.—Pulmonary Tuberculosis. Date. Name of Vessel, Port of Registry and Official No. Where from. No. of Cases. How dealt with. 1924. Jan. 7 ss. " Kalyan," Liverpool, 137,449. Yokohama 4 To Naval Hospital. „ 19 ss. " Devanha," Greenock, 117,400. Kobe 1 Landed at Penang. Feb. 1 ss. " Kaisar-i-Hind," Greenock, 128,653. ,, 1 Proceeded home. „ 14 ss. " Dorset," London, 118,256. New Zealand 1 To report to Tuberculosis Officer at Croydon. „ 19 ss. " Khiva," Liverpool, 135,533. Kobe 2 1 landed at Port Said, 1 at Marseilles. „ 29 ss. " Umtali," London, 105,810. Beira 1 Landed at Durban. Mar. 9 ss. " Macharda," Calcutta 1 Died on board. „ 17 Liverpool, 140,593. ss. " Kashgar," Greenock, 128,654. Kobe 1 Remained on board. „ 25 ss. " Sandon Hall," Liverpool, 143,734. ,, 1 Died on board. Carried forward 13 17 Pulmonary Tuberculosis—continued. Date. Name of Vessel, Port of Registry and Official No. Where from. No. of Cases How dealt with. 1924. Brought forward 13 Apl. 7 ss. " Hardwicke Grange," London, 146,177. Buenos Aires 1 Proceeded home. „ 14 ss. " Syria," Lying off Southend 1 Admitted to Seamen's Hospital, Greenwich. „ 16 ss. " Kaisar-I-Hind," Greenock, 128,653. Bombay 1 Proceeded home. „ 17 ss. " Iris," London, 145,540. Antwerp 1 Admitted to Seamen's Hospital, Greenwich. „ 25 ss. " Naldera," Greenock, 142,257. Kobe Landed at Bombay. May 13 ss. " Koranna," London, 120,498. — 1 Admitted to Seamen's Hospital, Greenwich. „ 14 ss. " City of Madrid," Glasgow, 113,965. Marmagon 1 Landed at Alleppey. „ 15 ss. " Troilus," Liverpool, 145,865. Taku Bar 1 Removed to hospital at Medhurst. „ 19 ss. " Nagoya," Greenock, 135,323. Calcutta 1 Died on board. „ 23 ss. " China," Belfast, 104,467. Sydney 1 Went to a hospital in London. „ 28 ss. " City of Cairo," Liverpool, 137,423. Tsingtao 1 Taken charge of by Admiralty. June 3 ss. " Hertford," London, 144,656. Wellington 1 Proceeded to Switzerland. „ 5 ss. " Mahratta," Liverpool, 140,545. Calcutta 1 Landed at Colombo. „ 5 ss. " Goorkha," Southampton, 106,917. Beira 1 Admitted to Seamen's Hospital, Greenwich. „ 9 ss. " Ionic," Liverpool, 115,337. Auckland 1 „ „ „ 14 ss. " Highland Pride," London, 129,086. Buenos Aires 1 Proceeded home. „ 14 ss. " Largs Bay," Adelaide, 137,225. Brisbane 1 Admitted to Royal Albert Dock Hospital. „ 17 ss. " Ormonde," Glasgow, 141,866. • 1 Died on board. „ 29 ss. " Lancashire," Liverpool, 140,529. Rangoon 1 „ July 18 ss. Laomedon," Liverpool, 131,442. Yokohama 3 In charge of Naval Authorities. „ 19 ss. " Moldavia," Liverpool, 145,973. Sydney 6 In charge of Military Authorities. Aug. 1 ss. " Farraday," London, 147,458. Turks Island 1 Proceeded home. „ 9 ss. " Llanstephan Castle," London, 135,315. Mombasa 1 Landed Cape Town. „ 13 ss. " Guildford Castle," London, 132,611. Beira 1 Proceeded home. „ 19 ss. " Esperance Bay," Fremantle, 140,148. — 1 Admitted to Royal Albert Dock Hospital. „ 20 ss. " Herefordshire," Liverpool, 120,903. Rangoon 1 Remained on board. „ 22 ss. " Carmarthenshire," Belfast, 136,347. Vladivostock 1 Proceeded home. Sept. 5 ss. " Manela," Glasgow, 144,250. Calcutta 1 „ „ .. 5 ss. " Dumana," Glasgow, 146,327. Karachi 8 1 died. 7 Military cases. ,, 6 ss. " Burmese Prince," Newcastle, 129,765. „ 1 Admitted to Seamen's Hospital, Greenwich. „ 10 ss. " Nyanza," Greenock, 123,529. Calcutta 1 Isolated in Ship's Hospital. „ 14 ss. " Kilnsea," Hull, 147,087. Cuba 1 Admitted to Seamen's Hospital, Greenwich. „ 20 ss. " Antonia," Liverpool, 145,937. — 1 „ „ „ 20 ss. " Turakina," Plymouth, 145,998. — 1 „ „ „ 22 Barge " Mafeking," London, 112,777. — 1 „ „ Carried forward 63 18 Pulmonary Tuberculosis.—continued. Date. Name of Vessel, Port of Registry and Official No. Where from. No. of Cases. How dealt with. 1924. Brought forward 63 Sept. 28 ss. " Jervis Bay," Sydney, 150,187. Sydney 2 Proceeded home. „ 29 ss. " Highland Rover," London, 129,067. Buenos Aires 1 „ „ 29 ss. " Minnewaska," Belfast, 145,433. New York 1 „ Oct. 5 ss. " Baradine," Belfast, 145,149. Sydney 1 „ „ 10 ss. " Nerbudda," Glasgow, 141,898. „ 1 Admitted to Seamen's Hospital, Greenwich. „ 10 ss. " Clan Macgillivray," Glasgow, 129,596. Chittagong 1 Landed Aden. „13 ss. " Highland Glen," London, 129,139. Buenos Aires 1 Died. „ 23 ss. " Mathura," Liverpool, 143,690. Calcutta 1 Landed Colombo. „ 26 ss. " Argun Maru," Tokio. Kobe 1 Proceeded home. „ 26 ss. " Nagoya," Greenock, 135,323. Yokohama 4 Naval Cases. „ 29 ss. " Durham Castle," London, 118,387. Beira 1 Landed Durban. Nov. 3 ss. " Lepanto," Hull, 139,278. Cebu 1 Proceeded home. „ 4 ss. " Durban Maru," Tokio, 26,431. Yokohama 1 Died on board. „ 5 ss. " Hektos," Helsingfors. — 1 Admitted to Seamen's Hospital, Greenwich. „ 20 ss. " Osterley," Glasgow, 128,287. Brisbane 1 Proceeded home. „ 22 ss. " Botne," Dramner. Norway 1 Admitted to Seamen's Hospital, Greenwich. „ 26 ss. " City of Eastbourne," Liverpool, 147,213. Calcutta 1 Landed Port Said. „ 26 ss. " Amatonga," N. Shields, 115,957. - 1 Admitted to Seamen's Hospital, Greenwich. Dec. 4 ss. " Persic," Liverpool, 110,620. Cape Town 1 Landed Southampton. „ 12 ss. " Merkara," Glasgow, 136,332. Calcutta 1 Landed Marseilles. „ 18 ss. " Trafford Hall," Liverpool, 120,906. Durban 1 Attended a hospital in London. „ 19 ss. " Malwa," Greenock, 127,543. Yokohama 1 Proceeded home. „ 22 ss. " Ceramic," Liverpool, 135,474. Durban 1 Landed Southampton. 90 TABLE XV.—Tuberculosis (other kinds). Date. Name of Vessel, Port of Registry and Official No. Where from. No. of Cases. How dealt with. 1924. June 12 ss. " Caledonia," Greenock, 102,390. Bombay 1 Died on board. July 10 ss. " Novara," Greenock, 131,860. Calcutta 1 Proceeded home. „ 19 ss. " Balranald," Greenock, 145,597. Sydney 1 „ Sep. 29 ss. " Glenapp," Glasgow, 144,230. — l Admitted to Seamen's Hospital, Greenwich. Nov. 5 ss. " Torfinn Jarl," Trondhjem. — l „ „ Dec. 22 ss. " Minnewaska," Belfast, 145,433. New York l Proceeded home. 6 19 TABLE XVI.—Malaria. Date. Name of Vessel, Port of Registry and Official No. Where from. No. of Cases. How dealt with. 1924. Jan. 3 ss. " Nariva," Southampton, 143,562. Buenos Aires l Proceeded home. Feb. 26 ss. " Borda," Greenock, 135,340. Sydney 2 Patients well on arrival. Mar. 8 ss. " Dunluce Castle," London, 118,490. Beira 8 „ „ „ 15 ss. " Dagfin," Christiania. Bathurst 1 „ „ Apl. 29 ss. " Manela," Glasgow, 144,250. Karachi 1 Landed at Port Said. May 16 ss. " Macedonia," Belfast, 116,012. Bombay 1 Died. June 6 ss. " Machaon," Liverpool, 143,674. Yokohama 1 Remained on board. „ 9 ss. " Madura," Glasgow, 146,268. Calcutta 1 Well on arrival. „ 11 ss. " Astronomer," Liverpool, 140,531. „ 5 „ „ „ 14 ss. " Laertes," Amsterdam. Sourabaya 4 „ „ „ 20 ss. " Lahore," Sunderland, 137,272. Bombay 1 Remained on board. July 1 ss. " Kashmir," Greenock, 128,655. Kobe 1 Military case. „ 30 ss. " Macharda," Liverpool, 140,593. Calcutta 1 Died. Aug. 8 ss. " Benalder," Leith, 129,456. Sourabaya 1 Landed at Seychelles. „ 10 ss. " Delta," Belfast, 120,709. Bombay 1 Died on voyage. „ 17 ss. " Patamac " Tampico 1 Well on arrival. Sept. 5 ss. " Manela," Glasgow, 144,250. Calcutta 3 „ „ 5 ss. " Dumana," Glasgow, 146,327. Karachi 3 Landed Plymouth. „ 6 ss. " Baron Napier," Adrossan, 128,956. - 1 Removed to Seamen's Hospital, Greenwich. Oct. 3 ss. " Nore," Greenock, 123,531. Calcutta 1 „ „ „ 16 ss. " Macedonia," Belfast, 116,012. Bombay 42 25 recovered. 1 fatal. 16 to Seamen's Hospital, Greenwich, and Royal Albert Dock Hospital. „ 19 ss. " Antigone," London, 123,694. Smyrna 1 Well on arrival. „ 21 ss. " Macedonia," Belfast, 116,012. Bombay 2 To Royal Albert Dock Hospital. „ 22 „ 2 „ „ „ 23 ss. " Mathura," Liverpool, 143,690. Calcutta 1 Well on arrival. „ 28 ss. " Thurso," Hull, 144,022. Venice 1 To Seamen's Hospital, Greenwich. „ 28 ss. " Macedonia," Belfast, 116,012. Bombay 11 To Hospital for .Tropical Diseases, Euston. „ 28 ss. " Orvieto," Belfast, 129,628. Brisbane 1 „ „ „ 28 ss. " Mantua," Greenock, 127,544. Yokohama 1 „ „ „ 28 ss. " Naldera," Greenock, 142,257. Bombay 6 „ „ „ 30 ss. " China," Belfast, 104,467. Bombay 46 44 recovered. 2 to Royal Albert Dock Hospital. Nov. 6 ss. " Bassa," London, 142,341. Oporto 8 Well on arrival. „ 10 ss. " City of Bristol," Liverpool, 135,427. Calcutta 1 Landed Colombo. „ 11 ss. " Atlantic City," Bideford, 140,863. Karachi 1 To Royal Albert Dock Hospital. Carried forward 163 c 20 Malaria—continued. Date. Name of Vessel, Port of Registry and Official No. Where from. No. of Cases. How dealt with. 1924. Brought forward 163 Nov. 13 ss. " Caledonia," Greenock, 102,390. Bombay 4 Well on arrival. „ 15 ss. " Portgwarra," Cardiff, 139,625. Bahia Blanca 1 To Seamen's Hospital, Greenwich. „ 16 ss. " Alcinous," Liverpool, 110,636. Java 1 Well on arrival. „ 25 ss. " Patroclus," Liverpool, 147,218. Chingwangtao 1 Mild recurrent attack. „ 26 ss. " Morvada," Glasgow, 136,319. Bombay 16 Well on arrival. Dec. 2 ss. " Kyno," Hull. Alexandria 1 Landed Liverpool. „ 3 ss. " Laertes," Amsterdam. Macassar 2 Well on arrival. „ 9 ss. " Kashgar," Greenock, 128,654. Yokohama 6 „ „ 12 ss. " Naldera," Greenock, 142,257. Bombay 1 „ „ 12 ss. " Valacia," Liverpool, 129,524. Calcutta 1 Removed to Tilbury Hospital. „ 22 ss. " Clan Macquarrie," Glasgow, 133,157. Chittagong 1 Landed Chittagong. „ 23 ss. " Manela," Glasgow, 144,250. Karachi 1 Admitted to Royal Albert Dock Hospital. „ 25 ss. " Kaisar-I-Hind," Greenock, 128,653. Bombay 2 Well on arrival. „ 29 ss. " Clan Macbride," Glasgow, 133,087. Marmagon 1 Remained on board. 202 SS. " MACEDONIA "—MALARIA. The ss. " Macedonia " left Tilbury, August 11th, 1924, and arrived at Bombay via the Suez Canal on the 19th September. Leaving Bombay on the 27th .September, the vessel arrived in London on October 18th. At Bombay on September 24th, " Macedonia " received 29 persons—European crew of ss. " Delta," this ship having broken down. The ships were together in dock at Bombay. The " Delta " was 10 days in dock before transfer of the 29 crew of the ss. " Macedonia." Ten of the transferred crew were ill at the time of transfer, suffering from malaria. The crew of both ships had access to the shore at will. About 40 cases in all were treated for malaria during the voyage home. In the fatal case, the " Macedonia's " 3rd Officer was taken ill on October 6th (ship at Port Said, 10 days out, 18 days since arrival in Bombay), was vomiting severely on the 12th and collapsed suddenly and died on the 15th. Eight Europeans and 16 natives of the " Macedonia's " crew and 10 Europeans of the " Delta's " crew were landed to the Seamen's Branch Hospital and Seamen's Hospital, Greenwich. The majority of cases were benign tertain, one or two sub tertian and one or two mixed infection. Both crews having been subject to the same conditions in Bombay, it is not clear that the " Delta " cases influenced incidence of the " Macedonia " cases. Theoretical considerations are against any probability of this. This malaria morbidity being excessive on these ships, the conditions in Bombay Dock in the latter half of September as regards infection must have been unusually bad. 21 TABLE XVII.—Pneumonia. Date. Name of Vessel, Port of Registry and Official No. Where from. No. of Cases How dealt with. 1924. Jan. 13 ss. " President Monroe," New York, 220,325. New York l Remained on board. Mar. 24 ss. " Tasso " (Italian) Fiume l Removed to Port Sanitary Hospital. „ 26 s/v. " Martin," London, 115,966. London l „ „ May 7 ss. " Nyanza," Greenock, 123,529. Calcutta l Died on board. „ 11 ss. " Khyber," Liverpool, 135,564. Kobe l Landed at Singapore. June 4 Training Ship " Exmouth " - l Removed to Eastern Hospital (M.A.B.) „ 12 ss. " Caledonia," Greenock, 102,390. Bombay l Died on board. „ 14 ss. " Largs Bay," Adelaide, 137,225. Brisbane l Well on arrival. „ 17 ss. " Ormonde," Glasgow, 141,866. „ l Died on board. June 22 ss. " Narenta," London, 144,349. Buenos Aires l Landed Monte Video. „ 23 ss. " Mathura," Liverpool, 143,690. Calcutta l Died. „ 24 ss. " Baltara," London, 124,676. Libau l Well on arrival. „ 24 ss. " Dunluce Castle," London, 118,490. Beira l „ July 9 Training Ship " Exmouth " — l Removed to Eastern Hospital (M.A.B.) Aug. 10 ss. " Mandala," Glasgow, 137,806. Calcutta 1 landed Madras. 1 died. „ 28 Training Ship " Exmouth " — l Isolated in Ship's Hospital. Sept. 2 ss. " Highland Pride," London, 129,086. Buenos Aires l Convalescent on arrival. Oct. 5 ss. " Baradine," Belfast, 145,149. Sydney l Went to a hospital in London. „ 10 Training Ship " Exmouth " — l Isolated in Ship's Hospital. Nov. 26 ss. " Barrabool," Belfast, 145,424. Sydney l Died on board. Dec. 6 ss. " Canadian Conqueror," Montreal, 141,831. Montreal l Admitted to Seamen's Hospital, Greenwich. 22 TABLE XVIII.—Influenza. Date. Name of Vessel, Port of Registry and Official No. Where from. No. of Cases. How dealt with. 1924. Jan. 2 ss. " Andania," Liverpool, 145,934. New York l Admitted to Seamen's Hospital, Greenwich. „ 12 ss. " Sudbury," Cardiff, 115,388. Antwerp l To Port Sanitary Hospital for observation. Mar. 19 ss. " Woodarra," Glasgow, 141,930. Brisbane and Hull l Treated on board. Apl. 26 ss. " Leicestershire," Liverpool, 127,995. Rangoon l Proceeded home. June 14 ss. " Laertes," Amsterdam. Sourabaya l Well on arrival. „ 23 ss. " Mathura," Liverpool, 143,690. Calcutta 2 Landed Suez. „ 28 ss. " Pacific Shipper " San Francisco 1 Remained on board. Aug. 3 ss. " Port Melbourne," London, 132,046. Hobart 8 Treated on board. Sept. 8 ss. " Cordeen " — 1 Removed to Tilbury Hospital. Dec. 5 ss. " Gloucestershire," Liverpool, 131,296. Rangoon 15 Well on arrival. „ 8 ss. " Hagno," Rotterdam. Rosario 1 „ „ 29 ss. " Balranald," Greenock, 145,597. Sydney 1 Admitted to St. Bartholomew's Hospital. 34 C2 22 TABLE XIX.—Dysentery. Date. Name of Vessel, Port of Registry and Official No. Where from. No.of Cases. How dealt with. 1924. Jan. 4 ss. " Eurylochus," Liverpool, 131,424. Manila l To Royal Albert Dock Hospital. „ 19 ss. " Devanha," Greenock, 117,400. Kobe l Landed at Marseilles. Feb. 4 ss. " Gitano," Hull, 144,082. Alexandria l Admitted to Seamen's Hospital, Greenwich. „ 11 ss. " Highland Glen," London, 129,139. Buenos Aires l Landed at Las Palmas. Mar. 25 ss. " Sandon Hall," Liverpool, 143,734. Kobe l Landed at Penang. Apl. 30 ss. " Devanha," Greenock, 127,543. Bombay l Proceeded home. July 23 ss. " Kandahar," N. Shields, 133,318. Madras l Well on arrival. Sept. 6 ss. " Manipur," Liverpool, 143,661. Calcutta l Landed Colombo. „ 24 ss. " City of Poona " „ Landed Calcutta. Oct. 17 ss. " Atreus," Liverpool, 131,322. Hong Kong l Well on arrival. „ 23 ss. " Kaisar-I Hind," Greenock, 128,653. Kobe Admitted to Seamen's Hospital, Greenwich. „ 28 ss. " Grane," Bergen. Casablanca l Well on arrival. Nov. 10 ss. " Rhesus," Liverpool, 131,363. Manila l Landed Colombo. „ 11 ss. " Clan Macneil," Glasgow, 146,281. Bombay 2 cases landed Cochin. 1 died. „ 20 ss. " Osterley," Glasgow, 128,287. Brisbane l Put on board at Colombo free from infection. „ 25 ss. " Clan Keith," Glasgow, 136,654. Chittagong l Well on arrival. Dec. 12 ss. " Naldera," Greenock, 142,257. Bombay l Proceeded home, convalescent. „ 23 ss. " City of Winchester," Liverpool, 140,546. Sydney l Admitted to Tilbury Hospital. 22 TABLE XX.—Chickenpox. Date Name of Vessel, Port of Registry and Official No. Where from. No. of Cases. How dealt with 1924. Mar. 7 ss. " Mardinian," Liverpool, 140,644. Antwerp l Admitted to Poplar Hospital. „ 27 ss. " Osterley," Glasgow, 128,287. Brisbane l Convalescent on arrival. Apl. 16 ss. " Kaisar-I-Hind," Greenock, 128,653. Bombay l Admitted to Port Sanitary Hospital. „ 17 ss. " Modasa," Glasgow, 146,272. Calcutta „ „ „ 21 ss. " London Commerce," London, 146,693. New York l „ „ „ 24 ss. " Nevasa," Glasgow, 133,102. Calcutta l Landed at Madras. „ 29 ss. " Manela," Glasgow, 144,250. Karachi l Landed at Bombay. May 10 ss. " Herefordshire," Liverpool, 120,903. Rangoon 2 Landed at Rangoon. Tune 3 ss. " Ausonia," Liverpool, 145,970. Montreal l Well on arrival. July 22 ss. " Nantucket," U.S.A. Rouen 1 Removed to Joyce Green Hospital. Aug. 1 ss. " Osterley," Glasgow, 128,287. Brisbane l Landed at Plymouth. „ 1 ss. " Neuralia," Glasgow, 133,081. Calcutta 14 11 to Port Sanitary Hospital. 3 isolated on shore. „ 8 ss. " Borda," Greenock, 135,340. Sydney 1 Convalescent on arrival. Carried forward 29 23 Chickenpox—continued. Date. Name of Vessel, Port of Registry and Official No. Where from. No. of Cases. How dealt with. 1924. Brought forward 29 Aug. 14 ss. " Beltana," Greenock, 131,853. (Outward Bound) 1 Removed to Port Sanitary Hospital. „ 15 ss. " Neuralia," Glasgow, 133,081. Calcutta 3 Isolated on shore. Sept. 23 ss. " Karmala," Liverpool, 135,590. Yokohama 2 Removed to Port Sanitary Hospital. „ 28 ss. " Jervis Bay," Sydney, 150,187. Sydney 2 Well on arrival. Oct. 10 ss. " Euripides," Aberdeen, 133,648. (Outward Bound) 1 Removed to Port Sanitary Hospital. „ 18 ss. " Ormuz," London, 144,399. Brisbane 1 „ „ 39 DENGUE FEVER. Since August, ships arriving in the Port, especially from Calcutta, declared many cases of a mild epidemic disease, diagnosed as Dengue Fever, as having occurred during the voyage. Thus on the 29th August, 52 cases ; 10th September, 24 cases ; 13th September 2 cases ; 23rd September, 6 cases and one death. 24th September, a ship declared 16 cases of Dengue with one fatal case ; the fatal case was in a passenger, who was otherwise ill, and the death is probably referable to combinations of the former state and the supervening Dengue. The consensus of opinion as to diagnosis is in favour of Dengue, though in one of the two fatal cases declared, the question lay between Dengue and Influenza. Dengue is a continued fever of the tropics lasting a few days, the chief signs being severe pains in the limbs, back and joints, and an eruption like measles. The pains are of an agonising character. Alternative names are, three-day, seven-day and break-bone fever. The disease is only communicated by certain species of mosquito which are not indigenous here. ANTHRAX. On February 7th information was received from the Medical Officer of Health for West Ham, that a man had been admitted to Whipp's Cross Hospital on the 4th, suffering from anthrax. The patient, an assistant foreman in the Skin Department, London Docks, first complained of illness on the 1st February. He had a boil; went to work the following day, returned home about noon and immediately took to his bed. Became worse on the 3rd after being poulticed. Enquiries were made in the dock, and it appears that the man was working amongst sheep skins from about January 25th to 1st February. He did not handle the skins, doing clerical work only. He is reported to have worked and handled mohair, camel hair, and wool on the 20th January. Three weeks previous to his illness he was handling Eastern wool and skins. Another man had a similar boil, and medical attention was at once advised. He was working amongst skins. This case proved not to be anthrax. Anthrax notices and skin regulations are placed about the dock. Overalls are worn ; towels, soap, water and disinfectant solution are available. 24 TABLE XXL—Venereal Diseases. Date. Name of Vessel. Case (Nature of). No. ot Cases. Passenger or Crew rating. Advice given. 1924. Ian. 2 " Somerset " Syphilis l Crew Seamen's Hospital. „ 5 " Orsova " „ l „ „ „ 7 " Kalyan " Gonorrhoea l „ „ „ 13 " Rheseus " Syphilis l „ „ „ 13 " President Monroe " Gonorrhoea l Passenger „ „ 14 " Sarpedon " „ l Crew „ Syphilis l „ „ „ 14 " Carlsfeld " Gonorrhoea l „ To be treated in Germany „ 14 " Highland Pride " Soft Sore l „ Connaught Rd. Hospital. „ 16 " Thurso " Gonorrhoea l „ London Hospital. „ 17 " Nagoya " „ 2 „ Connaught Rd. Hospital Syphilis l „ ,, „ 18 " City of Simla " „ l „ Tilbury Hospital (?) „ 19 " Devanha " Gonorrhoea l „ Landed at Colombo. „ 19 " Leicestershire " Soft Chancre l „ Venereal clinic at Liverpool. „ 21 " Mardinian " Gonorrhoea and Soft Chancre l „ Seamen's Hospital. „ 23 " Nore " Chancre l „ Connaught Rd. Hospital „ 23 " Cito " Gonorrhoea l „ London Hospital. „ 28 " Glenamoy " Syphilis l „ Landed Genoa. Feb. 1 " Saxon Star " „ l „ To Seamen's Hospital, Greenwich. „ 3 " Norman Star " Gonorrhoea l „ „ „ 5 " El Cordobes " Syphilis 2 „ To Seamen's Hospital, Soft Sore „ Connaught Road. „ 6 " Nicholaston " Venereal Bubo l „ To Seamen's Hospital, Greenwich. „ 24 " Mulbera " Gonorrhoea l „ Convalescent. „ 24 " City of Sparta " „ l „ „ „ 28 " Dal worth " „ l „ To Seamen's Hospital. „ 28 " Gloucester Castle " „ 3 „ „ Mar. 2 " Morocco " „ 2 „ „ „ 5 " Moorby " „ l „ „ „ 8 " Dunluce Castle " „ l „ „ „ 14 " Euryades " Syphilis l „ „ „ 15 " Lancashire " Soft Sore and Bubo. l „ To Gravesend Hospital. „ 15 " Maine " Gonorrhoea l „ To Seamen's Hospital, Greenwich. „ 15 " Sue vie " „ l „ Hospital at Liverpool. „ 15 " Novara " „ l „ To Seamen's Hospital, Connaught Road. „ 18 " Port Victor " Syphilis l „ To Seamen's Hospital, Greenwich. „ 21 " Mantua " Gonorrhoea and Syphilis. l „ To Seamen's Hospital, Greenwich. „ 21 " Morvada " Soft Sore l „ To Connaught Road Hospital. „ 21 " Nordia " Gonorrhoea 2 „ To London Hospital. Soft Sore l „ „ „ 22 " Settler " Bubo l „ Landed Barbados. „ 27 " Osterley " Syphilis l „ To Seamen's Hospital, Greenwich. „ 28 " Morea " Gonorrhoea 2 „ „ „ l Passenger To Private Doctor. April 1 " Clan Malcolm " „ l Crew Convalescent. Syphilis l „ „ „ 1 " Bolbek " Gonorrhoea 4 „ To London Hospital. Chancre & Bubo 1 „ 1 " Highland Piper " Gonorrhoea 2 Passengers Private Doctor Carried forward 60 25 Venereal Diseases—continued. Date. Name of Vessel. Case (Nature of). No. of Cases. Passenger or Crew rating. Advice given. 1924. Brought forward 60 Apl. 11 " Mooltan " Syphilis 1 Crew Transferred at Aden to another ship. „ 12 " Clan Sinclair " Gonorrhoea and Soft Sore. 1 „ To Gravesend Hospital. „ 13 " Karmala " Gonorrhoea 2 „ Landed Colombo. „ 14 " Sardinia " Syphilis 1 „ To Connaught Road Hospital. „ 14 Clan MacBrayne " Syphilis 1 „ To Gravesend Hospital. „ 30 " Devanha " Bubo 1 „ To Seamen's Hospital, Greenwich. May 1 " Polloc " Gonorrhoea 2 „ „ 2 „ " Melford Hall " „ 1 „ Shipping Co's surgeon to arrange for treatment. „ 3 " Gascon " Orchitis 1 „ To Seamen's Hospital, Greenwich. „ 3 " Lake wood " Gonorrhoea 1 „ „ „ 4 " Kedoc " Chancre and Bubo. 1 „ Remaining on board for Rotterdam. „ 9 " Pembrokeshire " Syphilis 1 „ To Seamen's Hospital, Greenwich. „ 9 " City of York " Gonorrhoea 1 „ „ „ 20 " Oswego " Gonorrhceal Rheumatism. 1 „ „ „ 23 " Neuralia " Soft Sore and Bubo. 1 „ „ „ 23 " Princesa " Syphilis 1 „ „ Gonorrhoea 2 „ „ „ 28 " Nellore " Soft Sore 1 „ Landed at Colombo. „ 31 " Independence " Gonorrhoea 5 „ Reported cured. June 6 " Domala " Syphilis 1 Native Crew To Royal Albert Dock Hospital. „ 6 " Student " Chancre 1 Crew To Seamen's Hospital, Greenwich. Gonorrhoea 1 „ „ „ 10 " Goslar " Gonorrhoea 2 „ To Guy's Hospital. „ 17 " Emseus " Syphilis 1 Passenger To attend Hospital. „ 17 " Carlo " Gonorrhoea 1 Crew „ „ 18 " Settler " „ 2 „ To attend Hospital at Liverpool. „ 22 " Gironde " „ 2 „ To attend Hospital in Belgium. „ 23 " Ethelwolf " Syphilis 1 „ To attend Guy s Hospital „ 23 " Mathura " „ 1 „ To attend Seamen's Hospital. Soft Sore 1 „ ,, „ 24 " Patrolclus " Gonorrhoea 2 „ „ „ 25 " Crane " „ 1 „ „ „ 27 " Kintosno " Syphilis 1 Passenger In transit to Holland. July 1 " Corrientes " Gonorrhoea 1 Crew To attend Seamen's Hospital. „ 3 " Actor " Chancre 1 „ ,, ,, 6 " Tydens " Gonorrhoea 2 „ Reported cured. „ 10 " Naldera " Syphilis 1 D.B.S. To attend Seamen s Hospital. „ 17 " Egyptian Transport " Soft Chancre 1 Crew „ „ 17 " Durenda " Svphilis 1 „ ,, „ 18 Kosmo " Gonorrhoea Bubo 2 „ Reported cured. „ 24 " Brookvale " Gonorrhoea 1 „ To attend Seamen's Hospital. „ 24 " Mentor " Syphilis 1 „ ,, „ 25 " Author " „ 1 „ ,, „ 30 " Bochum " Gonorrhoea 3 „ To be treated on board. „ 31 " Diana " Syphilis 1 „ To be treated in Germany. Carried forward 120 26 Venereal Diseases—continued. Date. • Name of Vessel. Case (Nature of). No. of Cases. Passenger or Crew rating. Advice given. 1924. Brought forward 120 Aug. 3 " Port Melbourne " Orchitis and Gonorrhoea. 2 Crew To attend Seamen's Hospital. „ 9 " Agamemnon " Gonorrhoea 1 „ „ „ 10 " Princesa " „ 1 „ „ Syphilis 1 „ „ „ 11 " Ausonia " Gonorrhoeal Orchitis. 1 „ „ „ 13 " Guildford Castle " Syphilis 1 Passenger To attend London Hospital. „ 14 " Clan MacBride " „ 1 Crew Landed at Havre. „ 16 " Mooltan " Gonorrhoea 1 „ To attend Hospital. „ 17 " Gallia " „ 1 „ To attend Seamen's Hospital. Syphilis and " Bubo. „ „ „ 21 " Senator " Gonorrhoea 1 „ To attend Hospital in London. „ 28 " Priam " Syphilis 1 „ To attend Hospital in Liverpool. „ 29 " Malwa " Chancre and Bubo. 1 „ To Royal Albert Dock Hospital. „ 29 " Ormuz " Gonorrhoea 1 „ To Seamen's Hospital. Syphilis and Gonorrhoea. 1 „ „ Sept. 5 " Newton " Soft Chancre 1 „ To Connaught Road Hospital. „ 9 " City of Hong Kong " Gonorrhoea 1 „ To attend Hospital at Liverpool. Syphilis 1 „ „ „ 10 " Nyanza " Genorrhoea 1 „ To Seamen's Hospital. „ 11 " Ionic Star " Soft Sore Bubo. 1 „ „ „ 13 " Benalla " Syphilis 1 „ „ Gonorrhoea 1 „ „ „ 14 " Devanha " „ 1 „ To Connaught Road Hospital. „ 15 " Oxfordshire " Gonorrhoeal Orchitis. 1 „ „ Venereal Bubo 1 „ „ „ 18 " Defender " Chancre and Bubo. 1 Native Crew To Seamen's Hospital. „ 18 " Biela " Syphilis 1 Alien Proceeding to Antwerp. „ 21 " Yangtzee " Gonorrhoea 1 Crew Landed at Batavia. „ 23 " Maimyo " Chancre and Bubo. 1 Native Crew Royal Albert Dock Hospital. „ 24 " Pacific Transport " Gonorrhoea 2 Crew „ „ 24 " Teiresias " „ 1 „ „ „ 24 " Pilar de Larrinaga " „ 1 „ Reported to be well, but to go to Seamen's Hospital. „ 29 " Rhodesian Transport" Chancre 1 „ To Seamen's Hospital. „ 29 " Millais " Gonorrhoea 1 „ „ „ 29 " Andania " „ 1 „ „ Oct. 3 " Clan Urquart " „ 1 „ Landed at Calcutta. „ 3 " Verbania " Chancre 1 „ To Seamen's Hospital. „ 4 " Rhor " Gonorrhoea 1 Alien Proceeding to Hamburg. „ 14 " Glenshiel " Syphilis 1 Crew To Gravesend Hospital. „ 17 " Empire Star " Gonorrhoea 1 „ To Poplar Hospital. Chancre and Bubo. 1 „ „ „ 17 " El Paraguayo " Gonorrhoea 1 „ To Seamen's Hospital. „ 21 " Mulbera " Gonorrhoea and Gonorrhoeal Rheumatism. 1 „ To Connaught Road Hospital. Carried forward 165 27 Venereal Diseases—continued. Date. Name of Vessel. Case (Nature of). No. of Cases. Passenger or Crew rating. Advice given. 1924. Brought forward 165 Oct. 22 " Auditor " Syphilis 1 Crew To Connaught Rd. Hospital. „ 24 " Clan Macbean " Gonorrhoea 1 D.B.S. To attend Liverpool Clinic. „ 25 " Warwickshire " Soft Chancre 1 Crew Landed Rangoon. „ 27 " Pembrokeshire " Gonorrhoea 1 D.B.S. Convalescent. Secondary Syphilis. 1 Native Crew To attend Royal Albert Dock Hospital. „ 29 " Princesa " Syphilis 1 Crew To attend Seamen's Hospital. Gonorrhoea „ To attend Connaught Rd. Hospital. Nov. 2 " Eumseus " Gonorrhoea and Epididymitis 1 „ To attend Seamen's Hospital. „ 4 " Actor " Gonorrhoea 1 „ To attend Tilbury Hospital. „ 5 " Port Macquarie " „ 1 „ To attend Seamen's Hospital. „ 16 " Kashmir " „ „ Landed Bombay. „ 16 " Autolycus " Syphilis 1 „ To attend Connaught Rd. Hospital. „ 18 " Turkestan " Gonorrhoea 1 „ Landed Calcutta. „ 30 " Atsuta Maru " Soft Sore 1 „ Treated on board. Dec. 5 " San Andres " „ 1 „ To attend Seamen's Hospital. „ 5 " Kabinga " „ 1 „ „ „ 7 " Machaon " Gonorrhoea 1 „ „ „ 12 " Collegian " Syphilis and Bubo. 1 „ „ „ 12 " Thesus " Syphilis 1 „ To attend Southern Hospital, Liverpool. „ 12 " Deutschland " Gonorrhoea 1 „ Proceeding to Hamburg. „ 12 " Naldera " Gonorrhoeal Rheumatism. 1 „ To attend Seamen's Hospital. „ 12 " Kashima Maru " Soft Sore and Bubo. 1 „ Treated on board. „ 14 " Knaresboro " Gonorrhoea 1 „ Landed at Calcutta. 1 „ Landed at Colombo. „ 15 " Pommern " Syphilis 1 „ To go to Germany for treatment. Gonorrhoea 1 „ „ „ 17 " Gascon " Chancre and Bubo. 1 Passenger To attend Seamen's Hospital. Gonorrhoea 1 Passenger (Alien.) In transit to Norway. „ 21 " Highland Rover ' Sore and Bubo 1 Crew To attend Royal Albert Dock Hospital. „ 24 " Gaika " Gonorrhoea 6 Passengers Naval Ratings. „ 24 " Eurymachus " „ 2 Crew To attend Royal Albert Dock Hospital. „ 29 " Bogota " „ 1 „ Landed at Christobal. „ 29 " Balranald " „ 1 „ To attend Royal Albert Dock Hospital. 206 d 28 TABLE XXII.—Miscellaneous Diseases. Aneurism of Aorta 2 C., 1 died. Brought forward 171 Anaemia 3C.,1 died. Hodgkin's Disease 1 P., died. Anthrax 1 Dk. worker. Heat Stroke 3 C., 2 died. Apoplexy 1 P., died. Hepatitis 1 C. Appendicitis 5 C. Impetigo 1 P. Abscess 3 C. Intestinal Obstruction 1 C. Beri-Beri 9 C., 3 died. Inguinal Adenitis 1 Bronchitis and Bronchial Jaundice 1 C. Catarrh 5 C. Meningitis 2 1 P. died. Boils 2 C. Mumps 5 P. Cerebral Embolism 1 P., died. Morbus Cordis 2 C. Congestion of Lungs 2 C. Malignant Endocarditis 1 C. Cerebral Haemorrhage 1 C., died. Nerves 1 C. Constipation 1 C. Neuralgia 1 Colitis 3 1C,2 P. Neurasthenia 1 Cerebral Tumour 1 P., died. Nephritis 3 1 P. died. Cancer 1 P. Old Age 1 Carbuncle 1 c. Pyrexia 6 Dengue 90 1 P. died. Pleurisy 3 1 C. died. Pertussis 1 52 on one ship ; 15 on another. Pleural Effusion 1 Rheumatism 1 Sprue 1 P. Diarrhoea 3 C. Septic Adenitis 1 C. Delirium Tremens 1 C. Senile Decay 5 Pilgrims, all died. Drowning 1 P. Ear Disease 1 P. Skin Rash 1 Enlarged Glands 1 Seven-day Fever 5 C. Febricula 4 C. Septic Throat 1 Gastro Enteritis 1 P. Scabies 1 C. Gallstones 1 C. Scalded Foot 1 C. Gastric Ulcer 1 C., died. Tonsillitis 3 2C,1 P. Gastritis 16 12 P., 4 C. Three-day Fever 24 C & P. On one ship. Gonorrhoeal Rheumatism 1 C. Hernia 2 C. Whooping Cough 4 P. Heart Disease 6 C., 1 died. Carried forward 171 Total 256 Note.—C. =Crew ; P.=Passenger. In view of a certain amount of " slackness " in the declaration of cases of illness (infectious or otherwise) which occurred on vessels during the voyage, your Medical Officer caused the following circular letter and " Notice to Masters and Officers in Charge of Vessels " to be sent to Shipping Companies trading with the Port of London :— Gentlemen, I have to bring to your attention the extreme importance of the medical inspection of ships entering the Port of London, and would ask that the facilities afforded for expedition by the Port of London Sanitary Authority, which are equal, I believe, to those of any Port in the world, be met by your masters, surgeons and pilots with as utter facilitation of the work of Medical Officers at Gravesend as is possible ; especially the arriving ship should have such time at her disposal on reaching Gravesend that the work of the Medical Officer in the examination of the state of the ship with regard to illnesses which have occurred during the voyage, may be thoroughly carried out. In cases where a few minutes may make all the difference between orderly examination and satisfactory information, or otherwise, the master of the incoming ship should not expect the benefit of these few minutes at the expense of a thorough medical examination, but should give every facility, including sufficient time for this, free from hurry as to saving tides or other bustle attendant on arrival. The medical inspection must be met as one which requires fuller time than that sometimes allotted to it. Your obedient servant, (Signed) W. M. WILLOUGHBY, Medical Officer of Health, Port of London. 29 Corporation of London. Port of London Sanitary Authority NOTICE to MASTERS and OFFICERS IN CHARGE OF VESSELS arriving at or being within the PORT OF LONDON, and to all others whom it may concern. Illness. 1. All cases of illness of whatever nature which have occurred on board a vessel from Foreign during the voyage or during the stay in any port of lading must be declared to the Medical Officer of Health or other officer of this Authority immediately on arrival of the vessel within the Port. An arrival from Foreign is visited by a Medical Officer at Gravesend or at Sheerness for this purpose. Infectious Disease. 2. Every case of infectious disease being or occurring on board a vessel within the Port must be notified forthwith to the Medical Officer of Health or other officer of this Authority. Dead or Sick Bats. 3. The finding of dead or sick rats on board during the voyage must be notified immediately on arrival to the officer visiting the ship at Gravesend or Sheerness. 4. The finding of dead or sick rats on board on opening the hatches or during the discharge of cargo in the Port of London must be notified forthwith to the Medical Officer of Health or other officer of this Authority. Vermin other than Rats, and Insanitary Conditions. 5. Verminous or other insanitary conditions of any nature in the living quarters or holds of a vessel must be reported to an officer of this Authority. Assistance or Information. 6. Every assistance and information required by an officer of this Authority must be given, and his directions must be complied with. Rats. 7. Measures must be taken— (a) To destroy the rats on the ship. (b) To prevent the escape of rats from the ship to the shore. There are HEAVY PENALTIES for non-compliance with the terms of these directions. (See the Port Sanitary Authorities (Infectious Diseases) Regulations, 1920, and the Rats and Mice (Destruction) Act, 1919.) Offices : 5, Church Passage, . Guildhall, London, E.C. 2. Telephones : London Wall 6400. Gravesend 325. February, 1921. W. M. WILLOUGHBY, M.D., Medical Officer of Health, Port of London. D2 30 TABLE XXIII. Vessels and Premises Disinfected from 1st January to 31st December, 1924. Month. Reason for Disinfection. Fumigation for Rats, etc. Rat Precautions. Vessels kept under observation. U.S.A. requirements. Total. Diphtheria. Enteric Fever. Smallpox. Scarlet Fever. Continued Fever. Measles. Chicken pox. Dysentery. Pulmonary Tuberculosis. Malaria. Erysipelas. Mumps. Whooping Cough. January 1 1 1 - - - - 2 1 - - - - 3 1 10 February - — - - - 1 — — 2 - - - - 5 — 8 March - 1 - - - 2 2 — — - - - - 4 1 10 April - 1 2 - - 1 3 — 2 - - 1 - 5 — 15 May - 2 1 1 - 3 1 — 6 - - - 1 4 2 20 June - 4 1 1 1 3 1 — 5 - - - - 4 1 21 July - 1 — 1 - — — — — - - - - 9 2 14 August - 3 — - - 2 1 — — - - - - 2 2 10 September 1 2 — - - 1 1 — 3 - - - - 6 5 19 October - — - - - 2 — — 3 - - - - 6 11 22 November - 3 — 1 - 1 - - - - - - - 10 7 22 December - — — - - 1 — — 3 1 1 - - 13 5 24 Totals 2 18 5 4 1 17 9 2 25 1 1 1 1 71 37 195 TABLE XXIV. Number of Disinfections of Effects, Bedding, &c., from 1st January to 31st December, 1924. Month. Reason for Disinfection. Hospital Bedding, &c. Total. No. of times disinfector was used. Fumigated in cabin of Vessel. Scarlet Fever. Diphtheria. Enteric Fever. Smallpox. Measles. German Measles. Chickenpox. Pulmonary Tuberculosis. Malaria. Pneumonia. Erysipelas. January - - 1 1 - - - 2 - - - 1 5 3 1 February — 1 - - - - - - - - - - 1 1 — March — - 1 — i - - — 1 1 - l 5 3 2 April — - 1 1 — 1 4 2 - - - 1 10 7 1 May 1 - 2 1 l - - - - - 2 7 4 2 June 2 - 1 1 2 - 1 — - - - 1 8 4 3 July — - — — 1 1 — — - - - 1 3 3 1 August — - 1 — 2 - 1 — - - - — 4 2 2 September — 1 2 — 1 - — 1 - - - — 5 5 3 October — - — —. 2 - — — - - - 3 5 4 1 November 1 - 2 - - - - - - - - 1 4 3 1 December - - 1 - - - - - - - 1 1 3 3 3 Totals 4 2 12 4 10 2 6 5 1 1 1 12 60 42 20 31 TABLE XXV.—Return of Rats caught and destroyed during 1924. The entire cost of destroying these rats has been borne by the Shipowners and Port of London Authority. Jan. Feb. March. April. May. June. July. Aug. Sept. Oct. Nov. Dec. Totals. Millwall Dock— Warehouses 347 329 323 338 435 289 332 338 350 263 361 275 3,980 Vessels during voyage — — — — — — — 101 — — — — 101 „ while in dock 109 50 107 253 54 64 69 192 48 37 75 81 1,139 Surrey Commercial Dock— Warehouses 66 113 67 28 40 41 57 65 72 56 64 51 720 Vessels during voyage — — — — — — — — — — — — — ,, while in dock — — — 12 44 42 21 43 93 80 29 23 387 Regent's Canal Dock— Warehouses 4 — — — 4 4 18 28 19 28 22 14 141 Vessels during voyage — — — — — — — — — — — — — ,, while in dock — — — — — — — — — — — — — St. Katherine's Dock— Warehouses 53 64 83 67 123 67 70 85 86 83 104 74 959 Vessels during voyage — — — — — — — — — — — — — „ while in dock — — — — — — — — — — — — — London Dock— Warehouses 155 167 196 197 294 187 225 239 224 242 291 209 2,626 Vessels during voyage — — — — — — — — — — — — — „ while in dock — — — — — — — — — 6 — — 6 Royal Albert Dock— Warehouses 126 70 50 63 93 34 40 41 28 56 67 44 712 Vessels during voyage 418 101 528 36 282 34 749 819 776 266 269 1,114 5,392 „ while in dock 233 212 215 383 504 293 317 271 379 282 325 344 3,758 Royal Victoria Dock— Warehouses 86 56 68 62 42 43 37 52 29 59 62 93 689 Vessels during voyage — — 188 — 70 — — — 181 — — — 439 ,, while in dock 66 85 113 112 126 90 371 119 37 62 86 57 1,324 King George V. Dock Warehouses 13 21 34 20 15 26 26 12 15 21 18 22 243 Vessels during voyage 133 90 538 44 238 26 57 351 90 12 134 80 1,793 ,, while in dock 156 107 162 296 240 329 190 254 168 93 122 152 2,269 West India Dock- Warehouses 141 140 153 146 189 122 98 112 121 107 76 85 1,490 Vessels during voyage — — — — — — — — — — — — — „ while in dock 186 103 200 51 158 208 227 278 122 169 159 177 2,038 East India Dock— Warehouses 19 18 21 19 23 17 25 49 33 15 27 27 293 Vessels during voyage — — — — — — — — — — — — — ,, while in dock 29 31 49 35 110 94 38 47 32 176 68 48 757 Tilbury Dock- Warehouses 158 134 180 148 169 109 124 175 126 190 238 138 1,889 Vessels during voyage 616 472 551 373 1,555 395 295 549 263 316 520 164 6,069 „ while in dock 236 461 177 165 194 258 46 179 527 417 490 94 3,244 River— During voyage — — — — — — — — — — — — — While in river — — — — — — — — — — — — — Totals 3,350 2,824 4,003 2,848 5,002 2,772 3,432 4,399 3,819 3,036 3,607 3,366 42,458 Total from February, 1901, to 31st December, 1923 1,318,060 Total from 1st January to 31st December, 1924 :— In Dock Warehouses 13,742 On Vessels during voyage 13,794 On Vessels while in Dock and River 14,922 Total 1,360,518 32 TABLE XXVI. ANALYSIS OF ACCOMPANYING TABLES. RETURN OF RATS EXAMINED DURING THE YEAR ENDED 31ST DECEMBER, 1924. DOCK. Number from each Dock. Found Dead. Trapped. Found Dead. Trapped. Infected. NonInfected. Infected. Non-Infected. Infected. Non-Infected. M.D. M.R. M.A. M.M. M.D. M.R. M.A. M.M. M.D. M.R. M.A. M.M. M.D. M.R. M.A. M.M. Hound Dead. Trapped. Found Dead. Trapped. Mill wall Dock 299 — 299 — — — — 258 38 3 — — 299 — — — — 258 38 3 — — — — 299 Royal Albert Dock 347 l 346 — 1 — — 177 169 1 — — 347 — — — — 177 169 1 — — — 1 346 West India Dock 83 — 85 — — — — 50 34 1 — — 85 — — — — 50 34 1 — — — — 85 East India Dock 107 — 107 — — — — 56 51 — — — 107 — — — — 56 51 — — — — — 107 Victoria Dock 325 2 323 — 2 — — 252 73 — — — 325 — — — — 252 73 — — — — 2 323 Tilbury Dock 433 — 433 — — — — 302 131 — — — 433 — — — — 302 131 — — — — — 433 King George V. Dock 260 — 260 — — — — 117 136 7 — — 260 — — — — 117 136 7 — — — — 260 Surrey Commercial Dock 162 8 154 3 5 — — 121 41 — — — 162 — — — — 121 41 — — — — 8 154 South-West India Dock 28 — 28 — — — — 16 11 1 — — 28 — — — — 16 11 1 — — — — 28 East Wood Wharf 5 — 5 — — — — 2 3 — — — 5 — — — — 2 3 — — — — — 5 Bellamy's Wharf 1 — 1 — — — — 1 — — — — 1 — — — — 1 — — — — — — 1 Unknown Dock 3 — 3 — — — — 2 1 — — — 3 — — — — 2 1 — — — — — 3 2,055 11 2,044 3 8 — — 1354 688 13 — - 2,055 - - - - 354 688 13 - - - 1 1 2,044 2,055 2,055 2,055 2,055 2,055 33 TABLE XXVII. Return of Rats Examined.—1924. Dock. No. Classification of Species. m.d. m.r. m.a. m.m. Millwall Dock 299 258 38 3 — Royal Albert Dock 347 177 169 1 — West India Dock 85 50 34 1 — East India Dock 107 56 51 — — Victoria Dock 325 252 73 — — Tilbury Dock 433 302 131 — — King George V. Dock 260 117 136 7 — Surrey Commercial Dock 162 121 41 — — South-West India Dock 28 16 11 1 — East Wood Wharf 5 2 3 — — Bellamy's Wharf 1 1 — — — Unknown Dock 3 2 1 — — 2,055 1,354 688 13 — Table of Classification. M.D. Mus decumanus (Norvegious) 1,354 M.R. Mus Ratus 688 M.A. Mus alexandrinus 13 M.M. Mus musculus — Total 2,055 Return of Rats Found Dead or Trapped. Dock. Total. Found Dead. Trapped. Millwall Dock 299 — 299 Royal Albert Dock 347 1 346 West India Dock 85 — 85 East India Dock 107 — 107 Victoria Dock 325 2 323 Tilbury Dock 433 — 433 King George V. Dock 260 — 260 Surrey Commercial Dock 162 8 154 South-West India Dock 28 — 28 East Wood Wharf 5 — 5 Bellamy's Wharf 1 — 1 Unknown Dock 3 — 3 2,055 11 2,044 Found Dead 11 Trapped 2,044 Total 2,055 Analysis of Non-Infected Rats. Dock. Found Dead. Trapped. Classification of Species. M.D. M.R. m.a. M.M. Millwall Dock — 299 258 38 3 — Royal Albert Dock l 346 177 169 1 — West India Dock — 85 50 34 1 — East India Dock — 107 56 51 — — Victoria Dock 2 323 252 73 — — Tilbury Dock — 433 302 131 — — King George V. Dock — 260 117 136 7 — Surrey Commercial Dock 8 154 121 41 — — South-West India — 28 16 11 1 — East Wood Wharf — 5 2 3 — — Bellamy's Wharf — 1 1 — — — Unknown Dock — 3 2 1 — — 11 2,044 1,354 688 13 — 34 Analysis of Infected Rats. Dock. Found Dead. Trapped. Classification of Species. M.D. M.R. M.A. M.M. Millwall Dock — — — — — — Royal Albert Dock — — — — — — West India Dock — — — — — — East India Dock — — — — — — Victoria Dock — — — — — — Tilbury Dock — — — — — — King George V. Dock — — — — — — Surrey Commercial Dock — — — — — — South-West India Dock — — — — — — East Wood Wharf — — — — — — Bellamy's Wharf — — — — — — Unknown Dock — — — — — — — — — — — — Analysis of Rats Found Dead. Dock. Found Dead. Classification of Species. M.D. M.R. M.A. M.M. Millwall Dock — — —- — — Royal Albert Dock l — 1 — — West India Dock —- — — — — East India Dock — — — — — Victoria Dock 2 — 2 — — Tilbury Dock — — — — — King George V. Dock — — — — — Surrey Commercial Dock 8 3 5 — — South-West India Dock — — — — — East Wood Wharf — — — — — Bellamy's Wharf — — — — — Unknown Dock — — — — — 11 3 8 M.D 3 M.R 8 M.A — M.M — Total 11 Analysis of Rats Trapped. Dock. Trapped. Classification of Species. M.D. M.R. M.A. M.M. Millwall Dock 299 258 38 3 — Royal Albert Dock 346 177 168 1 — West India Dock 85 50 34 1 — East India Dock 107 56 51 — — Victoria Dock 323 252 71 — — Tilbury Dock 433 302 131 — — King George V. Dock 260 117 136 7 — Surrey Commercial Dock 154 118 36 — — South-West India Dock 28 16 11 1 — East Wood Wharf 5 2 3 — — Bellamy's Wharf 1 1 — — — Unknown Dock 3 2 1 — — 2,044 1,351 680 13 — M.D 1,351 M.R 680 M.A 13 M.M — Total 2,044 35 TABLE XXVIII.—Rat Fumigations. Date. Vessel. Where lying. Parts of Vessel Fumigated. Fumi- gant used. No. of Rats reported found dead after fumigation. 1924. Jan. 10 " London Exchange " Surrey Com. Dk. Whole Ship Sulphur 6 11 Dioxide „ 12 " Andania " King George V. Holds. Passenger „ 3 13 Dock accommodation, stewards' qrs., lavatories and wash-houses aft. After peak and deck stores. Fore peak and deck stores. Sailors', Greasers' and boy's cabin. Alleyway spaces. Petty Officer's, Asst. Steward's mess rooms. Galley. „ 14 " Rhode Island " Surrey Com. Dk. Whole ship „ 108 Feb. 5 " Verentia " „ Whole ship except Engine Room, Boiler Room, Bunkers and Chart Room. 14 „ 5 " Antonia " King George V. Dock „ „ — „ 9 " Saxonia " Tilbury Dock „ „ 91 „ 12 " Rhuahine " King George V. Dry Dock Whole Ship except Engine, Boiler and Chart Rooms, Galley Bunkers. Hydrocyanic Acid Gas „ 17 " Rimutaka " Victoria Dock Whole Ship except Engine, Boiler and Chart Rooms, Bunkers, Fore peak and 10 Boats. „ Mar. 5 " Vellavia " Surrey Com. Dk. Whole Ship, except Engine Room, Boiler Room, Bunkers, and Chart Room. Sulphur Dioxide „ 15 " Ocean Transport " Royal Albert Dry Dock Holds, Bunkers, Poop, Fore and After Peaks, Stewards' Room, Sailors' and Firemen's Forecastle. „ 61 „ 28 " Minnewaska " King George V. Dock Whole Ship, except Engine Room, Boiler Room, Bunkers, and Chart Room. „ - „ 29 " Albania " Royal Albert Dock „ „ — Apr. 13 " Menominee " „ Whole Ship, except Engine, Boiler and Chart Rooms and Bunkers. „ 66 E 36 Rat Fumigations-continued Date. Vessel. Where lying. Parts of Vessel Fumigated. Fumigant used. No. of Rats reported found dead after fumigation. 1924. Apr. 17 " Eden Hall " Millwall Dock Holds Nos. 1, 2, 3, 4 and 5. 'Tween Decks Nos. 1, 2, 4, and 5, Poop, Lazarette, Fore Peaks, Lower and Upper. Sulphur Dioxide - „ 24 " Lancastria " King George V. Dock Whole Ship, except Engine, Boiler and Chart Rooms and Bunkers. „ - „ 2628 " Banbury Castle " East India Dock Nos. 1, 2, 4, 5 and 6 Lower Holds. Nos. 1, 2, 4, 5 and 6, 'Tween Decks. Forecastles. „ - „ 29 " London Commerce " Surrey Com. Dk. Whole Ship „ - May 1 " Aleppo " Millwall Dock Whole Ship, except Engine, Boiler and Chart Rooms and Bunkers. „ - „ 5 " Remuera " Royal Albert Dock „ „ 25 „ 7 " Dominion Miller " Surrey Com. Dk. „ „ 6 ,, 17 " London Mariner " Millwall Dock „ „ 3 18 June 6." 7 " Kaikoura " Whole Ship, except Engine, and Boiler Rooms, Stokehold, Officers and Engineers' Quarters. „ 50 „ 19 " Belgenland " King George V. Dock Whole Ship, except Engine, Boiler and Chart Rooms and Bunkers. „ - „ 21 " Hertford " Royal Albert Dock Whole Ship, except Engine, Boiler and Chart Rooms, Bunkers and 5 Boats. „ - „ 28 " Bolingbroke " Millwall Dock Nos. 1, 2, 2a, 3, 4, Holds, Nos. 1, 2, 3, 4 and 5 'Tween Decks, Deep Tank, Forward Shelter, After Shelter, Forecastle, Casing Sides, Peak Stores, Water Closets and Bath Rooms. „ (in cylinders). July 1 " Ethelwolf " Millwall Dock Nos. 1, 2, 3, 4 and 5 Holds, Fore Peak and Poop. Sulphur Dioxide - „ 2 " Tekoa " Royal Albert Dock Whole Ship, except Engine, Boiler and Chart Rooms. „ 46 37 Rat Fumigations—continued. No. of Rats reported found dead after fumigation. Date. 1924. Vessel. Where lying. Parts ot Vessel Fumigated. Fumi- gant used. July 8 " Verbania " Surrey Com. Dk. Whole Ship, except Engine, Boiler and Chart Rooms. Sulphur Dioxide 58 „ 11 " Shonga " Millwall Dock Whole Ship, except Engine, Boiler and Chart Rooms. " 37 „ 11 " Dakarian " Victoria Dock Whole Ship, except Engine, Boiler and Chart Rooms, 4 Life Boats. " „ 12 " Otaki" Royal Albert Dock Whole Ship, except Engine, Boiler and Chart Rooms, Lifeboats. " _ „ 14 " Neuralia " " Whole Ship Hydrocyanic Acid Gas _ „ 19 " Khiva " " Whole Ship, except Lifeboats. Sulphur Dioxide. 275 „ 24 " London Exchange " Millwall Dock Nos. 1, 2, 3, 4, 5 and 6 Lower Holds, Nos. 1, 2, 3, 4, 5 and 6 'Tween Decks, No. 1 Oorlop Deck Forward and After Shelter Deck, Strong Room, Shelter Deck Casing, Crew's Quarters, Lavatories, Steam Steering House, Nos. 1, 2, 3 and 4 Boats. " _ Aug. 8 " North-Western Miller " Surrey Com. Dk. Whole Ship " _ „ 9 " Mississippi " Royal Albert Dock Whole Ship except Engine, Boiler and Chart Rooms. " _ Sept. 3 " Turakina " " ,, " _ „ 5 " Maryland " ,, ,, ,, _ 10 " Caledonia " Tilbury Dock Nos. 1, 2, 3, and 4 Holds, Reserve Engine Room, Boiler Room, Bunkers, Passengers' Accommodation, Stores, Mail Rooms, Crew's Quarters, Fore and Aft Peak, Officers' Quarters. Liquid Hydrocyanic Acid Gas 228 „ 20 " Novian " Royal Albert Dock Whole Ship, except Engine, Boiler and Chart Rooms. Sulphur Dioxide „ 27 " Bos worth " Millwall Dry Dk. Whole Ship " 30 " Mesaba " King George V. Dock Whole Ship, except Engine, Boiler and Chart Rooms, and Bunkers. " E 2 38 Rat Fumigations—continued. No. of Rats reported found dead after fumigation. Date. 1924. Vessel. Where lying. Part of Vessel Fumigated. Fumigant used. Oct. 9 " Clan Lamont " Tilbury Dock Nos. 1, 2, 3, 4 and 5 Holds, Fore Peak, Native Crew's Quarters, Store-room. Sulphur Dioxide 223 „ 10 " Maine " Royal Albert Dock Whole Ship, except Boiler and Chart Rooms. " _ „ 16 " San down Castle " East India Dock — " 40 „ 17 " Andalusian " Millwall Wharf Whole Ship " 187 „ 25 " Ruahine " Royal Albert Dock Whole Ship, except Engine Room, Boiler Room, Bunkers and Chart Room. " 75 „ 30 " Arabistan " Bellamy's Wharf Holds, Storerooms, Engine Room, Bunkers, Boiler Room, Crew's Quarters and Magazine Room. " 74 Nov. 1 " City of Alexandria " Millwall Wharf Whole Ship " — „ 4 " London Commerce " Surrey Com. Dk. " 6 „ 5 " China " Tilbury Dock ,, Hydrocyanic Acid Gas 253 „ 8 " Letrim " Royal Albert Dock Whole Ship, except Engine, Boiler and Chart Rooms, and Bunkers. Sulphur Dioxide _ ,, 15 " Brecon " Millwall Dock Whole Ship " — „ 18 " London Mariner " Surrey Com. Dk. Whole Ship, except Boiler Room. " 7 „ 22 " Vellavia " South-West India Dock Whole Ship, except Engine, Boiler, Chart Rooms and Bunkers. " 1 „ 28 " Umzinto " West India Dock Whole Ship " 52 „ 28 " Vardulia " King George V. Dock Whole Ship, except Engine, Boiler and Chart Rooms. " 51 „ 29 " Morea " Royal Albert Dock Whole Ship Hydrocyanic Acid Gas 83 Dec. 3 " Cogne " Millwall Dock ,, Sulphur Dioxide 103 „ 6 " Brandon " ,, - " 16 Mice. „ 6 " Rotorua " Royal Albert Dock Whole Ship, except Engine, Boiler, Chart Rooms and Bunkers. " _ „ 6 " Rotenfels " Millwall Dock Whole Ship " 103 „ 11 " Virgilia " Royal Albert Dock Whole Ship, except Engine, Boiler and Chart Rooms. " _ „ 13 ss. " Empress of France ' ' King George V. Dock Whole Ship Hydrocyanic Acid Gas _ „ 20 " Bothwell " Millwall Dock " Sulphur 43 Mice. 39 Rat Fumigations—continued. No. of Rats reported found dead after fumigation. Date. Vessel. Where lying. Parts of Vessel Fumigated. Fumigant used. 1924. Dec. 20 " Bellglade " Millwall Dock Whole Ship Sulphur Dioxide. 40 „ 24 " Kent " Green's Dry Dock Whole Ship, except Boiler and Chart Rooms. " 21 „ 27 " Antonia " Royal Albert Dock Whole Ship, except Boiler and Chart Rooms, and Bunkers. " „ 24 " Trecarn " Millwall Dock Whole Ship " — „ 27 " Lancastria " Victoria Dock Whole Ship, except Engine, Boiler, Chart Rooms, and Bunkers. " „ 27 " Ausonia " Millwall Dock " " 15 It is a matter of interest that the rat report of the ss. " Merkara " showed nothing which could suggest rattiness on the ship. On February 14th the ship was fumigated at Calcutta—the holds only—with Sulphur Dioxide and no dead rats were found. Amongst the rat attractive material in the cargo was grain, ground nuts, rice and hides. A fumigation of the crew's quarters was performed by the Fumigation Services, Ltd., who placed the information at my disposal that no less than 55 rats were found in the firemen's quarters. The only possible suggestion which could be made on the information, and supposing that the fumigation of the holds in Calcutta was satisfactory, was that on discharge of the cargo the rats sought undisturbed quarters while in Port and found them in the crew's quarters. One could not, under the circumstances, of necessity consider that the ship was excessively ratty. The instance is one to be recorded amongst rat experiences. In ordering the disinfestation of a ship, your Medical Officer received a letter from the shipping company concerned, stating at its conclusion : "We shall be pleased to carry out your instructions regarding this matter, always providing there be no detention of the steamer in doing so." This proviso on the part of the Company called for the following letter which was duly sent to the Company concerned :— 31st October, 1924. Gentlemen, ss. " " In reply to your letter of the 30th instant with regard to the disinfestation of the above vessel, I must point out that my letter must be accepted as an Order under the Rats and Mice (Destruction) Act, 1919, and a specific requirement under the Port Sanitary Authorities (Infectious Diseases) Regulations, 1920. Your proviso that " there be no detention " of the steamer is not consonant with the duties and powers of the Port of London Sanitary Authority, though the Authority, as is customary, is always ready to consider any point in the convenience of shipping, where this is brought to their notice specifically with details, in any case arising. Your obedient servant, W. M. WILLOUGHBY, Medical Officer of Health, Port of London. 40 TABLE XXIX.—Rat Precautions. U.S.A. Requirements. In accordance with the Order of your Worshipful Committee, certificates specifying the precautions taken to prevent the ingress of rats from shore to ship, while in the port, were issued in respect of the following vessels :— Date. 1924. Vessel. Where lying. Jan. 10 ss. " Vellavia" Surrey Commercial Dock. Mar. 20 ss. " Maine " ... Royal Albert Dock. May 22 ss. " Verbania " Surrey Commercial Dock. „ 29 ss. " Vardulia " Surrey Commercial Dock. June 7 ss. " Virgilia " King George V. Dock. July 30 ss. " Andania " Surrey Commercial Dock. „ 31 ss. " Belgian " Royal Albert Dock. Aug. 12 ss. " Antonia " Surrey Commercial Dock. „ 15 ss. " Verentia " King George V. Dock. Sept. 3 ss. " Saxonia " King George V. and Victoria Docks. „ 10 ss. " Andania " King George V. Dock. „ 18 ss. " American Merchant " Tilbury Dock. „ 25 ss. " American Banker " Tilbury Dock. „ 27 ss. " Lancastria " King George V. Dock. Oct. 2 ss. " Vasconia " Surrey Commercial Dock. 2 ss. " American Farmer " Tilbury Dock. 3 ss. " Minnewaska " Royal Albert Dock. „ 9 ss. " American Shipper " Tilbury Dock. „ 16 ss. " American Trader " Tilbury Dock. „ 17 ss. " Minnetonka " Royal Albert Dock. „ 20 ss. " Barbadian " Royal Albert Dock. „ 22 ss. " Menominee " Royal Albert Dock. „ 23 ss. " American Merchant " Tilbury Dock. „ 29 ss. " Missouri " Royal Albert Dock. „ 30 ss. " American Banker " Tilbury Dock. Nov. 6 ss. " American Farmer " Tilbury Dock. „ 6 ss. " Maryland " Royal Albert Dock. „ 13 ss. " American Shipper " Tilbury Dock. „ 19 ss. " Novian " Royal Albert Dock. „ 20 ss. " American Trader " Tilbury Dock. „ 21 ss. " Mesaba " Royal Albert Dock. „ 27 ss. " American Merchant " Tilbury Dock. Dec. 1 ss. " Scythian " Royal Albert Dock. „ 4 ss. " American Banker " Tilbury Dock. „ 11 ss. " American Farmer " Tilbury Dock. „ 18 ss. " American Shipper " Tilbury Dock. ,,24 ss. " American Trader " Tilbury Dock. These certificates are issued in agreement with requirements of the United States of America. The certificates exonerate ships from routine fumigation in instances acceptable to the Consulate of the United States. TABLE XXX.—FORM A. AMOUNT OF SHIPPING ENTERING THE PORT SANITARY DISTRICT DURING THE YEAR 1924. Number. Tonnage. Number Inspected. Number Reported to be Defective. Number of Orders issued. By the Medical Officer of Health. By the Sanitary Inspectors.* Foreign - Steamers 11,614 No Record 899 13,193 103 40 Sailing No Record — 441 3 1 Fishing " — — — — — Total Foreign 11,614 899 13,634 106 41 Coastwise Steamers 6,817 No Record 1,432 54 30 Sailing 676 " — 490 50 44 Fishing — " — — — — Total Coastwise .... 7,493 1,922 104 74 Total Foreign and Coastwise 19,107 899 15,556 210 115 * Includes repeated Inspections. TABLE XXXI.—Form B. (See Tables XXV. and XXVII). 41 TABLE XXXII. In connection with Form C, the following procedure, in the Port of London, supplies the data :— All vessels from foreign ports are visited by a Medical Officer. The questions put by the Customs Officer and the answers made by the Master are heard by him and all cases of reported sickness during the voyage examined or enquired into. Ships from ports in the Eastern Hemisphere, south of latitude 45° N. (except European ports west of longitude 20° E.) and ships from ports in the Western Hemisphere south of latitude 30° N., are considered as from " infected ports " and are boarded and examined whatever the report. Ports or rather coastlines containing ports are added or exempted according to reports of the movement of infection. Medical examination under this system, whether in spite of a negative or because of a positive report of illness, has from time to time led to the detection of serious conditions of infection. On proceeding, these ships come again under scrutiny by a Sanitary Inspector while in dock, special attention being given to those on which there has been suspicious circumstance during the voyage. PRECAUTION AGAINST PLAGUE.—Form C. Particulars Relating to Vessels " Infected " or "Suspected," or from Infected Ports. No. of Vessels. Date of Arrival. Whether infected, suspected or trom an infected port. Methods of Rat Destruction employed. No. of rats killed. Whether a certificate of deratisation was issued. Remarks. Fumigation by sulphur dioxide. Fumigation by hydrocyanic acid. Trapping, poisoning, &c. 1 2 3 4 5 6 7 8 9 1,205 1st Jan. to 31st Dec., 1924. From Infected Ports. Nil. Nil. Traps and Poison, Traps, Ratcatchers. 5,346 Nil. The full Table is prepared, but is not printed herewith. TABLE XXXIII.—Form D. VESSELS (other than those dealt with in Form C), subjected to measures of Rat Destruction Number of Vessels Fumigated by S02 Number of Rats killed. Number of Vessels Fumigated by HCN. Number of Rats killed. Number of Vessels on which trapping, poisoning, &c., were employed. Number of Rats killed. Number of Fumigation Certificates issued on Form " Port 10." Number of other Certificates issued. 64 1,906 7 564 37 48 55 (See Table XXIX.) TABLE XXXIV.—Hospital. Number of Cases Admitted, Cost of Maintenance, &c. Patients remaining in Hospital on 31st December, 1923 Nil. Admitted. Discharged. Died. Remaining under treatment. Enteric Fever 13 12 1 Scarlet Fever 6 4 1 1 Diphtheria 1 1 — _ Erysipelas 1 1 _ _ Measles 8 8 _ _ Chickenpox 25 25 _ _ Mumps 1 1 _ _ Pneumonia 3 3 _ _ Tonsillitis 1 1 _ _ Skin Disease 1 1 _ _ Total 60 57 1 2 Remaining in Hospital on 31st December, 1924 2 Total number of days' treatment during the year 1,053 Average number of days' treatment for each case 17.55 Average daily number of patients in Hospital .16 Average daily cost of maintenance per patient 0.89d. Average total annual cost of maintenance per patient £1.7.3 HOSPITAL During the year four cubicles for nurses were added, in a separate building, to the accommodation provided for the nursing staff. This permits of a separate room each for nurses and servants and for storage accommodation for linen, etc., which was much needed. In a spot as outlying as is Denton Hospital it is natural that the Staff, when off duty, should have much appreciated the installation of a wireless apparatus, which receives both from Chelmsford and London stations with sufficient facility to permit of distribution throughout the administrative block. 42 TABLE XXXV. Quantity and Description of Unsound Food Seized and Destroyed for the Year ending 31st December, 1924. MEAT— Fresh and Frozen— Beef Original Packages. Sundry Quantities by Weight. Loose Articles. Approximate Total Wei Goods Destroyed. ght of No. Description. Tons Cwts. Qrs. Lbs. No. Description. Tons Cwts. Qrs. Lbs. 1,621] quarters, crops, &c. 4 19 0 17 363 bags, &C. 141 8 2 17 Mutton and Lamb 403 carcases 3 14 0 27 798 pieces 13 11 1 5 Veal, Pork and Offal 13 614 carcases, bags, &c. — — — — 290 — 27 9 1 12 Sausages 76 cases — — — — — — 1 14 2 3 Preserved— Tinned 3 cases — — — — 362 tins — 16 0 15 Smoked and Salted 6 cases — — — — 2 pieces — 3 0 7 Casings, Bungs, Middles, &c 193 casks — — — — — — 45 15 1 2 Sundry 429 bags — — — — — — 9 13 1 3 RABBITS— Frozen 74 cases 48 1 4 2 17 Tinned — — — POULTRY and GAME FISH— 7 bags — — — — — — — — 1 2 Preserved, Dried ,, Tinned and Bottled 467 cases — — — — 480 tins 12 6 0 5 Shell — — — — — — — — — — — Wet 8 boxes — — — — — — — — 3 0 FRUIT— Fresh 1,503J cases, &c. — — — — — — 39 4 2 23 Preserved, Dried „ Tinned and Bottled 11,536 1,310 cases cases — — — — — — — — 1,301 tins 362 41 14 17 3 0 19 5 ,, J am, Marmalade'& 1 Ioney 44 cases — — — — — — 2 6 1 6 VEGETABLES— Fresh 429 packages 10 8 0 8 — — 52 4 2 7 Preserved, Dried — — — — — — — — — — — — ,, Tinned 117 cases — — — — 273 tins 5 9 3 11 NUTS— Whole 8 bags — — — — — — — 10 0 26 Sundry PROVISIONS— 395 cases — — — — — — 34 1 0 3 Tea 2 cases — — — — — — — 1 1 15 Cocoa — — — — — — — — — — — — Coffee 9 — — — — — — — 7 1 24 Chicory 75 oags no crc — — — — — — 3 10 3 8 Butter, Cheese, Lard, Margarine 59 Udgb cases. &c. — — 6 10 0 18 Condensed Milk 129 cases — — — — 2 tins 2 7 3 24 Prepared Foods 93 cases 4 14 2 2 Biscuits and Confectionery 23 cases — — — — — — 1 11 3 13 Sugar 78 bass — — — — — — 6 17 2 24 Sugar Sweepings 15,581 bags — — — — — — 1,425 1 0 0 GRAIN— O Wheat, Maize, Barley, Rice, &c. 12 bags 650 2 1 26 — — 660 3 3 27 MEAL and FLOUR 88 bags — — — — — — 12 17 0 18 EGGS 4 — — — — — — — — 2 0 EGG YOLK 401 casks — — — — — — 77 1 0 2 DRUGS 9 cases — — — — — — — 19 0 0 SUNDRIES 140 cases,&c. — — — — — — 3 15 0 18 Totals 35,959| 'packages 669 3 3 22 3,919 tins, &c. 2,998 11 2 17 Approximate weight of goods destroyed during the Year 1914 1,184 11 1 1 " " " " 1915 3,118 5 3 19 „ „ ,, 1916 5,664 9 2 5 1917 4,847 8 1 5 ,, „ „ ,, 1918 1,200 7 0 27 1919 2,829 15 0 19 1922 3,989 12 2 3 1923 1,751 9 0 19 " " " " "1923 1924 2,998 11 2 17 43 TABLE XXXVI.—Description of Meat Destroyed. year. beef. mutton. veal pork, offal. tinned. smoked and salted, &c. total. Tons cwts. qrs. lis. Tons cwts. qrs. lis. Tons cwts. qrs. lis. Tons cwts. qrs. lbs. Tons cwts. qrs. lis. Tons cwts. qrs. lis. ( Pork and Veal— 27 ) 1915 294 18 2 20 64 2 1 15 13 Offal— 7 u 6 3 0 15 17 2 0 2 453 14 2 26 I 58 1 1 3 J f Pork and Veal— 1916 162 7 2 4 10 12 1 10 1 ; 21 Offal— y 2 4 ;■ e 15 l 26 693 6 2 9 918 17 0 0 i 24 5 2 3 j f Pork and Veal—■* 15 ) 1917 227 11 1 18 44 10 2 19 0 Offal— 9 2 i \ 1 10 0 18 78 17 3 16 361 13 0 1 i 8 13 0 27 J r Pork and Veal— 1918 274 15 0 2 5 5 1 20 i ) 0 Offal— 16 3 1 \ 30 14 0 12 0 10 2 6 331 1 0 15 I 18 19 1 2 J f Pork and Veal— 6 \ 1919 52 14 2 2 28 4 2 15 ) 13 Offal— u 1 j> 27 18 1 13 272 14 1 26 435 17 3 0 I 41 5 1 22 j r Pork and Veal— ) 1920 116 1 3 2 122 12 0 19 i 16 Offal— 13 1 24 y 88 6 2 19 82 3 3 5 455 18 1 1 I 30 0 1 16 J f Pork and Veal— 8 ) 1921 212 9 3 1 267 6 o 3 51 Offal— 17 3 12 16 0 24 0 11 1 0 634 14 3 0 i 89 13 0 20 " J ( Pork and Veal—- 21 1922 51 5 0 25 52 11 2 2 j ) 7 Offal— 18 1 >14 12 2 5 0 4 2 5 139 6 2 14 I 12 14 1 12 j Pork and Veal— 17 ) 1923 30 18 1 2 84 16 3 23 1 Offal— 18 3 r 9 14 1 9 0 0 3 10 146 17 0 11 I 19 7 3 6 J r Pork and Veal— 19 ) 1924 141 8 2 17 13 11 1 5 0 Offal— 9 > 0 16 0 15 0 3 0 7 183 8 2 0 I 26 19 2 21 J Total for ten years.... 1,564 10 3 9 | 693 13 3 19 458 1 3 22 199 7 0 16 1,145 15 0 2 4,061 8 3 12 44 PUBLIC HEALTH (FOREIGN MEAT) REGULATIONS, 1908. During the year, Notice was served under Articles III. (5), IV. (1) of the above-mentioned Regulations, for the exportation of the following meat : — Date of Arrival. Name of Vessel. Where from. Where lying. Description and quantity of Meat in respect of which Notice was served. 1924. Nov. 5 ss. " American Farmer " America Tilbury Dock .... 10 cases pig tongues. FOOD INSPECTION. Action under the Regulations of the Ministry of Health made under the Public Health (Regulations as to Food) Act, 1907, resulted in 2,989 tons 17 cwts. 3 qrs. 26 lbs. of Unsound Food being destroyed or disposed of in such a manner as to prevent it being used for human consumption. Exceptions are shown in the disposal of some of the goods for the manufacture of confectionery, distillation, refining and by exportation. The goods for the manufacture of confectionery were condensed milk, which had either undergone a yeast fermentation or had been returned to this country owing to " caramelisation " and discolouration. The deleterious qualities were removed in the process of remanufacture, and thus the use of a considerable quantity of valuable food material was retained. The goods for distillation consist usually of dried fruits, e.g., dates, prunes, raisins and sultanas, and the material disposed of for the purposes of refining comprised damaged sugar and loose sugar swept up from the floors of warehouses, etc. Disposal of the material was carried out as follows, only those goods which could not be used for some useful purpose being actually destroyed. Tons. Cwts. Qrs. Lbs. Boiled down (recovery of fat, &c.) 164 8 2 25 Cattle and Poultry Food 979 7 3 24 Re-manufacture (Confectionery, &c.) — 17 2 14 Extraction of Caffeine — — — — Distillation 120 5 2 16 Refining 1,425 1 0 0 Exportation 176 0 1 9 Destroyed—Buried 92 8 1 25 Burned 40 1 3 . 16 Total weight 2,998 11 2 17 The number of seizures made during the year was 992, this being the highest number ever reached in any year. Actinomycosis in Ox-tongues.—Most of the ox-tongues which arrived in the Port of London were, at the request of the consignees, removed from the district of the Port of London Sanitary Authority (without inspection) to Cold Stores within the City of London, and the Metropolitan Borough of Finsbury, to be examined there under the supervision of the Medical Officers of Health of those districts. About 116 separate consignments were put into Cold Store within the district of the Port Sanitary Authority, where the tongues totalling 19,475 were thawed out and carefully examined, and 274, equalling 1-41 per cent, found to be affected with Actinomycosis. The consignments showing on a 10 per cent, examination upwards of 2 per cent, diseased were as follows :— Number of Tongues examined. Number found diseased. Percentage of those examined. 36 l 2.77 480 (roots) 24 5.0 716 „ 35 4.88 36 2 5.55 76 2 2.63 96 2 2.08 72 4 5.55 48 1 2.08 48 2 4.16 45 Ox-tongue Roots.—It having been brought to my notice by certain consignees that they were receiving ox-tongue roots, I considered this material too liable to actinomycosis to pass without close examination. Thawing out 480 tongue roots showed 5% affected with actinomycosis. I gave instructions that until further notice all tongue roots must be placed in dock store for thawing and examination. The percentage was much larger than that which had been recently found in whole ox-tongues examined. Beef.—The total quantity of frozen and chilled beef stopped by your officers, surrendered by the consignees, and disposed of as unfit for human consumption, was 1,621 quarters and crops, 363 bags and a quantity of trimmings and pieces, the total weight of which was 141 tons 8 cwts. 2 qrs. 17 lbs., as compared with 30 tons, 18 cwts. 1 qr. 2 lbs. in the preceding year. The largest quantity from any one vessel was 929 quarters and crops weighing 51 tons 18 cwts. 1 qr. 4 lbs. Mutton and Lamb.—The total quantity of frozen mutton stopped by your officers and disposed of as unfit for human consumption was 403 carcases, 798 pieces and a quantity of trimmings, the total weight being 13 tons 11 cwts. 1 qr. 5 lbs. as compared with 84 tons 16 cwts. 3 qrs. 23 lbs. in the preceding year. The largest quantity from any one vessel was 231 carcases, weighing 3 tons 17 cwts. 0 qrs. 15 lbs. Pork.—During the year a careful examination was made of a percentage of all consignments of pig carcases landed within the district of the Port of London Sanitary Authority, and resulted in a detailed examination of 4,441 carcases, of which 13, equalling 0.29 per cent., were found to be affected with tuberculosis. Veal.—Nil. Offal.—The offal stopped as unfit for human consumption was as follows :—- Tons. Cwts. Qrs. Lbs. Ox Tongues—120 bags, 277 loose 5 14 1 13 Ox Hearts—115 bags 2 12 3 17 Ox Kidneys—97 bags 2 19 3 23 Ox Tails—115 bags 2 12 0 12 Ox Skirts—248 bags 5 15 3 11 Ox Cheeks—61 bags 1 3 3 27 Ox Livers—139 bags, 13 loose 3 2 0 20 Tripe—15 bags — 9 3 9 Sweetbreads—10 bags — 2 3 24 Sheep Hearts—98 bags 2 2 3 13 Sundries—19 bags, cases, &c 1 9 2 20 Total weight .... 26 19 2 21 Sausages.—76 boxes of sausages, weighing 1 ton 14 cwts. 2 qrs. 3 lbs., were seized during the year, as compared with 4 cwts. 0 qrs. 14 lbs. last year. Meats (Canned).—This class of goods shows a decrease as compared with last year. Tinned meats seized and disposed of consisted of 3 cases and 362 tins, weighing 16 cwts. 0 qrs. 15 lbs. Meats (Smoked and Salted).—6 cases, weighing 3 cwts. 0 qrs. 7 lbs. Rabbits (Frozen).—74 crates, weighing 1 ton 4 cwts. 2 qrs. 17 lbs. Poultry and Game.—7 bags, weighing 1 qr. 2 lbs. Fish.— Tons. Cwts. Qrs. Lbs. Wet—8 boxes _ _ 3 0 Tinned—467 cases and 480 tins 12 6 0 5 Total weight 12 6 3 5 F2 46 Fruit (Green).—A decrease is shown in this class of goods as compared with the preceding year. Tons. Cwts. Qrs. Lbs. Apples—267 cases, barrels 7 6 2 14 Oranges—152 cases 3 7 2 9 Bananas—91 crates 3 1 1 16 Pears—627 cases, 18f barrels 10 0 0 10 Tomatoes—10 bundles — 6 3 20 Plums—22 boxes — 4 3 17 Grapes—80 barrels, 4 boxes 1 2 4 14 Mangoes—51 boxes — 8 3 20 Grape Fruit—7 cases — 4 2 0 Melons—26 cases 1 2 1 6 Mandarinas—49 cases 2 9 0 0 Sundries—99 cases 9 9 1 9 Total weight 39 4 2 23 Fruit (Dried).—This shows an increase as compared with the preceding year. Tons. Cwts. Qrs. Lbs. Dates—6,825 packages 237 9 0 27 Figs—49 bags — 19 2 1 Raisins and Currants—1,152 cases 32 18 0 13 Sultanas—3,368 cases, &c. 88 3 3 15 Prunes—137 cases 3 0 3 11 Sundries—5 cases — 3 1 8 Total weight .... 362 14 3 19 Fruit (Tinned and Bottled).— Tons. Cwts. Qrs. Lbs. Apricots—16 cases, 5 tins — 11 1 13 Peaches—17 cases, 2 tins — 13 3 15 Pines—9 cases, 57 tins — 5 2 27 Tomatoes—12 cases, 56 tins — 9 1 4 Pears—78 cases, 31 tins l 16 3 6 Cherries—35 cases, 519 tins l 19 1 16 Plums—5 cases — 5 0 21 Fruit Pulp, 989 cases, 587 tins 30 8 3 15 Tomato Puree—89 cases, 40 tins 3 8 0 8 Sundries—60 cases, 4 tins 1 18 1 20 Total weight .... 41 17 0 5 Jam, Marmalade and Honey— Tons. Cwts. Qrs. Lbs. 44 cases 2 6 1 6 Vegetables.— Tons. Cwts. Qrs. Lbs. Fresh—429 cases 52 4 2 7 Tinned—117 cases, 273 tins 5 9 3 11 Total weight 57 14 1 18 Nuts.— Tons. Cwts. Qrs. ] Whole—8 bags — 10 0 26 Sundry—395 cases 34 1 0 3 Total weight 34 11 1 1 Provisions.—This class of goods shows an increase as compared with last year. Tons. Cwts. Qrs. Lbs. Tea—2 cases — 1 1 15 Coffee—9 bags — 7 1 24 Chicory—75 bags 3 10 3 8 Butter—2 packages — — 1 21 Cheese—9 crates, 46 cases 6 8 2 9 Lard—2 cases — 1 0 16 Condensed Milk—129 cases, 2 tins 2 17 3 24 Sugar—78 bags 6 17 2 24 Sugar Sweepings 15,581 bags 1,425 1 0 0 Total weight ... 1,445 6 2 1 47 Prepared Foods.— Tons. Cwts. . Qrs. Lbs. Macaroni—14 boxes — 9 3 0 Tapioca — 12 0 0 Tapioca Sweepings — 3 0 3 Spaghetti—11 cases 2 3 0 0 Rolled Oats—18 cases — 4 3 6 Sundries—50 cases 1 1 3 21 Total weight 4 14 2 2 Biscuits and Confectionery :— Tons. Cwts. Qrs. Lbs. Confectionery—23 cases 1 11 3 12 Grain.—- Tons. Cwts. Ore. Lbs. Wheat 628 15 1 13 Maize 13 19 3 22 Barley 1 16 2 27 Rice 15 11 3 21 Total weight .... 660 3 3 27 Meal and Flour.— Tons. Cwts. Ors. Lbs. Meal—62 bags 6 14 2 0 Flour—21 bags 1 5 0 10 Flour Sweepings 4 17 2 8 Total weight .... 12 17 0 18 Eggs.— Tons. Cwts. Qrs. Lbs. 4 cases — — 2 0 Egg Yolk.— 401 casks 77 1 0 2 Drugs.— 9 cases — 19 0 0 Sundries.— 140 cases 3 15 0 18 During the year the following foodstuffs were submitted to the Analyst who reported as follows :— 1924. Boric Acid, per cent. Tin. • (grains per lb.) Crystallised Sulphate of Copper, (grains per lb.) Jan. 15 Bacon 018 — — „ 21 Beans, in tins — 110 0.48 Red Pepper, in tins — 1.22 — Tomatoes, in tins — 1.40 — Peas, in tins — 0.55 — Feb. 9 Tinned Spinach — — 1.35 Mar. 11 Sardines and Tomatoes, in tins — 1-43 — Sodium Chloride 1.52 per cent. Apl. 23 Beef—Parts per million of Formaldehyde—7.7, 7.7, 3.8, 2.7, 3.8, 2.7, 1.0, 1.0, 1.0. Boric Acid, per cent. Tin. (grains per lb.) Crystallised Sulphate of Copper. (grains per lb.) May 14 Tinned Peas — — 0.96 „ 27 Tinned Peas — 0.87 July 2 Tinned Spinach — — 5.3 „ 4 Tinned Spinach — — 4.8 „ 9 Tomato Puree — 308 — „ 11 Lemon Juice Acidity (calculated as citric acid) 7.70 grammes per 100 cubic cm. Alcohol—1.5 per cent, proof spirit. Salicylic Acid, Sulphurous Acid, Arsenic, Free Mineral Acid^ and Tartaric Acid absent. 48 Boric Acid, per cent. Tin. (grains per lb.) Crystallised Sulphate of Copper, (grains per lb.) 1924. Oct. 10 Tinned Peas — — 1-93 „ 24 Tinned Spinach — — 3-95 ,, 25 Tinned Peas — — Absent 27 Tinned Spinach — — 3.1 „ 27 Stewed Kidneys — 0.66 — Stewed Kidneys — 1.40 — Stewed Kidnevs 0.77 — „ 28 Tinned Spinach — — 3.48 & 3.86 Nov. 24 Honey Glucose, Salicylic Acid and Sulphites—absent. The sample contained 0-01 per cent, of suspended matter insoluble in water. This consisted chiefly of vegetable fibre mixed with a few pollen grains. Boric Acid, per cent. Tin. (grains per lb.) Crystallised Sulphate of Copper, (grains per lb.) Nov. 24 Tinned Spinach 2.40, 2.42, 2.32, 1.84, 2.02, 3.09 „ 27 Tinned Spinach — — 3.09 & 2.90 Dec. 12 Tinned Spinach — — 2.90 & 3.38 „ 19 Tinned Spinach — — 3.48, 2.41, — — 2.70, 3.38 „ 23 Tinned Spinach — — 3.67, 3.78, 3.67 During the year, applications were received from Importers to be allowed to remove various foodstuffs from the district of the Port of London, without examination by your officers, on the understanding that the goods would be examined and dealt with under the supervision of the Medical Officer of Health of the district to which the goods were removed. The permission asked for was given in respect of the following foodstuffs :— For removal to the City of London :— 13,686 bags of ox-tongues. For removal to the Borough of Finsbury :— 31,032 bags and cases of ox-tongues. For removal to the Borough of Southwark :— 2,651 cases of ox-tongues. SS. " KENT." FORMALIN IN BEEF. On Thursday, the 3rd April, your Medical Officer visited the ss. " Kent " and saw the opening out of a hold containing meat which had been subjected to the Linley process of formalin preservation. I understand that this experiment of bringing over chilled meat under formalin was marred by a series of accidental circumstances ; owing to delay in ports in New Zealand in hot weather it was found necessary from the condition of the meat to freeze it down before leaving New Zealand. The consignment thus consisted of formalined frozen meat instead of formalined chilled meat. Representatives of the Ministry of Health were present at the opening out of the special hold used. The condition of the meat was one of considerable superficial mould. The meat was " brighter " in appearance, i.e., its natural colour better preserved, than would have been possible with ordinary freezing. This is a usual effect of formalin. On analysis of samples of the meat by Mr. E. A. Pinchin, your Analytical Chemist, it was found that the first 5 millimetre section from the surface of exposed muscle, contained in three samples 7.7, 7.7 and 3.8 parts per million of formaldehyde respectively ; the second 5 millimetre contained 2.7, 3.8 and 2.7 ; and the third 5 millimetre section about 1.0 per million in each sample. In a 10 millimetre section of fat no formalin could be detected. The above determinations were made in lean meat on an uncut surface but where the muscle was clearly exposed through its slight fascia. 49 Your Medical Officer noticed a slight sour smell such as might have been expected from the presence of a variety of moulds. There were only slight traces of black spot mould, so that the whole of the mould was superficial. Without knowing accurately the whole conditions as to temperatures and moisture maintained in the chamber during the voyage, one cannot say what was the cause of the apparent failure of the amount of formalin used to prevent this mould growth. On cutting, the meat appeared perfectly sound ; there was a trace of sourness to the sense of smell which, considering the susceptibility of fat to odours, might have been accounted for by the mould smell noticed in the chamber. A sour cheesiness was noticed also to a greater extent in two defrosted quarters later. On the general question of formalined meat, my opinion is that, though the penetration in this as in former consignments is comparatively slight, the effect of small quantities of formalin is so powerful that none of it should be permitted in foodstuffs for the purpose of preservation. The very preservation by such small quantities of formalin as are found suggest that since a mechanism of the preservation is the arrest of a chemical process very allied to digestion, this would render the meat indigestible and, therefore, not of such a nature as is desirable for human consumption. The good colour if preserved in the absence of mould would confer a marketable value on the meat which might be altogether misleading. This consideration is, of course, entirely theoretical ; at present there is no experimental basis for a decision as to the possibility of the use of formalin in minute quantities in foodstuffs. As regards this consignment, at the request of the consignees, the whole quantity (463 quarters) was destroyed by your contractors, irrespective of the formalin content. An experiment with this meat is worth recording. Some of the material stood at room temperature for a least a month in an unsterilised but covered screw-top bottle. The pieces were originally taken as presenting specimens of various moulds. The moulds grew heavily to a length technically known as " whiskers." Bacterial growth was so slow, however, that at the end of the experiment there was only slight deliquescence showing in some of the pieces ; the majority of the pieces were quite unaltered in appearance except for the mould growths and in consistency. This is in conformity with a method which I have found satisfactory in preserving small crabs and other crustacea for examination. The animal is allowed to die in formalin, one teaspoonful to the pint or more of sea water, and is then dried in the sun. Even large specimens of say Portunus Puber will thus remain inoffensive and undecomposing for years though freely exposed to the dust and hygrometric conditions of a house. The inferences are that processes of digestion which are comparable, if not identical with those of decomposition under bacterial or other ferments, being primarily simple hvdrations, must be seriously interfered with in the presence of traces of formalin. It is certain that all chemical preservatives in foods interfere in some degree with digestive processes apart from any direct injurious drug action the preservative material itself may exert. Their very mode of action is the rendering of preserved material incapable of fermentation, i.e., digestion—in their presence. The dilution or removal of the preservative is the first work thrown on the digestive organs on receiving preserved foods. Individuals of different ages or capacities vary in their powers of doing this work and any one individual's powers will differ from day to day. Proof of positive harm to individuals should never have been made a criterion in view of such obvious considerations. A strong condemnation of chemical preservatives, which are not natural to the human economy, lies in the fact that they do not kill, but do prevent life. One can but hope that the recommendations of the recent Departmental Committee in the matter will not long await the promised enactment. 50 PUBLIC HEALTH (FOREIGN MEAT) REGULATIONS. The official certificate of the Latvian Republic was recognised by the Ministry of Health by notice inserted in the London Gazette on the 30th May, 1924. CASHEW NUTS. A deputation from the London Chamber of Commerce interviewed your Medical Officer on the 1st September. A subject in question was a consignment of cashew nuts. It was suggested by the deputation that— (a) Maggots were a natural concomitant of every fruit and nut and often of cheese and other foods. (b) That the eating of maggots was not injurious to the human economy. (c) That at least exportation of the material to the Continent should be permitted. I set out the position as follows (a) That whereas an occasional maggot or alternatively a little maggot dung was welcome in a food as proof positive of the capacity of that food to support life (in contrast to the heavily boraxed or even lightly formalinised foods, of which the relative or absolute sterility show the capacity of the preservative to interfere with normal biological processes, such as digestion, and so depress vital functions, whether in the human or other animal organism), a parcel of nuts which showed one, two, three or even more tracks of maggot in every nut would, in the words of the law, and in fact, be deemed to be " unsound." This parcel was so " unsound " and " unfit for human consumption." (b) That I was aware of no experiment which could either support or oppose the suggestion of injury, and did not approach the subject from this point of view (to most people " wormy " or maggoty food is nauseating, and while it is a probability that instinctive nausea in connection with foods is primarily protective and implies phylogenetic history of danger to health wherever the nauseating factor exists) such considerations are only now emerging from an undeserved obscurity and were not pressed on this occasion. A question of killing larva and insect by cold storage having arisen in the matter, I suggested that whether the insect or larva were living or dead did not seem to be worth discussion for present purposes. Maggot or decomposing maggot and dung would still be present. (c) That I would advise your Worshipful Committee to direct the refusal of exportation of material in half as filthy a condition as the parcel under consideration as being outside the legal procedure laid down for dealing with unsound food, as affording possibility of the return to this country of the food in an unidentifiable form or method of packing, and as perpetuating that importation and bandying about of unsound food from trader to trader in this country, with inevitable leakage to the public, against which the spirit and letter of the Unsound Food Regulations is directed. Your Medical Officer informed the consignees that the parcel would be released by consent, under acceptable guarantee, for cattle feeding, or would be taken before a magistrate for his decision as to unsoundness. The vexed question in this case, however, was the one whether export of unsound material which had been seized as such should be permitted. Your Worshipful Committee agreed your Medical Officer's comment and action. Cashew nuts are a valuable commodity, and have such flavour and other properties as are welcomed in " almond " icing ; in the making of icing the nuts are simply crushed. The new nut is of course uninfested by weevil in any of its stages of development. 51 CANNED SPINACH. The following report to your Worshipful Committee was forwarded by their direction to the Ministry of Health, Medical Officers of Health for Port Sanitary Districts and Medical Officers of Health for Metropolitan Boroughs abutting on the River Thames :— CANNED SPINACH. " I have to bring to the notice of your Worshipful Committee another request for export of seized food material. The vegetable spinach in its natural state is found amongst foodstuffs because of two principles, first its Vitamin content (anti-scorbutic) and secondly as affording a cellulose residue which preserves the regular functions of the lower large bowel as an excretory organ— a residue which is largely wanting in the highly-concentrated foods of to-day. It possesses the minimum of nutriment. The presence of natural green (chlorophyll) is largely a measure of the Vitamin content. The vitamin is an essential to health. The consignment of spinach in question contains an excess of copper sulphate. This material is used to supplant the green colour of the vegetable which has disappeared together with the Vitamin usually associated with vegetable green-stuffs, in the process of canning. From the scientific point of view there is thus an addition of poison to the material, further to that deficiency in Vitamin which is the nature of all canned vegetables which have been subjected to heat in processing. Somewhat in contra-distinction to tinned or bottled peas, spinach is with difficulty coloured with copper sulphate in regulable proportions, and is so useless if not harmful a foodstuff when so coloured that one would welcome the absolute disappearance of this commodity from the list of available so-called foods. Its greening by means of a poison together with its deficiency in Vitamin should rule green tinned spinach out of the list of foodstuffs entirely. The eye of man naturally and hereditarily associates green vegetable material with that essential well being which accompanies the eating, amongst other foods, of leaves containing chlorophyll green and is due to Vitamin. The eye is vilely tricked by the substitution of a poison green for chlorophyll green—• or indeed the addition of any green colouration—in the absence of Vitamin. That the undiscerning public demands green colour and naturally finds it appetising, is a cogent reason for affording the completest protection to them in their exercise of this primitive and basal instinct towards health. The poison in green coloured preserved vegetables in the more subtle in that, unlike that of the green copper-containing oysters of some of ourwestern rivers (formerly mistaken for the succulent blue point of vegetable colouring) which immediately on ingestion produce disease, it as a rule only produces occult effects, because of the smaller quantity present. The importer in this case and the agent have called and written to put certain trade aspects of the case before your Medical Officer, and have stated — ' The packer has requested us to cancel all existing orders for coloured spinach, and states we are to inform our various buyers he will not ship any further quantities of coloured spinach against their orders in hand. ' We will, if necessary, give the Medical Officer an undertaking as agents that, if released, we will not try to re-import this spinach here through any other port. ' We will also ask our principals to give the Medical Officer their undertaking not to seek to re-import this coloured spinach to London or any other port of the United Kingdom. ' In view of the above facts we hope the Medical Officer will grant the release of these goods, so that they may be returned to Antwerp, Belgium, to the packers.' Considering the views expressed above, I am reluctant to suggest to your Worshipful Committee the permission to re-export these and such goods whatever the trade aspect of this particular case. I recommend that no food in which there is copper in excess of two grains per lb. be allowed for re-export on seizure. I further recommend that this report on the matter be forwarded to the Ministry of Health with a view to expressing the opinion of the Port of London Sanitary Authority that copper in whatever quantity as an adjunct or colouring matter to food should be entirely excluded as being unnatural to food and poisonous, a doubly pernicious tricking of man's hereditary instinct towards health and well-being." G 52 TABLE XXXVII.—General Summary, and Analysis, of the Sanitary Inspections of Vessels, &c., in the Port of London, for the year ended 31st December, 1924. 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, 1923 New Barges. Condemned. Use Discontinued. No. in District 31st December, 1924. 13,193 161 1,382 441 L 7 22 1,432 28 96 490 5 31 432 2 23 3,109 56 110 1,018 2 114 178 53 JO i> CO 107 378 48 19 — — — 19 Inspections. Docks and River. No. Nationalities. No. Total Inspections to 31st December, 1923 1,357,208 St. Katherine's 569 American 271 Argentine Total Inspections from 1st January to 31st December, 1924:— London 1,089 BRITISH 15,942 Regent's Canal 630 Belgian 371 Millwall 1,200 Brazilian Dutch 674 Foreign 13,634 Millwall 1,200 Danish 339 Coastwise 1,922 West India 721 Danzig Free State 13 Inland Navigation 4,737 Poplar 189 Esthonian 14 Premises on shore 3,474 Poplar 189 French 119 East India l531 Finnish 142 Total 1,380,975 Victoria 1,986 German 798 Royal Albert 1,498 Greek Italian 42 50 Cleansing of Crew's Quarters, &c. :— King George V. 1,399 Icelandic 9 Japanese 186 Total to 31st December, 1923 89,085 Commercial 1,446 Lettish 2 Norwegian and Swedish 1,244 Total No. of Vessels from 1st January to 31st December, 1924 1,793 Tilbury 1,370 Gravesend District — Polish 2 Portuguese 11 River—*Upper District 3,139 Russian 41 Roumanian 3 Total 90,878 *Middle „ 578 Spanish 13 *Lower ,, 2,948 Latvian 1 Number of vessels inspected :— In the Launches— Chilian 2 ,, Medway Uruguayan 2 Austrian 1 Lady lruscott 2,948 Total Vessels 20,293 Memel 1 " James Howell" " George Briggs " 3,717 Shore Premises 3,474 Shore Premises 3,474 Total 6,665 Total 23,767 Total 23,767 In the Docks, &c. 17,102 Total 23,767 ♦Upper District extends from Greenwich to Teddington. ♦Middle „ ,, „ ,, Erith. ♦Lower ,, „ ,, Erith to outer limits of the Port of London 1915. 1916. 1917. 1918. 1919. 1920. 1921. 1922. 1923. 1924. Yearly Average for the 10 years ending 31st Dec,, 1924. Total number of Inspections of vessels from— "Foreign" 12,472 10,244 8,365 8,362 11,030 11,778 11,076 12,601 13,040 13,634 11,260-2 " Coastwise," " Inland Navigation," and other Inspections 22,237 19,634 20,881 20,390 18,388 15,741 14,916 13,291 11,932 10,133 16,754-3 Total 34,709 29,878 29,246 28,752 29,418 27,519 25.992 25,892 24,972 23,767 28,014-5 . 53 TABLE XXXVIII. NUMBER OF NUISANCES ON VESSELS REPORTED AND DEALT WITH during the year ended 31st December, 1924. description of nuisances. January. February. March. April. May. June. July. August. September. October. November. December. Totals. Smoke Nuisances Number of complaints received 3 3 2 9 11 18 4 2 37 15 9 113 Number of recurrences reported — — — — 2 1 — — — 1 1 5 Offensive Cargoes (Bye-laws) :— Number of Infringements reported — 10 — — 1 — 2 — — 4 — — 17 Structural and other Defects :— Ventilation 22 10 5 2 — 4 2 5 2 6 4 2 64 Lighting 17 5 5 5 7 12 9 6 3 11 10 8 93 Heating 8 — 3 1 2 2 2 1 3 7 3 7 39 Bare iron in crew's quarters 5 — — — — — — — 1 — — — 6 Leaky decks, hawse-pipes, cable casings, &c 7 3 6 6 8 4 8 2 5 11 5 72 Defective bulkheads and floors 3 — — 3 — 3 2 3 5 3 6 6 34 Sanitary conveniences 3 7 3 4 6 8 2 5 5 9 7 4 63 Ship's gear or stores stowed in crew's quarters 2 — — — — — 1 — 1 3 — 1 8 Foul bilges and peaks — — — — — — — — — 1 — — 1 Storage of drinking water (dirty or defective tanks) 2 — — — 1 — 1 — — — 1 — 5 Dirty quarters 152 169 166 149 167 174 159 142 153 150 163 150 1,900 Accumulation of offensive matter 1 4 — 5 Miscellaneous Nuisances 4 2 2 4 7 4 13 9 4 11 12 7 79 Totals 228 206 193 176 211 223 219 177 184 254 239 199 2,509 Total number of vessels on which structural alt orations were ordered 22 10 14 15 17 25 17 18 15 28 22 17 210 Total number of vessels on which structural alterations were reported as carried out 12 10 13 37 30 14 26 ; 33 11 16 16 27 245 (includes orders made in previous years and reported carried out during 1924.) NUMBER OF NUISANCES IN THE RIVER REPORTED AND DEALT WILH during the year ended 31st December, 1924. From discharge of foul liquid, sewage, &c., into the River — — — — 2 — — — — — — — 2 Offensive condition of River water — — — — — — — — — — — — — Totals — — — — 2 — — — — — — — 2 G2 54 TABLE XXXIX. NUMBER OF NUISANCES ON SHORE PREMISES REPORTED AND DEALT WITH during the year ended 31st December, 1924. DESCRIPTION OF NUISANCES. January. February. March. April. May. June. July. August. September. October. November. December. Totals. Smoke Nuisances :— — — — — — — — — — — — — — Number of complaints received — — — — — — — — l — — l 2 Number of recurrences reported — — — — — — — — — — — — — Structural and other Defects :— Ventilation — — — — — — 1 — — — — — 1 Lighting — — — — — — — — — — — — — Heating — — — — — — — — — — — — I Dilapidations — — — — l l — 1 3 9 — 2 10 Sanitary conveniences 6 — 3 4 3 3 6 3 10 8 l 1 48 Water Supply Dirty Premises 25 13 21 28 39 43 42 35 28 34 39 27 379 Accumulation of Offensive Matter 1 1 1 5 2 5 4 8 5 1 33 Drainage 3 — — 2 4 5 2 2 5 3 4 3 33 Foul cesspits, latrines, &c. — 4 1 5 Miscellaneous Nuisances 1 — 1 1 11 1 10 2 3 2 — 1 33 Totals 36 17 28 36 65 60 66 43 54 57 49 36 545 Number of shore premises on which structural alterations were ordered 9 1 6 9 25 13 23 6 23 21 11 9 156 Number of shore premises on which structural alterations were reported as carried out 11 — 3 6 17 15 11 5 23 22 12 4 129 SUMMARY. Smoke. Structural. Offensive Cargoes. Drainage, Sewage, &c. Miscellaneous. Totals. Number of Nuisances reported— (a) On Vessels 118 381 17 — 1,993 2,509 (b) On Shore 9 60 — 38 445 545 (c) On the River — — — — 2 2 Totals 120 441 17 38 2,440 3,056 Number of written Intimations— (a) On Vessels 118 115 17 — 33 283 (b) On Shore 2 14 — 10 19 45 (c) On the River — — — — 1 1 Totals 120 129 17 10 53 329 Number of Statutory Notices—• (a) On Vessels 105 1 — 106 (b) On Shore 1 — — — — 1 (c) On the River — — — — — — Totals 108 1 — — — 107 55 TABLE XL.—Sanitary Works. (Part I.) Date completed. 1924. Works. Jan. 24 King George V. Dock. Erection of European and Lascars' convenience. Feb. 18 King George V. Dock. Drainage in connection with Dockmaster's office. Mar. 11 Royal Albert Dock. Drainage in connection with Messrs. Mowlem & Co.'s new main offices. Sept. 27 Royal Albert Dock. Drainage in connection with Customs' Huts, near Nos. 12, 16 and 22 sheds. „ 27 King George V. Dock. Drainage in connection with Customs' Huts, near No. 14 shed. Dec. 4 Regent's Canal Dock. Drainage, &c., at Messrs. Cohen's premises, 600, Commercial Road. „ 4 Regent's Canal Dock. Drainage at Customs' and Dockmaster's office. Sanitary Works. (Part II.) Sanitary Works and Alterations not yet reported as completed. Date Plan submitted. Works. 1924. June 17 London Dock. Proposed Latrines backing on to Nightingale Lane. TABLE XLI.—Bye-Laws. Offensive Cargoes. Seventeen cases of infringement of the above-mentioned Bye-laws were reported during the year. Written notice was sent to the owners of the barges except in the case of those marked * the infringement being remedied forthwith. Date. 1924. Name of vessel. Owners. Infringement. Feb. 18—20 Lighter " Thanet " Wilders & Walker Remaining within the district of the Port Sanitary Authority for a longer period than 48 hours, loaded with an offensive cargo, to wit, fish refuse. „ 18—20 Lighter " Dove " Ditto Ditto ditto. „ 22 Lighter " Ixia " Flower & Everett Ditto, loaded with house refuse. „ 22 Lighter " Myrtle " Ditto Loaded with an offensive cargo, to wit, house refuse which was not properly and securely covered so as to prevent any nuisance arising therefrom, and also loaded above the coamings. „ 22 Lighter " Crocus " Ditto Ditto ditto. „ 22 Lighter " Acacia " Ditto Ditto ditto. „ 22 Lighter " Magnolia " Ditto Ditto ditto. " 22 *Lighter " Westminster " .... Cory & Son, Ltd. Loaded with an offensive cargo, to wit, house refuse which was not properly and securely covered so as to prevent any nuisance arising therefrom. „ 28 " Superior " W. Cory & Co. Ditto ditto. „ 28 *" Boston " Ditto Ditto ditto. May 8 Lighter " Alan " .... Tilbury Contracting and Dredging Co., Ltd. Loaded with an offensive cargo, to wit, house refuse which was not properly and securely covered so as to prevent a nuisance arising therefrom, and also loaded above the coamings. July 7 " Bulgaria " G. J. Palmer & Sons Loaded with an offensive cargo, to wit, ship's refuse not properly and securely covered so as to prevent a nuisance arising therefrom. „ 9 " Medway " Prizeman & Co., Ltd. Ditto ditto. Oct. 9 Lighter " Jesse " Ditto Loaded with an offensive cargo, to wit, road sweepings, galley refuse, &c., not properly and securely covered so as to prevent any nuisance arising therefrom and also loaded above the coamings. 56 Offensive Cargoes—continued. Date. 1924. Name of vessel. Owners. Infringement. Oct. 14 Sailing Barge " Daisy " .. W. C. Dines Loaded with an offensive cargo, to wit, house refuse, not properly and securely covered so as to prevent any nuisance arising therefrom, and also loaded above the coamings. „ 23 Lighter " Victory " Prizeman & Co., Ltd. Not thoroughly cleansed and deodorised within six hours after the discharge therefrom of an offensive cargo. „ 28 Sailing Barge " Eight Brothers " J. T. Rayfield, Junr. Loaded with an offensive cargo, to wit, house refuse, not properly and securely covered so as to prevent any nuisance arising therefrom, and also loaded above the coamings. TABLE XLII.—Alien Examination. Attached is a table of Aliens examined in the Port of London during the year Quarter ending No. of vessels carrying aliens. Total No. of passengers. No. of aliens found suffering from infectious and other diseases. 1924. 31st March 138 2,750 2 30th June 185 6,065 3 30th September 230 9,341 1 31st December 156 3,627 6 Totals 709 21,783 12 PUBLIC HEALTH (SHELLFISH) REGULATIONS, 1915. The Shellfish laYings in the River Thames and within the jurisdiction of the Port of London Sanitary Authority, range on the south FROM the Blythe Sands to just beyond King's Ferry Bridge up the River Swale, the whole of the coast line as far as Sheerness and up the River Medway and West Swale, affording feed and foothold for winkles and oysters. Oyster culture, however, is only undertaken in one place, namely Coalmouth Creek, opening into the River Medway. Here, there is one private laying for oysters. On the east bank of the River Medway, from Sheerness to Stangate Spit, there are two stretches of land, namely, the Lappell from Sheerness to Oueenboro' Pier and the sand between Queenboro' Spit and Stangate Spit which afford oysters and oyster spat. The proximity of Sheerness and Queenboro' render these " public layings " unfit fishing grounds, especially the Lappell. Spat and oysters are taken from these grounds for culture and relaying in beds outside the jurisdiction. The northern coast line of the Island of Sheppey between Sheerness and Warden Point does not afford suitable foot-hold for shellfish, the nature of the cliff permitting of erosion and the foreshore being either of mud or shingle ; this is in contradistinction to the sands which occur along the Island of Grain and the Hundred of Hoo, as also the Leysdown district in the Isle of Sheppey, where the land behind the coast is flat and erosion does not take place. The East Swale from its proximity to Queenboro' and the flow of the tide over the Lappell is unfit as a ground for collection of shellfish for direct sale to the public. Collection of shellfish for relaying goes on in the West Swale. On the northern side of the estuary, the shore from Holehaven to Havengore Creek is suitable ground for the growth of shellfish, but is deemed polluted from the Chapman Lighthouse to well beyond Shoeburyness, owing to the large and increasing townships of Southend and Leigh and Shoeburyness. From west to east are included the Chapman Sands, the Bargander Sands, Benfleet Creek, Hadleigh Ray, Leigh Sands, Marshend Sands, Southend Flat, Shoebury Sands and the extreme eastern end of the Maplins. 57 Two private shellfish grounds, one to the east of Southend and another in the large "public laying" at Shoeburyness, exist on the north; both of these come under orders issued by the Port of London Sanitary Authority dated 16th November, 1916, and shellfish are not collected from them for direct sale, though oyster spat and oysters are collected for culture. Similar collection takes place from Southend flat. The whole district from the Chapman Lighthouse to Shoeburyness and further towards the Maplin Sands is under two prohibition orders or private undertakings. Cockles are collected from the whole of the said area and sterilized before distribution for sale, mostly at Leigh. Relaying grounds in use for the Southend and Shoebury district lie in the Rivers Roach and Crouch. The following communication of interest was received from Dr. Pugh, Medical Officer of Health for Southend:— Public Health Offices, Clarence Street, Southend-on-Sea. 10th April, 1924. Dear Dr. Willoughby, PUBLIC HEALTH (SHELLFISH) REGULATIONS. A girl, aged 15¾, of Bournes Green in this Borough was notified to me on the 5th instant to be suffering from Typhoid Fever and on enquiry I learn that she became ill on the 26th ultimo, developed spots on the 3rd instant, and gave a positive Widal reaction 1 in 200. She and other members of the family had partaken of periwinkles purchased from a street vendor on Sunday, 16th ultimo. The street vendor, I understand, obtains his periwinkles from Mr. W. Bygrave, 12, Rompart Street, Shoeburyness, who is said to collect them from the Thames foreshore off Wakering Stairs. A similar instance of Typhoid Fever, following the consumption of periwinkles, purchased from the same street vendor, came under notice in March, 1921. He was then warned as to the requirements of the Order made by your Authority, as to steaming under pressure for six minutes in an approved apparatus or cooking in water maintained at the boiling point for 15 minutes. The apparatus he then used for boiling the winkles consisted of a dilapidated copper in the yard with a defective furnace. The Inspector states that he is now informed the copper is not in use but that the winkles are boiled in a saucepan over the kitchen fire. I have sent the street vendor a warning letter but I think you will be interested to hear of the case. Yours faithfully, C. GRANT PUGH, Medical Officer of Health. I asked for an explanation of the seller, warning him that prosecution might follow. I further impressed upon him the necessity of following out the Regulations accurately. It is of interest that the matter of Enteric Fever in this district has again cropped up with the lesser shellfish—winkles. It will be remembered that at the time of the Shellfish enquiry an element of doubt was expressed as to whether winkles were a source of Enteric Fever and that considerable evidence was given in the account of a winkle epidemic which occurred in Northfleet and was reported to me by Dr. H. T. Sells, Medical Officer of Health for Northfleet. The Regulations were again published in two newspapers in the Southend district in order that Shellfish vendors may not plead ignorance of their responsibilities in the matter. LEGAL PROCEEDINGS. Date. Name of vessel. Offence. Police Court. Result. 1924 Nov. 18 ss. "Hadrian" (master) Failure to comply with the terms of a Statutory Notice served requiring the abatement of a smoke nuisance and the prevention of a recurrence of the same. Greenwich Summons dismissed. Dec. 17 ss. "Fred Everard " (master) Ditto. Tower Bridge Fined 3 guineas. Costs 3 guineas. 58 BYE-I.AWS—HOUSEBOATS. The following Bye-laws came into force on the 12th June, 1924:— Corporation of London. PORT SANITARY AUTHORITY FOR THE PORT OF LONDON. PUBLIC HEALTH (LONDON) ACT, 1891. BYE-LAWS made by the Mayor, Commonalty and Citizens of the City of London, as the Port Sanitary Authority of the Port of London, under Section 95 of the Public Health (London) Act, 1891, and the London Port Sanitary Authority (Additional Powers) Order, 1923, with respect to houseboats used for human habitation with the limits of the Port of London. INTERPRETATION OF TERMS. 1. Throughout these Bye-laws the expression "the Port Sanitary Authority" means the Mayor, Commonalty and Citizens of the City of London; the expression "the district" means the Port of London as established for the purposes of the laws relating to the Customs of the United Kingdom; the expression "infectious disease" means smallpox, cholera, diphtheria, membranous croup, erysipelas, the disease known as scarlatina or scarlet fever, measles, and the fevers known by any of the following names: typhus, typhoid, enteric, relapsing, continued, or puerperal; the expression "the Medical Officer of Health" means the Medical Officer for the District, or any legally qualified medical practitioner lawfully authorised to act on behalf of such officer ; the expression "houseboat" includes any vessel or boat which is lying in any river or water or on any foreshore within the district of the Port Sanitary Authority and is not afloat at all states of the tide and which is used mainly or wholly for human habitation, whether such use be temporary or intermittent or permanent, and the expression "the occupier," when used in relation to any houseboat, means the person who for the time being has the charge, management, or control of such houseboat. FOR PROMOTING CLEANLINESS IN AND THE HABITABLE CONDITION OF HOUSEBOATS USED FOR HUMAN HABITATION. 2. The occupier of a houseboat used for human habitation shall cause the internal surface and the floor thereof to be thoroughly cleansed from time to time as often as may be requisite for keeping the same in a cleanly condition. 3. The occupier of a houseboat used for human habitation shall, for the purposes of securing the habitable condition thereof, provide for such houseboat adequate means of permanent ventilation. 4. The occupier of a houseboat used for human habitation shall cause the same to be maintained so that it may be reasonably weatherproof at all times when so used. 5. The occupier of a houseboat used for human habitation shall cause the same to be at all times provided with a suitable dry flooring. 6. The occupier of a houseboat used for human habitation shall provide therefor a sufficient receptacle or receptacles for the storage of water, with proper coverings, so placed as to be easily accessible, and shall cause the same to be maintained at all times in good order, and shall provide a sufficient supply of wholesome water for the use of the inmates of such houseboat, and shall also cause every part of the interior of any such receptacle to be kept thoroughly clean. 7. Notwithstanding anything in the foregoing Bye-laws, the person by agreement with or by licence from whom any houseboat used for human habitation shall be brought or used on any foreshore between tide marks, shall provide within easy access to such foreshore a sufficient supply of wholesome water for the use of the occupants of such houseboat. FOR PREVENTING THE SPREAD OF INFECTIOUS DISEASE BY THE PERSONS INHABITING HOUSEBOATS USED FOR HUMAN HABITATION. 8. The occupier of a houseboat used for human habitation who shall have been informed, or shall have ascertained, that any inmate thereof is ill of an infectious disease, shall adopt all reasonable precautions that may be ordered by the Medical Officer of Health for preventing the spread of such disease. He shall not, at any time while such inmate is suffering from such infectious disease, cause or allow any other person, except the person in attendance on such inmate, to occupy such houseboat. 9. The occupier of a houseboat used for human habitation in which any person may within the preceding six weeks have been suffering from an infectious disease, and which has not since been properly disinfected, or, in which any person is at the time suffering from an infectious disease, shall comply with the following regulations:— (a) He shall, before causing or allowing such houseboat to be removed from the site on which it may be, give to the Medical Officer of Health twenty-four hours' notice of the intention to remove the same, and the place to which the same is proposed to be removed. (b) He shall not cause or allow such houseboat to be brought into any place which may for the time being be devoted to the purposes of public amusement, recreation, or resort, or to be removed to any site where, in the opinion of the Medical Officer of Health, there would be danger of spreading infection. 59 (c) He shall, where the Medical Officer of Health may, for the purpose of preventing the spread of infection, order the removal of such houseboat from any site, remove the same; in compliance with the order of the Medical Officer of Health, to another site within the district to which it may lawfully be removed. (d) He shall, when removing such houseboat, comply with such reasonable conditions as the Medical Officer of Health may impose for the purpose of preventing the spread of infection. (e) He shall not remove such houseboat out of the district until the same has been properly disinfected. 10. In every case, where, in pursuance of any statutory provision in that behalf, an order of a justice has been obtained for the removal from a houseboat to a hospital or other place for the reception of the sick, of a person who is suffering from any dangerous infectious disorder, the occupier of such houseboat shall, on being informed of such order, forthwith take all such steps as may be requisite to secure the safe and prompt removal of the said person in compliance with such order, and shall, in and about such removal, adopt all such precautions as, in accordance with any instructions which he may receive from the Medical Officer of Health, may be most suitable for the circumstances of the case. 11. The occupier of a houseboat used for human habitation shall, immediately after a person suffering from an infectious disease has been removed therefrom, or has died therein, or has recovered from such disease whilst being therein, give notice of such removal, death, or recovery to the Medical Officer of Health, and shall, as soon as conveniently may be, cause every part of such houseboat to be thoroughly cleansed and disinfected, and shall also cause all bedding, clothing, or other articles therein which may be liable to retain infection to be in like manner cleansed and disinfected, unless the Port Sanitary Authority shall have ordered the same to be destroyed, or unless the Port Sanitary Authority, or the Medical Officer of Health, shall, in pursuance of any statutory provision in that behalf, have required the owner of the same to cause the same to be delivered to an officer of the Port Sanitary Authority for removal for the purpose of disinfection. He shall comply with all proper instructions of the Medical Officer of Health as to cleansing and disinfection. When the houseboat and every such article as aforesaid shall have been thoroughly cleansed and disinfected in accordance with such instructions, notice thereof shall be given to the Medical Officer of Health. 12. The occupier of a houseboat used for human habitation in which any person has within six weeks previously been suffering from an infectious disease, shall not, without having such houseboat, and all articles therein liable to retain infection, disinfected to the satisfaction of a registered medical practitioner as testified by a certificate signed by him, cause or suffer any person newly to occupy or become an inmate of such houseboat. GENERALLY FOR THE PREVENTION OF NUISANCES IN CONNECTION WITH HOUSEBOATS USED FOR HUMAN HABITATION. 13. Notwithstanding any other provision of these Bye-laws, the occupier of a houseboat used for human habitation shall provide for the same a sufficient receptacle for refuse. 14. An occupier of a houseboat used for human habitation shall not cause or suffer any solid or liquid filth to be retained therein. He shall not deposit or cause to be deposited any solid or liquid filth within thirty feet from such houseboat, except in a proper receptacle. He shall not deposit or cause to be deposited any solid or liquid filth in any place so as to cause a nuisance. He shall cause every vessel, utensil, or other receptacle provided or used for the purpose of containing or removing any solid or liquid filth to be sufficiently cleansed immediately after it shall have been used for that purpose. 15. The person by agreement with or by licence from whom any houseboat used for human habitation shall be brought or used on any foreshore between tide marks, shall, in any case in which nuisance is likely to arise from the want of privy accommodation and of a receptacle for refuse for the use of the occupants of such houseboat, provide for their use within easy access to such land, sufficient privy accommodation, and a sufficient covered ashpit, dustbin, or other receptacle for refuse, and shall maintain the same in good repair and order and in a reasonably clean and wholesome condition. 16. The occupier of a houseboat used for human habitation shall not keep any animal, or deposit any filth or the dung of any animal, within a distance of forty feet from any well, spring, or stream, or other water used or likely to be used by man for drinking or domestic purposes, or for manufacturing drinks for the use of man, or any water used or likely to be used in any dairy, or otherwise, in such a position or in such a manner as to render any such water liable to pollution. PENALTIES. 17. Every person who shall offend against any of the foregoing Bye-laws shall be liable for every such offence to a penalty of five pounds, and in the case of a continuing offence to a further penalty of forty shillings for each day after written notice of the offence from the Port Sanitary Authority. Provided, nevertheless, that the Justices or Court before whom any complaint may be made or any proceedings may be taken in respect of any such offence may, if they think fit, adjudge the payment as a penalty of any sum less than the full amount of the penalty imposed by this Bye-law. Examined, HOMEWOOD CRAWFORD, City Solicitor. The Common Seal of the Mayor and Commonalty and Citizens of the City of London was affixed to these Bye-laws' at a duly constituted Meeting of the Court of Common Council held on the third day of April, 1924, and in my presence. JAMES BELL, Town Clerk. Allowed by the Minister of Health this twelfth dav of June, 1924. E. R. FORBER, Assistant Secretary, Ministry of Health. h 60 MINISTRY OF HEALTH.—GRANT-AIDED PUBLIC HEALTH SERVICES. County Councils. Circular 474. County Borough Councils. (England). Metropolitan Borough Councils. Other M.C.W. Scheme Authorities. Joint Tuberculosis Committees. Port Sanitary Authorities. Ministry of Health, Whitehall, London, S.W. 1. 8th February, 1924. Sir, I am directed by the Minister of Health to refer to the Circulars issued by his predecessors in February, 1921 (No. 182) and on the 18th March, 1923 (No. 295). The Government have considered the provisions of these circulars in so far as they relate to the grant-aided public health services (maternity and child welfare, tuberculosis, venereal disease, welfare of the blind and port sanitation), and have decided to revert generally to the position which previously existed. The Minister will accordingly be prepared, with the approval of Parliament, to make grants on the prescribed basis for such further development of these schemes as is considered advisable by, and is within the power of, the authority, subject of course to the ordinary process of approval of the particular proposal by the Ministry. I am, Sir, Your obedient servant, W. A. ROBINSON, Secretary. The Clerk of the Council or Joint Committee, or The Town Clerk. This circular is information that the grant in aid of Port Sanitation is continued as heretofore on the basis of half the approved expenditure. There had been a suggestion of other basis of subsidy. LAUNCHES. "George Briggs."—A thorough overhaul was made of the motor launch "George Briggs" by the builders, at a cost of £263 3s. 8d. It would seem a good policy with regard to a good launch, and one that serves its purpose satisfactorily, to submit the vessel to such complete overhaul periodically as should keep it in first-class working order. STAFF. During the year the following alterations were made amongst members of the permanent staff:— Medical Officers.—Dr. E. V. Legge, Boarding Medical Officer, stationed at Sheerness, was superannuated on the 29th September. Office Staff.—Mr. W. J. Albrow, Clerk, was superannuated on the 2nd July, owing to ill health and the office staff was re-arranged as follows :— Mr. E. A. Sorrell, 1st Assistant Clerk, promoted to Chief Clerk. Mr. W. C. Barham, 2nd Assistant Clerk, promoted to 1st Assistant Clerk. Mr. J. A. Gillis, Junior Clerk, promoted to 2nd Assistant Clerk. Mr. A. W. Moore, Junior Clerk, promoted to Junior Assistant Clerk. Food Inspectors.—Mr. T. W. Bailey was superannuated on the 30th June. Sanitary Inspectors.—Mr. W. W. Burr, promoted to Food Inspector ; Mr. H. R. Hopkins, appointed as Assistant Food Inspector; Mr. Paul Westron Coombe and Mr. William Ewart Smith, appointed Sanitary Inspectors on probation. Mr. W. Gray qualified by examination, in December, as an Inspector of meat and other foods. Hospital.—Several changes occurred on the nursing and domestic temporary staff at the hospital. Nurse H. Prior contracted Scarlet Fever while in the discharge of her duty and was treated in the hospital. 61 CANAL BOATS ACTS. In accordance with Section 3 of the Canal Boats Act, 1884, I beg to present herewith the 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 ended 31st December, 1924. 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). Hay's Dock. St. Saviour's Dock. Part of Grand Surrey Canal within the Surrey Commercial Docks. Deadman's Dock. Deptford Creek (River Ravensbourne). Dartford Creek (Rivers Cray and Darenth). The entrance to Gravesend Canal. Cliffe Creek. Yantlet and Coalmouth Creeks. Part of the River Medway, and of the Swale. On the left bank— From Teddington downwards :— The entrance to the River Brent. Hammersmith Creek. Chelsea Dock. Grosvenor Dock. Limekiln Creek. Bow Creek (River Lea). Barking Creek (River Roding). Rainham Creek (River Ingrebourne). Mucking Creek. Thames Haven. Hole Haven. Havengore Creek. River Roach as far as Rochford. RIVER. The whole of this area is divided into three districts, known as Upper, Middle and Lower, each district being in charge of an Inspector, as follows Upper District.— Teddington to Greenwich Inspector Gray, £156 per annum. Inspectors Coombe and Smith,£150 per annum (on probation). Ditto. Middle District.— Lower District.— Greenwich to Erith Erith to seaward limits of the Port of London (including part of the River Medway) Inspector Berry, £250 per annum. The docks are divided into four districts, known as the Central, Eastern, Western and the Gravesend District. Central District.— West India Dock South-West India Dock Poplar Dock Mill wall Dock Inspector Elward, £270 per annum. Eastern District.— Royal Victoria Dock East India Dock Royal Albert Dock King George V. Dock Inspector Burr, £270 per annum. Inspector Lambe, £270 per annum. Western District.— London Dock St. Katherine Dock Regent's Dock Surrey Commercial Dock Inspector Hopkins, £270 per annum. Gravesend District.— Tilbury Dock Left Shore, from Purfleet down Right Shore, from Erith down Inspector Massie, £260 per annum. The total number of inspections for the year was 164, representing a nett number of 100 boats. The remainder, 64, represents repeated visits by Inspectors of this Authority. The number of boats not conforming to the Acts and Regulations was 68 (inspected on 118 occasions, or 71.95 per cent. of the total inspections, the percentage for the previous five years being 23.52 per cent.). In addition to the above, 14 boats were at the time of visit found with the cabin doors locked, there being no persons on board. Inspection was therefore impossible, and these visits are not included in the number of boats inspected. h2 62 With reference to the various infringements of the Act :— 1924. Unregistered Boats. Mar. 8 " Providence" „ 11 " Renown " Registered Port of London, No. 497. ,, 14 " St. Clement " Port of London, No. 499. May 22 " Gwendoline " June 21 " Gwendoline " Aug. 19 " Gwendoline " Sept. 3 " Ribble",, Port of London, No. 500. „ 3 Tyne",, Port of London, No. 501. „ 3 " Severn",, Port of London, No. 502. ,, 3 " Dart"„ Port of London, No. 503. Oct. 22 "Gwendoline" ,, 22 " Lucy " Dec. 4 " Trent" ,, 4 " Tyne " Notification of Change of Master. Nil. Absence of Certificate of Registration. Jan. 9 *" Trent " Registered Uxbridge, No. 392. Apl. 14 " Florrie Maud ",, Ware, No. 48. June 20 " Nene ",, Brentford, No. 442. „ 25 *" Windsor",, Uxbridge, No. 448. Aug. 7 " Wey",, Port of London, No. 478. Sept. 1 " Victoria",, Uxbridge, No. 192. ,, 4 *" Fanny",, Uxbridge, No. 519. Oct. 20 " Frances Cooper",, Reading, No. 53. ,, 22 " The Solar"„ Uxbridge, No. 444. Dec. 18 " Ted " Brentford, No. 360. ,, 30 "Rosaline",, Port of London, No. 487. Certificates not Identifying Owner with Boat. Jan. 25 " Red Jacket " Registered Berkhampstead, No. 475. Dec. 1 " St. Clement",, Port of London, No. 499. Marking. Jan. 8 *" King" Registered Reading, No. 39. 8 *" Dauntless "„ Reading, No. 42. ,, 8 *" Betty" ,, Reading, No. 46. 8 *" Annie Marie "„ Reading, No. 47. ^ 22 *" Martha ",, Berkhampstead, No. 396. ,, 25 *" Alert",, Port of London, No. 239. ,, 25 *" Reliance ",, Guildford, No. 1. „ 28 *" Dufton "„ Ware, No. 55. ,, 28 *" Earl Roberts"„ Ware, No. 65. May 2 *" Rose ",, Brentford, No. 367. June 20 " Nene",, Brentford, No. 442. Aug. 7 "Wey"„ Brentford, No. 478. ,, 11 *" Earl Roberts",, Ware, No. 65. ,, 11 *" Fanny"„ Uxbridge, No. 519. ,, 12 *" Industry ",, Port of London, No. 461. Nov. 4 "Josephine",, Port of London, No. 493. Overcrowding. Nil. Separation of the Sexes. Nil. Cleanliness. Jan. 8 *" Dauntless " Registered Reading, No. 42. ,, 8 *" Betty",, Reading, No. 46. ,, 8 *" Annie Marie",, Reading, No. 47. ,, 9 " Stour",, Uxbridge, No. 419. ,, 9 *" Trent",, Uxbridge, No. 392. ,, 25 *" Reliance",, Guildford, No. 1. ,, 28 " Sandford "„ Brentford, No. 352. ,, 29 " Dufferin "„ Berkhampstead, No. 347. June 19 *" Kuroki",, Port of London, No. 428. „ 20 "Nene",, Brentford, No. 442. July 30 "Eliza",, Brentford, No. 395. ,, 30 "Emily",, Brentford, No. 396. Sept. 11 "Ada",, Berkhampstead, No. 404. Oct. 20 " Frances Cooper ",, Reading, No. 53. ,, 23 "Rose"„ Brentford, No. 367. * Information received that infringements had been remedied. 63 1924. Painting. Jan. 25 *" Reliance" Registered Guildford, No. 1. May 2 *" Rose"„ Brentford, No. 367. June 26 "Swan"„ Stepney, No. 3. July 3 *" John",, Uxbridge, No. 461. Aug. 7 "Wey",, Port of London, No. 478. ,, 26 " Phoebe",, Reading, No. 51. Ventilation. Jan. 29 "Dufferin" Registered Berkhampstead, No. 347. May 22 "Gwendoline" (Not registered). Dilapidation. Jan. 8 *"King" Registered Reading, No. 39. ,, 8 *"Betty"„ Reading, No. 46. ,, 8 *"Annie Marie"„ Reading, No. 47. ,, 9 "Stour",, Uxbridge, No. 419. „ 18 *"Marne"„ Brentford, No. 337. ,, 28 "Sandford"„ Brentford, No. 352. ,, 29 "Dufferin"„ Berkhampstead, No. 347. Feb. 1 "Nansen",, Berkhampstead, No. 281. Mar. 8 "Providence"— (Not registered.) ,, 24 "Stort" Registered Brentford, No. 350. Apl. 7 "Sir Robert Hay",, Ware, No. 60. ,, 7 "Phoebe",, Reading, No. 39. „ 14 "Florrie Maud"„ Ware, No. 48. May 2 "Rose",, Brentford, No. 367. ,, 15 " Stort",, Brentford, No. 350. June 20 "Percy",, Ware, No. 64. „ 26 *" King"„ Reading, No. 39. July 3 "John",, Uxbridge, No. 461. ,, 3 "Dufton",, WTare, No. 55. „ 3 *"Rose"„ Brentford, No. 367. Aug. 7 *"Wey",, Port of London, No. 478. „ 11 *"Earl Roberts",, Ware, No. 65. „ 12 *"Industry"„ Port of London, No. 461. „ 19 " Hilton "„ Ware, No. 53. ,, 21 " Greywell",, Uxbridge, No. 490. „ 21 *" Mapledurwell",, Uxbridge, No. 489. ,, 26 "Phoebe",, Reading, No. 51. Sept. 11 "Ada",, Berkhampstead, No. 404. Oct. 13 *" Prudence",, Ware, No. 38. „ 20 " Frances Cooper"„ Reading, No. 53. „ 22 "Lucy"— (Not registered). ,, 22 "Betty" Registered Reading, No. 46. ,, 23 "John",, Uxbridge, No. 461. Nov. 10 *" Medway",, Brentford, No. 347. „ 18 " Livingstone"„ Berkhampstead, No. 325. Dec. 18 "Ted",, Brentford, No. 260. Removal of Bilge Water. Jan. 29 "Dufferin" Registered Berkhampstead, No. 347. June 19 *" Kuroki" Port of London, No. 348. Provision of Water Cask. Jan. 8 *" King" Registered Reading, No. 39. ,, 8 *" Dauntless",, Reading, No. 42. ,, 8 *" Betty",, Reading, No. 46. „ 8 *" Annie Marie"„ Reading, No. 47. ,, 9 " Stour",, Uxbridge, No. 419. „ 28 " Sandford"„ Brentford, No. 352. ,, 29 "Dufferin",, Berkhampstead, No. 347. Oct. 20 " Frances Cooper",, Reading, No. 53. „ 23 " Rose "„ Brentford, No. 367. Dec. 18 " Ted"„ Brentford, No. 260. Notification of Infectious Disease. Nil. * Information received that infringements had been remedied. 64 1924. Double Bulkheads. Jan. 8 *"Betty" Registered Reading, No. 46. „ 8 *"Annie Marie"„ Reading, No. 47. June20 "Nene",, Brentford, No. 442. Dec. 18 " Brent",, Leicester, No. 140. Admittance of Inspector. Nil. Legal Proceedings. Nil. *Information received that infringements had been remedied. Double Bulkheads.—There were 4 infringements with regard to the condition of these. No boats have been detained for cleansing. On December 31st, 1924, there were 284 boats on the Register:— Propelled by Tugs and Oars 260 „ ,, Steam 15 ,, „ Motors 4 Six boats were registered in 1924. 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 1914 237 82 214 2.60 34.62 1915 156 36 101 2.80 23.07 1916 197 56 256 4.57 21.52 1917 118 41 134 3.26 34.74 1918 109 22 74 3.36 20.18 1919 92 16 69 4.31 17.39 1920 89 19 81 426 21.34 1921 65 14 48 3.42 21.53 1922 86 20 108 5.4 23.25 1923 199 24 81 3.37 12.06 1924 164 27 73 3.04 16.46 I have the honour to be, Gentlemen, Your obedient servant, W. M. WILLOUGHBY, Medical Officer of Health, Port of London. 65 SUMMARY OF CANAL BOATS FOR THE YEAR ENDED 31st DECEMBER, 1924. Jan. Feb. March. April. May. June. July- Aug. Sept. Oct. Nov. Dec. TOTAL. 1919. Total 1920. for the 1921. Years 1922. 1923. New boats registered – – – 2 – – – – – 4 – – 6 1 1 5 1 2 Registration owing to structural alterations – – – – – – – – – – – – – – – – – – Registration for other purposes – – – – – – – – – 1 – – 1 – – – – – No. of Inspections 27 2 13 12 19 14 14 11 11 13 14 14 164 153 141 97 178 199 Conforming to Acts and Regulations 12 1 9 9 16 7 9 3 4 6 11 9 96 120 102 79 142 161 Infringements in respect to :— Registration — — 3 — 1 1 — 1 4 2 — 2 14 5 7 3 4 3 Notification of change of master – – – – – – – – – – – – – – – – – – Absence of certificate 1 — — 1 — 2 — 1 2 2 — 2 11 11 16 7 12 2 Certificate not identifying owner with boat 1 – – – – – – – – – – 1 2 1 2 1 – Marking, &c. 9 — — — 1 1 — 4 — — 1 — 16 3 4 4 7 3 Overcrowding – – – – – – – – – – – – – 1 3 1 1 2 Partition separating sexes – – – – – – – – – – – – – – – – – – Males over age – – – – – – – – – – – – – – – – – – Females over age – – – – – – – – – – – – – – – – 2 — Cleanliness 8 — — — — 2 2 — 1 2 — – 15 6 4 1 5 6 Painting 1 — — — 1 1 1 2 — — — – 6 5 6 3 6 3 Ventilation 1 — — — 1 — — — — — — – 2 — 2 — 1 4 Dilapidation 7 1 2 3 2 2 3 7 1 5 2 1 36 19 24 10 21 21 Removal of bilge water 1 — — — — 1 — — — — — – 2 1 — 2 6 2 Without pump – – – – – – – – – – – – – – – – – – Refusal to admit Inspector – – – – – – – – – – – – – – – – – – No proper water vessel 7 – – – – – – – – 2 – 1 10 2 4 2 4 6 Double bulkheads 2 – – – – 1 – – – – – 1 4 — 3 1 3 7 Notification of infectious disease – – – – – – – – – – – – – 1 – – 1 — Detained for cleansing – – – – – – – – – – – – – – – – – – Proceedings taken — — — — — — — — — — – – — — — — — — Cautions given 13 1 2 3 3 5 2 8 2 6 3 4 52 31 33 18 33 36 ,, attended to 2 1 2 2 — 6 1 1 — 4 4 2 25 34 20 13 35 20 Total registered by Port Sanitary Authority since 1887 503 Cancelled 219 Actual No. on the Register, 31st December, 1924 284 Registered for 549 persons. Carrying males 217 females 54 children 73 66 PORT OF LONDON SANITARY ADMINISTRATION ACCOUNT. Dr. REVENUE ACCOUNT for Year ending 31st March, 1925. Cr. £ s. d. £ s. d. £ s. d. £ s. d. £ s. d. Salaries—Medical Officer, Deputy and Assistants 4,469 11 8 Contribution from General Rate 8,515 0 0 Travelling Expenses, Ditto 86 1 2 Contribution from Ministry of Health 8,795 6 1 Salaries—Inspectors 4,119 7 3 Rochester Port Sanitary Authority, Refund of Proportion of Medical Uniforms, Travelling Expenses—Inspectors 272 17 6 Officer's Salary 100 0 0 Clerical Assistance:— Sundry Fees ... 432 16 7 Salaries 1,344 8 6 Proceeds, Sale of Unsound Food 766 15 6 Other Expenses 13 11 8 Rent Received re Moorings at Greenwich 15 0 0 1,358 0 2 Miscellaneous 23 12 1 Provision and Maintenance of Hospital:— Capital Expenditure 36 13 4 Rent, Rates, Taxes and Insurance 145 6 3 Furniture, Equipment and Renewals 351 6 9 Repairs 382 12 8 Heating, Lighting and Cleansing 222 17 7 Interest on Loan re new quarters 11 13 9 Salaries—General 235 0 0 Nursing 305 14 11 Domestic 65 19 7 606 14 6 Cost of Food 301 10 3 Drugs and Medical Requisites 33 7 9 Uniforms 40 7 0 Miscellaneous 57 13 2 2,190 3 0 Expenses of Launches:— Wages 2,473 14 8 Uniforms 82 15 0 Upkeep and Running Expenses 1,245 7 7 Capital Expenditure 118 12 6 Interest on Loan 36 14 2 3,957 3 11 Laboratory Facilities, Chemical and Bacteriological Exams. 289 1 6 Examination and Analysis of Food 121 11 9 Disinfections 58 14 0 Office Expenses:— | : Rent, Rates, Water, Taxes and Insurance 160 7 10 Repairs 43 18 6 Lighting, Heating and Cleansing 29 1 8 Printing and Stationery 424 9 10 Postages, Telegrams, Telephones 162 11 0 — !' — 820 8 10 Proceeds of Sale of Unsound Food Returned to Consignees 668 16 4 Expenses of Delegates to Congresses 124 10 0 Miscellaneous 83 3 8 Legal Expenses 17 9 0 National Health Insurance Stamps 16 6 8 Balance Carried to Balance Sheet 4 16 2 £18,653 6 5 £18,653 6 5 Chamber of London, 20th April, 1925. .