Don.6148 PLON 40 88. PORT OF LONDON SANITARY COMMITTEE. ANNUAL REPORT of the MEDICAL OFFICER OF HEALTH, To 31st December, 1932. Presented 29 th June, 1933. 3 REPORT For the Year ended 31st December, 1932, of the MEDICAL OFFICER OF HEALTH for the PORT OF LONDON (CHARLES FRANCIS WHITE, M.B., Ch.B., D.P.H.Vict., D.T.M.Liverpool). GREENAWAY, Mayor. TRUSCOTT, Locum Tenens. A Common Council holden in the Chamber of the Guildhall of the City of London on Thursday, the 29th day of June, 1933, THE Port of London Sanitary Committee did this day deliver into this Court a Report in writing under their hands of their proceedings, and submitting the Annual Report of the Medical Officer of Health of the Port to the 31st December, 1932; 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. WE, whose names are hereunto subscribed, of your Port of London Sanitary Committee, to whom it has been referred to carry into execution the powers assigned to the Corporation, as the Port of London Sanitary Authority, beg to submit for the information of your Honourable Court the Annual Report of Dr. Charles Francis White, the Medical Officer of Health of the Port of London, for the year ended the 31st December, 1932, 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, 1933, is appended, in accordance with the Order of your Honourable Court, for the information of the Court. All which we submit to the judgment of this Honourable Court. Dated this tenth day of June, 1933. Sidney H. Greenaway. R. W. Vick. V. Allcard. C. Archibald Chubb. C. R. Heiser. George Edw. Withers. Richard Brodie. R. W. May. W. W. Green. J. S. Pearse. G. T. Sirrell Tranter. C. D. King Farlow. Cyril Gamon. W. N. Wright. E. H. Haywood. Fred. Whittingham. H. M. Howe. OFFICES of the Part of london sanitary Authoriy and Medical officer of health 5, CHURCH PASSAGE, GUILDHALL, LONDON, E.C.2. Telegraphic Address "MEDOFF, CENT, LONDON." Telephone No. METROPOLITAN 3636. BOARDING STATIONS. RIVER THAMES Hulk "Hygeia," Gravesend. RIVER MEDWAY Garrison Point, Sheerness. Telegraphic Address "HYGEIA," GRAVESEND. Telephone No. (Hulk "Hygeia") - GRAVESEND 325. HOSPITAL FOR INFECTIOUS DISEASES at DENTON, near GRAVESEND. Telephone No. (Hospital) GRAVESEND 257. „ (Medical Officer) GRAVESEND 373. 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 Paver Thames to an imaginary straight line drawn from the Pilot Mark at the entrance of Havengore Creek, in the County of Essex, to the land's 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 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 includes 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 also includes all other islands, rivers, streams, creeks, waters, watercourses, channels, harbours, docks and places within the before-mentioned limits contained. 2 INDEX. A. page Actinomycosis in Ox Tongues 10,34 Action under Public Health (Imported Food) Regulations, 1925 34 Aliens Order, 1920 41 Ambulance Transport 10 Amount of Shipping Entering the Port (Table " A ") 12 Analyst's Reports 39, 40 Association of Port Sanitary Authorities—Annual Meeting 43-45 B. Bacteriological Examinations 9, 29, 39 Beef 35 Boarding Station 1 Bye-Laws—Offensive Cargoes 10,42 Bye-Laws of Port Sanitary Authority 76 C. Canal Boats Acts and Regulations 46-50 Canned Foods 34 Cargo Traffic (Table " B") 12 Caseous Lymphadenitis in Mutton 10,33,34 Cerebro-Spinal Meningitis 22 Certificates—Fumigation Issued (Tables "H "&" I ") 29,30 Certificates under Public Health (Imported Food) Eegulations, 1925 38 Cholera 9, 15 Classification of Nuisances (Table " J") 30 Cleaning Orders 9 Confectionery 37 Crews' Spaces—Hygiene of 30-32 D. Damaged Cargo ex ss. " Rouinelian " 33 Dangerous Drugs 41 Deratisation Certificates 10,29 „ Exemption Certificates 10,29 Deratisation—Methods of 10 Destruction of Eats on Vessels (Table " E ") 29 ,, „ in Docks, Quays, &c. (Table " F ") 29 „ „ on Vessels from Plague Infected Ports (Table " H ") 29 Detection of Eodent Plague 22, 23 „ Infectious Disease on Vessels 12 Detention of Fat under Public Health (Imported Food) Regulations, 1925 35 Foodstuffs 35 Diphtheria 41, 42 E. Exportation Notices under Public Health (Imported Food) Regulations, 1925 38 F. Fats—Detention and Control under Public Health (Imported Food) Regulations, 1925 35 Fertilisers and Feeding Stuffs Act, 1926 38 Fish 36 Food Inspection 10, 11, 32-38 „ „ —Detentions and Seizures 35 Fruit 36 Fruit Pulp, &c. 37 „ Tinned and Bottled 36 Fumigation Certificates (Tables " H " & " 1 ") 29,30 „ of Vessels for Eat Destruction 10 G. Grain, &c— 37 Graph I 28b „ II 28c „ III 28d 3 H. page Ham 35 Hospital 1,9,10 (new Works) 10 Hygiene of Crews' Spaces 30-32 I. Imported Foodstuffs 10,11 Infected Ports—Vessels from (Table " H") 29 " Infected " Vessels (Table " G ") 29 Infectious Disease, Detection of 12 ,, Sickness Landed from Vessels (Table " C") 14 ,, ,, Occurring during Voyage (Table " D") 14 Infectious Disease, Prevention of Importation 12-22 Influenza 9 Introduction 9-11 L. Legal Proceedings 11, 42 Lethal Chamber 28a Limits of Port of London 1 M. Measures of Eat Destruction on Vessels from Plague Infected Ports (Table " H ") 29 „ „ „ „ other Ports (Table " I") 30 Medical Inspection of Aliens 41 Medical Inspection of Vessels 9, 12 Mumps 9 Mutton—Caseous Lymphadenitis 10,33,34 Mutton and Lamb 35 N. Notices of Exportation under Public Health (Imported Food) Regulations, 1925 38 Notifiable Infectious Diseases 9 Nuisances—Classification of (Table " J") 30 Nuts 37 O. Offal—Seized and Destroyed 36 Offensive Cargoes—Bye-laws 10,42 Offices Office Accommodation for Inspectors 10 Official Certificates recognised under the Public Health (Imported Food) Regulations 38 Ox Tongues affected with Actinomycosis 10,34 P. Parrots (Prohibition of Import) Regulations, 1930 9,42 Passenger Traffic (Table " B") 12 Plague 9 Pork 34,35 Port of London, Limits of 1 Poultry 35 Powers of Port Sanitary Authority 75,76 Prepared Foods, &c. 38 Provisions, &c. 37 Public Health (Deratisation of Ships) Regulations, 1929 10 „ ,, (Imported Milk) Regulations, 1926 38 „ „ (Imported Food) Regulations, 1925 34,38 „ „ „ „ —Notices served under Article II. (4) 38 „ „ (Shellfish) Regulations, 1915 39 „ „ (Preservatives, &c., in Food) Regulations, 1925 to 1927 38 Pulmonary Tuberculosis 9 R. Rat Flea Investigation 9, 24-28d Rat Proofing 23,24 Rats Destroyed on Vessels (Table " E") 29 „ „ in Docks, Quays, &c. (Table " F") 29 Rats and Rat Destruction (Tables " H " and " I ") 29,30 Rodent Plague, Detection of 22,23 Routine Boarding of Ships 43-45 4 S. PAGE Samples 11, 39, 40 Sanitary Inspections 9,12 Scarlet Fever 9 Seizure of Foodstuffs 35 Shellfish 39 Ship Surgeon's Post-Graduate Course 11 Shipping Entering the Port (Table"A")12 Small-pox 9, 15-21 Smoke Nuisance 10 Source of Water Supply 12 Staff 7,8,11 Statutory Notices 10 Structural Defects 9,12 Sundries (Foodstuffs, &c.) 38 "Suspected" Vessels (Table " G") 29 T. Table " A" Shipping Entering the Port 12 „ "B" Cargo and Passenger Traffic 12 „ "C" Infectious Sickness Landed from Vessels 14 ,, "D" ,, „ occurring during Voyage 14 „ "E" Destruction of Rats on Vessels 29 „ "E" „ „ in Docks, Quays, &c.29 „ "G" " Infected " Vessels. Measures of Rat Destruction 29 „ " H " Vessels from Infected Ports. Measures of Rat Destruction 29 ,, "I" Measures of Rat Destruction on other Vessels 30 „ "J" Classification of Nuisances 30 Tallow—Seized and Destroyed 35 Telegraphic Address 1 Telephone Numbers 1 Tinned Meats 35 Tonnage of Vessels Entering Port 9,12 Training Ships 9,41 Trapping 10 Tuberculosis, Pulmonary 9 U. Unsound Food, Disposal of 34, 35 ,, ,, Quantity Destroyed 35 V. Vegetables 37 „ Tinned 37 Venereal Disease 9,13,14 Visit to United States of America 11 Visitors to Port Sanitary District 11,43 W. Water Barges 10 „ Supply, Source of 12 5 INDEX TO APPENDICES. B. page Bacteriological Examination of Eats (Appendix XXVI.) 66 Bye-Laws (Appendix XXXIV.) 75, 76 C. Cerebro-Spinal Meningitis Appendix XIX.) 62 Certificates under International Sanitary Convention (Appendix XXVII.) 66-69 Chicken-pox (Appendix XVIII.) 61, 62 Cholera (Appendix IV.) 52 Classification of Miscellaneous Diseases (Appendix XXI.) 63 Compulsory Notification of Infectious Disease (Appendix III.) 52 Crew Medically Inspected at Gravesend (Appendix I.) 51 „ „ „ Sheerness (Appendix I.) 51 D. Deaths from Infectious Disease (Appendix III.) 52 Deratisation Exemption Certificates (Appendix XXVII.) 69 Destruction of Unsound Meat, Weights, &c.(Appendix XXXI.) 73 Diphtheria (Appendix VII.) 53 Diseases, Miscellaneous—see "M"(Appendix XXI.) 63 Disinfection of Vessel and Premises (Appendix XXIII.) 64 Dock Areas (Appendix XXXIII.) 74 Dysentery (Appendix XVI.) 60 E. Enteric Fever (including Typhoid Fever and Paratyphoid Fever) (Appendix VIII.) 34 Erysipelas (Appendix XI.) 55 Exemption Certificates (Appendix XXVII.) 69 F. Fumigation of Vessels for the Destruction of Bats (Appendix XXVII.) 66-69 G. German Measles (Appendix X.) 55 Gravesend—Medical Inspection at (Appendix I.) 51 H. Hospital—Cases Admitted and Cost of Maintenance, &c. (Appendix XXIV.) 64 I. Infectious Disease (Appendix II.) 51 „ „ Cases Reported (Appendix II.) 51 „ ,, „ Treated in Port Sanitary Hospital (Appendix II.) 51 „ „ Notified to Ministry of Health (Appendix III.) 52 „ „ Compulsory Notification with Number of Deaths (Appendix III.) 52 Influenza (Appendix XV.) 59 International Sanitary Convention of Paris, 1926 (Appendix XXVII.) 66-69 M. Malaria (Appendix XVII.) 60,61 Measles (Appendix IX.) 54, 55 „ German (see " G") (Appendix X.) 55 Medical Inspection—Gravesend and Sheerness (Appendix I.) 51 Miscellaneous Diseases Classified (Appendix XXI.) 63 Mumps (Appendix XX.) 62 6 N. page New Buildings and Sanitary "Works (Appendix XXXII.) 74 Notification of Infectious Disease (Appendix III.) 52 Nuisances on Vessels (Appendix XXIX.) 71 „ the River (Appendix XXIX.) 71 „ Shore Premises (Appendix XXX.) 72 P. Paratyphoid Fever (Appendix VIII.) 54 Passengers Medically Inspected—Gravesend (Appendix I.) 51 „ „ „ —Sheerness (Appendix I.) 51 Pneumonia (Appendix XIV.) 59 Powers (Appendix XXXIV.) 75,76 Premises Disinfected (Appendix XXIII.) 64 „ —Nuisances on (Appendix XXX.) 72 R. Rats Caught and Destroyed (Appendix XXV.) 65 „ Examined (Appendix XXVI.) 66 „ —Fumigation of Vessels for Destruction of (Appendix XXVII.) 66-69 River, Nuisances on (Appendix XXIX.) 71 S. Sanitary Inspections—Summary (Appendix XXVIII.) 70 „ „ —Nuisances on Vessels (Appendix XXIX.) 71 „ „ — „ River (Appendix XXIX.) 71 „ „ — „ Shore Premises (Appendix XXX.) 72 Sanitary Works (Appendix XXXII.) 74 Scarlet Fever (Appendix VI.) 53 Sheerness—Medical Inspection (Appendix I.) 51 Small-pox (Appendix V.) 52 Statutory Notices Served (Appendix XXX.) 72 T. Tuberculosis, Pulmonary (Appendix XII.) 56-58 „ Other kinds (Appendix XIII.) 58 Typhoid Fever (Appendix VIII.) 54 U. Unsound Meat Destroyed, Weight, &c.(Appendix XXXI.) 73 V. Venereal Diseases (Appendix XXII.) 64 Vessels Disinfected (Appendix XXIII.) 64 „ Fumigated for Rats (Appendix XXVII.) 66-69 „ „ „ (Appendix XXIII.) 64 „ —Nuisances on (Appendix XXIX.) 71 „ arriving from " Foreign" at Gravesend (Appendix I.) 51 „ „ „ „ Sheerness (Appendix I.) 51 W. Water Barges (Appendix XXVIII.) 70 Weight, &c., of Unsound Meat Destroyed (Appendix XXXI.) 73 7 STAFF. List of Officers forming the Staff of the Port of London Sanitary Authority, 31st December, 1932. Office. Name of Officer. Date of entering the Service. Date of appointment to present position. MEDICAL OFFICER OF HEALTH C. F. White, M.B., Ch.B., D.P.H.Vict., D.T.M.Liverpool. September, 1928 September, 1928. DEPUTY Col. J. S. Warrack, A.M.S., T.D., M.A., M.D., C.M.Aberdeen, D.P.H.Camb., Barrister-at-Law. April, 1903 February, 1916. BOARDING MEDICAL OFFICERS— A. Kidd, M.R.C.S., L.R.C.P., D.P.H.Lond. October, 1908 October, 1908. Gravesend Surg.-Lieut. H. M. Willoughby, M.R.C.S., L.R.C.P., D.P.H., D.T.M. & II., R.N.V.R. May, 1929 May, 1929. Do. (Locum Tenens) E. Kean, M.B., Ch.B., D.P.H. January, 1932 January, 1932. Sheerness †H. A. Madwar, L.R.C.P., L.R.F.P.S. January, 1928 February, 1928. CLERICAL STAFF— Principal Clerk E. A. Sorrell October, 1894 January, 1929. Principal Assistant W. C. Barham March, 1901 January, 1929. 1st Class „ J. A. Gillis March, 1914 January, 1929. 2nd „ „ A. W. Moore January, 1920 January, 1929. 3rd „ „ W. L. McLorg February, 1927 January, 1929. „ „ „ R. C- Ratliff March, 1930 March, 1930. Charwoman Mrs. E. Kail November, 1922 November, 1922. FOOD INSPECTORS, Grade I(a) *W. J. Berry February, 1914 January, 1930. *F. J. Massie March, 1909 January, 1931. SANITARY INSPECTORS, Grade I(b) *P. R. Lambe January, 1900 January, 1929. *W. Elward March, 1909 January, 1929. *W. Gray September, 1921 January, 1930. *P. W. Coombe December. 1924 October, 1931. *R. Clifford July, 1925 September, 1931. SANITARY INSPECTORS, Grade II *E. H. Johnson August, 1929 July, 1929. *T. G. Edwards June, 1929 January, 1930. D. E. Madeley September, 1932 September, 1932. TEMPORARY SANITARY INSPECTORS †J. S. Beattie May, 1931 November, 1931. †C. E. Wright July, 1931 November, 1931. ASSISTANT RAT OFFICERS C. F. Woodrow November, 1928 November, 1928. P. J. Wilkins November, 1928 November, 1928. C. W. Moody February, 1929 February, 1929. E. C. Watkins May, 1929 May, 1929. S. A. Croft May,1929 May, 1929. G. F. Boult May, 1929 May, 1929. DENTON HOSPITAL— Medical Officer in Charge Col. J. S. Warrack April, 1903 February, 1916. Matron J. Jackson February, 1910... February, 1910. Staff Nurse † — — Senior Assistant Nurse † — — Assistant Nurse † — Cook-General † — Wardmaid † Wardmaid † Housemaid † Handyman, &c †F. R. Wenham June, 1929 June, 1929. Laundress †B. A. Wenham June, 1929 June, 1929, Gardener †W. H. James January, 1931 December, 1930. 8 S T A F F—continued. List of Officers forming the Staff of the Port of London Sanitary Authority, 31st December, 1932. Office. Name of Officer. Date of entering the Service. Date of appointment to present position. LAUNCHES— " Howard Deighton " and " Joseph White "— Master C. A. Strange December, 189S December, 1930. 1st Mate C. H. Price May,1912 December, 1930. 2nd Mate A. J. Humphreys April, 1931 March, 1931. Chief Engineer R. J. Roberts April, 1931 October, 1931. Engineer †F. H. Yeo August, 1932 August, 1932. " †A. V. Ryder August, 1932 August, 1932. Deckhand and Acting Engineer A. E. Howard February, 1912 December, 1930. Deckhand J. R. Steen March, 1927 December, 1930. „ †H. J. Debnam April, 1931 April, 1931. Boy †W. J. Reader April, 1931 April, 1931. „ †L. J, Youngs April, 1931 April, 1931. „ †S. G. Twocock February, 1932 February, 1932. " James Howell "— Master A. F. Rough November, 1914 December, 1930. Engineer J. A. Hardman July, 1893 December, 1930. Boy †J. V. Shelton April, 1931 April, 1931. GEEENWICH MOORINGS— Barge " Ella Vicars "— Watchmen E. Ditch January, 1915 November, 1917. J. C. Row January, 1927 August, 1932. GRAVESEND—Hulk " Hygeia Shipkeepers H. A. Clarkson May, 1912 January, 1927. A. F. Clements January, 1927 October, 1931. * These Inspectors possess the Special Certificate of the Royal Sanitary Institute for Inspectors of Food. † Temporary Staff. 9 5, Church Passage, Guildhall, E.C. 2, January, 1933. TO THE WORSHIPFUL THE PORT OF LONDON SANITARY COMMITTEE. Gentlemen, I have the honour to submit my Annual Report as Medical Officer of Health of the Port of London. I have not included in the text a detailed account of the health administration of the Port as this was fully described in my last Report, but I have recorded all events of special interest. The tonnage of vessels entering the Port of London during 1932 was 26,855,937 tons, being 1,133,129 tons less than during the previous year. Of the 12,567 vessels arriving from foreign ports, 1,537 vessels were boarded and inspected by your Medical Officers. Three hundred and thirty-eight vessels arrived on which there were or had occurred during the voyage a total of 687 cases of infectious sickness. This total included 27 cases of Mumps and 289 cases of Influenza. The remaining 371 were cases of infectious sickness notifiable in the Port Sanitary District, and of these 135 were cases of Pulmonary Tuberculosis, 101 being passengers and 34 members of crews. Fifty-three cases, all of whom recovered, were treated in your Hospital at Denton. In the Training Ships there occurred 26 cases of infectious sickness, including 13 of Measles, 7 of Scarlet Fever, 4 of Chicken-pox, 1 of Cerebro-spinal Fever and 1 of Tuberculosis. One case of Scarlet Fever and 1. of Erysipelas occurred amongst the other residents in the Port Sanitary District. No case of Plague arrived and no Plague-infected rats were found in ships or on shore in the Port. Seven hundred and twenty-five rats from ships and 1,587 rats from shore premises were bacteriologically examined, but in no case was there any suspicion of Plague infection. A report on an investigation into the number and types of fleas on rats caught ashore in all parts of the Port is included in this Report, but it may be mentioned here that although 728 rats were examined not a single specimen of the Xenopsylla cheopis flea was found. If it is agreed that the " cheopis index" is a measure of the susceptibility of a district to Plague infection, it would appear that there is very little danger of the development of an epizootic of rodent Plague in the Port of London. It is proposed to continue this investigation and to extend it to rats caught in ships in the Port. One vessel arrived on which there had occurred 3 cases of Cholera and 10 vessels arrived on which a total of 14 cases of Small-pox were reported, 2 cases being landed in this Port. Under the Parrots (Prohibition of Import) Regulations, 1930, 70 notices were issued in respect of 283 parrots, &c. One hundred and twenty parrots were admitted under Ministry of Health permits, 149 were exported and 14 destroved. During the year your Worshipful Committee issued Notices in 18 different languages calling attention to the dangers of Venereal Diseases and the facilities for free treatment at clinics in the vicinity of the docks and River. Your Sanitary Inspectors made 15,413 inspections of vessels and 5,560 inspections of shore premises. Orders to cleanse crew quarters were made on 2,119 vessels and it was found necessary to call for structural alterations and repairs to 399 vessels. Orders to remedy structural defects were made in respect of 75 premises. 10 Nineteen Statutory Notices were served on Masters of ships in respect of smoke nuisances. During the year arrangements were made with the Port of London Authority for the provision of office accommodation for your Inspectors in the various dock groups. These facilities have proved most useful in the saving of time to your Staff and in the communication to them of messages from your Offices in Guildhall. The number of certificates issued under the Public Health (Deratisation of Ships) Eegulations, 1929, was 1,030; 141 Certificates of Deratisation and 889 Certificates of Exemption from Deratisation. The number of vessels fumigated for rat destruction under the supervision of your Inspectors was 138; 76 by Sulphur Dioxide and 62 by Hydrogen Cyanide. By the former method 1,045 rats and 454 mice and by the latter 758 rats and 616 mice were destroyed. The average number of rats destroyed per fumigation was 13. If mice are taken into consideration also, the average number of rodents destroyed per fumigation was 21. In addition 2,141 rats were trapped in ships and 5,698 rats on shore in the Port. The former figure shows an increase of 336 rats over the corresponding figure of last year. This is not due to the employment of trapping as an alternative to fumigation, but to the fact that shipowners realise that, to obtain exemption from fumigation, they must constantly employ other methods of rat destruction. The number of rats trapped ashore is 85 less than last year, although there has certainly been no relaxation of efforts in this direction. Intimation Notices were served in regard to 3 cases of infringement of the Bye-laws relating to Offensive Cargoes. In each instance the offender took such steps as to render further action unnecessary. The arrangements made with the Port of London Authority whereby the annual re-registration of Water Barges was made conditional upon the satisfactory report from your officers as to the fitness of the barges for the carriage of drinking water worked smoothly and efficiently during the year. Out of 15 barges, 2 were put out of service during the year. The arrangements made last year to ensure the prompt inspection of vessels having sickness or board or arriving from infected ports have worked satisfactorily, and will be easily adapted to the requirements of the new Port Sanitary Eegulations which will come into operation during 1933. The boarding launch "Howard Deighton" has greatly facilitated the work of your Boarding Medical Officers and the safe and speedy removal of cases of infectious sickness to your Hospital at Denton. Electric lighting was installed throughout your Plospital and the windmill waterpump was overhauled, an electric-motor pump being also provided for use in calm weather. Unfortunately, towards the end of the year there was evidence that salt water was reaching the well, and it became necessary to keep the water under constant observation and to consider other sources of supply. The drainage system was overhauled and made thoroughly sound and the exterior of the Hospital was painted. Some further improvements were effected in the Hospital garden, but as the site is below Thames high-water mark and the soil heavy the ground is frequently waterlogged in wet weather. The inspection of imported foodstuffs is an important part of your work and during the year 2,655 tons of foodstuffs were condemned as unfit for human consumption and were either destroyed or disposed of for industrial purposes. The incidence of Caseous Lymphadenitis in imported mutton continued to decline, and in June a Conference was held at the Ministry of Health at which it was decided that the standard of examination abroad justified a reduction in the proportion of carcases examined on arrival in this country to 5 per cent. It was recommended, however, that pieces of mutton should continue to be subjected to 100 per cent, examination. A proportion of frozen ox-tongues imported from South America was examined on arrival, the proportion found to be affected with Actinobacillosis being 0.8 per cent. 11 Special sampling of certain consignments of yeast, butter and canned salmon were undertaken at the request of the Ministry of Health. A special report on the examination of foodstuffs from the flooded holds of a ship which had been damaged in collision at sea appears on another page, being of interest as showing how various types of food containers stood up to this exceptional test. Legal proceedings were not taken in regard to any foodstuffs as merchants voluntarily surrendered everything found to be unsound or unfit for human consumption, and there was no instance of any deliberate attempt to import food in contravention of any of the Public Health Eegulations. During the year the Minister of Health, the Medical Director-General of the Naval Medical Service and the Association of Port Sanitary Authorities of the British Isles visited the Port Sanitary District. In April your Medical Officer visited the United States of America and Canada, where he was received with the greatest kindness and hospitality and was given every facility to study Quarantine Administration in New York, Boston, Montreal and Quebec. The first Post-graduate Course in "Hygiene for Ships' Surgeons" was given in the London School of Hygiene and Tropical Medicine in November. It is hoped that sufficient interest will be taken in this Course to enable it to be held annually. During the year all grades of your Staff carried out their duties in a highly satisfactory manner. Inspector W. W. Burr retired on pension, after 34 years' service, and D. E. Madeley joined your Staff of Sanitary Inspectors. The health work of so large a Port could not be carried out by a comparatively small Staff without the co-operation of the Officers of His Majesty's Customs, the Port of London Authority, the Pilots and the members of the Staffs of the Shipping Companies and Merchants, and their assistance and courtesy is gratefully acknowledged. I have the honour to be, Gentlemen, Your obedient Servant, CHAELES F. WHITE. 12 I.—AMOUNT OF SHIPPING ENTERING THE PORT DURING THE YEAR 1932. Table A. Number Inspected, Number of Vessels on which Defects were Remedied. Number of Vessels reported as having or having had, during the voyage Infectious Disease on Board. Number. Tonnage. By the Medical Officer of Health. By the Sanitary Inspector. Number reported to be Defective. Foreign - Steamers 10,027 16,075.925 1,446 10,999 2,011 1,906 322 *Motor 2,455 4,014,394 90 Sailing 85 52,964 1 91 1 1 2 Fishing — (See Note.) — — — — — Total Foreign 12,567 20,143,283 1,537 11,090 2,012 1,907 324 Coastwise - Steamers 9,578 6,354,038 — 1,986 397 333 7 *Motor 1,343 222,719 — Sailing 1,745 135.897 — 284 51 28 Fishing — (See Note.) — — — - — — Total Coastwise 12,666 6,712,654 — 2,270 448 361 7 Total Foreign and Coastwise 25,233 26,855,937 1,537 13,360 2,460 2,268 331 Inland Navigation — — — 2,053 58 58 7 * Includes mechanically propelled vessels other than Steamers. See also Appendix I. Note.—British Fishing Vessels are excluded from the Returns of the Navigation of the United Kingdom. Foreign Fishing Vessels are included, but not separately distinguished. II.-CHARACTER OF TRADE OF PORT. Table B. (a) Passenger Traffic during 1932:— To and prom NON-EUROPEAN Countries. Number of Passengers. 1st Class. 2nd Class. 3rd Class. Tourist. Inwards 16,157 9,714 14,916 13,006 Outwards 16,318 7,272 8,250 10,070 To and from CONTINENT OF EUROPE. Inwards 59,796 (including 2,733 Transmigrants). Outwards 54,735. Countries from which passengers principally arrive: North America, Australia, Europe, British South Africa, India and the Far East. (b) Cargo Traffic:— Principal Imports—Merchandise of all kinds, principally Provisions, Fruit, Grain and Flour, Hides and Skins, Meat, Oil and Fats, Rubber, Textile Materials, Tobacco, Wood and Wool. Principal Exports—Manufactured Goods of all kinds. Countries with which the Port principally trades—The Port of London trades with all parts of the world. III.—SOURCE OF WATER SUPPLY. The arrangements for the supply of water to ships in the Port of London are as described in my last Report. The number of water barges has been reduced from 15 to 13, two barges having become unserviceable during the year. IV.—INFECTIOUS DISEASE. The administrative measures for the prevention of the importation of infectious disease were set out in detail last year. They have worked smoothly and efficiently and should easily be adapted to the requirements of the new Port Sanitary Regulations which come into operation on May 1st, 1933. 18 VENEREAL DISEASES. At the meeting of your Worshipful Committee in July, 1931, authority was given for the preparation and printing of notices in various languages drawing the attention of seamen to the facilities for the free treatment of the Venereal Diseases in clinics in the vicinity of the Port of London. The Port of London Authority kindly agreed to post these notices in the sanitary conveniences on the docks. A list of the conveniences was drawn up showing in each case the nationality of the ships berthing near by. A notice as follows was prepared:— Venereal Diseases. Syphilis (Pox) and Gonorrhoea (Clap) can be cured by skilful treatment in the early stages. If treatment is neglected or unskilful these diseases become difficult to cure and there is grave risk of years of ill-health and premature death to the sufferer and of the spread of infection to others. Skilled treatment free of charge and under conditions of secrecy can be obtained at the following clinics at the times stated :— London. Seamen's Hospital, King William Street, Greenwich, S.E. 10. Syphilis—Monday and Wednesday, 7 p.m. Gonorrhoea—Tuesday, 6 p.m. ; Friday, 7 p.m. (Merchant Seamen may attend at any other time.) Miller General Hospital, Greenwich Road, Greenwich, S.E. 10. Daily, 8 a.m. to 8 p.m. Seamen's Hospital, Royal Albert Dock, E. 16. Monday, Tuesday, Thursday, Friday, 9 a.m. to 6 p.m.; Wednesday 9 a.m. to 2 p.m.; Saturday, 9 a.m. to 12.80 p.m. (Merchant Seamen may attend at any other time.) London Hospital (Whitechapel Clinic), Turner Street, Mile End, E. 1. Daily, 8 a.m. to 9 p.m.; Sundays, 10 a.m. to 1 p.m. and 4 p.m. to 7 p.m. Guy's Hospital, St. Thomas Street, Borough, S.E. 1. Daily, 9 a.m. to 8 p.m. St. Thomas's Hospital, Westminster Bridge, S.E. 1. Daily, 8 a.m to 10 p.m.; Sundays, 10 a.m. to 12 noon. St. Paul's Hospital, Endell Street, Covent Garden, W.C. 2. Daily, 8 a.m. to 10 p.m.; Sundays, 10 a.m. to noon and 6 p.m. to 8 p.m. St. Bartholomew's Hospital, 20, Golden Lane, E.C. 1. Monday, 5 p.m. to 7 p.m.; Thursday, 12 noon to 2 p.m. Gravesend. 22, Cobham Street, Gravesend. Tuesday, 11 a.m. to 12.45 p.m.; Thursday, 4.45 p.m. to 6.30 p.m. A copy of this notice was sent to 16 foreign Consuls in London with a request to each that, in the interest of seamen of his own country, he should translate the notice into his own national language. All the Consuls willingly and graciously complied, with the result that the notice has now been translated into Greek, Italian, Spanish, Portuguese, French, German, Dutch, Danish, Norwegian, Swedish, Finnish, Latvian, Estonian, Russian, Japanese and Chinese. In regard to a notice for the benefit of Indian seamen, it was not possible to obtain in London a translation which would be understood by all the native seamen in the Port. The Peninsular and Oriental Steam Navigation Company kindly undertook to take a copy of the notice to Bombay, to get it translated into the dialect which is understood by all natives, and also into Goanese, and to have it printed there. These notices are now posted in the Sanitary Conveniences in your district in languages corresponding to the nationalities of the ships berthing in the vicinity. 14 They have suffered much less from deliberate defacement than was anticipated. Your Sanitary Inspectors also carry copies for distribution to the Masters of ships in which cases of venereal diseases are notified. Your Medical Officer wrote to the Secretary of the British Council for the Welfare of the Mercantile Marine, suggesting that double-sided glass covered notice-boards should be erected at the various exits from the docks and that in these should be displayed notices in appropriate foreign languages giving seamen information regarding local hospitals, clinics, sailors' homes, boarding houses, facilities for recreation, &c., in fact everything which would suggest to them a definite place to make for when they leave their ships as an alternative to aimless wandering about the streets exposed to the various risks which this entails. The British Council adopted the scheme, but have been obliged to modify it because sufficient funds were not available to carry out the proposals in full. Table C. Cases of Infectious Sickness landed from Vessels. Disease. Number of Ca ses during 1932. Average Number of Cases for Number of vessels Passengers. Crew. previous 5 years. concerned. Small-pox — 2 1.8 2 Scarlet Fever — — 12.6 — Diphtheria 2 5 8.8 7 Enteric Fever 3 8 19.2 10 Measles 1 — 10.8 1 German Measles — — 13.2 — Erysipelas — 1 0.6 1 Continued Fever — — 0.6 — Pulmonary Tuberculosis 76 24 68.6 65 Tuberculosis (other kinds) — 2 3.0 2 Pneumonia 3 5 15.2 8 Influenza 1 4 4.8 3 Cerebro-spinal Meningitis 3 — 0.2 2 Dysentery 1 3 10.6 4 Encephalitis Lethargica — — — — Malaria 4 9 17.8 11 Chicken-pox 4 14 16.8 8 Remittent and Relapsing Fever — — 0.2 — Mumps 1 2 — 2 Note.—The following oases of infectious disease occurred on board Training Ships moored in the Thames:— Measles 3, German Measles 10, Tuberculosis (other kinds) 1, Scarlet Fever 7, Cerebro-spinal Meningitis' l, Chicken-pox 4. The following cases of infectious disease occurred amongst persons resident in the dock areas or on Houseboats:— Erysipelas 1, Scarlet Fever 1. Table D. Cases of Infectious Sickness occurring on Vessels during the Voyage, but disposed of prior to arrival. Disease. Number of Cases during 1932. Average Number of Cases for Number of vessels Passengers. Crew. previous 5 years. concerned. Cholera — 3 3.0 1 Plague — — 0.6 — Small-pox 2 10 12.2 8 Scarlet Fever 2 2 3.0 4 Diphtheria 3 — 3.4 3 Enteric Fever 5 7 21.2 11 Measles 13 8 28.6 14 German Measles 12 — 4.4 6 Erysipelas — — 2.2 — Continued Fever — — 0.4 — Pulmonary Tuberculosis 25 10 43.0 25 Tuberculosis (other kinds) 1 — 1.0 1 Pneumonia 5 13 32.2 14 Influenza 206 78 153.2 5 Cerebro-spinal Meningitis — 2 0.6 1 Dysentery 5 8 14.4 8 Encephalitis Lethargica — — 0.6 — Malaria 7 26 83.4 19 Chicken-pox 11 21 32.8 19 Remittent and Relapsing Fever — — — — Mumps 18 6 — 11 15 Cholera. The ss. " Patroclus " arrived at Gravesend on 11/10/32, having landed two of he native crew and one of the European crew at Kobe on 26/8/32, suffering from Cholera. The patients were removed to the Quarantine Hospital, where they subsequently recovered. The vessel was placed in Quarantine where it was under the entire charge of the Quarantine Medical Staff, who carried out all the necessary Drecautions. No other case occurred. Small-pox. ss. " City of Perth."—An apprentice was landed from the above vessel at Dalny on the 29th November, 1931. All the crew were vaccinated and a new native crew shipped at Singapore on December 18th. Thorough disinfection was carried out at Dalny. No other case occurred. ss. "Merkara."—Previous Information.—A letter was received from the Ministry of Health on the 12th February, 1932, enclosing a copy of a cablegram received from the Quarantine Board of Egypt to the effect that the ss. "Merkara" had landed two cases of modified Small-pox at Aden on 1st February, 1932. Movements of Vessel:—- 14/1/32 Native crew signed on in Calcutta. 16/1/32 Ship sailed from Calcutta. 18/1/32 Called at Madras. 21/1/32 „ Cuddalore. 24/1/32 ,, Colombo. 1/2/32 „ Aden. 6/2/32 ,, Suez. 6/2/32 „ Port Said. 13/2/32 ,, Marseilles. 20/2/32 ,, Plymouth. 21/2/32 Arrived at Gravesend. Number of Persons on Board.—Passengers, 52 (47 British, 5 Aliens). Crew ; Europeans, 38; Natives, 122. History of Cases.—Case 1.—On 29/1/32 Abdul Rahman, Steward, reported sick with marked constitutional symptoms (headache, backache, temperature 100°) and a rash just developing on his forehead and wrists. The Ship's Surgeon diagnosed Small-pox, and isolated him in hospital. Case 2.—On 1/2/32 a Lascar, Mohasan, reported sick with a similar rash, but less marked constitutional symptoms. The same day the vessel arrived at Aden, where the diagnosis was confirmed by Colonel Phippson, I.M.S., and the cases were landed. Cases 3, 4, 5 and 6—A Lascar reported sick on 16/2/32 with an eruption. On examination of the remainder of the natives, three other cases were discovered— one Lascar, one Fireman and one Coaltrimmer. In all these cases the eruption was very slight, and there were practically no constitutional symptoms. The Surgeon diagnosed modified Small-pox, and on 20/2/32 the cases were landed at Plymouth, where a diagnosis of Chicken-pox was made. Action taken on Board.—The cases were all isolated immediately they were detected. On the day of the discovery of the first case every soul on board was vaccinated by the Ship's Surgeon. The crew were subsequently inspected daily. After landing the cases at Aden the Lascar quarters were fumigated with Formaldehyde, and sprayed out with a disinfectant solution, the bedding of the two patients being thrown overboard. The crew's quarters were again disinfected after the isolation of the second group of cases. 16 Action taken in London.—The vessel arrived off Gravesend at 12.30 p.m. on 21st February. It was boarded by Dr. H. Willoughby, accompanied by two of the clerical staff, a Sanitary Inspector and one of the assistant rat officers. The Medical Officer examined all the passengers and crew, and the clerks carefully checked the addresses of all who were leaving the ship. The passengers were then allowed to land—about 1.45 p.m. The native crew were taken by launch, with their bedding and effects, to Denton Hospital, where they were all bathed and their bedding, &c., steam disinfected. This procedure took about seven hours. Meanwhile their quarters aft, and the isolation hospital forward, were put under Sulphur fumigation— 3 lbs. of Sulphur being burned per 1,000 cubic feet of space. On return the natives were housed in the second-class saloon. The vessel proceeded to dock on the night tide. The native crew were kept under observation while in London. The names and addresses of the passengers and European crew were all dispatched to the Medical Officers of Health of the districts concerned by the 6.30 p.m. post from Gravesend on 21/2/32. No further case occurred whilst the vessel was in London. The vessel left for Hamburg on the 25th February, and the Medical Officer of Health of Hamburg was notified of the circumstances attaching to this vessel. Observations.—The history of the first two cases as given to the Boarding Medical Officer certainty suggested that the diagnosis of Small-pox at Aden was correct. On the other hand the diagnosis of Chicken-pox in the cases landed at Plymouth was confirmed by the Ministry of Health. If the cases at Aden were Small-pox, and those at Plymouth Chicken-pox, it is difficult to see where the latter were infected. If the Aden cases were Chicken-pox, then the dates of onset of the Plymouth cases was just right for infection from the Aden cases. It seems probable, therefore, that either both the Aden cases were Chicken-pox, or one was Chicken-pox and the other Small-pox. At the time the vessel arrived in London the information from Plymouth was not absolutely conclusive, and therefore it was necessary to take all precautions against the possible spread of Small-pox. ss. "Cheshire."-On the 17th March the Ministry of Health reported that they had received from Marseilles the names and addresses of English passengers landing there from the ss. " Cheshire," together with the recommendation that these persons should be kept under surveillance for 14 days from the 14th March as contacts with a suspected case of Small-pox. Your Medical Officer immediately communicated with the London Agents, Messrs. Alexander Howden & Co., and asked them to obtain information from their Marseilles Agent and from the ship. This they kindly did. It appeared that there were on board three members of the native crew who, in the opinion of the Ship's Surgeon, were suffering from Chicken-pox, but that the Medical Officer at Marseilles had suspected Small-pox in one of the cases. The vessel was calling at Plymouth, and in order that everything might be in readiness to deal with the vessel promptly on her arrival in London, your Medical Officer telephoned to the Port Medical Officer at Plymouth asking him to telephone the diagnosis when he had seen the cases. On 19th March, Plymouth telephoned that the cases were all definitely Chicken-pox. The vessel arrived in London on Sunday, 20th March, and was boarded by Dr. H. Willoughby, who confirmed the diagnosis of Chicken-pox, and removed the patients, with their effects, to Denton Plospital. 17 The history of the occurrence is as follows : The native crew signed on at Calcutta on 4/2/32, and joined the ship at Rangoon on 10/2/32. On 19/2/32 a Lascar was taken ill. Small-pox was diagnosed, and he was removed to hospital at Rangoon the same day. On 24/2/32 two other Lascars reported sick and the Ship's Surgeon diagnosed Chicken-pox. These two cases were landed at Colombo on 26/2/32. On 9/3/32 another Lascar and on 11/3/32 two more Lascars developed Chicken-pox and were isolated on board, subsequently being landed to hospital at Gravesend on 20/3/32. Observations.—The three cases landed in London were obviously infected from the two cases landed at Colombo, who were probably infected ashore either at Calcutta or Rangoon. Since the cases landed at Rangoon were not taken ill until 19/2/32, and the first case of Chicken-pox developed on 24/2/32, it would appear that these cases were not connected, and therefore there is no reason to doubt the diagnosis of Small-pox in the former case, despite the subsequent outbreak of Chicken-pox. On 24th March four cases, and on 26th March one case of Chicken-pox developed in the native crew while the vessel was lying in the Tilbury Dock. All these cases were removed to the Port Sanitary Hospital at Denton. ss. " Tainui."—On 23rd March a letter was received from the Medical Officer of Health of Southampton to the effect that a case of suspected Small-pox had been landed from the ss. " Tainui " on the 21st March. The vessel arrived in London on 23rd March and was boarded by Dr. Kidd, who ascertained that a third-class passenger, Mr. B., had embarked at Wellington on 10th February. On 17th February he fell ill, and on 21st February reported to the Ship's Surgeon, who diagnosed modified Small-pox and promptly isolated the patient and vaccinated all the passengers and all the crew with the exception of the firemen and four others. On arrival at Southampton no further case was discovered, and all necessary disinfection was carried out. Whilst in London the crew remaining on board were kept under daily observation. No further cases occurred. ss. "Oomorin."—Previous Information.—A letter was received from the Ministry of Health on the 31st May to the effect that on the arrival of the ss. " Comorin " at Marseilles on 27th May a case of mild Small-pox was notified on board. Movements of Vessel:— Brisbane April 14 Aden May IS Sydney " 20 Port Said " 22 Melbourne " 26 Marseilles " 27 Adelaide " 28 Gibraltar " 30 Fremantle May 2 Plymouth June 2 Colombo " 11 London " 3 Bombay " 14 Number of Persons on Board.—Passengers, 245. Crew: Europeans, 92; Natives, 165. (Surgeon on board.) History of Case.—A new native crew was shipped at Bombay on 14th May. All were alleged to have been vaccinated before joining the ship. On 25th May a Lascar Fireman reported ill with backache and malaise. On inspection, he was found to have a pustular rash on face, forehead, chest and back. His temperature was 102°. The patient was isolated on board, and landed at Marseilles on 27th May with his bedding and effects. The crew and passengers were vaccinated on board between 25th and 30th May, with the exception of 20 who refused. 18 Action taken in London.—The vessel arrived off Gravesend at 10 a.m. on 3rd June and was boarded by Dr. Warrack and Dr. Kidd, who obtained a history of the case from the Ship's Surgeon and then proceeded to a careful inspection of the crew. One native Fireman had been placed in the isolation hospital on board at Plymouth for observation, as he had a few pustular spots on his left shoulder and back. On arrival at Gravesend, this case was diagnosed as Acne. None of the passengers or crew presented any signs or symptoms resembling those of Small-pox. All names and addresses were carefully checked with the individual passengers, and the vaccinal state of all on board was recorded on the crew and passenger lists. The names and addresses of the passengers and such of the crew as were leaving the ship were posted to the Medical Officers of Health of the districts concerned at 4.30 p.m. on the day of arrival of the ship. Disinfection having been carried out at Marseilles, no further measures of this nature were deemed necessary. The crew remaining on board were kept under daily observation while the ship was in this Port. It would appear that the case was infected ashore in India, as the patient only joined the ship on 14th May and developed the eruption on 24th May. Sailing Barge "Blue Mermaid."—On 15th September, 1932, the Port of London Authority Police, Royal Albert Dock, reported that on the previous evening W. G Master of the above barge lying at No. 22 Shed, Royal Albert Dock, was admitted to Seamen's Hospital, Greenwich, suffering from "Fever." Further enquiry revealed that the Medical Officer at the Hospital had called in Dr. Annis, Medical Officer of Health of Greenwich, who had diagnosed Small-pox and this had been confirmed at the London County Council Small-pox Diagnosis Station at South Wharf. Your Medical Officer proceeded to the barge and ascertained that the patient, W. G aged about 52, of 4, James' Terraqe, Mistley, Essex, had been taken ill on Monday, the 12th September, with pains in the body and general malaise. He remained in his bunk on board on the 12th, 13th and 14th instant. On the 14th an eruption appeared on his face and arms and he went to the Greenwich Hospital to see a doctor, presumably travelling by Ferry. The only other person on board the barge was the Mate N. H aged 20, of 2, High Street, Mistley, Essex. In addition, P. L . aged 33, of 4, Priory Place, Ipswich, had sailed the barge up from Erith, as the Master, W. G was not well enough to do so. He had only been in contact with the patient on deck, whereas H had attended to him in his cabin. Your Medical Officer ascertained that PI had never been vaccinated and that L had not been vaccinated since infancy so, with their consent, your Medical Officer vaccinated them both immediately. The movements of the " Blue Mermaid " were as follows:— Arrived Victoria Dock, 25th August. Sailed Victoria Dock, 3rd September. Arrived Mistley, Essex, 5th September. Sailed Mistley, Essex, 9th September. Arrived Grays, 10th September; Erith, 12th September; Royal Albert Dock, 14th September. It would appear that W. G . contracted the infection while his vessel was in the Victoria Dock between 25th August and 3rd September. There were cases of Small-pox in West Ham about this time. 19 The Medical Officers of Health of both Mistley (Essex) and Ipswich were notified of the circumstances. The barge was thoroughly disinfected and the patient's bedding and effects were removed to Denton Hospital for steam disinfection. ss. "Floristan."—The above vessel arrived at Gravesend on the 4th November from Basra, having landed a case of Small-pox at Aden on the 17th October. The whole of the crew were vaccinated at Aden and the infected quarters fumigated with sulphur. The bedding used by the patient was destroyed. On arrival at Gravesend the whole of the crew were carefully examined, but no other case or suspicious case was discovered. On the arrival of the vessel in dock the infected quarters were again fumigated with sulphur, cleaned and repainted. No further case occurred during the vessel's stay in this Port. ss. "Lorca."—At 10 a.m. on the 9th November information was received from the Medical Officer of Health for Greenwich that a member of the crew of the ss. "Lorca," who had attended the Out-patient Department of Seamen's Hospital, Greenwich, the previous evening, was suspected to be suffering from Small-pox and had been removed to the London County Council South Wharf Observation Station, Eotherhithe, S.E. Dr. J. S. Warrack visited the vessel lying at Bellamy's Wharf, and ascertained the following facts:— Movements of Vessel:— Left Basra, 8th October. Arrived Port Said, 22nd October (six hours' stay). ,, Oran, 29th October (three hours' stay). ,, Gravesend, 6th November, 5 p.m. Number of Persons on Board.—Passengers, nil. Crew: Europeans, 34; Natives, nil. History of Case.—On or about 3rd November an Ordinary Seaman complained that he felt ill and had severe backache. He reported to the Chief Officer, who stated that at that time there were no signs of anv eruption and that he considered the man had a "chill." Action taken in London.—The vessel arrived at 5 p.m. on 6th November off Gravesend and was boarded by Dr. H. Willoughby, who examined every member of the crew, none of whom presented symptoms suggesting infectious disease. The vessel proceeded to her berth at Bellamy's Wharf, Rotherhithe, S.E., to discharge cargo, principally cases of dates and oats in bulk. On 7th November the patient was seen by one of the Shipping Federation doctors, who diagnosed "weakness after cold" and prescribed a tonic. On the evening of 8th November the patient developed a rash, and attended the Out-patient Department of the Seamen's Hospital, Greenwich, S.E., where it was thought that he was suffering from Small-pox. He was accordingly removed by ambulance to the London County Council Observation Station at South Wharf, Eotherhithe, S.E. On 9th November, Dr. Warrack offered vaccination to the members of the crew then on board; 27 accepted and five declined (all these latter showed well-defined marks of previous vaccinations). The remaining two members of the crew were vaccinated by your Medical Officer of Health on 10th November. Seven immediate contacts, occupants of the same forecastle as the patient, were removed to your Hospital at Gravesend, together with their bedding and effects, for bathing and disinfection. The whole of the crew's quarters forward were fumigated with Sulphur Dioxide and washed down with Izal. 20 Observations.—Although it was reported by the Chief Officer that Small-pox was prevalent amongst the workers in the date packing factories in Basra, the patient could not have been infected there as four weeks elapsed between his leaving that port and the onset of symptoms of illness. Careful search was made for a "missed" case, but none was found. The patient was not ashore in Port Said, but numerous bum-boat men boarded the vessel there and mixed with the crew. Just twelve days elapsed between the vessel leaving Port Said and the first symptoms of illness in this case. The rash appeared five or perhaps four days later. It therefore seems probable that infection took place at Port Said. ss. "Jervis Bay."—On 17th November the Aberdeen and Commonwealth Line informed this Authority that they had received a wireless message from the Master of the ss. "Jervis Bay" to the effect that a lady passenger had died on board on the night of the 16th November from Hæmorrhagic Small-pox. Movements of Vessel.—The vessel was bound from Australia to London via Southampton, calling at Colombo, Port. Said and Malta. Number of Persons on Board.—Passengers, 215 (all landed at Southampton, 21st November). Crew, 171 (British). History of Case.—The patient, accompanied by her husband, had been touring Palestine and had travelled by local steamer from Haifa to Port Said, where she embarked on the "Jervis Bay" on 11th November. The next day she complained of headache and vomiting. These symptoms continued despite treatment until the evening of 14th November, when she developed a morbilliform rash, principally on the trunk and legs. The patient was immediately isolated in the ship's hospital, and her cabin, clothes and bedding were disinfected. The next day she had a high temperature and there were haemorrhages into the skin, particularly on the trunk, face and arms. On 16th November the temperature fell to normal and the patient was collapsed. There was extension of the haemorrhages into the skin and also haemorrhages from the mucous membranes. The patient rapidly sank, and died at 6.15 p.m. She was buried at sea at 11 p.m. the same night. The deceased had been vaccinated in infancy only and presented one good mark. Action taken prior to Arrival.—Upon removal of the patient to the ship's isolation hospital her cabin was disinfected by means of Formalin and sealed. Her bedding and effects were disinfected in the steam disinfector on board. After the death of the patient the isolation hospital was disinfected with Formalin and sealed, the bedding and clothing were steam disinfected and the mattress thrown overboard. Her husband was isolated in his cabin. Everybody on board, except three passengers (two of whom refused and one who had had Small-pox), was vaccinated during the night of 16th November and early morning of 17th November. A daily medical inspection was carried out until the arrival of the ship at Southampton. Action taken upon arrival at Southampton.—The vessel arrived at Southampton during the night of 20th November and was dealt with by the Southampton Port Sanitary Authority. The cabin occupied by the patient and the isolation hospital were again disinfected. Her bedding and effects were removed ashore for steam disinfection. All passengers' bedding and linen were landed at Southampton and not returned to the ship. The passengers and crew were examined. All passengers landed at Southampton. Action taken upon arrival at London.—The vessel arrived at Gravesend at 3 a.m. on 22nd November. She was boarded by the Deputy Medical Officer of Health, the Boarding Medical Officer on duty, a Sanitary Inspector and a Clerk. The whole •21 crew were medically inspected and two were re-vaccinated. The addresses of the crew were carefully checked, and were forwarded the same day to the Medical Officers of Health of the various districts concerned. Observations.—The patient must have been infected during the time she was in Palestine, probably at Damascus. The Ship's Surgeon undoubtedly did everything possible to prevent the spread of infection on board and gave every assistance to the Port Sanitary Authority. mv. "British Splendour"—Previous Information.—On 19th November, a letter was received from the Ministry of Health calling attention to a report in the Press that a case of Small-pox had been landed from the mv." British Splendour" at Gibraltar on 17th November. This report was confirmed in telephone conversation with the owners of the vessel. Movements of Vessel Abadan October 27 Suez November 11 Gibraltar 17 Peauillac November 22 Rouen 26 London 29 Number of Persons on Board.—Passengers, nil. Crew, 40 Europeans. History of Cases.—B. P...., ship's carpenter, was ashore in Abadan on 26th October. On 7th November he complained of headache and backache and had a temperature of 101° P. He was seen by a Medical Officer at Suez on 11th November, but there was then no evidence that he was suffering from Small-pox. On 13th November a papular rash developed on his face and all over his body. On arrival of the vessel at Gibraltar on 17th November the case was diagnosed as Small-pox and was removed to hospital. The crew were all vaccinated, and the necessary disinfection was carried out. On arrival at Rouen on 26th November, an assistant steward was taken to hospital suffering from tonsillitis and the boatswain, donkeyman and cook were feverish and were taken to hospital for observation. The personal effects of all these men except the cook were taken ashore and their bedding was destroyed. On 28th November, a telegram was received from the Medical Officer of Health of the Port of Rouen, to the effect that three of the four men landed there were suffering from Small-pox. Action in London.—The vessel arrived off Gravesend at 8 a.m. on 29th November, and was boarded by Dr. Warrack, Dr. Kean and a Sanitary Inspector. The crew were carefully inspected, their condition as regards vaccination recorded, and their names and addresses were carefully checked. The cook's bedding and effects were removed to the Port Sanitary Hospital for steam disinfection, and all the cabins which had been occupied by the sick men were disinfected with sulphur. The crew remained on board and were visited daily. On the 1st December, six men went home and their addresses were duly notified to the Medical Officers of Health concerned. One officer left to join another ship. Although his vaccination at Gibraltar had not been successful, he appeared still to be protected by successful vaccination in 1924. Observations.—The first case was probably infected ashore at Abadan, and the three secondary cases were infected by the first case, the vaccination at Gibraltar being too late to prevent them. The telegram from the Port Medical Officer of Rouen confirming the diagnosis in regard to the cases landed there is an example of the value of the arrangements for exchange of information between ports, particularly as the Master of the "British Splendour" said he had received information from the hospital that the cases landed at Rouen were not Small-pox. 22 Cerebro-Spinal Meningitis. Case 1.—On the 5th April, 1932, the ss. "Clan MacBean" arrived at Tilbury from Chittagong and other Indian ports via the Suez Canal for Tilbury Dock. The Master reported that a Lascar fireman had been off duty in bed for the last 24 hours with a bad cold. He was examined by the Boarding Medical Officer and found to have a normal temperature, but no other symptoms except those of a cold. The Master was advised to obtain the services of a doctor, and, if necessary, to send the patient to Tilbury Hospital. There were then no symptoms of Cerebro-spinal Meningitis. On the 14th April your Deputy Medical Officer of Health, on receipt of a notification from London, proceeded to Tilbury Hospital with Dr. Kean and examined the patient there. It was ascertained that he had been admitted to this Hospital on the 6th April, complaining of pains in the head and spasms of the neck. He subsequently had lumbar puncture on three occasions, and serum was given three times. A culture was made of the fluid from a lumbar puncture and the characteristic germ, the meningococcus, was discovered in pure growth. On the date on which the patient was seen he was found to be recovering. He was isolated in Hospital, and all precautions were being, and had been, taken. He was considered to be unfit to be removed, and it was arranged that he should stay in Tilbury Hospital until he recovered. Case 2.—The ss. "Manaar" arrived at Gravesend early on 20th April. This vessel left Calcutta on 12th January and proceeded to Boston, New York and Philadelphia during February, and Baltimore, Norfolk, Philadelphia and Santa Cruz during March, arriving at Criselda on 4th April. On 5th March a native fireman was sent to hospital at Baltimore with suspected Meningitis, but the diagnosis was not confirmed before the vessel left. He was reported as having suffered from delirium, and no other particulars could be obtained. Case 3.—On 21st March a native coal trimmer complained of headache and pains in the back, he became comatose and died on 10th April and was buried at sea. He was seen by a Spanish doctor at Criselda and treated for "intoxicated stomach," which might have been one of the symptoms of the disease. It is considered that both these were cases of Cerebro-spinal Meningitis, and that Case 3 was infected from Case 2. Observations.—The ss. "Clan MacBean" arrived subsequently at Liverpool via Rotterdam, and the Liverpool Port Sanitary Authority was notified and the vessel disinfected there. The crew of the ss. "Clan MacBean" had been transferred to the ss. "Halizones" which had also left for Middlesbrough and the Medical Officer of that Port was similarly informed. The patients' effects were recovered from Tilbury Hospital and taken to Denton Hospital for disinfection. No further cases were reported. The ss. "Manaar" was kept under daily observation while in this Port, and no fresh cases were discovered. The infected forecastle was disinfected and subsequently repainted. V.—MEASURES AGAINST RODENTS. The measures taken for the prompt detection of rat Plague in ships or on shore in the Port, for the examination of ships in accordance with the Public Health (Deratisation of Ships) Regulations, for the destruction of rats and for the extension of rat-proofing which I described in my last Report, have been continued throughout the year. The total number of rats destroyed in ships was 3,944, of which 1,803 were killed by fumigation and 2,141 were trapped. On shore 5,698 rats were destroyed, all by trapping or poisoning. 23 The Table given below shows the annual number of fumigations during the last ten years, the number of certificates of exemption from deratisation issued annually since Article 28 of the International Sanitary Convention, 1926, was put into operation ; the total number of rats and mice destroyed in ships by fumigation and the average number of each per vessel. The latter figures have been plotted in a graph on page 28d. Tne increase in tne number of mice destroyed in the last two years is due principally to the discovery of large numbers of mice in ships carrying grain from Australia and Canada:— Year. No. of fumigations. No. of exemptions. Total No. of rats found after fumigation. Total No. of mice found after fumigation. Average No. of rats per vessel. Average No. of mice per vessel. 1923 38 — 1,000 6 26.32 0.16 1924 71 — 2,470 59 34.79 0.83 1925 111 — 3,123 56 28.13 0.50 1926 136 — 2,564 15 18.85 0.11 1927 112 — 2,419 65 21.60 0.58 1928 175 64 5,058 2 28.90 0.01 1929 214 202 3,108 99 14.52 0.41 1930 233 999 3,398 89 14.58 0.38 1931 165 884 2,590 625 15.70 3.78 1932 138 889 1,803 1,070 13.07 7.75 Bat-Proofing. Your Medical Officer understands that a Sub-Committee of the Joint Sanitary Committee of the Chamber of Shipping of the United Kingdom and the Liverpool Steamship Owners' Association has been set up to enquire into the question of ratproofing, from the point of view both of new vessels and of existing vessels. There is no doubt that rat-proofing is the only measure of rat-repression which will give results of permanent value. Trapping, poisoning and even fumigation frequently leave a few live rats behind from which a new colony rapidly grows. But even if these methods are completely effective, re-infestation will inevitably occur if there exist on board good nesting-places and an accessible supply of food and water. Good homes for rats do not long remain untenanted. Afloat as well as ashore it is essential to build against the rat. The broad principles of rat-proofing are simple:— 1. Dead spaces in which rats may nest and breed undisturbed must be eliminated, or, if it is not possible to eliminate them, they must be made inaccessible to rats. In this connection it is important to appreciate how small an opening will admit a rat and how strong are their teeth. Consequently, if openings are not blocked by sheet metal it is necessary to use expanded metal of not more than half-inch mesh. 2. Openings through which rats may pass from one compartment to another must be closed in order to prevent rats from travelling about the ship in search of food and water. 3. Rats do not usually gnaw on flat surfaces, but on edges and angles to which special attention is therefore necessary. Though these principles are simple and even obvious their application to the varied conditions in ships requires a knowledge of ship construction, imagination and an eye for detail. Mr. B. G. Holsendorf. of the United States Public Health Service, is thus equipped and in association with Dr. S. B. Grubbs has compiled a report on " The Bat-Proofing of Vessels," which contains not only the theory of rat-proofing, but practical instructions for the execution of the work together with a large number of illustrative diagrams and photographs. During the visit of your Medical Officer to New York he had the advantage of spending several days with Mr. Holsendorf, and of visiting ships under construction and ships in commission which had been rat-proofed in accordance with his specifications. Your Medical Officer was already convinced of the value of rat-proofing, 24 but he was very greatly impressed by Mr. Holsendorf's enthusiasm and by the thoroughness with which he had tackled every aspect of the problem. Some of those who have studied Mr. Holsendorf's recommendations critically may consider that it is unnecessary to rat-proof spaces which, though they provide potential rat-harbourage, are, from their situation, unlikely to become rat-infested. But experience has shown that rats do establish themselves in such places, and though, in considering any particular case, the risk of rat-infestation may be weighed against the cost of rat-proofing, care must be taken not to under-estimate the former. Others may observe that it is no use attempting the rat-proofing of existing ships. But it is well worth while dealing even with the more obvious defects because every bit of rat-proofing increases the efficiency of fumigation by reducing the possibilities of rats escaping from lethal concentrations of the poisonous gas employed. Thus the inter-fumigation period is prolonged and the cost of rat-proofing is repaid. Your Medical Officer recently visited a ship in which two insulated holds were reported to be rat-infested despite several fumigations at intervals of six months. It was found that rats had burrowed into the insulation and thus escaped the effects of the hydrocyanic acid gas which had been the fumigant employed. The insulation was protected by strong wire screening of small mesh covered with cement, but in the corners and angles, just the parts which would be attacked by rats, the protection was not complete, showing the necessity of paying special attention to these points by overlapping at the edges and interlocking at the corners or flashing with sheet metal. Objection may be raised to the cost of rat-proofing, but there are some respects in which rat-proof construction is actually more economical than the usual practice, and these at least should be studied and adopted forthwith. The recommendations of the Committee on rat-proofing will be eagerly awaited by all Port Sanitary Authorities. Bat-Flea Index. Bubonic Plague is primarily a disease of rats which is conveyed from rat to rat or rat to man by fleas. The more numerous the fleas on the rats the more readily is Plague spread. Moreover, though there are a number of different types of fleas which are capable of carrying the infection, the species Xenopsylla cheopis is the principal one concerned. It therefore appears that both the extent to which the shore rats are flea-infested and the types of fleas they harbour are to some extent indications of the susceptibility of the Port to infection by rat Plague. Your Worshipful Committee directed that during the year both the "Bat-flea Index" and the "Cheopis Index" (i.e., the average number of all fleas per rat and the average number of Xenopsylla cheopis fleas per rat) should be worked out in the Port of London. Dr. Kean, one of your Boarding Medical Officers, undertook this investigation and his report appears below. The extent of the Port necessitated special arrangements for killing the rats and their fleas at the same time and as soon as possible after trapping. Special portable "lethal chambers" were therefore designed, to which the Assistant Bat Officers could transfer the rats from the cages in which they were caught. Only rats trapped alive and singly were combed. At first Dr. Kean's classification of the fleas was checked by Dr. P. A. Buxton, Dr. V. B. Wigglesworth and Mr. H. S. Leeson, of the Department of Entomology of the London School of Hygiene and Tropical Medicine, but, as he was consistently correct in his identification, periodical checking of all the fleas collected during a month or so was substituted for checking the fleas combed from each rat. The strict conditions of the investigation limited the number of rats examined, because it not infrequently happens that more than one rat is caught in a cage trap and also many rats are caught in snap traps, and these were not examined. It is, however, proposed to continue the investigation for another year, and to extend it to rats obtained from ships in the Port. 25 So far 728 rats have been examined, of which 497 were black and 231 brown; 2,246 fleas were collected, of which 1,862 were Ceratophyllus fasciatus, 370 were Leptopsylla musculi, 9 were Ctenophthalmus agyrtes and 5 Ctenocephalus felis. Not a single Xenopsylla chopis was found. The total flea index rose from about 1.5 in the winter to about 4 in the summer. From the absence of Xenopsylla cheopis and the low total flea index it would seem that there is little danger of any imported rat Plague giving rise to a serious epizootic in the Port of London. Report on Rat-flea Survey by Dr. E. Kean.—In the early part of 1932 it was decided to institute a systematic examination of rats trapped in the Port with a view to determining— (a) The "Cheopis Index" for the area. (5) The degree of flea-infestation of the rat population. After the project had been taken in hand it was considered advisable to have the scope of the enquiry extended so as to include a recorded classification of the various types of fleas encountered. Acting on the advice of Dr. P. A. Buxton, of the London School of Hygiene and Tropical Medicine, it was decided that this survey should be presented in accordance with a standard method devised to ensure, as far as possible— (1) That each rodent when captured was harbouring its natural complement of parasitic fleas. (2) That each rodent was transferred alive into a specially constructed lethal chamber of a portable type. (3) That each rodent and its attendant parasites were killed and the numbers, species and sexes of the latter determined by a standard technique. A card-index file was maintained, and the result of the examination of each rodent was separately recorded thereon. Owing to the distances separating the several dock areas in the Port it was decided that the killing and examination of all rodents should be conducted at a central station. All the rats examined were caught alive in cage traps. For the purpose of carriage of the rats several portable lethal chambers, each divided into four separate compartments, were constructed of plywood. Each compartment was lined with block tin and the entire inside was coated with white enamel. To each compartment was fitted a sliding door, an observation window and a small aperture for the introduction of chloroform. To ensure that each rodent when trapped harboured its natural complement of parasitic fleas, it was essential to examine only rodents which had been caught singly. When two or more rats are caged together, fighting or friction against the bars of the cage will result in a diminution in the numbers of fleas normally carried by the rats. Such escaped fleas will attach themselves to other rodents prospecting in the vicinity of the cage and the combing of such rats may give an entirely erroneous flea count. On the apposition of the open entrance of the lethal chamber to the opened cage door the rat quickly passed into the darkened interior of the lethal chamber and was there secured. One rat only was carried in each compartment of the chamber. The lethal agent used during this survey was chloroform. It was found that one drachm of chloroform on a pledget of cotton-wool was lethal for a large rat, brown or black, when the rat was confined in a space of small dimensions and was subjected to the influence of the vapour for a period of five to eight minutes. All attendant fleas were likewise killed in ten minutes. 26 Determination of the total number of Fleas per Rat.—The dead rat was carefully taken from the lethal chamber and placed on a large square of white paper. The interior of the chamber was then examined for fleas which might have jumped or fallen from the rat. The rat was then held by the tip of the tail and the fur was combed with a fine comb in a direction away from the operator or " against the grain." The whole fur of the rat was thus searched, particular attention being paid to the inguinal regions, abdomen and neck. The cadaver was next lifted by the tip of the tail and well beaten all over with a light rod. This operation was followed by a similar beating of the cadaver held suspended by the ears. (This procedure may with advantage be repeated two or three times.) All fleas obtained as a result were collected to await identification and were labelled under the serial number allotted to the individual rats. The following particulars of the rat were recorded— (1) Serial number. (2) Date of capture. (3) Locality of capture, and nature of premises. (4) Species. (5) Sex ; and in the case of females whether pregnant. Preparation of Fleas for Identification.—The medium employed for clarifying fleas for identification was absolute Phenol. The Phenol was warmed to melting-point, the specimens were immersed therein and subjected to the action of the Phenol for some ten minutes. Such treatment shows up clearly the necessary distinguishing features of the specimens, which may be preserved indefinitely in this medium. Should permanent preparations, mounted in Balsam, be desired, it is necessary only to pour off the excess of Phenol and drop on the Balsam. When fleas from many rats had to be identified it was found convenient to employ a special porcelain tile containing twelve depressions, each depression being numbered and of about 1 c.c. capacity. By this means fleas from twelve rodents could be cleared simultaneously. The identification of the fleas was carried out under the low power of the microscope. All fleas examined were allotted to their respective genera, were numbered by sexes, and the results were entered on the card index under the serial numbers of their respective hosts. Area investigated.—For the purpose of rat control the Port of London Sanitary area is divided into six zones, which are as follows:— A. London Dock, St. Katharine Dock, Regent's Canal Dock and wharves on the North side of the River Thames. B. Surrey Commercial Dock and wharves on the South side of the River Thames. C. Millwall Dock, Poplar Dock and West and South West India Docks. D. Royal Albert and King George V. Docks. E. Victoria and East India Docks. F. Tilbury Dock and lower reaches of the Thames up to and including the Medway. During the course of this investigation all rats examined have been trapped in one or other of these zones. The area involved in Zone B. is extensive and includes several privately-owned wharves not within the area of jurisdiction of the Port Sanitary Authority. From those private wharves, through the courtesy of the proprietors, many rats were collected and examined. 27 Species of "Rats.—Under the heading "Black Eat" are included the different varieties of Mus rattus, and under that of "Brown Rat" are included all varieties of Mus norvegicus. Observations on Rats.—During the investigation 728 rats were examined. This number was comprised of 497 black and 231 brown rats. Of the total, 242 rats were found not to be harbouring fleas. The greatest number of fleas obtained from a single rat was 61. This host was an old brown rat trapped at Tilbury Dock in November, 1932. All the fleas were C. fasciatus. A small number (10 per cent.) of all the rats were autopsied with a view to ascertaining the presence of any microscopical lesions in the viscera which might seem to indicate a "plague carrier," but in none of these rats was any suspicious lesion noticed. Observations on Fleas.—The average number of fleas per rat for the whole period was 3.08. C. fasciatus appears to be the predominating flea throughout the year, the number encountered being 83.09 per cent. of the total flea count for the year. The C. fasciatus Index for all zones reached its highest in November, when it was 3.6. The G. fasciatus index for all zones for the whole period under review is 2.55. Leptopsylla musculi.—During the winter months occasional specimens of this flea were met with. With the onset of warmer weather its numbers increased so that in June, 1932. it constituted 18.3 per cent. of the total fleas examined. In July, this figure rose to 20 per cent., and this percentage was maintained throughout August. A rise to 34 per cent. of the total fleas examined was recorded in September. During October the figure reverted to 20 per cent. and this was followed by a sudden decline in the numbers encountered during the months of November and December. The period of its maximum incidence would appear to correspond fairly closely to that of C. fasciatus. Ctenophthalmus agyrtes.—Only nine specimens of this flea were obtained from two hosts. Seven were obtained from a brown rat trapped at Tilbury Dock in February, 1932, and two were obtained from a brown male rat caught in the Royal Albert Dock in May, 1932. Ctenocephalus felis was encountered on four occasions only. Five in number, they were obtained from four black rats during the months of June, July, October, 1932, and January, 1933. The hosts of four of those fleas came from B. Zone and the host of one from A. Zone (St. Katharine Dock). Xenopsylla, C. londiniensis, P. irritans.—A noteworthy feature was the failure to discover a single representative of either of the above genera. All fleas examined were submitted to the Department of Entomology, London School of Hygiene and Tropical Medicine, for confirmation of identifications. TABLE SHOWING RATS EXAMINED BY ZONES, SPECIES AND MONTHS. Zones 1932. February March April May June July August September October November December 1933. January Totals for whole period. Bl. Br. Bl. Br. Bl. Br. Bl. Br. Bl. Br. Bl. Br. Bl. Br. Bl. Br. Bl. Br. Bl. Br. Bl. Br. Bl. Br. Bl. Br. Total A. — — 2 — 5 6 9 4 11 2 3 3 5 6 5 6 4 2 11 3 7 — 6 — 68 32 100 B. — — 2 3 27 7 28 2 129 5 48 15 17 24 18 26 16 3 5 1 — — 8 5 298 91 389 C. — 2 7 2 2 1 5 2 6 5 2 3 3 5 3 3 3 3 5 1 1 — 1 2 38 29 67 D. 1 1 4 8 1 6 5 4 2 3 1 1 — — — — 4 2 2 6 3 — — — 23 31 54 E. 1 3 4 7 2 7 1 2 1 1 4 4 13 4 13 4 4 6 5 3 2 — 3 — 53 41 94 F. — 1 2 1 — — — — 2 — 1 — — — — — — 8 5 — — 4 — 17 7 24 2 7 21 21 37 27 48 14 151 16 59 26 38 39 39 39 31 16 36 19 13 — 22 7 497 231 728 Totals 9 42 64 62 167 85 77 78 47 55 13 29 728 TABLE SHOWING TOTALS OF DIFFERENT SPECIES OF RATS COLLECTED EACH MONTH. Species 1932. February March April May June July August September October November December 1933. January Totals C. fasciatus 8 79 146 100 444 273 245 240 79 201 10 37 1,862 L. musculi — 1 1 5 100 84 60 83 16 13 1 6 370 C. agyrtes 7 — — 2 — — — — — — — •— 9 C. felis — — — — 2 1 —- — 1 — — 1 5 X. cheopis — — — — — — — — — — — — — C. londiniensis — — — — — — — — — — — — — Totals 15 80 147 107 546 358 305 323 96 214 11 44 2,246 TABLE SHOWING C. FASCIATUS AND TOTAL-FLEA INDICES EACH MONTH. 1932. February March April May June July August September October November December 1933. January C. fasciatus index 0.8 1.8 2.2 1.6 2.6 3.2 3.1 3.0 1.6 3.6 0.8 1.2 Total index 1.6 1.9 2.2 1.7 3.2 4.2 3.9 4.1 2.0 3.8 0.8 1.5 28 28a 28 b 28c 28d 29 Eats Destroyed during 1932. TABLE E. (1) On Vessels. Number of Jan. Feb. Mar. April. May. June. July. Aug. Sept. Oct. Nov. Dec. Total in Year. Black Rats 95 1ll 44 76 80 42 36 30 69 42 57 17 699 Brown Rats — — 5 3 4 — — 1 — 7 4 2 26 Species not Recorded 195 509 188 260 299 260 311 145 174 490 203 185 3,219 Rats examined 95 111 49 79 84 42 36 31 69 49 61 19 725 Rats infected with Plague nil nil nil nil nil nil nil nil nil nil nil nil nil See also Appendices XXVI. and XXVII. TABLE F. (2) In Docks, Quays, Wharves and Warehouses. Number of Jan. Feb. Mar. April. May. June. July. Aug. Sept. Oct. Nov. Dec. Total in Year. Black Rats 23 48 34 25 26 25 25 14 48 46 52 26 392 Brown Rats 81 113 136 100 105 89 90 25 108 109 121 118 1,195 Species not Recorded 286 238 247 444 361 359 519 388 341 395 235 298 4,111 Rats examined 104 161 170 125 131 114 115 39 156 158 173 141 1,587 Rats infected with Plague nil nil nil nil nil nil nil nil nil nil nil nil nil RATS EXAMINED—Vessels, Docks, Quays, &c 2,312 See also Appendices XXVI. and XXVII. TABLE G. Particulars relating to Plague "Infected" or "Suspected" Vessels arriving in the Port during 1932. Name of Vessel. Date of arrival. Whether "Infected" or "Suspected" Method of Rat Destruction employed. Number of Dead Rats recovered. Whether a Certificate of Deratisation was issued. Remarks. 1. 2. 3. 4. Nil 5. 6. 7. TABLE H. Measures of Eat Destruction on Vessels from Scheduled Ports (other than those included in Table G) arriving in the Port during 1932. and number of Certificates issued in respect of such Vessels. Total Number of Vessels arriving from Plagueinfected Ports. Number of such Vessels fumigated by S02. Number of Dead Bats recovered. Number of such Vessels fumigated by HCN. Number of Dead Rats recovered. Number of such Vessels on which Trapping, Poisoning, &c., were employed. Number of Dead Rats recovered. Number of such Vessels on which measures of Rat Destruction were not employed. Number of Fumigation Certificates issued on Form "Port 11." Number of other Certificates issued. Deratisation. Exemption. 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. 11. 2,114 65 932 (359 mice.) 51 483 (307 mice.) 1,377 1,702 737 116 By fumigation. 1 By trapping. 352 — 30 TABLE I. Measures of Eat Destruction on Vessels (other than those included in Tables G and H) and number of Certificates issued in respect of such Vessels during 1932. Number of Vessels fumigated by S02. Number of Dead Rats recovered. Number of Vessels fumigated by HON. Number of Dead Rats recovered. Number of Vessels on which Trapping, Poisoning, &c., were employed. Number of Dead Rats recovered, Number of Certificates issued on Form " Port 11." Number of other Certificates issued. Deratisation. Exemption. 1. 2. 3. 4. 5. 6. 7. 8. 9. 11 113 (95 mice.) 11 275 (309 mice) 746 439 22 By fumigation. 2 By trapping. 537 — For details of Fumigation of Vessels, see Appendix XXVII. VI.—HYGIENE OF CREWS' SPACES. TABLE J.—Classification of Nuisances. Nationality of Vessel. Number inspected during 1932. Defects of original construction. Structural defects through wear and tear. Dirt, Vermin and other conditions prejudicial to health. No. of defects reported. No. of vessels concerned. No. of defects reported. No. of vessels concerned. No. of defects reported. No. of vessels concerned. British 10,485 86 62 528 264 2,060 2,060 Hygiene of Crews' Spaces. Owing to the continued depression in the shipping industry few new ships are being built and it is therefore not possible, from observation in the Port of London, to say what has been the effect of the recommendations of the Manning Committee of the Shipping Federation contained in their reports on "Officers' and Crews' Accommodation in Cargo Vessels " to which I referred in my last Report. Although, in spite of the plight of the shipping industry, we may reasonably hope that, in new construction, the recommendations of the Shipping Federation Committee will be adopted, we cannot at the present time expect that structural alterations to the accommodation in existing ships will be undertaken. In these difficult days we are obliged to make the best of things as they are, and therefore it is a particularly appropriate time to draw attention to the fact that the sanitary condition and the comfort of crew quarters depends in no small degree upon the crew themselves. It is not uncommon to find in one ship accommodation looking clean, bright and reasonably comfortable and in another ship where the crew quarters are structurally exactly the same there are dirt, vermin and every evidence of discomfort. There is no doubt that Officers who take an interest in their men and know how to handle them can work wonders with the most unpromising accommodation. The men themselves must be consistently clean and tidy in their habits. Spasmodic efforts to clean up after days of neglect are thoroughly unsatisfactory. This is particularly true in the control of bed bugs. Your Medical Officer believes that if on the first appearance of bed bugs an insecticide spray is used intelligently at regular intervals of a week, and if the quarters are kept thoroughly clean, it is possible to get rid of them, but if infestation is neglected nothing less than a prolonged fumigation with hydrogen cyanide will effect a cure of the condition. He recently visited a ship in which the crew accommodation was ideal for the development of infestation with bed bugs. The firemen's quarters were heavily infested, in the sailors' quarters there was not a bug. The difference was entirely due to the efforts of sailors to keep their quarters clean and free from vermin. The firemen "just grumbled about the bugs and occasionally squashed one on the matchboard sheathing of the bulkhead. Seamen in this respect are like tenants of houses ashore, some of whom will create slum conditions in good property, others will make an attractive home in a slum. But just as the better class of house attracts the better type of tenant so the better type of crew accommodation attracts the better type of seamen, and the ships with the worst living quarters get the worst crews. 31 Provided the conditions of life in ships are reasonably good, there is an ample supply of men of the right type to meet all the requirements of the shipping industry, and there should be no need to engage men who are devoid of any sense of personal responsibility in regard to the comfort and cleanliness of their quarters or who are utterly irresponsive to their environment. A ship gets the type of crew she deserves. At the end of 1932, the Board of Trade issued a report by Dr. P. G. Edge, of the London School of Hygiene and Tropical Medicine, entitled "Statistics relating to Mortality in the Mercantile Marine." Your Medical Officer summarised this report for the February, 1933, number of the Bulletin of Hygiene, and by courtesy of the Director of the Bureau of Hygiene and Tropical Diseases the summary is reprinted below:— The Board of Trade, recognising the lack of reliable statistics on which could be based comparisons between the health of seamen and of persons engaged in shore occupations, conclusions as to improvement or deterioration in the health of merchant seamen as a class or estimates as to the extent to which they are affected by certain diseases, referred the question to the Permanent Consultative Committee on Official Statistics. This Committee expressed the opinion that owing to the lack of data a statistical report on the health of the mercantile marine was impracticable and that a periodical investigation into occupational mortality was the only effective method of measuring statistically the effect of this occupation on health. In 1929 the Joint Advisory Committee of the Board of Trade and Ministry of Health recommended that such an enquiry should be made, and the work was entrusted to Dr. Edge. The author observes that enquiries into occupational hazards and mortality are always difficult, but are specially so in regard to the Mercantile Marine. Since sea life still demands a high degree of physical fitness a medical examination of men on engagement is usual, but the standard varies greatly and the examination is often perfunctory. Discontinuity of service is another difficulty. Between voyages there are often long periods of unemployment and the sailor may take up temporary or permanent work ashore. Further, he has exceptional temptations to acquire harmful habits tending to shorten life and finally he, unlike the worker on shore, is exposed to at least some of the risks of his occupation for the whole 24 hours of every day he is at sea. The investigator was asked to find the mortality rate per 1,000 seamen in a given year; the principal causes of death; whether there was any excess mortality at particular ages or in particular ratings and to compare the mortality rates in the Merchant Service with those in shore occupations. To answer these questions it is necessary to have an estimate of the population at risk and a complete list of deaths showing in each case the cause of death, the age at death and the rating of the decedents. Neither of these is easily obtained. The Board of Trade's Annual Census of Seamen records only those actually in employment on 31st March each year. Moreover, the Board of Trade definition of seaman does not include all men of the seafaring community, thus pilots and the crews of tugs, fishing vessels, &c., are excluded whilst the deck-steward of a cross-Channel boat would be included. It is obvious that the figure 127,518 British seamen in the Annual Census of Seamen taken on 31st March, 1930, must be an under-estimate of the population at risk, and since this forms the denominator in calculations of mortality the estimates resulting must be too high. The most satisfactory figure would be the number of seamen ashore on the night of the Decennial Census plus the number in crews at sea on the same night. But since the investigation commenced in September, 1930, the figures of the General Census of 1931 were not available in time for the report. The author is, however, of the opinion that the figure of 197,360 British seamen calculated on this basis from the 1921 Census might fairly be applied to the year 1930, since in view of the unparalleled depression in the shipping industry it is highly improbable that there has been any significant increase in the population of seamen. Deaths of seamen in ships at sea or in ports abroad must be reported to and recorded by the Registrar-General of Shipping and Seamen, deaths of British subjects abroad must be recorded by Consular officers, deaths at home in the United Kingdom 32 are recorded by local registrars and by them reported to the Registrars-General. It is thus possible to obtain the total number of deaths of men stated to be seamen, but in connection with civil registration it is necessary to ascertain whether the decedents could, at the time of death, be accepted as seamen within the Board of Trade definition. Accordingly copies of all entries relating to deaths of seamen reported to the Registrars-General at any time between 1st October, 1929, and 30th September, 1930, were sent to the Board of Trade for information as to the date of the last sea service of the deceased and for decision as to whether he was correctly described as a seaman. If the Board of Trade had no records of the decedent, local enquiries were made. As a result, 16.3 per cent. of the recorded deaths were rejected as not being of seamen within the Board of Trade definition. The total number of deaths thus accepted as of British seamen in the year under review was 3,166. Taking the population at risk as that obtained from the Annual Census of Seamen on 31st March, 1930, this gives a mortality rate of 24.8 per 1,000. Basing the population on the figures obtained from the General Census of 1921 the mortality rate is 17.61. Calculations of the mortality amongst lascars and foreigners are obviously of no value, because "large and unknown numbers of these men having served on British ships retire to their native countries and die there." Eighty per cent. of deaths were due to disease; 6 per cent. to injury and accident; 4 per cent. to old age; and 3 per cent. to suicide. Diseases of the respiratory system are responsible for 20 per cent. of all deaths, of the circulatory system for 19.6 per cent., cancer for 11 per cent., diseases of the digestive system for 5.4 per cent., and of the genito-urinary system for 6.2 per cent. Fundamental differences between service in the Navy and in the Mercantile Marine render dependable comparisons between the mortality rates extremely difficult. Comparison is only possible if mortality rates for the Mercantile Marine are calculated by relating the deaths of British seamen at sea and in ports abroad to the population as enumerated at the Annual Census of Seamen, and on this basis the rates for the Merchant Service compare favourably with those for the Navy. Lack of accurate information regarding population and age distribution and the small number of deaths investigated prevents the use of the method of a standardised population for comparison between mortality rates in the Merchant Service and in shore occupations, and the author has been obliged to resort to the method of proportionate mortality. In this way comparisons are made with a number of shore occupations in which a high standard of physical fitness is demanded : Coal Miners, Agricultural Labourers, Carmen, Carriers, &c., Railway Engine Drivers, Stokers, &c., Dock Labourers. It appears that though respiratory diseases are one of the principal causes of death the mortality from this cause at all ages in the Mercantile Marine is below the average in the selected occupations; in circulatory diseases there is an excess mortality at age 55-65 and a considerable excess at 65 and over; diseases of the digestive system are slightly above the average, particularly from 35-45. Cancer is below the average except between 35 and 45 and over 65. Mortality from genitourinary diseases is slightly in excess between 35-45 and over 65. Accidents are an excessive cause of mortality, particularly up to age 35. Suicides also are excessive at all ages. Alcoholism is not a more frequent cause of death than in the selected shore occupations. It therefore appears that service in the Mercantile Marine is no more inimical to life and health than are many of the occupations ashore frequently regarded as healthful, indeed, in many instances it has been shown that the advantage distinctly lies with the seaman. The author concludes that the whole scope of enquiry must be widened if dependable conclusions are to be reached, the data should relate to more than one vear and more time must be allowed for their analysis. The difficulties experienced by an expert statistician in investigating this question, even when special facilities were afforded to him, show that conclusions based on the data ordinarily available are of little or no value. 33 VII.—FOOD INSPECTION. There has been no change in the administrative procedure described in my last Report. Details of condemnations, samples submitted for chemical analysis or bacteriological examination, &c., are given below. The following report of the examination of the damaged cargo of the ss. "Roumelian" may be of interest— The ss. "Roumelian" left London on loth May with a large general cargo for the Mediterranean. Off the Isle of Wight she was in collision with another vessel and was so severely damaged that she had to be beached. The two after-holds were awash, number two hold had eleven feet of water in it and number one about eighteen inches. Temporary repairs were effected and the vessel returned to London, arriving on 26th May. The discharge of cargo commenced the following day. The flooded holds contained not only foodstuffs in tins, bottles, cases and sacks, but also sheets of galvanized iron, copper, paint, soda, alum and drugs. It was therefore necessary to regard all the foodstuffs as contaminated, unless it was certain that the containers had absolutely prevented the access of any water from the holds. Over three thousand packages were examined by Inspector P. W. Coombe, over 1,800 of which were detained for sorting, 1,376 being finally condemned as unfit for human consumption. The following points from Inspector Coombe's report show how, under the pressure in the lower holds, water was forced into many of the food containers and how quickly rusting and perforation of cans took place. Canned Foods.—Cans which had been lacquered or painted showed no evidence of rust, only the labels had come off. Where the tins had been packed in tight cases there was only slight rust, but when they were packed in sawdust or straw the rusty condition was very pronounced. Some tins, e.g., dried milk, had a press-on lid with a thin air-tight cover inside. In these water had got past the lid and in some cases the inner cover had rusted through. The press-on lids were all removed and the inner cover dried. Each tin was then weighed against a new one, and if it was heavier it was concluded that water had got past the inner cover. Tins of biscuits, mustard, custard-powder and baking powder, &c., were not water-tight and their contents were ruined. In the case even of biscuit tins with an inner cover under the lid water had entered through the seams. Water found its way into the large tin-lined cases in which confectionery was packed. Bottled Goods.—Bottles fitted with screw-caps escaped, except in a few instances, where the cap was not screwed on tightly. Bottles containing sauces, pickles, &c., closed by glass or porcelain stoppers escaped in every case. Jars of jam fitted with air-tight metal covers were unaffected, but small glass jars of fish paste, &c., with metal caps secured by a clip were in many instances water damaged; the caps could be removed without effort and water was found on the grease-proof paper over the contents. Barrels and Casks varied, some having remained tight and others having leaked. Dry Goods, such as currants, prunes, apricots, rice and flour, in boxes or sacks were, of course, irretrievably damaged. The assistance of Officers of H.M. Customs, the Port of London Authority and the Liverpool and Glasgow Salvage Association in the control and sorting of this damaged cargo is gratefully acknowledged. Caseous Lymphadenitis.—In May of this year representation was made to the Ministry of Health suggesting that some modification might be made in the examination of imported mutton and lamb for Caseous Lymphadenitis. As the result of a Conference attended by the Medical Officers of Health principally concerned, the Ministry decided that the position justified a reduction in the routine examination to 5 per cent. of all carcases whatever the country of origin, but that pieces of mutton should continue to be subjected to a 100 per cent. examination. 34 The Ministry also concurred in a suggestion that the system of sending notifications of marks and quantities of consignments to Medical Officers of Health of the districts of destination might be discontinued. If the 5 per cent. retained for examination in the Port proved unsatisfactory the whole of the next consignment from the same source would be held in dock store until 5 per cent. and any further examination which might be considered advisable had been completed. This arrangement was put into immediate operation in respect of consignments for provincial destinations, but it was deemed advisable to continue the "forward notification" of all consignments intended for stores in the Metropolitan area. The results of the examination during the year of mutton and lamb, weight 43 lbs. and over, from Australia, New Zealand and South America were as follows:— Where from. Carcases examined. Carcases found to be diseased. Carcases found to have Lymphatic Glands missing. Australia 7,330 3 Nil. New Zealand 25,344 21 Nil. South America 28,487 63 6 Totals 61,161 87 6 Percentage condemned. From Australia 0.04 „ New Zealand 0.08 „ South America 0.22 Pig Carcases.—A careful examination was made of a percentage of pig carcases arriving in the Port, the number of carcases examined being 1,787. Two carcases were found to be diseased. Actinomycosis in Ox Tongues.—A percentage examination was made of every consignment of ox tongues arriving in the Port. 231 consignments were put into dock store, where careful examination was made by your Officers of 27.102 tongues, and 226 tongues were found affected with Actinomycosis. Canned Foods.—In the Port of London every blown can which comes under the notice of your Inspectors is condemned. It is sometimes argued that although a can may appear blown the contents may be fit for human consumption. This is quite true, but without opening the affected cans it is impossible to be sure of the cause of the increased pressure within. The vast majority of canned foods are landed in this country in such condition that Food Inspectors have no reason to doubt their soundness. If tins appear blown there is something wrong somewhere, either in the nature, quality or condition of the product canned or in the quality of the can or in the process of canning, or in the subsequent transport and storage, and the obligation is on the manufacturers and the merchants to ascertain what is wrong and to correct it. It is therefore not unreasonable for your Inspectors to proceed on the principle that a " blown can is an unsound can and must be condemned," indeed, only on this basis can the inspection of canned food be carried out effectively. (1) Action under the Public Health (Imported Food) Regulations, 1925, resulted in 2,654 tons 13 cwts. 1 qr. 16 lbs. of unsound food being destroyed or disposed of for purposes other than human consumption. Disposal of Condemned Foods:— Tons. cwts. qrs. lbs. Boiling down (recovery of Fats, &c.) 67 18 1 13 Cattle and Poultry Foods 1,387 10 0 10 Distillation 9 2 2 7 Refining 78 8 0 19 Experiment (laboratory work) — 1 0 25 Exportation 166 15 0 4 Caffeine manufacture 8 7 0 4 Soap-making 10 4 0 21 Removed to other districts 18 5 0 16 Reconditioning 27 19 3 17 Manure 3 18 2 26 Destroyed—Buried 802 4 3 15 „ —Burnt 73 18 0 7 Total weight 2,654 13 1 16 35 Foodstuffs Condemned:— Dock. Tons. Quantity. No. of seizures. cwt. qrs. lbs. Royal Albert Dock 233 13 0 1 330 Royal Victoria Dock 257 6 3 9 230 King George V. Dock 15 7 2 2 62 East India Dock 462 8 2 24 32 West India Dock 109 10 1 11 225 Millwall Dock 30 9 2 23 21 Surrey Commercial Dock 1,115 13 0 24 52 London Dock 225 8 0 1 357 St. Katharine Dock 53 1 0 19 112 Regent's Canal Dock 114 13 0 9 82 Tilbury Dock 32 1 3 5 90 Total weight 2,654 13 1 16 1,593 The approximate weight of goods condemned and the number of detentions and seizures made annually during the last ten years were as follows:— Year. Approximate weight. No. of seizures. Tons. cwts. qrs. lbs. 1923 1,751 9 0 19 848 1924 2,998 11 2 17 992 1925 1,423 11 0 19 1,196 1926 4,011 15 3 5 1,620 1927 1,813 14 2 4 1,369 1928 6,018 3 1 22 1,436 1929 1,743 5 3 19 1,569 1930 2,572 10 3 1 1,547 1931 1,408 8 1 17 1,375 1932 2,654 13 1 16 1,593 The detention and control of Fats under the Public Health (Imported Food) Regulations, 1925, during the year was as follows:— No. of casks, &c., reported as imported into the district 22,817 No. of casks, &c., found to be officially certificated — No. of casks, &c., released to wharves under Notice of Exportation 12,037 No. of Exportation Notices served 304 No. of casks, &c., released for exportation 2,515 No. of casks, &c., released for soapmaking, &c 16,686 No. of casks, &c., in transit on through Bills of Lading 88 1,233 barrels, &c., of whale oil also arrived in the Port; this material was released. Foodstuffs disposed of as unfit for human consumption:— Tons. cwts. qrs. lbs. Mutton and Lamb—2,859 carcases, parts ex 2,439 carcases. 56 8 3 9 Beef—26 hinds, crops, &c., 19 bags 3 19 3 15 Pork—2 carcases, 17 sides — 6 2 16 Hams—1 case — 2 2 19 Poultry—3 cases — 1 0 0 Rabbits—5 crates — 2 3 26 Total weight 61 2 0 1 Meats (Tinned): — Tons L CWtS. qrs. lbs. Mutton—1 tin — — — 10 Hams—7 cases — 15 0 16 Potted Meats—21 cases, 39 tins — 8 2 24 Total weight 1 3 3 22 Fats:— Ton s. ewts. qrs. lbs. Tallow—25 barrels 5 9 2 9 Vegetable Pat—18 barrels 3 0 0 0 Total 8 9 2 9 36 Offal:— Tons. cwts. qrs. lbs. Ox Tongues—Diseased 226, no glands 165, bags 25, loose 50 1 19 3 26 Cow Tongues—1 bag — — 2 4 Ox Cheeks—1 bag — — 1 16 „ Skirts—19 bags — 9 2 18 „ Hearts—1 bag — — 2 0 „ Livers—154 bags, 15 loose 3 13 0 0 „ Tails—2 bags — 1 0 0 „ Kidneys—12 bags — 5 0 15 Sheep Kidneys—1 case — — — 27 „ Hearts—2 bags — 1 1 17 „ Tongues—18 bags — — 3 19 Calf Kidneys—1 bag — — 1 4 ,, Hearts—1 bag and loose — 3 0 25 ,, Tongues—18 bags — 11 3 20 Lamb Hearts—18 bags and loose — 9 3 22 „ Tongues—29 bags — 14 2 2 PigKidneys—6 cartons — 1 2 21 ,, Heads—4 loose — — 1 25 Sweetbreads—28 boxes — 8 0 4 Casings, &c.—4 casks — 18 2 0 Tripe—4 bags — 2 3 26 Pancreas Glands—1 case — — 2 4 Total 10 4 3 15 Fish:— Tons. cwts. qrs. lbs. Anchovies—12 barrels 2 19 0 0 Various—50 half-barrels 1 11 1 0 Total 4 10 1 0 Fish (Tinned):— Tons. cwts. qrs. lbs. Lobster—1 case, 54 tins — — 3 19 Sardines—4 cases, 308 tins — 12 2 8 Various—47 cases, 106 tins 1 4 3 2 Pish Paste—87 cases — 15 0 4 Shrimp Extract—1 package — — 3 5 Total 2 14 0 10 Fruit:— Tons. cwts. qrs. lbs. Currants—26 cases — 18 0 6 Eaisins—28 cases and ex 527 cases — 12 2 22 Sultanas—3 boxes and ex 1,100 boxes — 19 0 15 Apples—71 cases 1 16 2 1 Bananas—4,450 branches, &c 88 5 2 2 Figs — — 1 0 Grapes—108 cases 1 4 0 13 Oranges—33 cases 1 10 3 10 Melons—3 crates — 3 0 0 Pears—1,157 packages 21 13 1 14 Prunes—78 bags — 18 3 6 Dates—245 cases 13 2 3 23 Lemons—27 cases — 5 0 0 Tomatoes—830 cases 14 2 1 8 Various:— Fresh Fruit—3,820 packages 43 2 2 13 Dried Fruit—153 packages 6 10 3 14 Lemon Peel—1 pipe — 6 0 0 Citron Peel—2 cases —- — 3 0 Total 195 12 3 7 Fruit (Tinned and Bottled):— Tons. cwts. qrs. lbs. Tomatoes—126 cases, 189 tins 4 6 1 27 Various—423| cases, 439 tins 14 7 0 7 Total 18 13 2 6 37 Fruit Pulp, &c:— Tons. cwts. qrs. lbs. Tomato Puree—20 cases and 305 tins 2 14 0 18 Pulp—4 tins — — 1 27 „ Extract—37 cases 1 17 0 0 Blackcurrant Pulp—4 cases and 105 tins — 12 3 1 Apricot Pulp—6 cases and 19 tins 1 5 3 22 Greengage Pulp—17 cases and 6 tins 1 0 2 0 Raspberry Pulp—17| cases and 57 tins — 17 0 15 Tomato Paste—2 cases and 78 tins — 2 3 25 Fruit Juice—11 cases — 11 1 15 Total 9 2 1 11 Vegetables:— Tons. cwts. qrs. lbs. Onions—115 bags 5 13 2 2 Potatoes—13,007 bags 671 3 0 11 Various—1,684 packages 17 5 0 2 Peas—63 packages — 16 0 0 Beans—55 bags 2 9 2 24 Various sweepings, Peas and Beans, loose collected 5 14 2 20 Total 703 2 0 3 Vegetables (Tinned):— Tons. cwts. qrs. lbs. Peas—3 cases and 36 tins — 3 0 15 Various—18 tins — 1 0 0 Gherkins—5 cases and 5 tins 1 5 0 25 Total 1 9 3 12 Miscellaneous:— Tons. cwts. qrs. lbs. Soy—5 barrels 1 4 2 4 Mustard—4 packages — 1 2 20 Total 1 6 0 24 Nuts:— Tons. cwts. qrs. lbs. Almonds—26 bags 1 15 2 0 Chestnuts—475 bags 23 15 0 0 Various—1 bag — — 1 7 Total 25 10 3 7 Provisions, &c. Tons. cwts. qrs. lbs. Sugar—192 bags, 6 packages 18 5 2 23 Sugar Sweepings—691 bags 66 15 0 1 Butter—1 box — — 2 4 Margarine—108 boxes 1 12 2 12 Cheese—230 cases 3 4 0 14 Cocoa—32 bags 1 15 2 14 Coffee—13 bags — 17 0 12 Jam—1 case — 1 3 3 Tea—29 cases 1 9 2 17 Tea Sweepings—68 bags 4 0 2 6 Condensed Milk—30 cases, 70 tins — 16 0 25 Evaporated Milk—29 tins — — 1 10 Total 98 19 1 1 Grain and Flour:— Tons. cwts. qrs lbs. Wheat 114 8 3 0 Flour—3,605 bags 216 12 3 27 Oats 41 14 0 10 Rice 21 10 3 1 Maize 201 2 1 13 Total 595 8 3 23 Confectionery:— Tons. cwts. qrs. lbs. Confectionery—14 cases — 8 3 23 Total — 8 3 23 38 Prepared Foods. &c.:— Tons. cwts. qrs. lbs. Oats—9 cartons — 2 2 3 Macaroni — - 2 14 Yeast—100 bags 5 0 0 0 Marzipan substitute—4 boxes — 1 0 0 Various—22 cases, 85 tins, 200 bags 10 8 2 2 Total 15 7 2 19 Sundries:— Tons. ewts. qrs. lbs. Various—51 packages 9 16 1 13 Cereals—21,492 bags 891 9 3 6 Total 901 6 0 19 PUBLIC HEALTH (IMPORTED POOD) REGULATIONS, 1925. Official Certificates from the following countries are recognised by the Ministry of Health, under the above Regulations:— (1) In respect of Pork and other edible parts of the pig, Items (a) and (c) of Second Schedule:— Argentine Republic. Australia. Belgium. Brazil. Canada. Denmark. Estonian Republic. Latvian Republic. Netherlands. New Zealand. Sweden. United States of America. Uruguayan Republic. Union of South Africa. (2) Item (b), Second Schedule, Lard, Dripping, Edible Tallow and similar rendered Fats :— Australia. Argentine Republic. Brazilian Republic. Canada. Denmark. Hong Kong. Italy. New Zealand. Netherlands. Sweden. Switzerland. United States of America. Uruguayan Republic. In accordance with Article II. (4) of the above-mentioned Regulations, Notices were served for the exportation of the following material:— Description and Quantity of Meats and Fats. Where from. Number of Notices served. 12,651 casks, &c., Tallow New Zealand 218 6,594 „ „ Australia 81 736 ,, „ South America 4 160 „ „ Other Countries 1 PUBLIC HEALTH (IMPORTED MILK) REGULATIONS, 1926. No importation of milk requiring action under these Regulations was reported during the year. PUBLIC HEALTH (PRESERVATIVES, &c., IN FOOD) REGULATIONS, 1925 TO 1927. For action under these Regulations, reference is directed to the list of foodstuffs submitted for analysis. FERTILISERS AND FEEDING STUFFS ACT, 1926. No samples were taken under this Act during the year. 39 (2) SHELLFISH. Public Health (Shellfish) Regulations, 1915, Orders of November, 1916. Until the above Regulations are amended by the Ministry of Health it will not be possible to modify the Order made by the Port of London Sanitary Authority in November, 1916, so as to provide for the sterilization of Mussels by steam as an alternative to relaying. No cases of illness were reported during the year as having been traced to the consumption of shellfish from the layings in the district of the Port of London Sanitary Authority. (3) SAMPLES OF FOOD EXAMINED DURING THE YEAR. (a) Bacteriologist— Date. 1932. Sample. Analyst's Report. Action taken. Oct. 18 Tomali Paste The paste has a fresh smell and appears good to the naked eye. Film Examination shows no bacteria. Culture on Lactose Medium shows the presence of B. Coli of the order of 1,000 per gram of material. These organisms conform in their biochemical reactions to those of B. Coli of human origin. Culture in Anærobic Milk shows no sporebearing anærobus. Bacteriologically in its present condition the material appears fit for consumption. It, however, contains bacteria which may at ordinary temperatures, in the course fit time render it unfit. Whether this occurs or not depends on the inherent nature of the material as a bacteriological medium. The material appears to have been prepared under reasonably clean conditions, but sterilization by heat, if it has been carried out, is inadequate. Consignment released. (b) Analyst— Jan. 4 Dried Yeast Arsenic to the extent of 2 parts per million Released for Cattle food only. „ 5 Cod Liver Fat Iodine value 83.7 % Consignment released. Melting point 38. G. No evidence of hardened oil. A faint colour reaction for Vitamin A. The hexabromide test gave a positive result. All the above are consistent with the sample being mainly composed of Cod Liver Stearine, deodorised and refined. „ 14 Tinned Yeast Arsenic to the extent of 1½ parts per million „ „ 20 Raisins Free from the presence of Sulphur Dioxide „ „ 26 Treacle (Glucose Syrup) Free from preservatives other than slight traces of Sulphur Dioxide. „ » 26 Blackcurrant Pulp Sulphite Preservative equivalent to 1150 parts of Sulphur Dioxide per million. (Maximum allowed 1500 parts per million.) „ Feb. 1 Cooked Cod's Roe Tin compounds equivalent to 0.38 grains of tin per pound. „ 1 Capers Free from the presence of preservatives and other deleterious ingredients. „ „ 1 Mustard Powder Free from the presence of foreign ingredients „ „ 1 Honey Free from the presence of foreign ingredients „ „ 2 Butter The sample on analysis gave the following results:— Reported to the Ministry of Health. Reicbert-Wollny value 20.4 Polinski Value 1.6 Kirschner Value 15.1 Although the above figures are abnormally low for butter, they are not necessarily due to actual adulteration, since it has been established that butter of this class can be obtained as the result of bad farming practice, wrong methods of feeding or semi-starvation of stock. &c. Colouring matter and preservatives were not detected. 40 Date. 1932. Sample. Analyst's Report. Action taken. Feb. 18 Canned Cod's Roe Tin compounds equivalent to 0.52 grains of tin per pound. Consignment released. „ 23 Tomato Pulp Tin compounds equivalent to 1.55 grains of tin per pound. „ Mar. 2 Glucose Free from the presence of preservatives, arsenic and other deleterious ingredients. „ „ 4 Tomato Puree This sample was found to contain tin compounds equivalent to 1.10 grains of tin per pound, and copper compounds equivalent to 0.92 grains of crystallised copper sulphate per pound. No preservatives. „ 4 „ „ On analysis this sample was found to contain tin compounds equivalent to 1.54 grains of tin per pound, and copper compounds equivalent to 0.61 grains of crystallised copper sulphate per pound. No preservatives. „ „ 10 Cherries in Brine Sulphite preservative equivalent to 805 parts of sulphur dioxide per million. „ „ 10 Nulamoline No evidence of pollution. No nitrates were found and the quantity of chlorides was low (0.02 per cent. as NaCL), while none of the other tests carried out gave evidence of contamination from dock water. „ „ 17 Rindless Cheese This sample on examination was found to contain compounds equivalent to 2.7 grains of tin per pound. Consignment destroyed. Apri11 Tomali Lobster Paste The interior of the can was covered with paper folded over the top and bottom of the contents. The sample was found to contain tin compounds equivalent to 1/6 of a grain of tin per pound. The paint on the outside of the can was free from lead, but contained zinc. Consignment released. May 5 Sausage On stripping the skin from the sample, the nodules proved to be fat squeezed out of the meat. A microscopical examination of the inner surface of the skin revealed, except for the presence of numerous bacteria, nothing unusual. Preservatives and other deleterious ingredients were not detected. „ „ 6 Canned Salmon Trout Free from preservatives and other deleterious ingredients other than traces of tin. „ Canned Pilchards Canned Salmon fj 11 Cherries in Brine Sample contained sulphite preservative equivalent to 390 parts of sulphur dioxide per million. „ „ 23 Whole Egg Free from the presence of preservatives. „ July 13 Preserved Ginger A faint trace of alcohol and some signs of fermentation, but fit for human consumption. „ 14 Canned Pilchards in Tomato Sauce. Tin compounds equivalent to l.98 grains of tin per pound. „ „ 19 Yeast Free from the presence of arsenic. „ Aug. 2 Greengage Pulp Sulphite preservative equivalent to 1360 parts of sulphur dioxide per million. „ „ 4 Canned Pilchards Tin compound equivalent to 0.64 grains of tin per pound. „ Dec. 14 Sardines in Olive Oil This sample on examination was found to contain tin and tin compounds equivalent to 0.33 grains of tin per pound. " „ 30 Australia Butter (Tinned) This sample on examination gave the following results:— „ Moisture 11.63% Beichart No 31.3 Polenske 2.6 Kirschner 22.8 Acidity as Lactic Acid 0.28 Tin compounds None Boric Acid 0.11 % 41 ALIENS ORDER, 1920. Medical Inspection of Aliens. During the year 19,977 Aliens (excluding Alien Seamen) and 2,733 Transmigrants landed in the Port of London. Medical Certificates under the Aliens Order were issued in respect of 9 Aliens as follows :— Lunatic, Idiot or Mentally Deficient 4 Undesirable for Medical reasons 4 Physically incapacitated 1 Total 9 DANGEROUS DRUGS. On the 25th May your Medical Officer certified that the Master of the ss. " Havsten " was authorised to purchase and be in possession of 24 x 0'25 grain tablets of morphine for the use of the ship until it next reached its home port. The Certificate was issued under the Dangerous Drugs (No. 3) Regulations, 1923, amending the Dangerous Drugs Regulations, 1921, Regulation 15 of which is as follows :— " If a foreign ship in any port in Great Britain requires to obtain a supply of any of the drugs in order to complete the necessary equipment of the ship, the Master of the ship is authorised to purchase and be in possession of such quantity of any of the drugs as may be certified by the Medical Officer of Health of the Port where the ship is (or in his absence by the Assistant Medical Officer of Health of the Port) to be necessary for the purpose, the quantity not to exceed what is required for the use of the ship until it next reaches its home port. The certificate given by the Medical Officer or Assistant Medical Officer of Health of the Port shall be marked by the supplier with the date of the supply, and shall be retained by him and kept available for inspection." TRAINING SHIPS. The six Training Ships lying within the district of the Port of London Sanitary Authority are as follows :— "Arethusa" Lying at Greenhithe. "Cornwall" „ Denton. ''Exmonth" ,, Grays. "Warspite" ,, Grays. "Worcester" ,, Greenhithe. "Stork" ,, Hammersmith. The following cases of Infectious Disease occurred on these vessels during the year:—- T.S. "Arethusa" 4 cases Scarlet Fever, 10 cases German Measles, and 1 case Tuberculosis (other kinds). T.S. "Worcester" 4 cases Chicken-pox. T.S. " Stork " 3 cases Scarlet Fever, 1 case Cerebro-spinal Meningitis, and 3 cases Measles. By special arrangement twelve boys from the T.S. "Arethusa" were admitted to Denton Hospital for isolation and treatment. IMMUNISATION AGAINST DIPHTHERIA. For some years arrangements have from time to time been made through your Medical Officer for the boys of the T.S. "Cornwall " to be tested for susceptibility to Diphtheria, and for those giving a positive reaction to be immunised. Last autumn the Captain Superintendent reported that he had 119 boys who had not been tested. Your Medical Officer communicated with Dr. R. A. O'Brien, of the Wellcome 42 Physiological Research Laboratories, who kindly undertook to supply the material free of charge, and to send one of his assistants, Dr. Parish, to carry out the tests. The results were as follows :— No. of boys Schick tested 119 ,, Schick negative 94 (79 per cent.) (i.e. immune to Diphtheria.) ,, Schick positive 24 (i.e. susceptible to Diphtheria.) ,, Schick positive (?) 1 The 24 Schick positive reactors received injections of Diphtheria prophylactic on 9/12/31, 16/12/31 and 5/1/32. Re-testing was performed on 1/2/32, results being as follows :— Originally Schick positive, on re-test negative 23 ,, ,, ,, (?) ,, ,, 1 ,, ,, ,, ,, positive 1 The Schick positive (?) case was thus immunised by the testing dose without recourse to prophylactic injections. The boy who remained Schick positive received further injections of prophylactic. LEGAL PROCEEDINGS. It was not necessary to take Legal Proceedings for any infringement under the various Acts and Regulations administered by the Port Sanitary Authority. BYE-LAWS—OFFENSIVE CARGOES. Three cases of infringement of the above-mentioned Bye-laws were reported during the period covered by this Report. Written notice was sent to the owners of the lighters:- Date. 1932. Name of Vessel. Owner. Infringement. March 10 Lighter " Pom " W. R. Cunis, Ltd. Carrying an offensive cargo, to wit, house refuse, not properly and securely covered so as to prevent any nuisance arising therefrom, and loaded to a height of about three feet above the coamings. „ 14 Lighter " Waltham " Messrs. Cory Lighterage Co., Ltd. Ditto, and loaded to a height of about four feet above the coamings. „ 21 Lighter " Publius " Ditto. Ditto. PARROTS (Prohibition of Import) REGULATIONS, 1930. 283 parrots, &c., came under the notice of your Officers during the year. 70 Notices were issued in respect of 93 parrots, &c. Number exported in respect of Notices served 83 Number destroyed (Notice served to export) 10 Number destroyed. (No Notice served. Birds destroyed on arrival) 4 Number exported (not time to serve Notice owing to short stay of vessel) 6 Number admitted under Ministry of Health permits 120 Number in transit for a foreign port via London* 60 283 * This was the residue of a consignment of 130 parrots in 'transit, 70 of which died from " cold " during the voyage. 43 VISITORS TO THE PORT SANITARY DISTRICT. During the year the following Medical Officers and others visited the Port of London to study the Sanitary Administration either in general or in some particular respect:— Dr. Samarasinghe, of Ceylon. Dr. J. Pietrani, of Cyprus. Dr. J. Galea, of Malta. Dr. L. E. Poulier, of Ceylon. Dr. C. L. Williams, of United States of America. Dr. W. S. Berry, of Ireland. Dr. C. E. Lysaght, of Ireland. Dr. H. N. C. Kelaart, of Ceylon. Dr. Hailer, of Germany. Dr. L. C. Hirst, of Colombo. The Right Hon. Sir Edward Hilton Young, Minister of Health, the Medical Director-General and Officers of the Naval Medical Service and the Delegates to the Annual Meeting of the Association of Port Sanitary Authorities of the British Isles O V visited the Port during the year. ANNUAL MEETING OF THE ASSOCIATION OF PORT SANITARY AUTHORITIES. Mr. Cyril Gamon, C.C., being President of the above Association, the Annual Meeting was held in London on the 9th and 10th June, 1932. The Programme was as follows:— On 9th June, at 2.30 p.m., your Medical Officer delivered a Lantern Lecture to the Association on " The Port of London and the Work of the Port of London Sanitary Authority"; subsequently the Delegates were shown over the London School of Hygiene and Tropical Medicine and were entertained to tea by the Board of Management. In the evening the Court of Common Council entertained the Association at a Banquet in the Art Gallery, the Right Honourable the Lord Mayor presiding. The following morning, at 10 a.m., the Lord Mayor opened the Annual Meeting, which was held in the Public Health Committee Room of Guildhall. At this Meeting your Medical Officer read a Paper on " The Routine Medical Inspection of Ships from Infected Ports," which appears in full below. At 1.45 p.m. the Delegates proceeded to Tower Pier, where they inspected your boarding launch "Howard Deighton," and then, at the invitation of the Port of London Authority, proceeded on board the ss. "St. Katharine" down river to the King George V., Royal Albert, and Victoria Docks. The facilities for the handling of chilled beef, for the thawing and examination of ox tongues and for the storage of frozen meat were shown. In No. 6 Cold Store a demonstration was given of the methods of examining foreign meat. The party returned to Tower Pier at 6 p.m., and all expressed their appreciation of the generous hospitality which had been extended to the Association by the Corporation of the City of London, the Port of London Authority and the London School of Hygiene, and of the arrangements which had been made to show them as much as possible, in the short time available, of the work of the Port of London Sanitary Authority. The Routine Boarding of Ships from Infected Ports. In 1926, after some six years' experience of boarding ships in the port of Liverpool, I came to the conclusion that the routine boarding of ships from infected ports involved a great deal of work for which there was practically nothing to show in the way of discovery of unreported cases of infectious disease, and I presented to the medical officer of health, Dr. Mussen, and through him to the Ministry of Health, a scheme for discontinuing this practice and substituting a system whereby the master of an incoming ship would fill up a short form of " Declaration of Health." The medical inspection of the ship would then depend on the answers to the questions in this declaration and not on the health conditions existing in the ports of departure or call of the ship. The Ministry of Health at that time looked with favour on the idea of a declaration of health but foresaw administrative difficulties in the scheme I proposed. Since then I have given the matter careful consideration and in the light of further experience feel convinced that the 44 scheme is practicable. I intended to elaborate it at the conference of port medical officers of health held at the Ministry in April last to discuss the draft of the proposed new port sanitary regulations but time was too limited and moreover I knew that, though the Ministry took a more sympathetic view of the suggestions than they did six years ago, they felt that difficulties might arise because the scheme involved a wide departure from accepted international practice. Nevertheless I am taking this opportunity of submitting the scheme for consideration and criticism. In the two ports with which I am really familiar, viz., Liverpool and London, I believe it could be worked, but it may be that in some other ports it would be quite impracticable. Defects of the Present System.—First of all may I submit what seem to me to be the disadvantages of the present system under which all ships arriving from infected ports are medically inspected even if they report " all well and no sickness during the voyage." In the first place there is the difficulty of keeping the infected port list up to date and of acquainting pilots, customs officers, shipping companies and agents promptly of changes in the list. This difficulty has led in the ports of London and Liverpool to scheduling whole coast-lines rather than individual ports as infected. Other port sanitary authorities take the weekly record issued by the Ministry of Health as the basis of their infected port list. Consequently there is a lack of uniformity in the ports of the British Isles and the master of an incoming ship never knows whether his ship is going to be medically inspected or not. Sometimes he has his crew mustered and his papers ready only to find that he is not to be inspected ; much more frequently he has gambled on not being inspected and has nothing ready. Secondly there is a tendency amongst masters to think that port sanitary authorities are only interested in ships from infected ports and that we are not concerned with sickness on ships which have not touched at any such port. I have myself had this excuse offered to me by the master of a ship on which there was an undiagnosed case of typhoid fever which was only reported by the customs officer after the vessel had docked. Thirdly, let us consider the position of the medical officer who boards a healthy ship from an infected port. Frequently he will meet with considerable passive resistance to the mustering of all persons on board, particularly where passengers are concerned. If the medical officer is thoroughly conscientious he will insist on seeing everybody himself however unpopular he is in consequence. But I wonder whether all medical officers are both conscientious and determined enough to carry out a detailed inspection in every case ? Even the most conscientious medical officer is not infrequently faced with the situation that a detailed inspection means the ship losing her tide. Is he going to insist on mustering everybody then and be involved in correspondence and perhaps personal interview with the shipowner who points out that he has been put to very heavy expense by the delay to his ship ? I doubt it ! So that quite apart from differences in the practice of port sanitary authorities there are differences in the practice of the boarding medical officers even in the same port. Little wonder then that the masters of ships are confused as to what English port sanitary requirements really are and complain that they never know what is expected of them. Let us consider what results we have to show for this system which leads to so much confusion and which frequently places even the best boarding medical officer in a most difficult position. I should be interested to know in how many cases the routine boarding of ships from infected ports has led to the discovery of cases of the more serious infectious diseases when no indication was given by the master that illness requiring the attention of the port medical officer had occurred or was present on board. I have myself discovered a missed case of small-pox but only in an instance when the master had declared a primary case landed abroad. On the other hand, I have known at least one case of small-pox which escaped detection because the ship was not from an infected port and the master had not suspected the illness to be of an infectious nature, and I have known several cases of typhoid fever to be brought into dock under similar circumstances. I admit that if a single instance can be cited where small-pox or plague was discovered under the present system which would be missed if the scheme I am about to suggest had been in force, then my proposals go by the board ; but it appears to me that we have at present a confused system and that even so we are frequently obliged to accept the word of the master or of the surgeon that all is well on board a ship arriving from an infected port. Proposed Alternative Scheme.—It is obviously impossible that in every port in the British Isles every person on board every ship should be medically inspected on arrival ; some system of selection must be adopted. At present we select for inspection those ships which are most likely to have infectious disease on board and leave the rest unless the master reports infectious sickness either by wireless or to a customs officer. If the master fails to report it is difficult to prosecute him because he can always claim that, not being a doctor, he could not be expected to diagnose the disease in question. If we are agreed that the present system is unsatisfactory, what is the alternative ? I would suggest the following :— First of all I would provide by law that immediately before arriving in a port in the British Isles, the master should acquaint himself as to the state of health of every person on board his ship and then should answer " yes " or " no " to the following questions :— (1) Have you during the present voyage had on board any case of infectious sickness or of illness which you suspect to be of an infectious nature ? (2) Have you had on board any case of illness as to the nature of which you are in doubt. (3) Have you had any death from sickness during the voyage. (4) Have you on board at the time of arrival any case of sickness of any sort whatever; injuries excepted ? 45 I would instruct the master that if the answer to any of these questions is " yes " he must communicate with the port sanitary authority by the quickest possible means ; and the customs officers that, in similar circumstances, pratique must not be granted without the sanction of the port medical officer. I would provide heavy penalties for failure to comply with these instructions. It will be noted that the master is not required to make a diagnosis but simply to ascertain whether each person on board is well or ill. In the case of ships carrying a doctor I would add a proviso that if the doctor is absolutely certain that there is no suspicion whatever of infection in regard to the cases notified under questions 3 and 4, the ship need not report for the port medical officer and pratique may be granted without reference to him. A question might be added in regard to sickness or mortality amongst rats, but I have yet to board the ship the master of which will give a reply in the affirmative to this inquiry. The principle would then be that for boarding purposes the port sanitary authority would disregard the ports of departure and call of a ship, but they would require medically to inspect her :— (a) If any case of infectious disease had occurred during the voyage in order to ascertain that there was no danger of the spread of infection on board or on shore. (b) If any undiagnosed illness had occurred in order to ascertain whether it might have been of an infectious nature. (c) If any death from illness had occurred in order to ascertain if it had been from an infectious disease. (d) If there was any case of illness on board at the time of arrival in order to ascertain whether it might be of an infectious nature and to relieve the master of all responsibility in regard to the diagnosis. These would appeal to everybody as reasonable grounds for subjecting a ship to medical inspection and personally I believe we should run far less risk of the introduction of infectious disease into this country from abroad than we do at present. Certain criticisms I foresee and wish to anticipate. In the first place it may be said, " What then would be the use of the Ministry of Health record of infectious diseases at ports, &c., at home and abroad " ? It would still be of the greatest value in guiding the boarding medical officers in the diagnosis of doubtful sickness either during the voyage or on arrival or in coming to a conclusion as to the cause of any deaths reported. If, in view of the prevalence of plague, small-pox, typhus, cholera or yellow fever in any of the ports at which the vessel had called, his suspicions were excited he would be justified in making a full inspection of the ship and taking any further precautionary measures indicated. Again in regard to plague, the weekly record would indicate what ships should be kept under special observation while in port for evidence of an epizootic amongst the rats on board. In this country it is uncommon to find human cases of plague on board ships ; is is far more frequently the case that rodent plague is discovered during the discharge of cargo. Then there are administrative difficulties. In the larger ports where there is always a boarding medical officer on duty night and day, the scheme would not be difficult; with the proviso suggested for ships carrying a surgeon I do not think their work would be greatly increased and they would at least have the satisfaction of knowing that when they went off to a ship there would always be either a case to diagnose or some suspicious circumstance to investigate. In the smaller ports I can understand that the part-time medical officer would be afraid that he would always be going off to ships to see cases of trivial sickness. But in my view there should always be a sanitary inspector available during docking hours in every port and the port medical officer could permit the sanitary inspector to decide whether it was necessary to call him to the ship or whether the sanitary inspector himself could authorise the granting of pratique. After all, at the present time in regard to ships which are not from infected ports you leave it to the master or the customs officer to decide whether there is any suspicion of infection in regard to any case of illness and a sanitary inspector under the control of the port medical officer could be trained to be a far better diagnostician that the master of a ship or a customs officer is ever likely to be. Foreign ships are another difficulty, perhaps, though it is remarkable how rarely one comes across a foreign ship in which the master or the purser does not know sufficient English to be able to interpret the simple form of " Declaration of Health " proposed. Moreover, if the system was uniform for all ports in the British Isles, the instructions could be printed in the sailing directions for the various ports and the master would then have a copy translated into the language of the country under the flag of which his ship was sailing. The scheme may be open to other criticisms, but I hope it will not be hastily condemned. In the British Isles we never imposed the routine fumigation of ships from plague-infected ports but dealt with them according to their condition as regards rats, and other countries are gradually coming into line, thanks to the International Sanitary Convention. Similarly, I believe, that eventually we shall take the lead in discontinuing the routine medical inspection of ships from infected ports and shall substitute a system of dealing with ships strictly according to the health conditions existing on board. In any case there is no immediate danger of the introduction of this scheme because the new port sanitary regulations will shortly be issued which prescribe a much more elaborate form of " Declaration of Health " and provide for the continuance of the present practice of inspecting all ships from infected ports even if the answers to the questions in the declaration are all negative. Finally, I would like to admit that such a scheme as I suggest does not eliminate all risk of the importation of infectious disease, but I firmly believe that it is not only more rational than the present system but would be a far better safeguard. 46 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, 1932. The canals of this country have in the past suffered severely from the competition of the railways, and now both canals and railways are feeling the competition of motor-driven road transport. It is natural, therefore, that canal boat owners should endeavour to meet this new threat to their existence by speeding-up their craft, and consequently there appear to be signs that here again the horse will be replaced by the motor. So far as London is concerned, developments along these lines are as yet on a small scale, and there are at present only seven motor-driven canal boats on the Register. Nevertheless, it seems desirable that the Canal Boats Act and Regulations should be amended so as to safeguard the health of those who live on and work this new type of craft. The principal dangers are from exhaust gases and from fire. The position of the engine-room is likely to depend to some extent upon the weight of the engine and the fuel in relation to the size and build of the boat, so that the living accommodation may either be right aft or immediately forward of the engineroom. In either case there should be a gas-tight and fire-proof bulkhead between the cabin and the engine-room. This bulkhead should go right down to the keel and should be secured to the hull plating. If the cabin is abaft the engine-room, the clutch and gear-box should be on the engine-room side of the bulkhead and the propeller shaft where it passes through this bulkhead should be surrounded by a gas-tight gland. There should be no direct communication between the cabin and the engine-room, the entrance to the latter being by means of a vertical iron ladder from the deck. The bilge under the engine-room will be completely shut off by the gas-tight bulkhead, and should therefore have a separate bilge pump. The engine-room should be provided with adequate means of permanent ventilation in addition to the sky-light and the provision of fire-extinguishers should be compulsory. The discharge of exhaust gases requires special consideration, because if they are discharged through a low funnel they are likely to be inhaled by the person steering and may find their way into the accommodation through the scuttle. In some cases it may be convenient to have the cabin situated right forward, but there is no need to insist on this if the above conditions are complied with. If any revision of the Canal Boats Regulations is contemplated, it is suggested that a considerable increase in the minimum cubic space per person might be made, at least in regard to new boats. It would seem reasonable to recommend a minimum of 120 cubic feet for each adult and 80 cubic feet for each child. A glazed hinged skylight should be compulsory in the cabin and a cooking range with an oven should be provided. In steel boats all bare-iron surfaces except those of internal divisional bulkheads should be sheathed with wood to prevent dampness from condensation of moisture. The minimum capacity of the drinking water storage tanks should be increased from three gallons to ten gallons. These suggestions have been put forward by Inspector P. W. Coombe, who has had considerable experience in the inspection of canal boats, and are quite practicable so far as London is concerned, but may not all be applicable in the districts of other Canal Boats Registration Authorities. The Canal Boats 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 not within the ebb and flow of the tide." 47 The navigation, in addition to the enclosed Docks, includes the following navigable tributary waters and creeks of the River Thames :— On the right bank— On the left bank— From Teddington downwards:- From Teddington downwards :— Wandsworth Creek (River Wandle). The entrance of the River Brent. Hay's Dock. Hammersmith Creek. St. Saviour's Dock. Chelsea Creek. Part of the Grand Surrey Canal within the Grosvenor Dock. Surrey Commercial Dock. Limekiln Creek. Deadman's Dock. Bow Creek (River Lea). Deptford Creek (River Ravensbourne). Barking Creek (River Roding). The entrance to Gravesend Canal. Rainham Creek (River Ingrebourne). Cliffe Creek. Mucking Creek. Yantlet and Coalmouth Creeks. Thames Haven and Hole Haven. Part of the River Medway, and of the Swale. Havengore Creek. River Roach as far as Rochford. RIVER, The whole of this area is divided into three districts, known as the Upper, Middle and Lower ; each district is in charge of an Inspector, as follows :— Upper District Teddington to Greenwich A/Inspector Wright, £200 per annum. Middle District Greenwich to Erith A/Inspector Beattie, £200 per annum. Lower District ... Erith to the seaward limits of the ) Port (including part of the River Inspector Edwards, £220 per annum. Medway). ) DOCKS. The Docks are divided into four districts, known as the Central, Eastern. Western and the Gravesend District:— Central District West India Dock Inspector Elward, £380 per annum. South West India Dock Poplar Dock Millwall Dock Eastern District Royal Victoria Dock Inspector Gray, £340 per annum. East India Dock Royal Albert Dock Inspector Lambe, £380 per annum. King George V. Dock Western District London Dock Inspector Coombe, £320 per annum. St. Katharine Dock Regent's Canal Dock Surrey Commercial Dock Inspector Johnson, £230 per annum. Gravesend District Tilbury Dock Left Shore of River, from Purfleet down Right Shore of River, from Erith down Inspector Clifford, £320 per annum. The total number of inspections for the year was 236, representing a nett number of 94 boats. The remainder—142—represents repeated visits by Inspectors of this Authority. The number of boats not conforming to the Acts and Regulations was 25 (inspected on 36 occasions), or 15.25 per cent. of the total inspections, the percentage for the previous five years being 33.62 per cent. New Boats Registered. 1932. July 9 "Weybridge" Registered Port of London No. 555 Oct. 14 "Reliance" „ „ „ No. 556 Notification of Change of Master. Nil. 48 Absence of Certificate of Registration. 1932. Jan. 18 "Ethel" Registered Port of London No. 541 Mar. 18 " Franklin" ,, Berkhampstead No. 328 June 15 "Dart ,, Brentford No. 453 ,, 20 *" Weybridge" Awaiting Registration. July 20 *"Reliance" „ Sept. 1 "Perseverance" Registered Port of London No. 233 Nov. 16 "Ribble" ,, Brentford No. 454 Certificate not Identifying Owner with Boat. Nil. Marking, &c. 1932. Feb. 1 *"Josephine" Registered Port of London No. 535 July 13 " Titan" „ „ „ No. 549 Sept. 26 " Trent " ,, Uxbridge No. 497 Dec. 20 " Rehance" „ Port of London No. 556 Overcrowding. Nil. Partition Separating Sexes. Nil. Males over Age. Nil. Females over Age. Nil. Cleanliness. 1932. Jan. 12 *" Dee " Registered Brentford No. 469 No boat was detained for cleansing during the year. Painting. 1932. Apl. 19 *" Amber " Registered Port of London No. 530 May 27 " Cromford ,, ,, ,, No. 528 Aug. 30 " Victor " „ Uxbridge No. 470 Sept. 26 "Victor" „ ,, No. 470 Dec. 2 " Bolford ,, Port of London No. 524 „ 14 " Scot " „ „ „ No. 414 Ventilation. 1932. Apl. 28 "Charles" Registered Brentford No. 210 May 17 "Woking" „ Ware No. 70 „ 27 "Quaker" ,, „ No. 69 Dilapidation. 1932. Mar. 2 *"Industry" Registered Port of London No. 461 Apl. 1 "Bronze" ,, ,, ,, No. 531 May 17 "Woking" ,, Ware No. 70 „ 27 "Quaker" „ No. 69 June 22 "Amos" ,, Uxbridge No. 476 July 5 "Amos" „ No. 476 „ 7 "Ada" „ Berkhampstead No. 404 „ 19 "Amos" „ Uxbridge No. 476 Aug. 8 "Rosaline" ,, Port of London No. 487 Nov. 30 "Ada" ,, Berkhampstead No. 404 Dec. 2 "Bolford" „ Port of London No. 524 „ 14 "Scot" ,, ,, ,, No. 414 „ 19 "Ada" ,, Berkhampstead No. 404 49 Removal op Bilge Water. Nil. Without Pump. Nil. Refusal to admit Inspector. Nil. No proper Water Vessel. 1932. Oct. 17 *"Ashford" Registered Port of London No. 523 Double Bulkheads. Nil. Notification of Infectious Disease. Nil. Register. On the 31st December, 1932, there were 237 boats on the Register :— Propelled by Tugs and Oars 215 ,, „ Steam 15 „ „ Motors 7 Two new boats were registered during 1932. 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 Percentage of Boats with Children. 1923 199 24 81 3.37 12.06 1924 164 27 73 3.04 16.46 1925 279 67 168 2.50 24.01 1926 120 31 157 5.06 25.08 1927 83 19 66 3.04 22.89 1928 79 15 66 4.15 18.98 1929 82 20 96 4.80 24.39 1930 91 13 35 2.70 14.29 1931 108 20 40 2.00 18.52 1932 94 12 28 2.33 12.77 I have the honour to be, Gentlemen, Your obedient Servant, CHAS. F. WHITE, Medical Officer of Health, Port of London. 50 SUMMARY OF CANAL BOATS FOR THE YEAR ENDED 31st DECEMBER, 1932. Jan. Feb. March. April. May. June. July. Aug. Sept. Oct. Nov. Dec. TOTAL Total job Years 1927. 1928. 1929. 1930. 1931. New boats registered — — — — — — 1 — — 1 — — 2 9 7 7 8 9 Registration owing to structural alteration — — — — — — — — — — — — — — — — — — Registration for other purposes — — — — — — — — — — — — — — — — — — No. of Inspections 19 16 14 20 24 27 24 18 24 17 19 14 236 136 128 127 147 295 Conforming to Acts and Regulations 16 14 12 14 21 24 19 16 21 15 16 10 200 92 76 103 104 252 Infringements in respect of :— Registration — — — — — — 1 — — 1 — — 2 10 8 7 9 12 Notification of change of Master — — — — — — — — — — — — — — — — — — Absence of Certificate 1 — 1 — — 2 1 — 1 — 1 — 7 17 10 5 17 23 Certificate not identifying owner with boat — — — — — — — — — — — — — 1 6 1 1 — Marking, &c. — 1 — — — — 1 — 1 — — 1 4 7 12 2 3 4 Overcrowding — — — — — — — — — — — — — — — — — 2 Partition separating sexes — — — — — — — — — — — — — — — — — — Males over age — — — — — — — — — — — — — — — — — — Females over age — — — — — — — — — — — — — — — — — — Cleanliness 1 — — — — — — — — — — — — 3 — 1 5 — Painting — — — 1 1 — — 1 1 — — 2 6 2 10 5 6 3 Ventilation — — — 1 2 — — — — — — — 3 — 3 1 4 3 Dilapidation — 1 1 8 2 1 3 2 — — 1 4 18 21 21 5 20 13 Removal of bilge water — — — — — — — — — — — — — — — — — — Without pump — — — — — — — — — — — — — — — — — — Refusal to admit Inspector — — — — — — — — — — — — — — — — — — No proper water vessel — — — — — — — — — 1 — — 1 2 — — 2 1 Double bulkheads — — — — — — — — — — — — — — — — — — Notification of infectious disease — — — — — — — — — — — — — — — — — — Detained for cleansing — — — — — — — — — — — — — — — — — — Proceedings taken — — — — — — — — — — — — — — 1 — — — Written cautions given 1 1 2 — 1 — 1 1 — — 1 2 11 32 43 11 16 15 Cautions attended to — 1 — 1 1 2 3 1 2 2 — — 13 28 20 32 20 24 Total registered by Port Sanitary Authority since 1887 556 Cancelled 319 Actual number on Register, 31st December, 1932 237 51 APPENDIX I. MEDICAL INSPECTION. From 1st January to 31st December, 1932. (a) Gravesend. Jan. Feb. March April May June July August Sept. Oct. Nov. Dec. Total. No. Medically Inspected 149 117 145 164 107 130 122 124 104 125 123 127 1,537 No. of Passengers 2,515 1,658 2,153 2,726 1,484 3,012 1,700 2,076 1,639 1.675 1,061 923 22,622 No. of Crews 4,273 3,498 5,680 5,638 4,285 4,749 4,465 3,679 3,626 4,318 5,082 4,910 54,203 No. of Foreign Arrivals 967 1,126 851 894 930 991 946 960 916 978 930 935 11,424 (b) Sheerness. Jan. Feb. March April May June July August Sept. Oct. Nov. Dec. Total No. Medically Inspected 16 14 14 15 17 19 26 24 20 17 16 14 212 No. of Passengers — — — — — — — — — — — — — No. of Crews 343 286 233 313 321 334 510 445 383 311 274 264 4,017 No. of Foreign Arrivals 47 54 36 36 43 48 45 68 46 40 43 44 550 APPENDIX II. Infectious Disease. Disease. 1923. 1924. 1925. 1926. 1927. 1928. 1929. 1930. 1931. Mean Annual No. for 10 years ending 31st Dec., 1932. 1932. (a) Cases Reported : Cholera (including suspected cases) 3 1 — 26 6 5 2 1 1 4.8 3 Yellow Fever (ditto) — — — 2 — — — — — .2 — Plague (ditto) 4 1 3 1 — 2 1 — — 1.2 — Small-pox 12 17 27 20 14 8 22 11 14 15.9 14 Scarlet Fever 6 8 22 6 17 16 11 29 7 13.4 12 Diphtheria 29 23 23 13 13 13 17 9 16 16.6 10 Enteric Fever 49 42 49 50 36 72 46 25 23 41.5 23 Measles 82 46 77 94 21 47 48 50 11 50.1 25 German Measles 19 18 14 7 5 65 9 6 3 16.8 22 Erysipelas 2 5 2 5 2 4 4 2 2 3.0 2 Typhus Fever — — — — — — — — — — — Continued Fever 4 2 — 4 2 2 — 1 — 1.5 — Relapsing Fever 2 — — — — 1 — — — .3 — Tuberculosis :—- Pulmonary 83 90 82 86 82 86 126 116 147 103.3 135 Other kinds 6 6 11 2 1 4 7 4 4 4.9 4 Other diseases (including Chickenpox) 336 319 363 471 667 499 653 904 1,118 612.1 791 Total 637 578 673 787 866 824 946 1,158 1,346 885.6 1041 (b) Treated in Poet Sanitary Hospital : Cholera (including suspected cases) — — — — — — — — — — — Yellow Fever (ditto) — — — — — — — — — — — Plague (ditto) — — — — — — — — — — — Small-pox 3 — 3 5 3* — 4 — — 1.8 — Typhus Fever — — — — — — — — — — — Scarlet Fever — 6 16 8 5* 5 7 12* — 6.3 4 Diphtheria 1 1 4 2 6 9 5 3 1 3.6 4 Enteric Fever 10 13 6 14 6 20 23 9 4 11.4 9 Measles 1 8 7 9 7† 11 ‡18 **22 — 7.4 1 Erysipelas 2 1 — 2 — 1 — 1 — .7 — Parotitis — — — — — — — — 21 2.3 2 Continued Fever 2 — — — — — — — — .2 — Other diseases (including Chicken- pox) 10 31 89 23 20 29 30 *19 *23 25.7 33 Total 29 60 75 63 47 75 87 56 49 59.4 53 * Includes one contact. ** Includes three contacts. † Includes two contacts. ‡ Includes six contacts. 52 APPENDIX III. Return of the number of cases of Infectious Disease notified to the Ministry of Health during the year 1932, 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 which had either recovered or been removed from the vessel before arrival at Gravesend. Number. Deaths. Number. Deaths. Small-pox 2 — Brought forward 86 — Scarlet Fever 8 — Continued Fever — — Diphtheria (including Membranous Croup) 7 — Dysentery 3 — Ophthalmia Neonatorum — — Enteric Fever (Typhoid and Paratyphoid) 11 — Erysipelas 2 — Tuberculosis— Pneumonia 8 — Respiratory 95 2 Cholera — — Other kinds 3 — Plague — — Malaria 12 — Puerperal Fever — — Chicken-pox 20 — Puerperal Pyrexia — — Measles (including German Measles) 11 — Acute Poliomyelitis — — Acute Polioencephalitis — — Whooping Cough 2 — Encephalitis Lethargica — — Other Diseases 12 1 Typhus Fever — — Relapsing Fever — — Total 196 3 Carried forward 36 — APPENDIX IV.—Cholera. Date. 1932. Name of Vessel. Where from. No. of Cases. Passenger or Crew Rating. How dealt with. (a) Landed from Vessels—Nil. (b) Died, Landed elsewhere or well on Arrival— Oct. 13 ss. "Patroclus" Dairen 3 Crew Landed at Kobe. Total 3 (Crew) APPENDIX V.—Small-pox. Date. 1932. Name of Vessel. Where from. No. of Cases Passenger or Crew 3. Rating. How dealt with (a) Landed from Vessels— Sept. 14 Sailing Barge " Blue Mermaid " Mistley, Essex 1 Crew Admitted to London County Council Hospital. Nov. 6 ss. " Lorca " Basra 1 Crew Admitted to London County Council South Wharf Hospital. Total 2 (Crew) (b) Died, Landed elsewhere or well on Arrival— Jan. 20 ss. "City of Perth" Dalny 1 Crew Landed at Dalny. Feb. 21 ss. "Merkara" Calcutta 2 Crew Landed at Aden. Mar. 20 ss. "Cheshire" Rangoon 1 Crew Landed at Rangoon. „ 23 ss. "Tainui" Wellington 1 Pass. Landed at Southampton. June 3 ss. "Comorin" Brisbane 1 Crew Landed at Marseilles. Nov. 4 ss. "Floristan" Basra 1 Crew Landed at Aden. „ 22 ss. "Jervis Bay" . . Brisbane 1 Pass. Died. Buried at sea. „ 29 ss. "British Splendour" Abadan 4 Crew (10 Crew) 1 Landed at Gibraltar. 3 Landed at Rouen. Total 12 (2 Passengers) 53 APPENDIX VI.—Scarlet Fever. Date. 1932. Name of Vessel: Where from. No. o: Cases. Passenger f or Crew Rating. How dealt with. (a) Landed feom Vessels— July 2 Training Ship "Arethusa" Lying at Greenhithe 2 Crew Admitted to Port Sanitary Hospital, Denton. „ 6 „ „ "Arethusa" Ditto. 1 Crew Ditto. „ 11 „ „ "Arethusa" Ditto. 1 Crew Ditto. Dec. 3 „ „ "Stork" Lying at Hammersmith. 1 Crew Admitted to London County Council Grove Hospital, Hammersmith. „ 5 „ ,, "Stork" Ditto. 2 Crew Admitted to London County Council North - Eastern Hospital. Total 7 (Crew) (b) Died, Landed elsewhere or well on Arrival— May 12 ss. "Orford" Brisbane 1 Pass. Landed at Southampton. June 15 ss. "Ionie" Wellington 1 Pass. Ditto. July 1 ss. "Narkunda" Brisbane 1 Crew Well on arrival. Aug. 5 ss. "Strathaird" Mediterranean Cruise 1 Pass. (2 Crew) Landed at Monaco. Total 4 (2 Passengers) (c) Private Dock Residence— Jan. 24 No. 1, Limehouse Basin Cottages. - 1 - Admitted to Brook Hospital, Woolwich, S.E. Total 1 (Resident) APPENDIX VII.—Diphtheria. Date. 1932. Name of Vessel. Where from. No. of Cases. Passenger : or Crew Rating. How dealt with. (a) Landed from Vessels— Feb. 29 ss. "Lord Londonderry" (In Dock) 1 Crew Admitted to Seamen's Hospital, Greenwich. May 9 ss. "Alaunia" Montreal 1 Crew Admitted to Port Sanitary Hospital. Denton. „ 26 ss. "Orama" Brisbane 1 Crew Ditto. June 9 ss. "Royal Eagle" Thames Pleasure Steamer. 1 Crew Admitted to Seamen's Hospital, Greenwich. July 7 ss. "Port Wellington" Hamburg 1 Crew Admitted to Port Sanitary Hospital, Denton. „ 8 ss. "Moldavia" Mediterranean Cruise 1 Pass. Ditto. „ 19 ss. "Rajputana" Yokohama 1 Pass. (5 Crew) Ditto. Total 7 (2 Passengers) (b) Died, Landed elsewhere or well on Arrival— Mar. 3 ss. "Durham Castle" Capetown 1 Pass. Landed at Genoa. April 10 ss. "Barrabool" Brisbane 1 Pass. Well on arrival. May 20 ss. "Prahsu" Alexandria 1 Pass. Convalescent on arrival. Total 3 (Passengers) 54 APPENDIX VIII.—Enteric Fever. Date. 1932. Name of Vessel. Where from. No. of Cases. Passenger or Crew Rating. How dealt with. (a) Landed from Vessels— Jan. 1 ss. "Viceroy of India" Bombay 1 Crew Admitted to Port Sanitary Hospital, Denton. Feb. 3 ss."Staffordshire" Rangoon 1 Crew Ditto. „ 5 ss. "Cathay" Brisbane 1 Pass. Admitted to L.C.C. Whipps Cross Hospital. April 21 ss. "Almeda Star" Buenos Aires 1 Pass. Admitted to Port Sanitary Hospital, Denton. 29 ss. "Viceroy of India" Bombay 1 Pass. Ditto. July 7 ss. "Oronsay" Brisbane 2 Crew Ditto. Aug. 8 ss. "Oxfordshire" Rangoon 1 Crew Ditto. „ 12 ss. "Ormonde" Mediterranean Cruise 1 Crew Ditto. , 12 ss. "Umlazi" Beira 1 Crew Ditto. Oct. 21 ss. "Elie" Githaean 1 Crew (8 Crew) Ditto. Total 11 (3 Passengers) (b) Died, Landed elsewhere or well on Arrival— Feb. 15 ss. "Fushima Mara" Yokohama 1 Crew Landed at Colombo. Mar. 17 ss. "Highland Monarch" Buenos Aires 1 Crew Landed at Buenos June 1 ss. "Llangibby Castle" Mombasa 1 Crew Aires. Landed at Southampton. July 1 ss. "Narkunda" Brisbane 1 Pass. Landed at Gibraltar. „ 8 ss. "Eanchi" Yokohama 1 Pass. Landed at Suez. „ 29 ss. "Carthage" Brisbane 1 Pass. Convalescent on arrival. Aug. 7 ss. "Ormonde" Mediterranean Cruise 2 Crew 1 landed at Gibraltar. 1 landed at Southampton. Sept. 30 ss. "Durinda" Karachi 1 Crew Well on arrival. Oct. 3 ss. "Manora" Calcutta 1 Crew Landed at Aden. „ 27 ss. "Almeda Star " Buenos Aires 1 Pass. Convalescent on arrival. Nov. 16 ss. "Llangibby Castle" Port Louis 1 Pass. (7 Crew) Landed at Southampton. Total 12 (5 Passengers) APPENDIX IX.—Measles. Date. 1932. Name of Vessel. Where from. No. of Cases. Passenger or Crew Rating. How dealt with. (a) Landed from Vessels— May 9 ss. "Alaunia" Montreal 1 Pass. Admitted to Port Sanitary Hospital, Denton. „ 27 Training Ship "Stork" Lying at Hammersmith. 1 Crew Admitted to L.C.C. Hospital, Hammersmith. „ 28 ,, „ "Stork" Ditto 1 Crew Ditto. June 10 „ "Stork" Ditto 1 Crew (3 Crew) Ditto. Total 4 (1 Passenger) 55 Measles—continued. Date. 1932. Name of Vessel. Where from. No. of Crew Passenger or Crew Eating. r How dealt with. (b) Died, Landed elsewhere of well on Aeeival— Jan. 14 ss. "Orford" Brisbane 2 Pass. 1 landed at Toulon. 1 well on arrival. „ 19 ss. "Esperance Bay" Brisbane 1 Pass. Landed at Southampton. Feb. 13 ss. "Ingoma" Demerara 1 Crew Well on arrival. Mar. 23 ss. "Ausonia" New York 2 Pass. Convalescent on arrival. April 4 ss. "Alaunia" New York 2 Pass. Landed at Havre. „ 5 ss. "Jamaica Settler" Kingston 1 Pass. Well on arrival. „ 11 ss. "Otranto" (Cruising) 1 Pass. Landed at Algiers. „ 29 ss. "Rajputana" Yokohama 1 Pass. Well on arrival. May 3 ss. "Celtic Star" Chefoo 2 Crew Ditto. June 9 ss. "Highland Chieftain" Buenos Aires 1 Pass. Ditto. „ 29 ss. "Baltavia" Riga 1 Crew Ditto. July 21 ss. "Naldera" Yokohama 1 Pass. Convalescent on arrival. Sept. 16 ss. "Avila Star" Buenos Aires 1 Pass. Well on arrival. Oct. 19 ss. "Llandaff Castle" Mombasa 4 Crew (8 Crew) Landed at Southampton. Total 21 (13 Passengers) APPENDIX X.—German Measles. Date. 1932. Name of Vessel. Where from. No. of. Cases, Passenger. or Crew Rating. How dealt with (a) Landed from Vessels— July 6 Training Ship "Arethusa" Lying at Greenhithe 1 Crew Admitted to Port Sanitary Hospital, Denton. „ 10 ,, ,, "Arethusa" Ditto 3 Crew Ditto. „ 15 ,, ,, "Arethusa" Ditto 4 Crew Ditto. „ 19 „ „ "Arethusa" Ditto 2 Crew Isolated on board. Total 10 (Crew) (b) Died, Landed elsewheee oe well on Aeeival— Jan. 22 ss. "Maloja" Brisbane 1 Pass. Well on arrival. April 1 ss. "Naldera" Yokohama 2 Pass. Ditto. „ 10 ss. "Barrabool" Brisbane 5 Pass. Convalescent on arrival. May 13 ss. "Corfu" Yokohama 1 Pass. Well on arrival. 27 ss. "Rawalpindi'' Yokohama 2 Pass. Convalescent on arrival. Aug. 2 ss. "Alaunia" Montreal 1 Pass. Ditto. Total 12 (Passengers) APPENDIX XL—Erysipelas. Date. 1932. Name of Vessel. Where from. No. of Cases. Passenger or Crew Rating How dealt with. (a) Landed from Vessels— Jan. 22 ss. "Dunluce Castle" Beira 1 Crew Admitted to a London hospital. Aug. 27 House Boat "Taj Mahal" Lying in Leigh Creek. 1 Resident (1 Crew) Remained on board. (Slight case.) 2 (1 Resident) (b) Died, Landed elsewhere or well on Aeeival—Nil. 56 APPENDIX XII.—Pulmonary Tuberculosis. Date. 1932. Name of Vessel. Where from. No. of Cases. Passenger or Crew Rating. How dealt with. (a) Landed from Vessels— Jan. 5 ss. "Carthage" (In Dock) 1 Crew Admitted to Seamen's Hospital, Greenwich. „ 9 ss. "Rajputana" Yokohama 1 Pass. Proceeded home. „ 10 ss. "Kashima Maru" Antwerp 1 Crew Admitted to Seamen's Hospital, „ 19 ss. "Registan" — 1 Crew Royal Albert Dock. Admitted to Seamen's Hospital, Greenwich. „ 21 ss. "Corfu" Yokohama 5 Pass. 4 proceeded to Royal Naval Hospital, Chatham. „ 28 ss. "Orama" Brisbane 2 Pass. 1 proceeded home. Proceeded home. Feb. 3 ss. "Holmlea" Burutu 1 Crew Ditto. „ 22 ss. "Raranga" New Zealand 1 Crew Admitted to Seamen's Hospital, Greenwich. „ 25 ss. "Hobsons Bay" Brisbane 1 Pass. Proceeded home. „ 27 ss. " Charlbury " Eosario 1 Crew Ditto. Mar. 4 ss. "Chitral" Yokohama 1 Pass. Admitted to Seamen's Hospital, Greenwich. „ 10 ss. "Oronsay" Brisbane 1 Pass. Proceeded home. ,. 18 ss. "Margha" Calcutta 2 Pass. Ditto. „ 28 ss. "Llanstephan Castle" Capetown 1 Pass. Ditto. „ 31 ss. "Sultan Star" Buenos Aires 1 Crew Ditto. April 1 ss. "Naldera" Yokohama 2 Pass. Proceeded in charge of Military Authorities. „ 8 ss. "Malwa" Bombay 1 Pass. Proceeded home. „ 10 ss. "Barrabool" Brisbane 3 Pass. Ditto. „ 15 ss. "Carthage" Yokohama 2 Pass. Proceeded in charge of Military Authorities. „ 15 ss. "Mooltan" Brisbane 3 Pass. 1 proceeded home. 2 proceeded in charge of Naval ties. „ 29 ss. "Rajputana" Yokohama 6 Pass. 5 proceeded in charge of Naval Authorities. 1 proceeded in charge of Military Authorities. May 1 ss. "Ausonia" Montreal 1 Pass. Proceeded home. „ 6 ss. "Maloja" Brisbane 2 Pass. Proceeded in charge of Naval Authorities. „ 13 ss. "Corfu" Yokohama 1 Pass. Ditto. „ 14 ss. "Balranald" Brisbane 3 Pass. 2 proceeded in charge of Naval Authorities. „ 27 ss. "Rawalpindi" Yokohama 1 Pass. 1 proceeded home. Proceeded in charge of Naval Authorities. June 2 ss. "Madura" Beira 1 Crew Proceeded home. „ 10 ss. "Eanpura" Yokohama 1 Pass. Proceeded in charge of Naval Authorities. „ 11 ss. "Manora" Calcutta 2 Pass. Proceeded home. „ 16 ss. "Mongolia" Brisbane 1 Crew Ditto. „ 17 ss. "Malwa" Bombay 1 Crew Admitted to Seamen's Hospital, Tilbury Dock. „ 23 ss. "Baradine" Brisbane 2 Crew 1 proceeded gome. 1 proceeded by Ambulance to Netley Hospital. Carried forward 54 57 Pulmonary TubeRculosis—continued. Date. 1932. Name of Vessel. Where from. No. of Cases. Passenger or Crew Rating. How dealt with. ss. "Chitral" Brought forward 54 Pass. Proceeded in charge of Naval Authorities. June 25 Yokohama 1 „ 28 ss. "Manela" Calcutta 1 Pass. Admitted to Seamen's Hospital,Greenwich. July 1 ss. "Narkunda" Brisbane 1 Pass. Proceeded home. „ 8 ss. "Ranchi" Yokohama 2 Pass. 1 proceeded in charge of Military Authorities. 1 proceeded in charge of Naval Authorities. „ 12 ss. "Matheran" Calcutta 1 Pass. Proceeded home. ,, 22 ss. "Ballarat" Brisbane 3 Pass. Proceeded to Netley Hospital. „ 29 ss. "Carthage" Brisbane 1 Pass. Proceeded in charge of Military Authorities. „ 29 ss. "Lapland" Mediterranean 1 Crew Proceeded toAntwerp. Aug. 4 ss. "Otranto" Brisbane 2 Pass. 1 proceeded home. 1 proceeded to Finnish Mission to await transhipment to Finland. „ 5 ss. "Kaisar-I-Hind" Yokohama 1 Pass. Proceeded in charge of Military Authorities. „ 7 ss. "Aurania" Montreal 1 Pass. Proceeded to Finland. „ 8 ss. "Oxfordshire" Rangoon 1 Pass. Proceeded home. „ 9 ss. "Llandaff Castle" Mombasa 1 Crew Admitted to Seamen's Hospital,Greenwich. „ 13 ss. "Alaunia" Montreal 1 Crew Ditto. „ 19 ss. "Barrabool" Brisbane 1 Pass. Ditto. „ 23 ss. "Viceroy of India" — 1 Crew Ditto. „ 23 ss. "Largs Bay" — 1 Crew Ditto. „ 26 ss. "Corfu" Brisbane 4 Pass. 3 admitted to R.A.F. Hospital, Halton. 1 Crew 1 admitted to R.N. Hospital, Chatham. Admitted to Seamen's Hospital, Royal Albert Dock. „ 30 ss. "Alejandro" Magallanes 1 Crew Admitted to Seamen's Sept. 1 ss. "Orsova" Brisbane 1 Pass. Hospital,Greenwich. Proceeded home. „ 15 ss. "Balranald" Brisbane 1 Pass. Ditto. „ 17 ss. "Rawalpindi" Yokohama 1 Pass. Ditto. Oct. 3 ss. "Gloucester Castle" Mombasa 1 Crew Ditto. „ 3 ss. "Ranpura" Yokohama 1 Pass. Proceeded in charge of Naval Authorities. „ 13 ss. "Bendigo" Brisbane 2 Pass. Admitted to Royal Herbert Hospital, Woolwich (military cases). „ 14 ss. "Malwa" Bombay 1 Crew Proceeded home. Nov. 8 ss. "Gaboon" W. Africa 1 Crew Admitted to Seamen's Hospital, Royal Albert Dock. „ 25 ss. "Naldera" Yokohama 3 Pass. Proceeded in charge of Naval Authorities. „ 26 ss. "Ballarat" Brisbane 1 Pass. Proceeded home. Deo. 9 ss. "Rajputana" Yokohama 1 Crew Proceeded in charge of Naval Authorities. „ 22 ss. "Orontes" Port Said 3 Pass. Ditto. „ 28 ss. "Tuscan Star" Buenos Aires 1 Crew Proceeded home. „ 29 ss. "Rangitiki" Wellington 1 Pass. (24 Crew) Proceeded in charge of Naval Authorities. Total 100 (76 Pass.) 58 Pulmonary Tuberculosis—continued. Date. 1932. Name of Vessel. Where from. No. of Cases. Passenger or Crew Rating. How dealt with. (b) Died, Landed elsewhere or well on Arrival— Feb. 12 ss. "Ranpura" Bombay 3 Pass. Landed to Naval Hospital at Plymouth. „ 12 ss. "Mathura" Calcutta 1 Crew Landed at Colombo. „ 25 ss. "Baradine" Brisbane 1 Pass. Landed to Naval Hospital, Plymouth. „ 29 ss. "Clan Ogilvy" Chittagong 1 Crew Landed at Madras. Mar. 24 ss. "Nigaristan" Basrah 1 Crew Died in Hospital at Oran. May 3 ss. "Laguna" Falkland Islands 1 Crew Landed at Valparaiso. „ 13 ss. "Garth Castle" Beira 1 Pass. Landed at Southampton. July 5 ss. "Defender" Calcutta 1 Crew Landed at Port Said. „ 7 ss. "Oronsay" Brisbane 1 Pass. Died; buried at sea. „ 17 ss. "American Merchant" New York 1 Crew Died; body for return to New York. „ 22 ss. "Ballarat" Brisbane 1 Pass. Landed at Plymouth. „ 31 ss. "Bardiros" Teneriffe 1 Pass. Alien in transit to Norway. Aug. 5 ss. "Kaisar-I-Hind" Yokohama 1 Pass. Landed at Plymouth. Sept. 15 ss. "Balranald" Brisbane 3 Pass. Ditto. Oct. 13 ss. "Highland Monarch" Buenos Aires 1 Pass. Landed at Vigo. „ 27 ss. "Highland Chieftain" Buenos Aires 1 Pass. Ditto. Nov. 11 ss. "Carthage" Yokohama 1 Pass. Landed at Marseilles en route for Switzerland. „ 14 ss. "Ascania" Montreal 1 Pass. Landed at Havre. „ 18 ss. "Moldavia" Australia 2 Pass. Convalescent on arrival. „ 22 ss. "Jervis Bay" Brisbane 2 Pass. Landed at Southampton. Dec. 6 ss. "Ausonia" Montreal 1 Pass. Landed at Havre. „ 9 ss. "Rajputana" Yokohama 1 Pass. Landed at Plymouth. 3 Crew Ditto. „ 14 ss. "Llandovery Castle" Mombasa 1 Crew Landed at Durban. „ 23 ss. "Corfu" Yokohama 2 Pass. Landed at Plymouth. „ 23 ss. "Barrabool" Brisbane 1 Pass. (10 Crew) Ditto. Total 35 (25 Pass.) APPENDIX XIII.—Tuberculosis (other kinds). Date. 1932. Name of Vessel. Where from. No. of Cases. Passenger or Crew Rating. How dealt with. (a) Landed from Vessels— Feb. 10 Training Ship "Arethusa" — 1 Crew Admitted to Guy's Hospital. Mar. 4 ss. "Rawalpindi" Calcutta 1 Crew Admitted to Seamen's Hospital, Greenwich. May 14 ss. "El Argentino" Buenos Aires 1 Crew Admitted to Seamen's Hospital, Royal Albert Dock. Total 3 (Crew) (b) Died, Landed elsewhere or well on Arrival— Nov.18 ss. "Rawalpindi" Bombay 1 Pass. Landed at Plymouth. Total 1 (Passenger) 59 APPENDIX XIV.—Pneumonia. Date. 1932. Name of Vessel. Where from. No. of Cases. Passenger or Crew Rating. How dealt with. (a) Landed from Vessels— April 12 ss. "Wynding" - 1 Crew Admitted to Seamen's Hospital, Greenwich. May 12 ss. "City of Exeter" Calcutta 1 Crew Admitted to Seamen's Hospital, Tilbury. „ 16 ss. "Aurania" Montreal 1 Pass. Ditto. Nov. 11 ss. "Carthage" Yokohama 1 Crew Ditto. Dec. 8 ss. "Otranto" Brisbane 1 Pass. Ditto. „ 12 ss. "City of Hongkong" Calcutta 1 Crew Ditto. „ 15 ss. "Mongolia" Brisbane 1 Pass. Admitted to a London hospital (?) „ 19 ss. "Sanda" - 1 Crew (5 Crew) Admitted to Seamen's Hospital, Royal Albert Dock. Total 8 (3 Passengers) (b) Died, Landed elsewhere oh well on Arrival— Jan. 14 ss. "Orford" Brisbane 1 Crew Well on arrival. Feb. 3 ss. "Mandala" Calcutta 1 Crew Died; buried at sea. April 5 ss. "City of York" Calcutta 1 Crew Convalescent on arrival. „ 27 ss. "Rangitiki" Auckland 2 Pass. Ditto. 1 Crew Ditto. May 7 ss. "Inanda" Demerara 1 Crew Ditto. „ 19 ss. "Memnon" Yokohama 1 Pass. Died; body landed at Tor. June 11 ss. "Worcestershire" Rangoon 1 Crew Convalescent on arrival. July 9 ss. "Marghetta" Colombo 1 Crew Landed at Colombo. „ 21 ss. "Highland Patriot" Buenos Aires 1 Pass. Landed at Las Palmas. „ 27 ss. "Llandaff Castle" Mombasa 1 Pass. Died ; buried at sea. 1 Crew Ditto. Oct. 7 ss. "City of Wellington" Calcutta 1 Crew Ditto. Nov. 4 ss. "Mantua" Bombay 1 Crew Landed at Aden. Dec. 10 ss. "Ardenvohr" Dakar 1 Crew Landed at Auckland. „ 31 ss. "Clan Macquarrie" Calcutta 2 Crew (13 Crew) Landed at Aden. Total 18 (5 Passengers) APPENDIX XV.—Influenza. Date. 1932. Name of Vessel, Where from. No. of Cases. Passenger or Crew Rating. How dealt with. (a) Landed feom Vessels— Jan. 15 ss. "Ranchi" Bombay 1 Pass. Proceeded home. Mar. 3 ss. "Iskra" Murmansk 1 Crew Admitted to Port Sanitary Hospital, Denton. Dec. 6 ss. "Ausonia" Montreal 3 Crew Admitted to Seamen's Hospital, Greenwich. — (4 Crew) Total 5 (1 Passenger) (b) Died, Landed elsewheee of well on Aeeival— April 22 ss. "Strathnaver" Brisbane 40 Pass. Well on arrival. „ 27 ss. "Rangitiki" Auckland 58 Pass. and Crew Ditto. Dec. 6 ss. "Ausonia" Montreal 92 Pass. Ditto. 29 Crew „ 8 ss. "Otranto" Brisbane 20 Pass. Ditto. „ 14 ss. "Ascania" New York 25 Pass. Ditto. 20 Crew (78 Crew) Ditto. Total 284 (206 Passengers) 60 APPENDIX XVI.—Dysentery. Date. 1932. Name of Vessel. Where from. No. of Cases. Passenger or Crew Rating. How dealt with. (a) Landed feom Vessels— Jan. 9 ss. "Clan Malcolm" Mauritius 1 Crew Remained on board. May 24 ss. "Modasa" Bombay 1 Crew Admitted to Seamen's Hospital, Royal Albert Dock. Oct. 14 ss. "City of Lincoln" Calcutta 1 Crew To attend Seamen's Hospital, Tilbury. Nov. 17 ss. "Avila Star" Buenos Aires 1 Pass. Admitted to Hospital for Tropical Diseases, Endsleigh Gardens, W.C. — (3 Crew) Total 4 (1 Passenger) (b) Died, Landed elsewhere or well on Arrival— Jan. 19 ss. "Esperance Bay" Brisbane 1 Pass. Landed at Southampton. Feb. 21 ss. "Merkara Calcutta 3 Crew All landed at Aden. June 17 ss. "Malwa" Bombay 1 Pass. Died; buried at sea. „ 28 ss. "Manela" Calcutta 1 Pass. Well on arrival. Oct. 5 ss. "Temple Moat" Sourabaya 4 Crew 1 died in Hospital abroad. 1 landed at Port Said. 2 recovered. „ 12 ss. "Dalveen" Khersan 1 Crew Landed at Port Said. Nov. 4 ss. "Mantua" Bombay 1 Pass. Convalescent on arrival. „ 18 ss. "Rawalpindi" Bombay 1 Pass. (8 Crew) Well on arrival. Total 13 (5 Passengers) APPENDIX XVII.—Malaria. Date. 1982. Name of Vessel. Where from. No. of Cases. Passenger or Crew Rating. How dealt with. (a) Landed from Vessels— Jan. 26 ss. "Culebra" Bermuda 1 Crew Admitted to Seamen's Hospital, Royal Albert Dock. Mar. 25 ss. "Barbara Marie" Burutu 1 Crew Admitted to Seamen's Hospital, Greenwich. June 17 ss. "Malwa" Bombay 1 Pass. Proceeded home by Ambulance. July 29 ss. "Carthage" Brisbane 1 Pass. Proceeded home. 1 Crew Treated and remained on board. Aug. 26 ss. "Mashobra" Beira 1 Pass. Admitted to Hospital for Tropical Diseases, Endsleigh Gardens. „ 28 ss. "Ausonia" Montreal 1 Pass. Ditto. Nov. 4 ss. "City of Hankow" Calcutta 1 Crew Admitted to Seamen's Hospital, Tilbury. „ 5 ss. "Clan Macbride" Beira 2 Crew Admitted to Seamen's Hospital, Greenwich. „ 11 ss. "Lorca" Lying at Bellamy's Wharf. 1 Crew Admitted to Port Sanitary Hospital, Denton. Dec. 5 ss. "Alfred Jones" Oporto 1 Crew Admitted to Seamen's Hospital, Royal Albert Dock. „ 22 ss. "Almeda Star" Buenos Aires 1 Crew (9 Crew) Ditto. Total 13 (4 Passengers) 61 Malaria—continued. Date. 1932. Name of Vessel. Where from. No. of Cases. Passenger or Crew Rating. How dealt with. (b) Died, Landed elsewhere or well on Arrival— Jan.18 ss. "Mashobra" Calcutta 1 Pass. Landed at Marseilles. Feb. 3 ss. "Holmlea" Burutu 1 Crew Well on arrival. „ 9 ss. "Llandaff Castle" Mombasa 1 Pass. Ditto. „ 27 ss. "Beech Park" Opobo 2 Crew. Ditto Mar. 20 ss. "Cheshire" Rangoon 4 Crew Ditto. 1 Pass. Ditto. April 17 ss. "Shropshire" Rangoon 1 Crew Ditto. May 7 ss. "Inanda" Demerara 1 Pass. Ditto. „ 12 ss. "Burma" Rangoon 1 Pass. Convalescent and proceeded home. „ 15 ss. "Farndale" Warri 1 Crew Convalescent; remained on board. June 9 ss. "Durham Castle" Beira 1 Pass. Died ; buried at sea. „ 9 ss. "Floristan" Busrah 1 Crew Landed at Oran. „ 25 ss. "Makalla" Calcutta 1 Crew Well on arrival. July 2 ss. "Llandovery Castle" Beira 1 Crew Died ; buried at sea. „ 4 ss. "Mary Kingsley" Douala 1 Pass. Well on arrival. Sept. 24 ss. "Phoenician" New Orleans 1 Crew Ditto. Oct. 30 ss. "Mary Slessor" Lagos 6 Crew Ditto. Nov. 19 ss. "Macgregor Laird" Sapele 2 Crew Ditto. Dec. 8 ss. "City of Durban" Busrah 1 Crew Ditto. „ 12 ss. "Dagomba" Lagos 4 Crew (26 Crew) Ditto. Total 33 (7 Passengers) APPENDIX XVIII.—Chicken-pox. Date. 1932. Name of Vessel. Where from. No. of Cases. Passenger or Crew Rating. How dealt with. (a) Landed from Vessels— Jan. 5 ss. "City of Exeter" Calcutta 1 Crew Admitted to Port Sanitary Hospital, Denton. Mar. 4 ss. "Ranpura" (Outward bound) 1 Pass. Ditto. „ 20 ss. "Cheshire" Rangoon 3 Crew Ditto. „ 24 ss. "Cheshire" Rangoon 4 Crew Ditto. „ 26 ss. "Cheshire" Rangoon 1 Crew Ditto. April 25 ss. "Clan Kenneth" Marmagao 1 Crew Ditto. July 17 ss. "Ascania" Montreal 3 Pass. Proceeded home. „ 27 Training Ship "Worcester" Lying at Greenhithe. 4 Crew Admitted to College Sanatorium, Ingress Abbey. Aug. 8 ss. "Warszawa" Gdynia 2 Crew Admitted to Port Sanitary Hospital, Denton. Oct. 24 ss. "Alaunia" Montreal 1 Crew Admitted to London County Council South Eastern Hospital. Dec. 21 ss. "City of Harvard" Rangoon 1 Crew (18 Crew) Admitted to Port Sanitary Hospital, Denton. Total 22 (4 Passengers) (b) Died, Landed elsewhere or well on Arrival— Jan. 18 ss. "American Farmer" New York 2 Pass. Well on arrival. Feb. 12 ss. "Mathura" Calcutta 1 Crew Landed at Colombo. „ 21 ss. "Merkara" Calcutta 4 Crew Landed at Plymouth. „ 28 ss. "Clan Ogilvy" Chittagong 1 Crew Landed at Chittagong. Mar. 4 ss. "Clan MacVicar" Marmagao 1 Crew Landed at Bombay. „ 17 ss. "Narkunda" Brisbane 1 Pass. Well on arrival. „ 18 ss. "Nardana" Townsville 2 Crew Ditto. „ 20 ss. "Cheshire" Rangoon 2 Drew Landed at Colombo. Carried forward 14 62 Chicken-pox—continued. Date. Name of Vessel. Where from. No. of Cases Passenger or Crew Rating. How dealt with. 1932. April 1 ss. "Moldavia" Brought forward 14 Pass. Proceeded home. Brisbane 1 „ 1 ss. "Naldera" Yokohama 1 Pass. Well on arrival. „ 8 ss. "Malwa" Bombay 1 Pass. Landed at Marseilles. „ 13 ss. "Erria" Bangkok 1 Pass. Proceeded home. „ 13 ss. "Sagaing" Rangoon 1 Crew Well on arrival. „ 29 ss. "Mashobra" Calcutta 1 Pass. Proceeded home. „ 29 ss. "Rajputana" Yokohama 2 Pass. Well on arrival and proceeded home. 5 Crew „ 30 ss. "Diplomat" Calcutta 1 Crew Landed at Colombo. May 16 ss. "Suecia" Goteburg 1 Pass. Well on arrival. June 6 ss. "Franconia" World Cruise 1 Pass. Landed at Plymouth. Oct. 7 ss. "Chitral" Brisbane 3 Crew (21 Crew) Landed at Aden. Total 33 (12 Passengers) APPENDIX XIX.—Cerebro-Spinal Meningitis. Date. 1932. Name of Vessel. Where from. No. of Cases Passenger or Crew Rating. How dealt with. (a) Landed from Vessels— April 5 ss. "Clan MacBean" Chittagong 1 Crew Admitted to Seamen's Hospital, Tilbury. July 16 Training Ship "Stork" Lying at Hammersmith. 1 Crew Admitted to Western Hospital, Hammersmith. Dee. 22 ss. "City of Hongkong" Calcutta 2 Crew Admitted to Seamen's Hospital, Tilbury. Total 4 Crew (b) Died, Landed elsewhere or well on Arrival— April 20 ss. "Manaar" Calcutta 2 Crew 1 landed at Baltimore ; 1 died buried at sea. Total 2 Crew APPENDIX XX.—MUMPS. Date. 1932. Name of Vessel. Where from. No. of Cases Passenger or Crew , Rating. How dealt with. (a) Landed from Vessels—Nil. April 28 ss. "City of Poona" Calcutta 2 Crew Admitted to Port Sanitary Hospital, Denton. Aug. 24 ss. "Baltonia" Danzig 1 Pass. (2 Crew) Proceeded home. Total 3 (1 Passenger) (6) Died, Landed elsewhere or well on Arrival— Mar. 8 ss. "Manela" Calcutta 1 Crew Well on arrival. „ 14 ss. "Jeypore" Calcutta 1 Crew landed at Suez. April 28 ss. "City of Poona" Calcutta 2 Crew landed at Port Said. „ 28 ss. "Orsova" Sydney 3 Pass. Convalescent on arrival. May 13 ss. "Corfu" Yokohama 9 Pass. Well on arrival. „ 20 ss. "Strathaird" Brisbane 1 Pass. Convalescent on arrival. June 6 ss. "Franconia" World Cruise 1 Pass. Ditto. Aug. 3 ss. "Orient City" Port Lincoln 1 Crew Well on arrival. Sept. 1 ss. "Orsova" Brisbane 2 Pass. Convalescent on on arrival. „ 2 ss. "Glengarry" Yokohama 2 Pass. Well on arrival. „ 18 ss. "Strathnaver" Mediterranean 1 Crew (6 Crew) Ditto. Total 24 (18 Passengers) 63 APPENDIX XXI.—Miscellaneous Diseases (Classified). OTHER INFECTIOUS DISEASES. Landed from Vessels. Died, Landed elsewere or Well on arrival. OTHER INFECTIOUS DISEASES. Landed from Vessels. Died, Landed elsewhere or Well on arrival. Whooping Cough 5p. 3 P. DISEASES OF THE RESPIRATORY SYSTEM. Brucella Melitensis — 2 P. Anthrax — 1 C. Bronchitis — 1 C. Pleurisy 1 c. 1 C. Hæmoptysis 1 c. 1 c. TROPICAL DISEASES. Dengue Fever — 1 C., 1 P. DISEASES OF THE DIGESTIVE SYSTEM. Kala Azar 1 P. — Beri-beri — 5 C. Appendicitis 9 C. 3 C. Abscess of Liver 1C. — Duodenal Ulcer 1 C. — Gastritis — 1 C., 1 P. CATARRHAL DISEASES. Gastric Ulcer 1C. — Colic — 1 c. Catarrh — 1 C. Jaundice — 1 c. Tonsillitis 2C.,2P. 3 C., 2 P. Diarrhoea — 8 P. Pharyngitis — 1 C. Carcinoma of Throat 1 p. — Cholecystitis 1 c. — Hyperchlorhydria 1 c. — RHEUMATIC CONDITIONS. Cirrhosis of Liver 1 c. — Arthritis — 1 C. Rheumatism 1 c. 1 C. Rheumatic Fever 2 c. — DISEASES OF GEN1TO-urinary SYSTEM. Lumbago 1C. — Urethral Stricture 1 c. — Renal Calculus 1 c. — SEPTIC CONDITIONS. Vesical Calculus 1C. — Abscess 2 C. — Hæmaturia 1C. 1 c. Cystitis — 1 p. Septicaemia 1 C., 1 P. — Hypospadias 1 c. — Septic Sore Throat 2 C. 1 P. Fistula — 2 C. Ischio-rectal Abscess 1 C. — INJURIES. NERVOUS AND MENTAL DISORDERS. Injury 14 C. 6 C., 1 P. Acute Mania 2 P. — DISEASES OF THE EAR. Asthma — 1 C. Insanity Dementia 2 P. 2 C., 1 P. 1 P. Otitis Media 2 C. — Neurasthenia 1 C., 2 P. — DISEASES OF THE EYE. Hemiplegia 1 C. — Epilepsy — 1 P. Paralysis following C Nil. Fever 1 C. — DISEASES OF THE SKIN. DISEASES OF BONES AND JOINTS. Dhobie Itch — 2 P. Prepatellar Bursitis 1 c. — Dermatitis 1 P. — Traumatic Synovitis — 1 C. Herpes Zoster 1 c. — Necrosis of Ankle 1 p. Eczema — 1 C. Scabies — 2 C. Purulent Pemphigus 1 c. — OTHER DISEASES (not Classified). Mycosis Fungoides — 1 P. Pyrexia — 3 C., 2 P. DISEASES OF THE CIRCULATORY SYSTEM. Suicide — 2 C., 2 P. Adenitis — 2 C. Heart Disease 1 p. — Diabetes — 1 P. Heart Failure — 6 C., 2 P. Chill 1 c. — Aneurysm 1 c. — Heat Stroke — 5 C., 2 P. Leukaemia 1 p. 1 P. Unknown 1 c. — Cerebral Haemorrhage — 1 C., 2 P. Senile Decay — 1 P. Aortitis — 1 C. Premature Birth — 1 P. Mitral Stenosis — 1 P. Marasmus 1 p. — 64 APPENDIX XXII.— Venereal Diseases. Number of Cases reported- Crew. Passengers. Syphilis 61 1 Gonorrhoea 220 15 Soft Sore 25 2 Climatic Bubo 1 — 307 18 Total, 325 APPENDIX XXIII. Vessels and Premises Disinfected from 1st January to 31st December, 1932. Month. Reason for Disinfection. Fumigation for Rats, &c. Total. Cerebro-Spinal Meningitis. Mumps. Chicken-pox. Diphtheria. Enteric Fever. German Measles. Measles. Scarlet Fever. Small-pox. Pulmonary Tuberculosis. Influenza and Pneumonia January — — 2 .— 1 — 2 — 1 1 1 13 21 February — — 2 — 3 — — — 1 3 — 13 22 March — 1 2 — — •— 1 — 1 1 1 9 16 April — 2 3 — 2 — 2 — — 3 — 15 27 May — — 1 2 — — 1 1 — 4 1 7 17 June — — 1 1 — — — — — 3 1 10 16 July 1 — 2 2 3 1 — 3 1 7 — 9 29 August — — 1 2 3 1 — 1 — 2 — 8 18 September — — — — — — 1 — 1 3 — 12 17 October — — 1 — 1 — — — 1 1 1 16 21 November ... — — 1 — — — — — 2 5 — 12 20 December ... — — 1 — — — — — — 3 4 14 22 Totals 1 3 17 7 13 2 7 5 8 36 9 138 246 APPENDIX XXIV.—Hospital Number of Cases Admitted, Cost of Maintenance, &c. Patients remaining: in Hospital on 31st December, 1931 Nil. Admitted. Discharged. Died. Remaining under treatment. Chicken-pox 16 16 — — Diphtheria 4 4 — — Enteric Fever 9 9 — — Measles and German Measles 9 9 — — Mumps 2 2 — — Scarlet Fever 4 4 — — Other Diseases 9 9 — — Total 53 53 — — Remaining in Hospital on 31st December, 1932 Nil. Total number of days'treatment during the year 756 Average number of days'treatment for each case 14.3 Average daily number of patients in Hospital 0.14 Average daily cost of maintenance per patient 1s. 3d. Average total cost of maintenance per patient 17s. 11¼d. 65 APPENDIX XXV.— Return of Rats Caught and Destroyed during 1932. The entire cost of destroying these rats has been borne by the Shipowners and Port of London Authority. Jan. Feb. Mar. April. May. June. July. Aug. Sept. Oct. Nov. Dee. Total. Millwall Dock— Warehouses 43 48 63 54 56 54 75 67 84 82 73 68 767 Vessels while in dock 86 189 32 89 56 66 43 112 116 78 10 51 928 Surrey Commercial Dock— Warehouses 71 42 48 81 49 54 59 42 40 57 48 54 645 Vessels while in dock 22 59 9 47 2S 11 126 16 4 23 4 6 355 Regent's Canal Dock— Warehouses 30 24 35 57 26 41 6 2 13 48 24 25 331 Vessels while in dock 60 60 St. Katharine's Dock— Warehouses 115 98 109 95 126 147 111 89 95 99 88 101 1,273 Vessels while in dock — — — — — — — — — — — — — London Dock— Warehouses 68 62 63 Ill 100 50 170 83 79 62 48 88 984 Vessels while in dock — 1 4 — — — — — 2 3 — — 10 Royal Albert Dock— Warehouses 9 26 21 25 26 16 28 21 13 9 21 22 237 Vessels while in dock 55 — 8 66 57 39 31 — 11 32 3 20 322 Royal Victoria Dock— Warehouses 26 57 27 53 65 62 114 49 100 90 51 28 722 Vessels while in dock 26 119 30 18 13 15 13 3 13 24 24 — 298 King George V. Dock— Warehouses 1 — 3 3 7 3 2 9 — 10 5 3 46 Vessels while in dock 14 23 19 18 155 15 32 4 — — — — 280 West India Dock— Warehouses 14 3 28 22 12 11 15 22 22 17 11 17 194 Vessels while in dock 43 17 28 40 37 6 57 23 — 89 93 32 465 East India Dock— Warehouses 3 2 6 3 6 9 16 10 3 8 10 7 83 Vessels while in dock 15 102 3 13 5 14 27 6 21 31 2 3 242 Tilbury Dock— Warehouses 12 37 14 65 19 26 38 33 48 68 29 29 418 Vessels while in dock 24 6 31 48 25 41 18 12 15 20 7 32 279 River— While in River 3 104 73 — 7 95 — — 61 239 121 — 703 Totals 680 1,019 654 908 875 775 981 603 740 1,089 672 646 9,642 Total from 1st January to 31st December, 1932:— In Dock Warehouses 5,698 On Vessels while in Dock and River 3,944 Total 9,642 66 APPENDIX XXVI. BACTERIOLOGICAL EXAMINATION OF RATS DURING 1932. Source. Total Examined. Black Bats. Brown Bats. Species Unknown. Mice. Bats Infected with Plague. Found Dead. Trapped Poisoned, &c. Found Dead. Trapped, Poisoned, &c. Found Dead. Trapped, Poisoned, &c. Found Dead. Trapped. Poisoned, &c. Vessels 725 2 697 – 26 – – – – Nil. London Dock 316 – 38 8 270 – – – – Nil. St. Katharine Dock 326 – 61 – 265 – – – – Nil. Regent's Canal Dock 37 – 2 1 34 – – – – Nil. Surrey Commercial Dock 149 1 56 1 91 – – – – Nil. Poplar Dock 4 – – – 4 – – – – Nil. West India Dock 27 – 8 – 19 – – – – Nil South West India Dock 13 – 1 – 12 – – – – Nil. East India Dock 12 – 11 – 1 – – – – Nil. Royal Victoria Dock 97 – 71 5 21 – – – – Nil. Royal Albert Dock 59 – 10 – 49 – – – – Nil. King George V. Dock 22 – – – 22 – – – – Nil. Tilbury Dock 30 – 28 – 2 – – – – Nil. Millwall Dock 495 – 105 – 390 – – – – Nil. Totals 2,312 3 1,088 15 1,206 – – – – Nil. APPENDIX XXVII. INTERNATIONAL SANITARY CONVENTION. Deratisation Certificates. The number issued during the period covered by this Report was 141:— Date. Name of Vessel. Reason for Deratisation. Action taken. No. of Rats reported found dead after Fumigation or Trapping. 1932, Jan. 2 ss. "Port Hunter " Owners' request for Certificate. Fumigated with Sulphur Dioxide. Nil. ,, 2 ss. "Rangitik " „ Fumigated with Hydrogen Cyanide. Nil. „ 3 ss. "Llanstephan Castle " Rat Infested. „ 19 Fum. 6 Trap. „ 8 ss. "Dunster Grange" Owners' request for Certificate. Fumigated with Sulphur Dioxide. 10 „ 8 ss. "Orsova" „ Fumigated with Hydrogen Cyanide. Nil. „ 15 ss. "Otranto" „ „ Nil. „ 16 ss. "Guildford Castle" Rat Infested. „ 11 Fum. 15 Trap. „ 18 ss. "Kapetan Stratis " Owners' request for Certificate. Trapping 9 „ 20 ss. "Llandovery Castle" „ Fumigated with Hydrogen Cyanide. 32 (Mice) „ 22 ss. "Hardwicke Grange" „ Fumigated with Sulphur Dioxide. 11 „ 23 ss. "Ruahine" „ „ Nil. „ 23 ss. "Beaverhili" „ „ 50 (Mice) „ 29 ss. "Port Victor" „ „ Nil. „ 30 ss. "Sabor" „ Fumigated with Hydrogen Cyanide. 52 Feb. 3 ss. "Koura" „ Trapping 11 Trap. „ 4 ss. "Umkuzi" Rat Infested. Fumigated with Hydrogen Cyanide. 86 „ 5 ss. "Teal" „ „ 9 „ 6 ss. "Holmlea" „ Fumigated with Sulphur Dioxide. 89 67 Deratisation Certificates—continued. Date. Name of Vessel. Reason for Deratisation. Action taken. No. of Rats reported found dead after Fumigation or Trapping. 1932. Feb. 8 ss. "Ines Corrado" Bat Infested. Fumigated with Sulphur Dioxide. 35 „ 8 ss. "Jamaica Producer " Owners' request for Certificate. „ 4 „ 11 ss. "Port Huon" „ „ Nil. „ 12 ss. "Canonesa" „ „ Nil. „ 19 ss. "Polyktor" Bat Infested. „ 75 „ 20 ss. "Ormonde" Owners' request for Certificate. Fumigated with Hydrogen Cyanide. Nil. „ 20 mv. "Eangitata" „ „ Nil. „ 22 ss. "Harmodius" „ Fumigated with Sulphur Dioxide. Nil. „ 27 ss. "Beaverbrae" „ Fumigated with Hydrogen Cyanide. Nil. „ 27 ss. "Rotorua" „ „ Nil. Mar. 1 ss. "Somme" „ „ 23 „ 3 ss. "Malatian" Bat Infested. „ 75 „ 4 ss. "Marquesa" Owners' request for Certificate. Fumigated with Sulphur Dioxide. 4 „ 5 ss. "Baradine" „ „ 18 „ 12 ss. "Beaverburn" „ Fumigated with Hydrogen Cyanide. 292 Mice. „ 12 ss. "Geraldine Mary" „ Fumigated with Sulphur Dioxide. Nil. „ 16 ss. "Colborne" „ „ Nil. „ 18 ss. "Duquesa" „ „ 4 „ 26 ss. "Beaverford" „„ Fumigated with Hydrogen Cyanide. 39 April 2 ss. "Ballarat" „ Fumigated with Sulphur Dioxide. (38 mice) „ 3 ss. "Nigaristan" „ Fumigated with Hydrogen Cyanide. 6 „ 4 ss. "Tainui" „ Fumigated with Sulphur Dioxide. Nil. „ 9 ss. "Corner Brook" „ „ Nil. „ 9 ss. "Port Bowen" „ „ Nil. „ 15 ss. "Dunster Grange" „ „ 10 „ 16 ss. "Minnewaska" „ „ 45 „ 16 ss. "Remuera" „ Fumigated with Hydrogen Cyanide. 3 „ 22 ss. "Rina Corrado" „ Fumigated with Sulphur Dioxide. 4 „ 23 ss. "Beaverdale" „ Fumigated with Hydrogen Cyanide. 47 (17 mice) „ 24 ss. "Glenmoor" „ Fumigated with Sulphur Dioxide. Nil. „ 25 ss. "Banaderos" „ „ (38 mice) „ 29 ss. "Mahia" „ „ 9 „ 30 ss. "Minnetonka" „ „ 27 „ 30 ss. "Gaboon" „ Fumigated with Hydrogen Cyanide. 34 May 2 ss. "Baronesa" „ Fumigated with Sulphur Dioxide. Nil. „ 5 ss. "Tabaristan" „ „ 17 „ 7 ss. "Lancastria" Bat Infested. Fumigated with Hydrogen Cyanide and Trapping. (21 Trap. (75 Fum. „ 9 ss. "Sarthe" „ Fumigated with Hydrogen Cyanide. 22 „ 13 ss. "Hardwicke Grange" Owners' request for Certificate. Fumigated with Sulphur Dioxide. Nil. „ 14 ss. "Bangitiki" „ Fumigated with Hydrogen Cyanide. Nil. „ 27 June 3 ss. "El Argentino" ss. "Port Alma" „ Fumigated with Sulphur Dioxide. 6 Nil. ,, 5 ss. "Northumberland" „ Fumigated with Hydrogen Cyanide. 4 » 8 ss. "Ruahine" „ „ Nil. 68 Deratisation Certificates—continued. No. of Rats reported found dead after Fumigation Date. Name of Vessel. Reason for Deratisation. Action taken. or Trapping. 1932. June 11 ss. "Port Fairy" Owners' request for Certificate. Fumigated with Sulphur Dioxide. Nil. „ 14 ss. "Port Wellington" „ i' Nil. „ 22 ss. "Eangitata" „ Fumigated with Hydrogen Cyanide. Nil. „ 24 ss. "Upwey Grange" „ Fumigated with Sulphur Dioxide. Nil. „ 25 ss. "Port Hobart" „ „ Nil. „ 29 ss. "Duquesa" „ „ 3 „ 30 ss. "Parrakoola" Infested with mice. Fumigated with Hydrogen Cyanide. 275 (mice) July 3 ss. "Inanda" Owners' request for Certificate. „ 4 „ 7 ss. "Jamaica Pioneer" „ „ 12 „ 7 ss. "Colonial" „ „ 15 „ 12 ss. "Governor" „ „ 11 „ 16 ss. "Llanstephan Castle" Bat Infested. Fumigated with Hydrogen 14 Fum. Cyanide and Trapping. 5 Trap. „ 16 ss. "Franconia" Owners' request for Certificate. Fumigated with Hydrogen Cyanide. Nil. „ 16 ss. "Hororata" „ „ 6 „ 22 ss. "Ascania" Bat Infested. Fumigated with Hydrogen Cyanide and Trapping. 37 Fum. 37 Trap. „ 30 ss. "Port Victor" Owners' request for Certificate. Fumigated with Sulphur Dioxide. 283 (mice) Aug. 4 ss. "Baronesa" „ „ Nil. „ 6 ss. "Port Darwin" „ „ Nil. „ 14 ss. "Jamaica Planter" „ Fumigated with Hydrogen Cyanide. 2 „ 17 ss. "Coptic" „ Fumigated with Sulphur Dioxide. Nil. „ 22 ss. "Princesa" „ „ Nil. „ 22 ss. "Mantola" „ Fumigated with Hydrogen Cyanide. Nil. „ 26 ss. "Ernani" Bat Infested. Fumigated with Sulphur Dioxide. 79 „ 27 ss. "Kemi" Owners' request for Certificate. Trapping only. 10 „ 28 ss. "Cape Horn" „ Fumigated with Hydrogen Cyanide. Nil. Sept. 3 ss. "Alejandro" Bat Infested. Fumigated with Sulphur Dioxide. 23 „ 3 ss. "Olivebank" „ „ 16 „ 9 ss. "Mahana" Owners' request for Certificate. „ 11 „ 10 ss. "Port Fremantle" „ „ Nil. „ 13 ss. "Frances Massey" Bat Infested. „ 38 „ 14 ss. "Sydland" „ „ 97 „ 16 ss. "Bangitiki" Owners' request for Certificate. Fumigated with Hydrogen Cyanide. Nil. „ 18 ss. "Jamaica Settler" „ „ 10 „ 20 ss. "Bangitane" „ „ Nil. „ 22 ss. "Roseville" Bat Infested. „ — „ 23 ss. "Solafric" „ Fumigated with Sulphur Dioxide. 4 „ 30 ss. "El Argentino" Owners' request for Certificate. „ 6 Oct. 1 ss. "Orsova" „ Fumigated with Hydrogen Cyanide. 1 „ 8 ss. "Gloucester Castle" Bat Infested. Fumigated with Hydrogen Cyanide and Trapping. 5 Fum. 4 Trap. „ 8 ss. "Port Hunter" Owners' request for Certificate. Fumigated with Sulphur Dioxide. Nil. „ 10 ss. "Bajamar" „ „ 7 21 (mice) „ 11 ss. "Moreton Bay" Bat Infested. „ 18 „ 12 ss. "Port Sydney" Owners' request for „ 17 Certificate. 69 Deratisation Certificates—continued. Date. Name of Vessel. Reason for Deratisation. Action taken. No. of Rats reported found dead after Fumigating or Trapping. 1932. Oct. 12 ss. " Berkdale " Owners' request for Certificate. Fumigated with Hydrogen Cyanide. 68 „ 12 ss. " Buahine " „ „ Nil. „ 14 ss. " Gaza " Bat Infested. „ — „ 14 ss. " Orama " Owners' request for Certificate. „ Nil. „ 14 ss. " Upwey Grange " „ Fumigated with Sulphur Dioxide. 8 „ 15 ss. " Desio " Bat Infested. „ 180 „ 26 ss. " Baltonia " Owners' request for Certificate. Fumigated with Hydrogen Cyanide. Nil. ,, 29 ss. " Marquesa " „ Fumigated with Sulphur Dioxide. Nil. „ 29 ss. " Samaria " „ Fumigated with Hydrogen Cyanide. Nil. „ 29 ss. " Bangitata " „ „ Nil. Nov. 5 ss. " Oronsay " „ „ Nil. „ 11 ss. " Dunster Grange " „ Fumigated with Sulphur Dioxide. 3 „ 11 ss. " Hesperia " Battiness of store rooms. „ 7 „ 16 ss. " Premier " Bat Infested. „ 24 „ 18 ss. " Floristan " Owners' request for Certificate. „ Nil. „ 20 ss. " Sutherland Grange „ „ Nil. „ 21 ss. " Port Pirie " „ „ Nil. „ 21 ss. " Port Napier " „ „ Nil. „ 22 ss. " Dunluce Castle " Bat Infested. Fumigated with Hydrogen Cyanide. 59 „ 22 ss. " Yoko Mara " „ Fumigated with Sulphur Dioxide. 83 „ 25 ss. " Uganda " „ „ 27 „ 26 ss. " Port Huon " Owners' request for Certificate. „ Nil. Dec. 2 ss. " .Tervis Bay " „ „ Nil. „ 3 ss. " Botorua " „ Fumigated with Hydrogen Cyanide. 3 „ 3 ss. " Ormonde " „ „ 5 „ 3 ss. " Carinthia " „ „ Nil. ,, 9 ss. " El Uraguayo " „ Fumigated with Sulphur Dioxide. Nil. „ 10 ss. " Bemuera " „ Fumigated with Hydrogen Cyanide. Nil. ,, 17 ss. " Akaroa " „ Fumigated with Sulphur Dioxide. (45 Mice) „ 17 ss. " Alaunia " „ „ 17 „ 17 ss. " Port Gisborne " „ „ Nil. „ 17 ss. " Otranto " „ Fumigated with Hydrogen Cyanide. Nil. „ 19 ss. " Port Curtis " „ Fumigated wifh Sulphur Dioxide. Nil. „ 21 ss. " Hardwicke Grange „ „ Nil. „ 24 ss. "Piako" „ Fumigated with Hydrogen Cyanide. Nil. „ 31 ss. "Franconia" „ „ Nil. Deratisation Exemption Certificates.—The number issued during the year was 889. 70 APPENDIX XXVIII.—General Summary, and Analysis, of the Sanitary Inspections of Vessels, &c., in the Port of London, for the year ended 31st December, 1932. Foreign . Coastwise. Inland Navigation. Shore Premises. [ Sick Seamenref erred to Hospital Water Bakqes. Steam. Sail. Steam. Sail. Steam. Sail. Lighters (uninhabited) C'anal 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, 1931. New Barges. Condemned. Use discontinued. rreviously withdrawn and since resumed work. No. in District 31st December, 1932j 10,999 356 1,800 91 2 1 1,986 1 162 278 284 19 28 1 273 6 6 787 11 7 757 4 48 236 16 5 1 5,560 64 904 158 15 - 2 — 13 Inspections. Docks and River. No. Nationalities. No. Total Inspections from 1st January to 31st December, 1932:— St. Katharine 265 Austrian 1 London 1,377 American 192 Argentine 1 Foreign 11,090 Eegent's Canal 428 BRITISH 10,485 Belgian 123 Coastwise 2,270 Millwall 861 Dutch 896 West India 763 Danish 379 Inland Navigation 2,053 Danzig Free State 13 Premises on shore 5,560 Poplar 127 Estonian 50 East India 463 French 129 Total 20,973 Finnish 369 Victoria 1,281 German 656 Greek 76 Eoyal Albert 1,136 Italian 106 Cleansing of Crew's Quarters, &c.:— King George V 929 Icelandic 3 Japanese 204 Total No. of Vessels from 1st January to 31st December, 1932 2,173 Surrey Commercial 1,832 Latvian 61 Tilbury 1,080 Norwegian and Swedish. 1,452 Polish 32 Gravesend District - Portuguese 43 Russian 100 River—*Upper District 2,275 Roumanian 9 „*Middle„ 701 Spanish 16 Number of Vessels inspected:— In the Launches— Yugo-Slavakian 2 ‚Lower„ 1,895 Chilian 4 "Joseph White" 1,895 „ Medway I Egyptian 4 "James Howell" Hungarian 2 "Howard Deighton" Lithuanian 1 Total Vessels 15,413 Panama 4 "James Howell" 2.976 Shore Premises 5,560 15,413 Shore Premises 5,560 Total In the Docks, &c. 4,871 16,102 Total 20,973 Total 20,973 Total 20,973 *Upper District extends from Greenwich to Teddington* *Middle „ „ „ „ Erith. *Lower „ „ „ Erith to outer limits of the Port of London. 1923. 1924. 1925. 1926. 1927. 1928. 1929. 1930. 1931. 1932. Y early Average for the 10 years ending 31st Dec., 1932. Total number of Inspections of vessels from— "Foreign" 1 13,040 13,634 12,187 12,239 11,806 12,345 12,186 12,489 11,071 11,090 12,208.7 "Coastwise," "Inland Navigation," and other Inspections 11,932 10,133 11,397 10,215 11,427 9,947 8,880 8,613 9,429 9,883 10,185.6 Total 24,972 23,767 23,584 22,454 23,233 22,292 21,066 21,102 20,500 20,973 22,394.3 71 APPENDIX XXIX. NUMBER OF NUISANCES ON VESSELS REPORTED AND DEALT WITH during the year ended 31st December, 1932. description of nuisances. January. February. March. April. May. June. July. August. September. October. November. December. Totals. Smoke Nuisances:— Number of complaints received – – 2 2 7 1 1 3 – – 1 2 19 Number of recurrences reported – – – – – – – – – – – – – Offensive Cargoes (Bye-laws):— Number of Infringements reported – – 1 – – – 2 – – – – – 3 Structural and other Defects:— Ventilation 3 3 6 7 5 8 5 3 3 12 4 6 65. Lighting 6 8 7 12 15 3 8 6 11 15 13 9 113 Heating 10 17 4 12 8 3 7 — 9 14 24 17 125 Bare iron in crew's quarters 1 1 2 4 – – – – 1 – 1 – 10 Leaky decks, hawse-pipes, cable casings, &c. 12 4 9 13 18 8 10 9 13 12 11 7 126 Defectivebulkheads and floors 9 4 4 7 8 8 12 4 5 11 4 8 84 Sanitary conveniences 5 2 4 10 7 8 7 3 7 6 5 8 72 Ship's gear or stores stowed in crew's quarters – 1 – – 3 – 2 2 – – 1 1 10 Eoul bilges and peaks – – – – – – – – – – – – – Storage of drinking water (dirty or defective tanks) – 1 1 2 1 – 1 – 4 1 – 1 12 Dirty quarters 192 182 164 179 207 186 155 127 141 209 210 167 2,119 Verminous quarters 2 3 2 — 3 1 1 7 6 11 9 2 47 Accumulation of offensive matter 2 — 1 2 — — 1 — 1 — 7 Miscellaneous Nuisances 2 1 1 15 3 3 8 6 11 4 6 6 66 Totals 244 227 207 264 287 229 219 171 211 295 290 234 2,878 Total number of vessels on which sanitary defects were reported 223 203 184 211 251 208 182 157 179 256 255 209 2,518 Total number of vessels on which sanitary defects were remedied 200 191 176 191 216 190 177 143 174 246 221 201 2,326 (Includes Orders made in previous years and reported carried out during 1932.) NUMBER OF NUISANCES IN THE RIVER REPORTED AND DEALT WITH during the year ended 31st December, 1932. offensive accumulation on Foreshore – – – – – – – – – – – – nil. Totals – – – – – – – – – – – – nil. 72 APPENDIX XXX. NUMBER OF NUISANCES ON SHORE PREMISES REPORTED AND DEALT WITH during the year ended 31st December, 1932. description of nuisances. January. February. March. April. May. June. July. August. September. October. November. December. Totals. Smoke Nuisances:— Number of complaints received – – – – – – – – – – – – – Number of recurrences reported – – – – – – – – – – – – – Structural and other Defects:— Ventilation – – – – – – – – – – – – – Lighting – – – – – – – – – – – – – Heating – – – – – – – – – – – – – Dilapidations 1 1 1 2 – – 2 1 – 2 – – 10 Sanitary Conveniences 4 2 7 4 3 – 1 – 2 – – – 23 Water Supply – – – – – – – – – – – – – Dirty Premises 93 83 108 86 86 71 108 35 61 86 81 74 972 Accumulation of Offensive Matter 1 – 1 2 1 – 4 2 2 1 2 – 16 Drainage 1 1 3 3 – 5 2 1 – 2 1 3 22 Foul Cesspits, Latrines, &c – – – – – – – – – – – – – Miscellaneous Nuisances – – – – – 1 – 1 – – 1 1 4 Totals 100 87 120 97 90 77 117 40 65 91 85 78 1047 Number of shore premises on which sanitary defects were reported 99 85 114 93 89 75 112 40 64 91 85 78 1025 Number of shore premises on which sanitary defects were remedied 96 84 121 90 88 72 115 38 61 89 83 76 1013 73 APPENDIX XXXI.— Description of Meat Destroyed. Year. Beef. Mutton and Lamb. Veal, Pork, Offal. Tinned. Smoked and Salted, &c. Total. 1923 Tons. cwts. qrs. lbs. Tons. cwts. qrs lbs. Tons. cwts. qrs. lbs. Tons. cwts. qrs. lbs. Tons. cwts. qrs. lbs. Tons. cwts. qrs. lbs. 30 18 1 2 84 16 3 23 Pork and Veal— 9 14 1 9 0 0 3 10 146 17 0 11 1 18 3 17 Offal— 19 7 3 6 1924 141 8 2 17 13 11 1 5 Pork and Veal— 0 16 0 15 0 3 0 7 183 8 2 0 0 9 2 19 Offal— 26 19 2 21 1925 64 19 2 7 6 1 3 13 Pork and Veal— 1 15 1 6 0 9 0 9 109 4 2 24 4 2 0 18 Offal— 31 16 2 27 1926 51 10 3 25 44 19 3 26 Pork and Veal— 1 3 0 16 0 1 1 0 135 13 2 20 0 16 1 3 Offal— 37 2 0 6 1927 311 12 0 2 263 4 1 13 Pork and Veal— 0 2 0 6 Nil. 605 12 2 16 3 9 2 8 Offal— 27 4 2 15 1928 7 1 0 3 155 18 3 6 Pork and Veal— 0 0 1 26 4 17 2 13 184 6 1 13 0 6 1 22 Offal— 16 1 3 27 1929 8 17 3 4 367 12 1 8 Pork and Veal— Nil. 0 15 3 27 391 16 3 27 0 13 2 12 Offal— 13 17 1 4 1930 21 12 0 16 52 18 0 21 Pork and Veal— 0 4 1 27 1 0 2 27 95 17 2 4 1 10 0 25 Offal— 18 11 3 0 1931 1 14 1 16 65 4 2 24 Pork and Veal— 0 1 2 19 0 10 2 20 81 12 3 22 1 2 0 15 Offal— 12 19 1 12 1932 3 19 3 15 56 8 3 9 Pork and Veal— 1 3 3 22 0 2 2 19 72 6 3 12 0 6 2 16 Offal— 10 4 3 15 Total for ten years 643 14 2 23 1,110 17 1 8 229 1 3 8 15 1 2 6 8 1 3 20 2,006 17 1 9 74 APPENDIX XXXII.—New Buildings and Sanitary Works. Date Plans submitted. Works. Date Work reported as completed. WEST INDIA DOCK— – A new standard type of water-closet and urinal West of No. 11 Warehouse September, 1932. SOUTH WEST INDIA DOCK— June, 1932. New offices for the Union Castle Mail Steamship Company with private convenience, West of " F " Warehouse. October, 1932. SURREY COMMERCIAL DOCK— January, 1932. Drainage in connection with new water-closets, urinal and wash basins in Port of London Authority's main office April, 1932. — Two new temporary offices for H.M. Customs, one in Finland Yard and one in Swedish Yard March, 1932. July, 1932. New offices for Messrs. Chas. Gee & Co., East of Grain Office, Swedish Yard September, 1932. October, 1932. New offices for Messrs. T. Fletcher, Ltd., at South end of Canada Dock November, 1932. LONDON DOCK— — Drainage to new building for H.M. Customs at Wapping Old Basin February, 1932. December, 1932. Land drainage pipes to West Garden Wine Vault, No. 11 Department – POPLAR DOCK— — Conversion of an old iron trough closet into a three-stall pedestal closet with automatic flushing apparatus at London and North Eastern Railway Gate ... July, 1932. REGENT'S CANAL DOCK— January, 1932. Drainage to new building for H.M. Customs at Bergen Wharf February, 1932. TILBURY DOCK— February, 1932. Three new offices for H.M. Customs Officers, one between 22 and 23 Sheds, one between 18 and 19 Sheds, and one near the Tilbury Jetty March, 1932. APPENDIX XXXIII. DOCKS WITHIN THE JURISDICTION OF THE PORT OF LONDON SANITARY AUTHORITY. Docks. Water Area. Lineal Quayage. Acres. Yards. Miles. Yards Regent's Canal 11 38 – 966 St. Katharine 10 488 – 1,654 London 34 4,460 3 119 Surrey Commercial 161 2,717 16 200 West India 97 3,957 4 1,134 East India 31 2,878 1 1,242 Millwall 35 3,217 2 155 Royal Victoria 95 1,772 5 1,479 Royal Albert 87 213 3 905 King George V 64 997 3 663 Tilbury 104 2,166 3 1,667 The Eiver distance between the Western and Eastern limits of the Port is about 68½ miles. 75 APPENDIX XXXIV. POWERS. The work of the Port of London Sanitary Authority is carried out under the following Acts of Parliament and Statutory Rules and Orders :— Existing Acts and Orders applicable to the Port of London Sanitary Authority. CONSTITUTION OF THE AUTHORITY. Public Health (London) Act, 1891. ASSIGNMENT OF POWERS. L.G.B. Order, Port Sanitary Authority Assignment of Powers, Port of London 25th March, 1892. L.G.B. Order, Port Sanitary Authority Assignment of Further Powers, Port of London 29th December, 1894. L.G.B. Order, Port Sanitary Authority Assignment of Powers, Port of London 30th June, 1898. S.R. & O. 1922, No. 781. London Port Sanitary (Additional Powers) Order, 1922 18th July, 1922. S.R. & O. 1923, No. 812. London Port Sanitary (Additional Powers) Order, 1923 16th July, 1923. ADMINISTRATION. Port Sanitary Administration and Medical Inspection of Aliens under the Aliens Order, 1920 (Grants in Aid) 14th July, 1920. Public Health (Officers) Act, 1921. City of London (Various Powers) Act, 1922. S.R & O. 1926, No. 552. Sanitary Officers Order, 1926 27th May,. 1926. INFECTIOUS DISEASE. Infectious Disease (Notification) Acts, 1889 to 1899. Public Health Act, 1896. Public Health (Ports) Act, 1896. S.R. & O. 1907, No. 694. Regulations as to Cholera and Plague on Coasting Ships, 1907 9th September, 1907. S.R. & O. 1907, No. 695. Regulations as to Cholera and Plague on Outward Bound Ships, 1907 9th September, 1907. S.R. & O.1907, No. 710. Regulations as to Cholera, Yellow Fever and Plague Ships arriving from Foreign Ports, 1907 9th September, 1907. L.G.B. Order. Prevention of Epidemic Diseases Regulations as to Plague, Destruction of Rats, 1910 10th November, 1910. S.R & O. 1912, No. 1226 Public Health (Cerebro-spinal Fever and Acute Poliomyelitis) Regulations, 1912 15th August, 1912. S.R. & O. 1918, No. 67. Public Health (Notification of Infectious Diseases) Regulations, 1918 19th January, 1918 S.R. & O. 1920, No. 1924. Port Sanitary Authorities (Infectious Diseases) Regulations, 1920 14th July, 1920. S.R. & O. 1926, No. 972. Public Health (Notification of Puerperal Fever and Puerperal Pyrexia) Regulations, 1926 31st July, 1926. S.R. & O. 1927, No. 1207. Infectious Diseases (London) Regulations, 1927. 22nd December, 1927. S.R. & O. 1929, No. 830. The Public Health (Deratisation of Ships) 12th October, 1929. Regulations, 1929. S.R. & O. 1930; No. 299. Parrots (Prohibition of Import) Regulations, 1930 24th April, 1930. 76 CANAL BOATS Canal Boats Acts, 1877 and 1884. L.G.B. Order. Canal Boats Regulations 20th March, 1878. L.G.B. Order, Canal Boats (Registration Authorities) Order 7th June, 1887. L.G.B. Order, Canal Boats (Sale of Regulations) Order 26th July, 1887. S.R. & O. 1923, No. 451. The Canal Boats Order, 1922 10th July, 1922. S.R. & O. 1925, No. 843. Canal Boats (Amendment) Regulations, 1925 9th June, 1925. S.R. & O 1931, No. 444. Canal Boats (Amendment) Regulations, 1931 26th May, 1931. FOOD. Public Health (Regulations as to Food) Act, 1907. S.R. & O.1924, No. 1432. Public Health (Meat) Regulations, 1924 (Part IV.) 20th December, 1924. S.R. & O. 1925, No. 775 1926, No. 1577 1927. No. 577 Public Health (Preservatives, &c., in Food) Regulations 1928 S.R. & O. 1925, No. 273. Public Health (Imported Food) Regulations, 1925 23rd March, 1925. S.R. & O. 1926, No. 820. Public Health (Imported Milk) Regulations, 1926 6th July, 1926. SHELLFISH. S.R. & O. 1915, No. 125. Public Health (Shellfish) Regulations, 1915 16th February, 1915. RATS AND MICE. Rats and Mice (Destruction) Act, 1919. SMOKE ABATEMENT. Public Health (Smoke Abatement) Act, 1926. ABATEMENT OF NUISANCES and REMOVAL OF REFUSE. Public Health (London) Act, 1891. FERTILISERS AND FEEDING STUFFS. Fertilisers and Feeding Stuffs Act, 1926. S.R. & O.1928, No. 421. Fertilisers and Feeding Stuffs Regulations, 1928 23rd May, 1928. S.R. & O. 1928, No. 439. Order appointing 1st July, 1928, as the date for the coming into operation of the Fertilisers and Feeding Stuffs Act, 1926 30th May, 1928. DANGEROUS DRUGS. S.R. & O. 1923, No. 1095. Dangerous Drugs (No. 3) Regulations, 1923 10th September, 1923 ALIENS. S.R. & O. 1920, No. 448. The Aliens Order, 1920. BYE-LAWS. Bye-laws have been made by the Port of London Sanitary Authority:— 1. For preventing nuisances arising from barges or vessels carrying offensive cargoes. 2. For removing to hospital any person suffering from dangerous infectious disorders, and for keeping therein of such persons as long as may be deemed necessary. S. With respect to Houseboats used for human habitation within the limits of the Port of London. 77 PORT OF LONDON SANITARY ADMINISTRATION ACCOUNT. Dr. REVENUE ACCOUNT for Year ended 31st March, 1933. Cr. £ s. d. £ s. d. £ a. d. £ s. d. Salaries—Medical Officer, Deputy and Assistants 5,745 17 4 Contribution from General Rate 12,169 0 0 Travelling Expenses—Ditto 70 6 9 Contribution from Ministry of Health 12,160 13 8 Salaries—Inspectors 4,418 17 1 Sundry Fees 7 5 11 3 Uniforms, Travelling Expenses—Inspectors 206 17 4 Proceeds, Sale of Unsound Food 123 6 2 Clerical Assistance:— Deratisation Receipts 2,091 7 6 Salaries 2,046 12 5 Miscellaneous Receipts 114 17 2 Other Expenses 63 5 1 Rent re Mooring Launch 7 10 0 Assistant Rat Officers:— 2,109 17 6 Repayment by Hospital Patients 22 18 7 Salaries 1,066 8 10 Other Expenses 89 10 9 Provision and Maintenance of Hospital:— 1,155 19 7 Capital Expenditure 520 15 3 Rent, Rates, Taxes and Insurance 135 18 1 Furniture, Equipment and Renewals 91 4 5 Repairs 1,181 6 10 Heating, Lighting and Cleansing 284 2 3 Interest on Loans 240 7 9 Salaries—General 367 16 4 Nursing 474 1 7 Domestic 106 8 1 948 6 0 Cost of Food 197 5 6 Drugs and Medical Requisites 20 14 2 Uniforms 34 4 8 Miscellaneous 77 5 2 Expenses of Launches:— 3,731 10 1 Wages 3,758 7 11 Uniforms 87 8 2 Upkeep and Running Expenses 1,652 0 11 Capital Expenditure 1,288 15 5 Interest on Loans 340 1 0 7,126 13 5 Laboratory Facilities, Chemical and Bacteriological Examinations 235 3 4 Examination and Analysis of Food 38 3 4 Disinfections 109 6 2 Office Expenses:— Rent, Rates, Water, Taxes and Insurance 159 17 7 Furniture and Equipment 13 1 5 Repairs 34 15 6 Lighting, Heating and Cleansing 123 4 1 Printing and Stationery 429 13 0 Postages, Telegrams, Telephones 231 6 5 — 991 18 0 Part Proceeds of Sale of Unsound Food returned to Consigne es ... 98 9 8 Expenses of Delegates to Congresses ... 56 15 0 Miscellaneous 30 4 6 Legal Expenses 3 0 6 National Insurance 93 10 9 Interest on overdrawn Daily Balances 43 2 7 26,263 12 11 Balance to Balance Sheet 501 11 5 Chamber of London, 15th June, 1933. £26,765 4 4 £26,765 4 4 london: Printed by Charles Skipper & East Ltd., 49, Great Tower Street, E.C.3.