43 The Library 92 FORT OF LONDON HEALTH COMMITTEE. ANNUAL REPORT of the MEDICAL OFFICER OF HEALTH, To 31st December, 1936. Presented 22nd July, 1937. REPORT For the Year ended 31st December, 1936, of the MEDICAL OFFICER OF HEALTH for THE PORT OF LONDON (CHARLES FRANCIS WHITE, M.D., D. P. H.Vict., D.T.M. Liverpool). BROADBRIDGE, Mayor. A Common Council holden in the Chamber of the Guildhall of the City of London, on Thursday, the 22nd day of July, 1937. THE Port of London Health 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, 1936; which was read. Ordered—That the Report be printed and a copy sent to every Member of this Court. ROACH. 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 Health Committee, to whom it has been referred to carry into execution the powers assigned to the Corporation, as the Port of London Health 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, 1936, 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 Income and Expenditure in connection with the Port of London Health Authority for the year ended the 31st March, 1937, 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 July, 1937. A. Robertson. H. Davies Singer. H. W. Morris. E. T. Parkes. John D. Laurie. W. R. Nelthropp. Fred. Whittingham. Francis J. Caunter. Edgar H. Newton. Richard Brodie. Wm. H. Thomas. C. R. Heiser. Hugh T. Taylor. Archd. Galloway. B. S. Dunn. Port of London health Authority, 5, CHURCH PASSAGE, GUILDHALL, E.C.2. Telegraphic Address "PORTELTH LONDON." Telephone No. METROPOLITAN 3636. BOARDING STATIONS. RIVER THAMES Hulk "Hygeia," Gravesend. RIVER MEDWAY Garrison Point, Sheerness. Telegraphic Address "PORTELTH LONDON." 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 River Thames to an imaginary straight line drawn from the Pilot Mark at the entrance of Havengore Creek, in the County of Essex, to the 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 Actinobacillosis in Ox Tongues 10,28 Action under Public Health (Imported Food) Regulations,1925 28 Admissions to Denton Hospital 9 Aliens Order, 1920 53 Ambulance Transport 13 Amount of Shipping Entering the Port (Table "A") 12 Analyst's Reports 36, 45 Arrangements for Dealing with Declarations of Health 13 Article 16—Experience of Working 13 Assignment of Powers 85,86 B. Bacon 29 Bacteriological Examinations 9, 14, 33-36 Beef 29 Boarding of Vessels on Arrival 9,12,13 Boarding Station 1, 10 Bye-laws—Offensive Cargoes 10,55,56 Bye-laws of Port Health Authority 86 C. Canal Boats Acts and Regulations 57-61 Canned Poods, Inspection of 10,46-52 Canned Sild 11 Cargo Traffic (Table "B") 12 Caseous Lymphadenitis in Mutton 10, 27 Certificates—Fumigation Issued (Table "H") 25 Certificates under Public Health (Imported Food) Regulations, 1925 32 Classification of Nuisances (Table "J") 25 Cleansing of Persons and Clothing 13 Condemned Food—Disposal of 10,28,29 Conditions Prevailing in Coasting Vessels 9 Confectionery 31 Contacts, Surveillance of 9, 13, 18-23 Contamination of Sardines by Lead 10,11 Crews'Spaces—Hygiene of 25,26 D. Declarations of Health 13 Deratisation Certificates (Table "H") 25 „ Exemption Certificates (Table "H") 25 Destruction of Rats on Vessels (Table "E ") 24 „ „ in Docks, Quays, &c. (Table " F") 24 „ „ on Vessels from Plague-infected Ports (Table "G") 25 Detection of Rodent Plague 9 ,, Infectious Disease on Vessels 13 Detention of Fat under Public Health (Imported Food) Regulations, 1925 28 „ Foodstuffs 28 Diphtheria, Immunisation Against 9,53-55 Disinfection of Persons and Clothing 13 Disposal of Condemned Food 28,29 E. Exemption Certificates (Table "H") 25 Exportation Notices under Public Health (Imported Food) Regulations, 1925 32 F. Fats—Detention and Control under Public Health (Imported Food) Regulations, 1925 28, 29 Fertilisers and Feeding Stuffs Act, 1926 45,46 Fish 29 Food Inspection 27-52 „ „ —Detentions, Seizures and Destruction 10,28 Fruit 30 Fruit, Pulp, &c. 30 „ Tinned and Bottled 30 Fumigation Certificates (Table "H") 25 „ of Vessels for Rat Destruction 10 3 G. Page Grain, &c. 31 H. Ham 29 Harveian Society of London, Visit of 56,57 Hospital 1, 9, 10, 13 Houseboats 11 Hygiene of Crews'Spaces 25,26 I. Immunisation Against Diphtheria 9, 53-55 Infected Ports—Vessels from (Table "G") 25 "Infected" Vessels (Table "G") 25 Infectious Disease, Detection of 13 ,, Sickness Landed from Vessels (Table "C") 14 „ „ Occurring during Voyage (Table "D") 14 Infectious Disease, Prevention of Importation 13 Inspection of Canned Foods 10,46-52 Inspection of Imported Meat 10 Interment of Dead 14 Introduction 9-11 Irregular Certification of Lard 32 L. Lard—Irregular Certification of 32 Launches 10,13 Lead Contamination of Sardines 10,11 Limits of Port of London 1 M. Measures against Rodents 24 Measures of Rat Destruction on Vessels from Plague-infected Ports (Table "G") 25 Meat Inspection 10,27 Meats, Tinned 29 Medical Inspection of Aliens 53 Medical Inspection of Vessels 9,12 Metallic Contamination of Canned Foods 10,11 Mooring Stations 13 Mutton—Caseous Lymphadenitis 10,27 Mutton and Lamb 10,29 N. Notices of Exportation under Public Health (Imported Food) Regulations, 1925 32 Notification of Inward Vessels Requiring Special Attention 13 Nuisances—Classification of (Table "J") 25 Nuts 30 O. Offal —Seized and Destroyed 29 Offensive Cargoes—Bye-laws 10,55,56 Offices 1 Official Certificates recognised under the Public Health (Imported Food) Regulations 31, 32 Ox Tongues affected with Actinobacillosis 10,28 P. Parrots (Prohibition of Import) Regulations, 1930 9,56 Passenger Traffic (Table "B") 12 Pathological Examinations 14 Plague 9 Pollution of the River 11 Pork 28,29 Port of London, Limits of 1 Port Sanitary Regulations, 1933 13,14 Port Welfare Advisory Council 26,27 Poultry 29 Powers of Port Health Authority 85,86 Prepared Foods, &c. 31 Provisions, &c. 31 4 Page Public Health (Imported Milk) Regulations, 1926 33 „ ,, (Imported Food) Regulations, 1925 28, 31 „ „ „ ,, „ —Notices served under Article II. (4) 32 „ „ „ Amendment Regulations, 1933 28,31 „ „ (Shellfish) Regulations, 1915 and 1934 33 „ „ (Preservatives, &c., in Food) Regulations, 1925 to 1927 33 Pulmonary Tuberculosis 9 R. Rat Destruction by Fumigation 10 Rats Destroyed on Vessels (Table "E") 24 „ „ in Docks, Quays, &c. (Table "F") 24 Rats Examined 9 River, Pollution of 11 Rodent Plague—Detection of 9 S. Samples 33-46 Sanitary Inspections 9,12 Sardines—Contamination by Lead 10,11 Sausages 29 Seizure of Foodstuffs 28 Shellfish 33 Shipping Entering the Port (Table "A') 12 Sild, Canned 11 Small-pox 9, 15-17 Smoke Nuisance 10 Source of Water Supply 12 Staff 7,8 Standing Exemptions 13 Statutory Notices 10 Structural Defects 25 Sundries (Foodstuffs, &c.) 31 Supervision of Contacts 13 Surveillance of Contacts 9,13,18-23 Surveillance of Persons Landing 13 " Suspected " Vessels (Table "G") 25 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 24 „ "F" „ „ in Docks, Quays, &c 24 „ "G" "Infected" or "Suspected" Vessels or Vessels from Plague-infected Ports 25 „ "H" Deratisation and Deratisation Exemption Certificates 25 ,, "J" Classification of Nuisances 25 Telegraphic Address 1 Telephone Numbers 1 Third International Conference of the Health and Welfare of Merchant Seamen 26, 27 Tinned Meats 29 Tonnage of Vessels Entering Port 9,12 Training Ships 9,53-55 Tuberculosis, Pulmonary 9 U. Unsound Food, Disposal of 28 ,, „ Quantity Destroyed 28 V. Veal 29 Vegetables 30 ,, Tinned 30 Venereal Disease 14 Visit of the Harveian Society of London 56, 57 Visitors to Port Health District 56 W. Water Barges 10 „ —River 11 „ Supply, Source of 12 Watering Vessels—Facilities 10 Weil's Disease 24 Welfare of Seamen 26,27 5 INDEX TO APPENDICES. B. Page Bacteriological Examination of Rats (Appendix XXI.) 76 Bye-Laws (Appendix XXIX.) 86 C. Certificates under International Sanitary Convention (Appendix XXII.) 76-79 Chicken-pox (Appendix XV.) 72 Classification of Miscellaneous Diseases (Appendix XVII.) 73,74 Crew Medically Inspected at Gravesend (Appendix I.) 62 „ „ „ Sheerness (Appendix I.) 62 D. Deratisation Certificates (Appendix XXII.) 76-79 „ Exemption Certificates (Appendix XXII.) 79 Destruction of Unsound Meat, Weights, &c. (Appendix XXVI.) 83 Diphtheria (Appendix V.) 63, 64 Diseases, Miscellaneous—see "M" (Appendix XVII.) 73, 74 Dock Areas (Appendix XXVIII.) 84 Dysentery (Appendix XIII.) 70, 71 E. Enteric Fever (including Typhoid Fever and Paratyphoid Fever) (Appendix VI.) 64, 65 Erysipelas (Appendix IX.) 66 Exemption Certificates (Appendix XXII.) 79 F. Fumigation of Vessels for the Destruction of Rats (Appendix XXII.) 76-79 G. German Measles (Appendix VIII.) 66 Gravesend—Medical Inspection at (Appendix I.) 62 H. Hospital—Cases Admitted and Cost of Maintenance, &c. (Appendix XIX.) 74 I. Infectious Disease (Appendix II.) 62 „ „ Cases Reported (Appendix II.) 62 „ „ „ Treated in Port Sanitary Hospital (Appendix II.) 62 Influenza (Appendix XII.) 70 International Sanitary Convention of Paris, 1926 (Appendix XXII.) 76-79 M. Malaria (Appendix XIV.) 71 Measles (Appendix VII.) 65 „ German (see "G") (Appendix VIII.) 66 Medical Inspection—Gravesend and Sheerness (Appendix I.) 62 Miscellaneous Diseases Classified (Appendix XVII.) 73,74 Mumps (Appendix XVI.) 73 6 N. Page New Buildings and Sanitary Works (Appendix XXVII.) 84 Nuisances on Vessels (Appendix XXIV.) 81 „ the River (Appendix XXIV.) 81 „ Shore Premises (Appendix XXV.) 82 P. Passengers Medically Inspected—Gravesena (Appendix I.) 62 ,, „ „ —Sheerness (Appendix I.) 62 Pneumonia (Appendix XI.) 69-70 Powers (Appendix XXIX.) 85,86 Premises—Nuisances on (Appendix XXV.) 82 Pulmonary Tuberculosis (Appendix X.) 66-69 R. Rats Caught and Destroyed (Appendix XX.) 75 „ Examined (Appendix XXI.) 76 „ —Fumigation of Vessels for Destruction of (Appendix XXII.) 76-79 River, Nuisances on (Appendix XXIV.) 81 S. Sanitary Inspections—Summary (Appendix XXIII.) 80 „ „ —Nuisances on Vessels (Appendix XXIV.) 81 ,, „ — „ River (Appendix XXIV.) 81 „ „ — „ Shore Premises (Appendix XXV.) 82 Sanitary Works (Appendix XXVII.) 84 Scarlet Fever (Appendix IV.) 63 Sheerness—Medical Inspection (Appendix I.) 62 Small-pox (Appendix III.) 63 T i . Tuberculosis, Pulmonary (Appendix X.) 66-69 U. Unsound Meat Destroyed, Weight, &c (Appendix XXVI.) 83 V. Venereal Diseases (Appendix XVIII.) 74 Vessels Fumigated for Rats (Appendix XXII.) 76-79 „ —Nuisances on (Appendix XXIV.) 81 „ arriving from "Foreign" at Gravesend (Appendix I.) 62 Sheerness (Appendix I.) 62 W. Water Barges (Appendix XXIII.) 80 Weight, &c., of Unsound Meat Destroyed (Appendix XXVI.) 83 7 STAFF. List of Officers forming the Staff of the Port of London Health Authority, 31st December, 1936. Office. Name of Officer. Date of entering the Service. Date of appointment to present position. MEDICAL OFFICER OF HEALTH C. F. White, M.D., D.P.H.Vict., D.T.M .Liverpool. September, 1928 July, 1928. DEPUTY Col. J. S. Warrack, M.A., M.D., C.M.Aberdeen, D.P.H. Camb., Barrister-at-Law. April, 1903 February, 1916. BOARDING MEDICAL OFFICERS— Gravesend Surg.- Lieut.- Cmdr. H. M. Willoughby,M.R.C.S.,L.R.C.P., D.P.H., D.T.M. & H., R.N.V.R. May, 1929 May, 1929. Do. Do. P. B. P. Mellows, L.M.S.S.A., Lond., D.T.M.&H. October, 1934 June, 1934. Do. Do. J. A. Jones, M.B., Ch.B., D.P.H. April, 1935 April, 1935. Sheerness †H. A. Madwar, L.R.C.P., L.R.F.P.S. January, 1928 February, 1928. OFFICE 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. Veale September, 1935 February, 1936. SANITARY INSPECTORS (Senior) *W. J. Berry February, 1914 January, 1930. *F. J. Massie March, 1909 January, 1931. *R. Clifford July, 1925 September, 1932. *P. W. Coombe December, 1924 January, 1935. *W. Elward March, 1909 January, 1929. *W. Gray September, 1921 January, 1930. *E. H. Johnson August, 1929 January, 1933. *T. G. Edwards June, 1929 January, 1934. SANITARY INSPECTORS (Junior) *D. E. Madeley September, 1932 July, 1932. *C. E". Wright July, 1931 February, 1933. *J. S. Beattie May, 1931 May, 1933. *L. A. R. Hundy January, 1934 December, 1933. *T. L. Mackie November, 1934 October, 1934. *L. F. J. McDermott June, 1934 December, 1934. ASSISTANT RAT OFFICERS C. F. Woodrow 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. W. J.Reader November, 1934 December, 1934. 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 † — — Do † — — 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 Health Authority, 31st December, 1936. Office. Name of Officer. Date of entering the Service. Date of appointment to present position. LAUNCHES— "Howard Deighton"— Master C. A. Strange December, 1898 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. „ J. H. Meredith February, 1936 July, 1936. Deckhand J. R. Steen March, 1926 December, 1930. „ H. J. Debnam April, 1931 April, 1931. „ A. F. Clements January, 1927 September, 1933. Boy †L. J. Youngs April, 1931 April, 1931. „ †W. G. A. King November, 1933 November, 1933. „ †S. F. Tolhurst August, 1936 August, 1936. "James Howell"— Master A. F. Rough November, 1914 December, 1930. Engineer J. C. Row February, 1912 February, 1935. Boy †E. N. Rickwood October, 1935 October, 1935. "Frederick Whttingham"— Driver P. J. Wilkins November, 1928 October, 1934. Boy †S. H. Strange November, 1934 November, 1934. GREENWICH MOORINGS— Barge "Ella Vicars"— Watchman E. Ditch January, 1915 November, 1917. „ A. E. Howard January, 1927 February, 1935. GRAVESEND—Hulk "Hygeia"- Shipkeepers H. A. Clarkson May, 1912 January, 1927. E. W. S. Edmonds September, 1933 September 1933. * 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, 1937. TO THE WORSHIPFUL THE PORT OF LONDON HEALTH COMMITTEE. Gentlemen, I have the honour to submit my Annual Report as Medical Officer of Health of the Port of London. Circular 1598 issued by the Ministry of Health states that " any permanent arrangements which have been fully described in previous Annual Reports and have not been altered may be omitted from the Report for 1936." These arrangements were dealt with in my Report for the year 1933 and I have, therefore, in this Report described only such changes as have taken place since then. Continuing the policy of encouraging other Members of your Staff to make direct contributions to this Report, I have this year included an article entitled "Surveillance of Contacts," by Mr. J. A. Gillis, First Class Assistant Clerk, and some observations by Mr. J. S. Beattie, Inspector in the Middle River District on "Conditions Prevailing in Coasting Vessels." The tonnage of vessels entering the Port of London during 1936 showed an increase of 1,194,449 tons as compared with the previous year, the total being 30,868,381 tons. 14,454 vessels arrived from Foreign Ports, and of these 2,389 were boarded and inspected by your Medical Officers. Infectious Disease was reported as having occurred during the voyage on 204 vessels, the total number of cases being 317, of which 174, including 94 of Pulmonary Tuberculosis, were landed in the Port. In the Training Ships there occurred two cases of Scarlet Fever, 10 of Diphtheria, and one each of Measles and Mumps. One case of Diphtheria occurred on a Houseboat moored in the district. Owing to an epidemic of Diphtheria in one of the Training Ships I was requested to arrange for the immunisation of the boys. This was carried out by Dr. J. A. Jones, one of your Assistant Medical Officers, whose report appears on pages 53 to 55. Sixty-six cases, particulars of which are given in Appendix II., were admitted to your Hospital at Denton. No case of Plague occurred during the year on any vessel bound for London. Of the 2,508 rats examined bacteriologically, 983 were from ships and 1,525 were from shore premises. None showed any evidence of Plague infection. Six vessels arrived in Avhich a total of nine cases of Small-pox had occurred, but no case was actually landed in the Port. The Parrots (Prohibition of Import) Regulations, 1930, continued in operation, and the work done thereunder is reported on page 56. Your Sanitary Inspectors made 15,531 inspections of vessels and 6,070 inspections of shore premises. Three thousand, five hundred and fifty-six defects were reported in 2,643 vessels, in 2,492 of which the defects were remedied. Eleven hundred and eighty-four nuisances were reported in 1,170 shore premises, in 1,166 of which the nuisances were abated. 10 Nuisance from smoke was reported in 36 vessels, and in 14 instances a Statutory Notice was served on the Master. The number of vessels fumigated for rat destruction under the supervision of your Inspectors was 118, 72 by hydrogen cyanide and 46 by sulphur dioxide. By the former method 879 rats and 34 mice, and by the latter 916 rats and 41 mice were destroyed. The average number of rats killed per fumigation was 15.2. If mice are taken into consideration also, the average number of rodents destroyed per fumigation was 15.8. In addition, 4,968 rats were trapped in ships and 5,016 on shore in the port. Intimation Notices were served in respect of nine cases of infringement of the Bye-laws relating to Offensive Cargoes. The number of water barges in use in the Port remained at 12. As in previous years the annual re-registration of these water barges with the Port of London Authority was made conditional upon the satisfactory report of your Officers as to the fitness of the barges for the carriage of drinking water. These arrangements continued to work smoothly. Last year I reported that one of your launches, the "James Howell" was almost worn out, and accordingly, towards the end of the year, your Worshipful Committee decided to build a new launch suitable for the routine inspection of ships lying in the Middle River District, but also capable of taking over the work of your boarding launch "Howard Deighton" when she is laid up for overhaul or is for any other reason temporarily out of commission. The new launch, which has been designed by your Chief Engineer, Mr. Roberts, and which is being built by Messrs. James Pollock, Sons & Co., Ltd., of Faversham, will have an overall length of 54 feet 9 inches, a breadth of 12 feet, a draft of 4 feet 6 inches and a speed of 9f knots. She will be driven by one 8 L.3 Gardner H.S. Diesel Engine of 136 b.h.p. The launches "Howard Deighton" and "Frederick Whittingham" have given very satisfactory service during the year, and the new "Hygeia" has been much appreciated by your Boarding Medical Officers. The Corporation of the City of London made a further grant of £1,000 from City's Cash for the improvement of the grounds of your hospital at Denton. Unfortunately, the long-continued wet weather has delayed the work, but the raising of the level of the grounds will be completed as soon as it is possible to resume the tipping of soil, and then the planting of trees and the laying out of flower beds can be undertaken. During the year 3,288 tons of foodstuffs were condemned as unfit for human consumption and were either destroyed or disposed of for industrial purposes. The proportion of carcases of mutton examined for Caseous Lymphadenitis remained at 5 per cent. throughout the year, while pieces of mutton continued to be subjected to 100 per cent. examination. Evidence of this disease was found in 22 of the 9,062 carcases examined by your Inspectors. A proportion of frozen ox tongues imported from South America was examined on arrival, the percentage found to be affected with Actinobacillosis being 0.61. In connection with the inspection of canned food your Medical Officer read a paper at the Congress of the Royal Institute of Public Health and the Institute of Hygiene on 29th May, 1936, which appears in full on pages 46 to 52 by courtesy of the Editor of "The Journal of State Medicine." The examination of canned sardines for lead contamination was continued during the year. Samples from 51 consignments were analysed, the smallest amount of lead found being 2 parts per million, the greatest amount being 28 parts per million, and the average 9.7 parts per million. These figures compare favourably with the 11 corresponding ones for 1984, viz., 138 ; 2 ; 78 ; 17.3, and for 1935, 55 ; 0 ; 40 ; and 11.7. Six consignments representing 555 cases, or approximately 55,500 tins were returned to the packers under guarantee that they would not be sent back to this country. These figures compare with 7 ; 1,070 ; 107,000 for 1934 and 9 ; 880 ; 88,000 for 1935. In November, 1936, subsequent to a conference of Port Medical Officers at the Ministry of Health the following letter was addressed to all known importers of sardines in the Port of London:— "DearSirs, LEAD IN SARDINES. "I have to inform you that from the 1st July, 1937, the importation of sardines found on analysis to contain more than five (5) parts of lead per million, will be prohibited under the Public Health (Imported Food) Regulations, 1925. "This prohibition will be enforced in all ports of the United Kingdom. "I have further to inform you that it is considered by the responsible authorities that sardines should be free from lead or contain, at the most, only negligible traces of that metal. "The tolerence of five parts of lead per million will accordingly only be exercised for a limited period. "It is, therefore, recommended that you should impress upon your packers the importance of using every means to prevent any lead contamination of their product as, at a later date, of which you will receive ample notice, a still stricter standard than five parts per million will be imposed." The analysis of canned sild for tin was also continued during the year. Eight samples were analysed. The amount of tin found ranged between 0 and 5.16 grains per pound, the average being 0.9 grains per pound. Six hundred and fifty-seven cases, approximately 65,700 tins, in which the degree of contamination exceeded two grains of tin per pound, were destroyed. In regard to the Port of London Houseboat Bye-laws which are being made jointly by yourselves and the Port of London Authority, under the City of London (Various Powers) Act, 1933, agreement has been reached with the Port of London Authority and the Ministry of Health. The proposed Bye-laws have been advertised by the Port of London Authority, and objections are now receiving consideration. It is hoped that it will be possible to issue the Bye-laws before the end of 1937. No complaints were received during the year as to the pollution of the Biver by sewage discharged from the Northern and Southern Outfalls. This was due to the heavy rainfall which resulted in the Biver being flushed with fresh water from above Teddington. There were no changes in your Staff during the year, and I have pleasure in recording that all grades carried out their duties in an entirely satisfactory manner. The health work of so large a Port could not be carried out efficiently without the co-operation of the Officers of H.M. Customs and of the Port of London Authority, the Pilots and the Members of the Staffs of the Shipping Companies and Merchants whose assistance and courtesy are gratefully acknowledged. I have the honour to be, Gentlemen, Your obedient Servant, CHARLES F. WHITE. 12 I.—AMOUNT OF SHIPPING ENTERING THE PORT DURING THE YEAR 1936. Table A. Number. Tonnage. Number Inspected. Number reported to be Defective. Number of Vessels on which Defects were Remedied. Number of Vessels reported as having or having had, during the voyage Infectious Disease on Board. By the Medical Officer of Health. By the Sanitary Inspector. Foreign Steamers 9,886 16,640,728 2,068 11,105 1,869 1,769 204 *Motor 4,412 5,661,380 321 — Sailing 156 83,544 — 28 3 3 — Fishing — — — — — — — Total Foreign 14,454 22,385,652 2,389 11,133 1,872 1,772 204 Coastwise Steamers 11,130 7,773,905 6 2,786 490 467 7 *Motor 2,832 585,295 - Sailing 1,590 123,529 — 461 103 84 — Fishing — — — — — — — Total Coastwise 15,552 8,482,729 6 3,247 593 551 7 Total Foreign and Coastwise 30,006 30,868,381 2,395 14,380 2,465 2,323 211 Inland Navigation — — 2 1,151 178 169 4 * 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 1936:— To and from NON-EUROPEAN Countries. Number of Passengers. 1st Class. 2nd Class. 3rd Class. Tourist. Inwards 18,939 8,370 10,793 15,792 Outwards 21,215 5,977 1,825 17,574 To and from CONTINENT OF EUROPE. Inwards 64,530 (all classes). Outwards 58,348 (all classes). Countries from which passengers principally arrive: North America, Australia, Europe, British South Africa, India and the Par 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. (a) For the Port:— In all the docks, except Tilbury, water is supplied by the Metropolitan Water Board. Tilbury Docks take water from the South Essex Water Company. The majority of the wharves are supplied by the Public Water Companies within whose areas of distribution they are situated, but several have their own deep wells and some have no water available for ships, in which case any water required may be obtained from water boats. (b) For Shipping:— Ships usually obtain water from the shore supplies as indicated above, but when no water is available at the berth or if a ship is lying at moorings in the river, supplies are obtained from water boats. 13 IV.— PORT SANITARY REGULATIONS, 1933. Arrangements for dealing with Declarations of Health remain as described in my Report for the year 1933 and are working smoothly. Boarding of Vessels on Arrival.—The Boarding Launch " Howard Deighton " has given excellent service throughout the year and, apart from the period of her annual overhaul, has been constantly in commission. Notification to the Authority of Inward Vessel requiring Special Attention.—No changes have been made in the arrangements and with the exception of the difficulty in regard to light signals at night, as set out in my Report for 1935, the arrangements are working satisfactorily. Mooring Stations designated under Article 10:— (a) Within the Docks; (b) Outside the Docks. These remain as reported in 1933. There has, so far, been no occasion to make use of them. Particulars of any Standing Exemptions from the Provisions of Article 14.—None have been made and the arrangements described in my 1933 Report have worked smoothly. Experience of working Article 16 :— (1) As ships are cleared in the River immediately on arrival, no difficulty has been experienced in preventing the embarkation or disembarkation of unauthorised persons. (2) The arrangements for the surveillance of contacts have been facilitated by the use of the "Business Reply Card" system, described in the article "Surveillance of Contacts," on pages 21 and 22. What Arrangements have been made for:— (a) Premises and waiting rooms for medical examination. (b) Cleansing and disinfection of ships, persons and clothing and other articles. (c) Premises for the temporary accommodation of persons for whom such accommodation is required for the purposes of the Regulations. (d) Hospital accommodation available for Plague, Cholera, Yellow Fever, pox and other Infectious Diseases. As regards (a), (b) and (c) the arrangements remain as described in my Report for the year 1933, while as regards (d) the arrangements were described in my Report for 1935. (e) Ambulance Transport. The Boarding Launch "Howard Deighton" and the Upper River Launch "Frederick Whittingham" have continued to give excellent service. As reported last year the "James Howell" was almost worn out and accordingly, towards the end of the year, it was decided to build a new launch suitable for the routine inspection of ships lying in the Middle River District, but also capable of taking over the work of the Boarding Launch "Howard Deighton" when she is laid up for overhaul or is for any other reason temporarily out of commission. (f) Supervision of contacts. No changes have been made in the arrangements described in my Reports for the years 1933 and 1934. 14 Arrangements for the Bacteriological or Pathological Examination of Rats for Plague. Arrangements made for other Bacteriological or Pathological Examinations. Arrangements for the Diagnosis and Treatment of Venereal Diseases amongst Sailors. Arrangements for the Interment of the Dead. All remain as reported in detail in 1933. Table C. Cases of Infectious Sickness landed from Vessels. Disease. Number of Cases during the Year. Number of Vessels concerned. Average Number of Cases for previous 5 years. Passengers. Crew. Typhus Fever — — — 0.2 Small-pox — — — 0.4 Scarlet Fever 1 4 5 2.8 Diphtheria 1 10 2 4.0 Enteric Fever 1 13 12 11.6 Measles 2 5 7 5.4 German Measles 1 1 2 0.4 Erysipelas — — — 0.6 Continued Fever — — — — Pulmonary Tuberculosis 68 26 60 86.8 Tuberculosis (other kinds) — — — 2.6 Pneumonia 1 7 8 11.4 Influenza - 2 2 5.6 Cerebro-spinal Meningitis — — — 1.0 Dysentery 1 4 5 7.6 Encephalitis Lethargica — — — — Malaria 1 10 11 11.6 Chicken-pox 4 10 13 13.8 Remittent or Relapsing Fever — — — — Mumps — 1 1 8.4 Note.—The following oases of infectious disease occurred on Training Ships moored in the Thames:— Scarlet Fever 2; Diphtheria 10; Measles 1; Mumps 1. In addition 1 case of Diphtheria occurred on a Houseboat moored off Canvey Island. Table D. Cases of Infectious Sickness occurring on Vessels during the Voyage, but disposed of prior to arrival. Disease. Number of Cases during the Year. Number of Vessels concerned. Average Number of Cases for previous 5 years. Passengers. Crew. Cholera — — — 0.8 Plague — — — — Typhus Fever — — — — Small-pox — 9 6 8.8 Scarlet Fever 3 2 5 1.4 Diphtheria 3 2 4 3.4 Enteric Fever 4 11 15 10.8 Measles 9 — 7 19.0 German Measles 2 — 2 5.2 Erysipelas 2 — 2 1.0 Continued Fever — — — — Pulmonary Tuberculosis 21 5 19 41.2 Tuberculosis (other kinds) — — — 1.0 Pneumonia 9 2 7 16.6 Influenza 1 10 3 165.8 Cerebro-spinal Meningitis — — — 1.2 Dysentery 4 2 6 9.0 Encephalitis Lethargica — — — — Malaria 8 15 14 42.8 Chicken-pox 8 7 13 21.0 Remittent or Relapsing Fever — — — — Mumps 4 — 4 7.2 15 Small-Pox. ss. "Prince Rupert City."—The above-mentioned Vessel arrived at Gravesend on the 23rd January, from Vancouver (9th December, 1935), San Pedro (17th December, 1935), Panama Canal (30th December, 1935), and thence direct to London. On arrival of the Vessel in dock, it was ascertained that four cases of Small-pox had occurred during the voyage. History of Cases. Case 1.—An apprentice reported sick on 14th November, 1935, with backache, headache and vomiting. Rash appeared 16th November, 1935. He was isolated on board and, on arrival at Vancouver on 26th November, 1935, he died. This patient was unvaccinated. Case 2.—A cabin boy reported sick on 14th November, 1935, with backache, headache and vomiting. The rash appeared the same day. He was landed at Vancouver on 1st December, 1935. This patient also was unvaccinated and, although a severe case, was recovering when landed. Case 3.—Nine of the crew were left at the Quarantine Station, Vancouver, and one is said to have died there. Case 4.—An engineer was put ashore for observation on 6th December, 1935, and was said to have developed a mild attack on 9th December, 1935. Vaccination.—Vaccination of the whole of the crew was carried out at Vancouver on 1st December, 1935. Eight new crew were signed on at Vancouver, and were vaccinated on 9th December, 1935. Measures taken to prevent Spread of Infection.—Cases 1 and 2 were immediately isolated in the starboard alley-way. The bedding of the fatal case was destroyed, and all other infected bedding and effects were removed ashore for steam disinfection. All living quarters were disinfected with formalin gas (eight hours) and the sick isolation quarters for 20 hours. Action taken on arrival in London.—No fresh cases occurred en route. A general inspection was carried out by Dr. Warrack on 24th January, 1936, who reported no signs of recent Small-pox, and all crew thoroughly vaccinated or revaccinated. The personal effects of Case 1, although they had been steam disinfected and fumigated with formalin at Vancouver, were landed to Denton Hospital and again steam disinfected. ss. "Gaunless."—On 16th December, 1935, while the Vessel was at Sapele, a Kroo boy (dock worker) complained of feeling unwell, and was found by the Master to have spots on his face. He was immediately landed, and the Port Medical Officer diagnosed the condition as Small-pox. All bedding and effects were removed for disinfection, and the infected quarters disinfected. All the crew (with the exception of three who showed signs of recent successful vaccination) were vaccinated. No further cases occurred. ss. "Matra."—The ss. "Matra" arrived at Gravesend on 14th March, 1936, from Calcutta and reported having landed three of the native crew during the voyage, suffering from Small-pox. History of Cases.—The crew signed on in Calcutta and the entire ship's personnel was vaccinated on 31st December, 1935, at that port. Case 1.—Reported sick on 19th January, 1936. The patient was immediately isolated and on arrival at Suez on 21st January, 1936, was diagnosed to be suffering from Small-pox and removed to hospital. The entire crew were revaccinated at Suez on 21st January, 1936. On leaving Suez the forecastle and hospital were fumigated with Sulphur Dioxide. Case 2.—Reported sick on 26th January, 1936, and was landed at Oran on 28th January, 1936, for observation. (This man eventually arrived at Gravesend in another vessel as a Distressed British Seaman, and, on examination, showed no signs of having had Small-pox.) 16 Case 3.—Reported sick on 6th February, 1936. Landed to hospital at Boston (Mass.) on 14th February, 1936, for observation. He was returned to the ship on 20th February, 1936, as negative. The entire ship's company was revaccinated at Boston, and further fumigation carried out. Action on Arrival in London.—The entire personnel was examined, including the single passenger who had shared in the second and third revaccinations, special attention being given to Case 3. All were well except for one native who, though ill, showed no symptoms suggesting the onset of Small-pox. ss. "City of London."—Previous information.—On 23rd April I received a letter from the Ministry of Health, informing me that a case of Small-pox had been landed from the ss. "City of London "at Suez on 20th April. I accordingly communicated with the shipping company (Messrs. Ellermen Lines, Ltd.) and arranged for a sufficient number of cards for notification of address by passengers and white crew to be put on board the ship by the Pilot. On 30th April I was informed by the shipping company that a second case of Small-pox had developed on board. I therefore arranged to meet the ship on arrival myself, in company with the Boarding Medical Officer on duty. Movements of Ship.— The ss. "City of London "left Calcutta on 3rd April, 1936; Madras, 7th April; Colombo, 10th April; Suez, 20th April; Port Said, 21st April; and arrived in London on 2nd May. History of Cases. First Case.— On 12th April a Lascar, Nawab Ali, reported sick with a rash and slight fever. The Ship's Surgeon was unable to give a satifactory account of the rash. He described it as discrete and papular, mostly on the face. He isolated the patient in a lifeboat on the poop, there being no hospital of any kind in this ship. On arrival at Suez the case was diagnosed as Small-pox by the Port Medical Officer, and was landed to hospital. The Surgeon vaccinated all those on board who did not show evidence of recent vaccination. Second Case.— The second case was a deck boy, Shamshul Huq, aged 20, who reported sick on 26th April with a rash and fever. He was diagnosed as Small-pox and isolated in the lifeboat Which had been occupied by the previous case. Action on Arrival in London.— The ship arrived off Gravesend at 8 a.m. on 2nd May, and was boarded by Dr. Willoughby, Dr. Jones and myself, a Sanitary Inspector and two clerks. The patient was not ill, climbed out of the lifeboat in which he had been isolated and was examined on the poop deck. The eruption was discrete, definitely centripetal, superficial, and for the most part in the crusting stage. Some of the crusts had been scratched off and left typically oval scars. I examined him very carefully, and was quite satisfied that he was suffering from Chickenpox. Finally, the fact that he had been well vaccinated in infancy and again successfully at some later date and that vaccination performed at Calcutta on 1st April, 1936, before sailing, had been unsuccessful, supported this diagnosis. Nevertheless, since it was not safe to assume that the case landed at Suez was Chickenpox, though he sickened exactly fourteen days before the second case, who was a close contact, it was decided to proceed as for Small-pox. The patient was landed to the Port Isolation Hospital, and the 25 other lascars who had occupied the same forecastle were taken ashore, bathed, and their clothing disinfected. Meanwhile, their quarters were put under fumigation with S02. The passengers (184) and the crew (European 30 and Asiatic 166) were medically inspected. None showed any symptoms suggestive of the onset of Chickenpox or Small-pox. 17 The addresses of the passengers and white crew were carefully checked and forwarded to the Medical Officers of Health of the districts of destination. It is noteworthy that of the addresses on the cards which had been issued to the passengers, 45 per cent. were different from those on the passenger manifest. This demonstrates very clearly how useless it is to accept the addresses on the passenger manifest for purposes of surveillance, and how important it is to interrogate each person as to his immediate destination on disembarkation. The ship was kept under daily observation while in the Port of London. On 6th May she sailed for Dundee, and the Medical Officer of Health of that Port was informed of the circumstances. The ship subsequently proceeded to Dunkirk and Avonmouth. The Medical Officer of Health of the Port of Bristol informed me that a case of Chickenpox was landed from the ss. " City of London " at Dundee on 8th May, and another at Dunkirk on 13th May. ss. "City of Adelaide."—On April 30th the Ministry of Health forwarded a copy of a cablegram from Aden to the effect that the ss. " City of Adelaide " had landed a suspected case of Small-pox (diagnosis subsequently confirmed) at Colachel Travancore on 13th April. This vessel arrived in the Port of London at 11.30 p.m. on the 9th May, when it was ascertained that the patient, a native fireman aged 28, joined the ship at Rangoon on the 30th March with the rest of the native crew, who had all been vaccinated on the 28th March. He reported sick on the 13th April with a rash having worked right up to the appearance of the eruption. In the absence of a surgeon it was not possible to get any useful description of the eruption, but on inspection of the crew the Boarding Medical Officer, Dr. Jones, detected another native who showed evidence of a recent attack of Chickenpox. A few crusts still remained, so he was removed to the Port Isolation Hospital. This man showed two large scars on the left upper arm of vaccination in infancy, one more recent scar on the left upper arm, and a faint mark of the scarification when he was vaccinated at Rangoon on the 28th March, 1936, before joining the ship. Even if the first case was one of Small-pox, which seems unlikely, the incubation period had long expired. There were no passengers, and the crew remained on board while the ship was in London. A watch was kept for further cases of Chickenpox, and on 13th May another lascar developed the disease, and was promptly removed to the Port Isolation Hospital. ss. "Manipur."—In the" Weekly Record of Infectious Diseases at Ports, &c., at Home and Abroad" for the week ending 1st May, 1936, the following appeared:— "On 23rd April one case of Small-pox among the crew was disembarked at Port Sudan from the ship "Manipui" coming from Calcutta and bound for Suez." The ss. "Manipur" arrived off Gravesend on l0th May, and was boarded by Dr. H. Willoughby. The vessel left Calcutta on the 8th April, 1936, and called at Colombo 14th April; Port Sudan; 23rd to 25th April; Suez 28th April, Port Said 29th April. The Master reported that the case was a lascar who re-signed on at Calcutta on 8th April. He had been vaccinated on 2nd April, 1936. On 22nd April he reported sick, with an eruption on the face and body, and a temperature of 102° P. He had no prodromal symptoms. He was isolated forthwith, and the next day, 23rd April, the ship reached Port Sudan, where the Port Medical Officer diagnosed Small-pox and removed the case ashore with all his bedding and effects. All the crew, native and European, were revaccinated on 24th April. The lascars' forecastle and the cabin in which the patient had been isolated were disinfected. On arrival in the Port of London everybody on board was carefully inspected, and there was no evidence of any secondary or "missed" cases. As 17 days had elapsed since the case was removed from the ship, it was not deemed necessary to arrange for the surveillance of the three passengers, though their names and addresses were recorded. The crew were not paying off here, and were kept under observation until the vessel sailed for Dundee at noon on 13th May. 18 "SURVEILLANCE OF CONTACTS." (By J. A. Gillis, First Class Assistant, Port Health Office.) The International Sanitary Convention, 1926, and the Port Sanitary Regulations, 1933, both provide that persons on board ship who have been exposed to the infection of Plague, Cholera, Yellow Fever, Typhus Fever or Small-pox may, on arrival in a port, be subjected to observation or surveillance. "Observation" is defined as the isolation of persons whether on board ship or at a sanitary station before they obtain pratique. "Surveillance" means that persons are not isolated, that they receive free pratique immediately, but the authorities of the several places whither they are bound are informed of their coming, and they are subjected to a medical examination with a view to ascertaining their state of health. It is intended in this paper to deal only with "surveillance." I hope to show that the restrictions placed on the disembarkation of the personnel of ships which arrive in this country having on board or having had during the voyage a case or cases of one of the major infectious diseases, are now reduced to a minimum. In this connection it is interesting to compare present day procedure Avith the measures adopted in the past, and I am greatly indebted to Dr. C. F. White, who has given me the opportunity of reading, and his permission to use, the information he has gathered on Maritime Quarantine in the past, and which he has recorded in his paper "Maritime Quarantine—Past, Present and Future." Dr. White in the introduction to his paper says "The word Quarantine means literally 'a period of forty days,' and was originally applied to the time, arbitrarily fixed at forty days, during which ships from ports suspected to be infected with plague were detained before being permitted to have communication with the shore. During the nineteenth century the principle of detention was applied against cholera and yellow fever as well as plague, and the period of isolation was varied from time to time in efforts to adjust the balance between the demands of international commerce and the danger of importation of these diseases. The term quarantine, however, continued to be applied to this system of protection of the public health and in common parlance its meaning has now been further extended to include the period of relative isolation to which any person who has been exposed to any infection may be subjected." The two greatest pestilences in history were the Plague of Justinian in 542 a.d. and the Black Death of 1347-9. During the latter which destroyed at least a third of the population of Europe, maritime quarantine was introduced in Venice where, in 1348, three Overseers were appointed and authorised to spend public money on isolating infected ships, goods and persons on an island in the lagoon, a physician being stationed with the sick. The first properly constituted maritime quarantine station was established by the Venetian Authorities on the island of Santa Maria di Nazareth in 1403, and here all travellers from the Levant were isolated for forty days in an old almshouse known as the House of St. Lazarus. Hence arose the terms quarantine and lazarette, which are both still in use, though neither with exactly its original meaning. The Venetian Regulations whereby all ships from infected ports, whether there was any plague on board or not, should be detained for forty days without being allowed communication with the shore, became the basis of all subsequent quarantine procedure throughout the world. Despite all efforts to control the spread of plague it persisted in Europe for some 300 years after the Black Death and the part played by the rat was unsuspected, though the fact that a rat mortality preceded the human epidemic was often observed. Bills of Health were probably introduced in about 1527 during a severe epidemic of plague in Italy, but they were not generally adopted until 1665. A "clean" bill of health was granted to a ship if there was no suspicion of plague in the port of departure and there had been none for forty days; a "suspected " bill was issued if the port was free from plague but traded with infected districts, and a "foul" bill meant that plague actually existed in the port at the time the ship sailed. 19 The system of maritime quarantine thus began and was developed in the Mediterranean ports, but England does not appear to have taken any action for the prevention of the importation of plague until the middle of the 17th century. It was in 1636 that the question was referred to the Royal College of Physicians, who recommended that "neither man nor goods should come from any suspected place without a certificate of health or else be sent suddenly away, or be put to the pest house according to the custom of Italy." In 1664, however, the trade with the Levant which had hitherto been the monopoly of the Levant Company was thrown open, and in consequence the King in Council issued the first English Quarantine Regulations. In these Regulations it was laid down that bills of health should not be granted until forty days from the last case of plague, and that if plague developed in a ship in the Levant the vessel should not sail for England until the cargo had been landed and aired for forty days. The next year, 1665, the Great Plague of London occurred and lasted until 1667. Since that time plague has been almost non-existent in Great Britain, but for a number of years the outbreak of epidemics on the Continent led to panic legislation in this country. In 1720, Dr. Richard Mead in a paper entitled " A Short Discourse Concerning Pestilential Contagion and the Methods to be used to Prevent It " expressed the opinion that he was opposed to passengers and crews performing quarantine in their ships, but recommended that, if there was sickness on board the healthy should have their clothes burned, that they should be washed and shaved, and stay 30 to 40 days in the lazarette. The sick should be kept in houses remote from the healthy, and when recovered should be washed and shaved and have fresh clothes and be removed to the houses of the sound for 30 to 40 days. The recommendations of Dr. Mead and plague in Marseilles resulted in the Quarantine Act of 1721. At intervals further Quarantine Acts were passed, some of which imposed a delay of from 60 to 65 days on shipping, and shipping interests began to complain bitterly, for not only was detention of ships and cargoes a serious hindrance to trade, but vessels had even been burned and sunk and the quarantine dues were ruinous. In 1825 the last Quarantine Act was passed. It prescribed that vessels from ports infected with plague or other dangerous diseases should be liable to quarantine from the time of departure from an infected place as ordered by the King in Council. Customs Officers were instructed to put certain specified questions to Masters of ships and if there were any suspicious circumstances or answers the Officer of Customs was to transmit the answers and an account of the circumstances to the Privy Council, meanwhile detaining the ship in isolation. Up to the middle of the 19th century quarantine was only directed against plague, but thereafter it Avas applied against yellow fever and cholera. In 1831 England endeavoured by quarantine to prevent the importation of cholera from the Continent, but the system failed, and it was gradually realised that it was impossible to prevent the infection of cholera from reaching these shores from neighbouring countries, and that therefore it was of primary importance to remove the conditions ashore which favoured the spread of the disease. Thus began the great sanitary reforms in this country, and as they developed, so quarantine declined. The year 1848 was an important one in the history of Public Health, for it was in this year that the first Public Health Act and the Nuisance Removal and Diseases Prevention Act were passed and the General Board of Health formed. It was also the commencement of the English practice of dealing with ships according to the health conditions on board at the time of arrival rather than the conditions existing at the port of departure or call. 20 It is worthy to note the words of Sir John Simon, who as Medical Officer of the Privy Council in 1875 wrote the following condemnation of the quarantine system:— "A quarantine which is ineffective is a mere irrational derangement of commerce, and a quarantine of the kind which ensures success is more easily imagined than realised. Only in proportion as a community lives apart from the great highways and emporia of commerce or is ready and able to treat its commerce as a subordinate interest—only in such proportion can quarantine be made effectual for protecting it." This view was not accepted on the Continent, and in spite of a number of International Conferences it was not until the Venice Conference of 1892 that the European powers accepted the British principle that measures against the importation of infectious diseases should be based on the health conditions on board the ship rather than those existing in the port of departure. The next year a conference was held in Dresden and a Convention was drawn up. This Convention was ratified by Great Britain with the priviso that persons who appeared well at the time of disembarkation, might be kept under surveillance at their destinations rather than be detained under observation in the port of arrival. Further International Sanitary Conventions were held in 1903 in Paris and in 1907 in Rome, and the latter Convention saw the constitution of the Office International d'Hygiene Publique with headquarters in Paris which, until the present day, has continued to collect and distribute epidemiological information; to issue reports and recommendations on matters of international public health interest; has drawn up the International Conventions of 1912 and 1926, and recently the International Sanitary Convention for Aerial Navigation. In this country power to detain ships remained in the hands of the Customs Officers until 1871, which saw the foundation of the Local Government Board. In 1872-3 the Board constituted Port Sanitary Authorities. Further powers were given to the Board by the Public Health Acts of 1873, 1896 and 1904. The International Sanitary Convention of 1912 was not put into into operation owing to the war. After the war it was decided to revise this Convention, and so far as this country was concerned the gap was filled by the introduction of the Port Sanitary Authorities (Infectious Diseases) Regulations, 1920; but after the International Sanitary Convention of 1926 these and previous Regulations were repealed by the issuing of the Port Sanitary Regulations, 1933, which prescribe uniform action throughout the ports of the British Isles in dealing with the control of both the major and minor infectious diseases. The foregoing has been introduced into this paper mainly to show how severe were the restrictions of the old quarantine system, and how slowly they were discarded in spite of their failure. In the United Kingdom surveillance has been found to be an effective and practical measure, owing to the facts that the country is divided into comparatively small sanitary areas, each with its Medical Officer of Health; that means of communication are rapid and easy, and members of the population have, for the most part, a sense of their obligations to the community. The success of this system of surveillance depends very largely upon the accuracy and rapidity with which the names and addresses of passengers and crew are forwarded to the medical officers of health of their districts of destination. In London vessels from the Far East usually arrive on a Friday, and as it is on such vessels that the major infectious diseases are most likely to be found, speed in notification becomes an important factor in order to avoid delay over the week-end. Bearing this in mind a system has been evolved in the Port of London by which the minimum amount of work has been combined with the maximum amount of efficiency. Nowadays through either the aforementioned Office International d'Hygiene Publique, the Ministry of Health, the Press or the shipowners themselves, advance information is usually received of the occurrence of serious infectious disease on board ship, and as ships run to a schedule it is possible to know exactly when a particular vessel will arrive. 21 If a ship is an "infected" or "suspected" ship an effort is made to forward to the Master of such ship, full instructions of what is expected of him on the arrival of his ship in London. If the vessel is calling at an intermediate port before arriving in London this can usually be done by letter per the shipping company's courier or agent, but alternatively the shipping company who are in wireless communication with the ship, will pass on our instructions to the Master. These instructions call for the Master to hand to every passenger and member of the European crew a postcard on which is to be recorded the first address to which they are proceeding on disembarkation (the use of this postcard is described in detail later); a warning that all passengers and crew must be mustered for medical examination on arrival and a request that a complete passenger and crew list, giving addresses on disembarkation be prepared, in duplicate, it being pointed out that names of banks or travel agencies will not be accepted, and may lead to the detention of the individual until they can state their destination more precisely. Should a vessel not call at an intermediate port between the time of the development of the disease and her arrival in London, a slight delay naturally occurs in the issue and filling up of such cards. The postcard referred to above is in two halves and is here reproduced:— PORT SANITARY REGULATIONS, 1933. Penalty for Breach of Regulations, £100. In accordance with the above Regulations you are permitted to disembark on the following conditions:— 1. That you give to the Medical Officer of Health of the Port of London the precise address to which you are proceeding immediately on landing. 2. That if you change your address at any time within 14 days of disembarkation you shall notify forthwith your new address to the Medical Officer of Health of the Port of London on the attached card. I and members of my family are proceeding to the following address Name and forthwith:- Full Address No. or Name of House in Block Letters. Street Postal District County Signature PORT OF LONDON SANITARY AUTHORITY, PORT SANITARY REGULATIONS, 1933. Penalty for Breach of Regulations, £100. NOTIFICATION OF CHANGE OF ADDRESS WITHIN 14 DAYS OF DISEMBARKATION. Having disembarked from the s.s on (date) my address from (date) to (date) will be as under. Name and Full Address in Block Letters. Name No. or Name of House Street Postal District County Signature This Card may be sent through the post unstamped but If it is enclosed in an Envelope Postage must be Pre-paid. 22 When the vessel arrives at Gravesend it is boarded by the Boarding Medical Officer and members of the clerical staff. The passengers and crew having already been mustered the Medical Officer proceeds with his medical examination. As it is essential that every person on board is seen by the Medical Officer the opportunity is taken to interrogate such persons and ask them whether the address given on the top half of the above card is the actual address to which they are proceeding immediately on disembarkation. This portion of the card is retained by the clerk and the address given on it is checked with the address given on the list supplied by the shipping company, any alteration being rectified on the spot. At the same time it is pointed out that should they change their residence during the incubation period of the disease, such change should be notified by filling in and forwarding the bottom half of the postcard. This half of the postcard is printed on the reverse as follows:— no postage stamp postage necessary if will be posted in paid by great britain addressee. or northern ireland. Business Reply Card. licence no. 5341. THE MEDICAL OFFICER OF HEALTH, PORT OF LONDON, 5, CHURCH PASSAGE, GUILDHALL, LONDON, E.C.2. This is by arrangement with H.M. Post Office and is an incentive to the individuals to notify any change of their address, as it does not require stamping. It is usually arranged that passengers, after passing their medical inspection and the above-mentioned interrogation, are passed on to the Immigration Officers who see and stamp everybody's passport. This is a very satisfactory arrangement as it enables the Port Health Officers and the Immigration Officers to compare their respective lists and forms a double check that every person on board has been seen. Even the address of the Pilot is taken as a precautionary measure. It is then, and then only, that the ship is granted pratique and disembarkation commenced. Next commences the task of notifying the Medical Officers of Health of the districts to which the passengers and those members of the European crew who are leaving the ship are proceeding. It is first necessary to scrutinise each card collected from the passengers and crew and to ascertain the name of the local Authority in which the address given on the card is situated. This is an easy matter when the person is proceeding to a large town, but when the address is an out of the way village it is necessary to make reference to a Stationery Office Publication entitled "Index of Names and Places" arranged alphabetically and giving the Borough, Urban District or Rural District in which the place is situated. 23 This having been done it is next necessary to ascertain the address of the Medical Officer of Health for each individual local authority. For this purpose we have, in London, compiled our own index. This was achieved by circulating every County Medical Officer in the United Kingdom and asking him to be good enough to supply the official addresses of the Medical Officers of all Local Authorities in his area. This met with a 100 per cent. response and forms an invaluable reference. This information is obtainable through other references, but such references contain also a mass of information which is of no use for the purpose in hand and obviously takes longer to find. It is also our practice when sending out a notification to ask for an acknowledgment. When these are received they are checked with the addresses in our index, and any necessary alteration is made. For addresses in London and the suburbs an up-to-date and authentic directory, containing a street list, is used. This part of the routine having been completed and the envelopes addressed, the actual postcards, as filled in by the passengers and/or crew, are forwarded to their respective districts together with a short but concise note respecting the case or cases, e.g., "The person(s) mentioned on the enclosed card(s) arrived in London on (date) per s.s. (Vessel), from which Vessel a case of (disease) was landed to hospital at (place) on (date). The letter 'C' denotes a member of the crew." The sending of the card already filled in by the passenger or crew saves the time that would be involved if the particulars had to be copied out on to a notification form as was the practice a few years ago. The parting with the card is of no account as I have previously mentioned that the address thereon has been checked against that appearing on the list supplied by the shipping company, which list is, of course, retained for future reference. The efficiency of this system can be judged by the following actual experience:— A vessel with a personnel of 602 arrived off Gravesend and was boarded at 11 a.m. The disembarkation of passengers was permitted at 1.30 p.m. 403 actual cards were filled in, representing the 602 passengers and crew. These cards were forwarded to the Medical Officers of Health of 204 individual sanitary areas in the United Kingdom and were posted from London by the evening post the same day. Subsequently 131 passengers notified change of address once and 8 passengers notified change of address twice. Ten members of the crew notified change of address once and 10 notified their return to the ship. Although there were several queries in regard to addresses, every person on board was ultimately traced. Occasionally a medical officer of health has asked for an indication to appear on the notification as to the vaccinal state of the contacts, but Dr. White's view is that, in the first place this would frequently lead to delay in posting the cards and in the second place the information would not relieve the local medical officer of health of the responsibility of exercising surveillance. The aim of Port Health Administration should be the maximum of efficiency in the protection of the public health with the minimum of inconvenience to the travelling public, port authorities, shipping companies and merchants, and it is submitted that, in regard to the surveillance of contacts at least, the present system approaches as nearly as possible to this ideal. 24 V.— MEASURES AGAINST RODENTS. These remain as described in my Report for 1933. The results as shown in Tables "E," "F," "G" and "H," do not for this year call for any special comment. In December I reported as follows to your Worshipful Committee:— ''Weil's Disease or Infectious Jaundice is a severe form of fever usually associated with jaundice and enlargement of the liver and due to a spirochaete, Leptospira icterohcemorrhagice. "The natural reservoir of the infection is the rat which excretes the organism in the urine and faeces without being itself apparently ill. Human infections therefore arise amongst persons who come into close contact with material soiled by rats. Cases have been recorded in this country among miners, sewer workers and fish workers. "Recent work suggests that there are many mild and some severe unrecognised cases and methods of prevention are under investigation. "It has been suggested that rats caught ashore and in ships in the Port of London should be examined to ascertain whether they are carriers of the infecting organism. "Your worshipful Committee agreed that an investigation of the incidence of Leptospira icterohcemorrhagiœ in rats caught alive in the Port should be undertaken during 1937." Rats Destroyed during 1936. TABLE E. (1) On Vessels. Number of Jan. Feb. Mar. April. May. June. July. Aug. Sept. Oct. Nov. Dec. Total in Year. Black Rats 110 74 90 82 49 67 66 56 117 94 99 66 970 Brown Rats nil 1 2 nil nil nil nil nil 8 nil nil 2 13 Species not Recorded 199 452 235 203 287 265 442 154 578 327 323 520 3,985 Rats examined 110 75 92 82 49 67 66 56 125 94 99 68 983 Rats infected with Plague nil nil nil nil nil nil nil nil nil nil nil nil nil See also Appendices xx. and xxi. 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 110 170 92 56 49 64 53 60 47 90 79 43 913 Brown Rats 32 43 54 42 64 26 63 52 61 99 38 38 612 Species not Recorded 220 322 273 245 422 301 242 386 325 366 231 158 3,491 Rats examined 142 213 146 98 113 90 116 112 108 189 117 81 1,525 Rats infected with Plague nil nil nil nil nil nil nil nil nil nil nil nil nil RATS EXAMINED—Vessels, Docks, Quays, &c 2,508 See also Appendices xx. and xxi. 25 TABLE G. Measures of Rat Destruction on Plague "Infected" or "Suspected" Vessels or Vessels from Plague Infected Ports arriving in the Port during the Year. Total Number of suchVessels arriving. Number of such Vessels fumigated by so2. Number of Rats Killed. Number of such Vessels fumigated by HCN. Number of Rats Killed. Number of such Vessels on which Trapping, Poisoning, &c., were employed. Number of Rats Killed. Number of such Vessels on which measures of Rat Destruction were not carried out. 1. 2. 3. 4. 5. 6. 7. 8. 2,417 46 916 (41 mice.) 72 879 (34 mice.) 1,038 2,294 1,379 TABLE H. Deratisation Certificates and Deratisation Exemption Certificates issued during the Year. NET TONNAGE. Number of Ships. Number of Deratisation Certificates Issued. Number of Deratisation Exemption Certificates issued. Total Certificates issued. After Fumigation with After Trapping, Poisoning, &c. Total. HCN. Sulphur. HCN. and Sulphur. 1. 2. 3. 4. 5. 6. 7. 8. 9. Ships up to 300 tons 226 — — — — — 226 226 „ from 301 „ to 1,000 tons 316 l 3 — — 4 312 316 „ „ 1,001 „ „ 3,000 „ 218 12 18 — 2 32 186 218 „ „ 3,001 „ „ 10,000 „ 358 49 32 — 2 83 275 358 „ over 10,000 „ 44 18 — — — 18 26 44 Totals 1,162 80 53 — 4 137 1,025 1,162 VI.—HYGIENE OF CREWS' SPACES. TABLE J.—Classification of Nuisances. Nationality of Vessel. Number inspected during the year. Defects of original construction. Structural defects through wear and tear. Dirt, Vermin and other conditions prejudicial to health. British 9,603 105 1,222 1,742 The hygiene of crew spaces in ships, is, at the present time, receiving the close attention of the Board of Trade and of Shipowners. It is understood that the Board of Trade "Instructions as to the Survey of Master's and Crew's Spaces" are undergoing revision and already much improved accommodation is being provided in new ships, but until the new instructions are actually issued we shall not know whether they embody all the recommendations of the Association of Port Sanitary Authorities and of the Manning Committee of the Shipping Federation, nor shall we know whether the new standards will be applied as far as practicable to the crew's quarters in existing ships. This is therefore not the time to repeat the criticisms which have been so often made in the past nor to jump to the conclusion that the improved conditions recently observed will in future be the rule in new ships; but meanwhile attention may be drawn to other factors which affect the health of seamen. Adequate nutrition is probably the most important single factor in the maintenance of health and in this connection Mr. Beattie, your Inspector on the Middle River District, has submitted a report on "Conditions Prevailing in Coasting Vessels." Mr. Beattie points out that the crews of these ships ration themselves, and that this individual messing is unsatisfactory and uneconomical. The men do not lay out their money to the best advantage dietetically and in some, perhaps many cases, they tend to economise on their own food in order to make better provision for their families. For the latter reason and also because freedom to make even an unwise choice is regarded as a privilege, a change to collective messing would perhaps not be universally popular, but provided the food supplied comprised all that was required for adequate nutrition and was properly cooked, the men's health would undoubtedly benefit. 26 This brings Mr. Beattie to his second point. In 52 coasting vessels on which he made enquiries he found that 16 had no cook; 29 had an ordinary seaman and two an A.B. acting as cook, but not usually specially trained in the art, one had a galley boy cook who had a little experience which he had picked up in the galley of a bigger ship and four had a steward cook for the officers only. These are small ships with small crews and therefore the officers, including the Master, and the men frequently have very long hours of work under very trying conditions. Mr. Beattie mentions one coaster in which the official log recorded 72 trips totalling 24,000 miles in 12 months, and in which the Master had been on duty for as many as 127 hours in a single week. In another ship the Master had, a short time previous to Mr. Beattie's visit, 62 consecutive hours on duty and the mate had 32 hours' duty in 36. He gives other examples of long hours of work by officers and men, and asks whether under such conditions it is likely that they can keep physically fit if they have to cook their own food or if the member of the crew acting as cook has not reasonable training and experience. Mr. Beattie constantly sees new faces in his regular ships and finds on enquiry that the A.B. left "with a pain in his stomach"; the ordinary was "paid off sick"; the engineer is "having a trip ashore"; the fireman "couldn't stand it and cooking for himself." Mr. Beattie further draws attention to the meagre provision for the storage of the crew's food. In many cases the food locker is an unshelved, unventilated box situated in the living quarters and just big enough to hold six loaves of bread. It is impossible for a man to get the food he has bought for the voyage in this locker, and consequently food is stowed wherever there is space available, however unsuitable it may be. Surely these are questions worthy of the consideration of the owners of coasting vessels in the interests of efficiency as well as of the health and contentment of the crews of their ships. The Third International Conference of the Health and Welfare of Merchant Seamen. At the request of the Joint National Committee on Port Welfare and with the sanction of your Worshipful Committee, your Medical Officer attended the abovementioned Conference at Geneva on 5th October. There were present at the Conference delegates from the Health Section of the League of Nations; International Labour Office; International Transport Workers' Federation (Seamen's Section); League of Red Cross Societies; Union Internationale Contre le Peril Venerian; Apostolatus Maria Internationale Concilium; Denmark; France; Germany; Great Britain; Greece; Netherlands; Poland; Sweden. The British delegates were Colonel J. Sandeman Allen, M.P., Chairman of the National Committee on Port Welfare; Mr. L. Bowden, Secretary of the National Union of Seamen; Mr. F. Bowes, Honorary Secretary of the British Council for the Welfare of the Mercantile Marine; Mrs. C. Neville Rolfe, Secretary General of the British Social Hygiene Council; Captain F. A. Richardson, Secretary of the London Port Welfare Advisory Council, and your Medical Officer. Subsequent to the Second International Conference in 1929 the International Labour Office had circulated a questionnaire to all the countries interested in shipping, had tabulated the replies, and had drawn up draft Recommendations concerning the Promotion of Seamen's Welfare in Ports. These draft recommendations were arranged under the following headings:— 1. General Organisation of Port Welfare Work; the need for co-ordination of the efforts of all concerned in Port Welfare through local committees. 2. Regulations regarding the sales of intoxicating liquor, employment of women, safety and lighting, supervision and policing of dock areas. 3. Health, measures calculated to reduce soliciting and enticing in districts frequented by seamen ; to promote facilities for treatment under the Brussels Agreement, and propaganda among seafarers. 4. Accommodation and Recreation; the development of suitable accommodation for visiting seamen and provision of institutes and facilities for recreation. 27 5. Saving and Remittance, Wages. 6. Information of Seamen, measures to provide for the dissemination of information of importance and interest to seamen. 7. Financial Organisation, drawing the attention of Governments to certain possibilities with regard to financial organisation. Each of these sections was introduced by a separate speaker, and the recommendations were then discussed. The Joint National Committee on Port Welfare had already given careful consideration to the draft recommendations and had suggested a number of amendments. The British delegates had little difficulty in securing general agreement with these amendments. The recommendations of the Voluntary Conference were transmitted to the Twenty-first (Maritime) Session of the International Labour Conference, and were very carefully considered during the next fortnight. Captain Richardson remained at Geneva to attend the meetings and to explain points in connection with the recommendations. He informs me that during the Committee stages, in addition to the 18 amendments put forward by the International Voluntary Conference, seven were put forward by the Employers' groups jointly, one by the Indian Workers' group, three by the British Government, six by the Indian Government, two by the Japanese Government and two by the Chinese Government. Agreement was reached on all the questions, and in the final vote at the Plenary Session there were 88 delegates in favour of the proposals and none against them. I understand that in the official report of the proceedings special reference was made to the lucid explanations of experience in the field of Port Welfare gained by the London Port Welfare Advisory Council. Your Worshipful Committee will be interested to know that "A Seaman's Guide to London" has already been published by the London Port Welfare Advisory Council, and is being issued free to visiting seamen. An experimental Enquiry Bureau has, with the assistance of the British Sailors' Society, been established at the Royal Albert Docks, and is proving far more useful and popular than was anticipated. I do not think that it can yet be said that the London Port Welfare Committee is firmly established, but it has survived the difficulties attending its birth, it is growing in strength and weight and, as a result of the International Conference, it may reasonably be hoped that the Government will, in due course, contribute to its support and maintenance. So far the only nourishment it has had is £500 very generously contributed by the Corporation of the City of London. Its needs are small but, though ultimately there is little doubt that it will receive grants from various organisations who will awake to their responsibilities to the growing child, there appears to be a difficult period ahead when there will be a real danger of it dying from starvation. Its sponsors have more or less promised that it shall not beg in the same streets as the Missions to Seamen, so that it does not know where to turn for help until it is generally recognised as a national asset. VII.—FOOD INSPECTION. Caseous Lymphadenitis.—During the year the proportion of carcases of imported mutton examined for Caseous Lymphadenitis, irrespective of the country of origin, remained at 5 per cent., and that for pieces of mutton at 100 per cent. 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 1,298 3 — New Zealand 5,811 10 — South America 1,953 9 — Totals 9,062 22 — Percentage condemned From Australia 0.23 „ New Zealand 0.17 South America 0.46 28 Pig Carcases.— A careful examination was made of a percentage of pig carcases arriving in the Port, the number of carcases examined being 2,356. Five carcases were found to be diseased. Actinobacillosis in Ox Tongues.— A percentage examination was made of every consignment of frozen ox tongues arriving in the Port. 315 consignments were put into dock store, where careful examination was made by your Officers of 28,065 tongues, and 172 tongues were found affected with Actinobacillosis, a percentage of 0.61. Action taken under the Public Health (Imported Food) Regulations, 1925, resulted in 3,288 tons 14cwts. 0qrs. 26lbs. 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.) 45 2 3 26 Cattle and Poultry Foods 779 2 2 10 Refining 509 14 0 14 Experiment (Laboratory work) — 3 1 25 Exportation 86 6 2 10 Soap-making 1 15 2 0 Removed to other districts — 4 2 27 Reconditioning 31 15 2 8 Technical purposes 4 15 3 11 Distillation 18 7 1 3 Destroyed—Buried 1,749 17 0 16 „ —Burnt 61 8 1 16 Total weight 3,288 14 0 26 Foodstuffs Condemned:— Dock. Tons. Quantity. No. of seizures. cwts. qrs. lbs. Royal Albert Dock 375 7 1 15 237 Royal Victoria Dock 622 11 2 2 370 King George V. Dock 59 12 3 8 131 East India Dock 204 18 3 25 80 West India Dock 805 9 2 0 195 Millwall Dock 117 12 0 4 28 Surrey Commercial Dock 671 16 2 13 145 London Dock 131 2 3 22 173 St. Katharine Dock 171 6 3 6 20 Regent's Canal Dock 98 12 1 27 49 Tilbury Dock 30 3 0 16 160 Total weight 3,288 14 0 26 1,588 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. 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 1933 1,303 17 2 23 1,359 1934 1,825 14 2 10 1,567 1935 2,368 13 3 20 1,454 1936 3,288 14 0 26 1,588 The detention of Fats under the Public Health (Imported Food) Regulations, 1925, during the year was as follows:— No. of Exportation Notices served 175 No. of casks, &c., released for exportation 3,360 No. of casks, &c., released for soapmaking, &c 9,160 No. of casks, &c., released to wharves under Notice of Exportation 6,720 29 Foodstuffs disposed of as unfit for human consumption:— Tons. cwts. qrs. lbs. Mutton and Lamb—811 carcases, parts ex 1,330 carcases. 18 3 3 5 Beef—61 hinds, crops, &c., parts ex 45 hinds, crops, &c., 44 bags and a quantity of trimmings. 15 11 0 18 Bacon—3 cases, 4 sides, and part of 1 side — 6 0 8 Pork—11 carcases and parts of 35 carcases, 6 cases. 1 0 2 6 Poultry—1 case and 12 loose chickens — — 1 8 Veal—3 bags. — 2 2 14 Hams—2 cases and 43 loose hams — 6 1 22 Sausages—1 case — — 2 0 Total weight 35 11 1 25 Meats (Tinned):— Tons. cwts. qrs. lbs. Beef—20 tins — 1 0 8 Hams—106 tins — 9 1 22 Ox Tongues—6 cases, 2 tins — 6 0 19 Pork—15 tins — — 3 21 Veal—1 tin — — — 7 Total weight — 17 2 21 Fats:— Tons. cwts. qrs. lbs. Lard—32 packages — 18 2 0 Offal:— Tons. cwts. qrs. lbs. Ox Tongues—172 diseased, 24 bags 1 11 0 15 „ Cheeks—5 bags — 2 3 11 „ Skirts—6 bags — 2 1 20 „ Hearts—59 bags and 7 loose 1 5 3 15 „ Livers—190 bags, parts of 12 bags, 6 loose 4 8 0 14 „ Tails—2 bags — 1 1 4 „ Kidneys—130 bags and parts of 16 bags, 4 cases and parts of 16 cases 1 5 0 10 Bungs, Casings, &c., 6 casks and a quantity loose collected 1 13 2 17 Sheep Hearts—24 bags — 7 2 16 Calf Tongues—1 bag and 78 loose — 1 1 2 „ Livers—17 packages — 7 3 22 „ Kidneys—4 bags — 1 0 23 Lamb Hearts—75 bags — 19 2 6 „ Livers—1 Pail — — — 9 „ Tongues—parts of 4 bags — — — 14 Pig Livers—1 barrel, 1 loose — 3 0 21 „ Heads—3 heads — — — 24 Pancreas Glands—13 bags — 5 1 12 Goose Livers—13 cases — 6 2 0 Total weight 13 3 2 3 Fish:— Tons. cwts. qrs. lbs. Anchovies—1 case — 2 0 0 Fresh Fish—1 keg — 1 0 0 Various—Tinned, 1,443 cases 27 8 3 14 Sardines—607 cases, 95 tins 14 4 0 26 Lobster—419 tins — 16 2 27 Total weight 42 12 3 11 30 Fruit:— Tons. cwts. qrs. lbs. Apples—508 packages 16 8 3 14 Bananas—27,200 bunches, stems, &c., and a quantity loose collected 813 11 0 17 Currants—851 packages 17 1 1 5 Citrons—315 cases 12 2 0 11 Figs—15 bags — 3 3 0 Baisins—24 packages 1 16 0 0 Grapes—614 boxes 5 10 1 22 Melons—538 cases 22 19 1 19 Pears—2,791 packages 40 19 0 8 Prunes—18 cases — 4 1 15 Peaches—4 packages — — 2 0 Tomatoes—502 packages 19 19 3 16 Olives—132 kegs 1 15 0 17 Dates—717 cases 20 9 3 1 Mandarines—32 packages 1 3 1 8 Lemons—282 packages 10 1 3 22 Lemon Peel—3 baskets — 2 3 12 Oranges—16,298 cases and a quantity loose collected 608 4 1 22 Orange Peel—55 baskets 1 11 2 6 Sundry—3,541 packages 125 13 3 13 Total weight 1,720 6 0 4 Fruit (Tinned and Bottled):— Tons. cwts. qrs. lbs. Tomatoes—184 cases, 57 tins 4 7 0 16 Various—356 cases, 299 tins 11 2 2 6 Total weight 15 9 2 22 Fruit Pulp, &c.:— Tons. Cwts. qrs. lbs. Tomato Puree—37 tins — 2 2 25 ,, Pulp—926 tins 2 13 3 19 Blackcurrant Pulp—25 cases, 34 tins 1 8 0 16 Apricot Pulp—79 cases, 169 tins 4 2 0 19 Fruit Pulp—8 barrels, 20 tins 1 19 0 0 Quince Pulp—2 parcels — — 2 9 Raspberry Pulp—1 case, 11 tins — 1 2 2 Strawberry Pulp—16 cases, 9 tins — 18 1 17 Fruit Juice—33 casks 12 10 2 21 Grape Fruit Juice—9 packages — 18 0 22 Total weight 24 15 1 10 Vegetables:— Tons. cwts. qrs. lbs. Potatoes—914 packages 47 12 3 18 Onions—366 packages 16 3 0 0 Peas—Quantity loose collected — 7 2 27 Beans—4 sacks — 5 0 0 Various—66 packages 1 18 2 7 Total weight 66 7 0 24 Vegetables (Tinned):- Tons. cwts. qrs. lbs. Various—23 tins — — 2 4 Nuts:— Tons. cwts. qrs. lbs. Apricot Kernels—19 bags 1 3 3 4 Ground Nuts—Quantity loose collected 1 7 3 0 Cashew Nuts—31 packages — 1 3 21 Various—178 cases and a quantity loose collected 7 2 2 17 Chestnuts—76 bags 3 2 3 0 Total weight 12 18 3 14 31 Provisions:— Tons. cwts. qrs. lbs. Sugar sweepings—470 bags 56 18 9 18 Butter—38 packages — 18 0 0 Margarine—23 packages — 4 0 18 Cheese—41 packages 2 9 1 2 Cocoa—762 bags 50 0 1 18 Coffee—1 bag — 1 0 16 Jams—1 case, 209 tins — 4 3 16 Biscuits—5 cases — 2 0 5 Sugar—3,850 bags 302 6 0 22 Tomato Paste—162 tins — — 3 18 „ Soup—732 tins — 9 1 4 „ Ketchup—16 tins — 1 0 0 Tea—2 packages — — 3 16 „ Sweepings—3 packages — 4 1 23 Milk powder—30 packages — 18 0 0 „ Evaporated—139 tins — 1 0 27 „ Condensed—1,262 cases 24 18 3 13 Egg Yolk—4 cases, 2 tins — 4 2 1 Total weight 440 3 1 21 Grain and Flour:— Tons. cwts. qrs. lbs. Wheat 780 3 1 25 Barley — 11 1 2 Flour 69 3 2 0 Oats 34 10 1 6 Bice 5 17 1 0 Maize 8 19 2 16 Rye 4 9 1 3 Total weight 903 14 2 24 Confectionery:— Tons. cwts. qrs. lbs. Confectionery—3 bags — 2 0 13 Prepared Foods, &c.:— Tons. cwts. qrs. lbs. Boiled Oats—10 sacks, 55 cartons 1 7 2 0 Macaroni—5 packages — — 1 3 Various—145 packages — 8 0 26 Total weight 1 16 0 1 Sundries:— Tons. cwts. qrs. lbs. Various—353 packages 9 16 1 25 PUBLIC HEALTH (IMPORTED FOOD) REGULATIONS, 1925, AND PUBLIC HEALTH (IMPORTED FOOD) AMENDMENT REGULATIONS, 1933. Official Certificates from the following countries are recognised by the Ministry of Health, under the above-mentioned Regulations:— (1) In respect of Items (a) and (c) of the Second Schedule of the Amendment Regulations, i.e.:— (a) A severed part of the carcase of an animal (including the head thereof, and the whole carcase without the head, but not including any part of the carcase of a pig which has been salted, cured, pickled, dried and smoked, or otherwise prepared in the manner in which bacon or ham is ordinarily prepared) from which no submaxillary, pre-scapular, pre-crural, superficial inguinal, supramammary, or popliteal gland has been taken out; (c) All edible parts of an animal other than (i) the head or other severed parts of the carcase, (ii) the intestines prepared in the form of sausage casings and (iii) meat which has before importation been made ready for human consumption in the form of a sausage or other prepared or manufactured article of food. 32 Argentine Republic. New Zealand. Australia. Iceland. Bechuanaland Protectorate. South West Africa. Brazil. Southern Rhodesia. Canada. United States of America. Chilian Republic. Uruguayan Republic. French West Africa. Union of South Africa. Madagascar and Dependencies. (2) In respect of Item (b) of the Second Schedule of the Amendment Regulations, i.e., lard, dripping, edible tallow and all other rendered animal fats, except oleo oil, oleo stearine and premier jus— Australia. Hong Kong. Canada. Uruguayan Republic. Denmark. Brazilian Republic. French West Africa. Hungary. Italy. Poland. Madagascar. Lithuania. New Zealand. Bulgaria. Netherlands. Estonia. Roumania. Latvia. Sweden. Belgium. Switzerland. Danzig Free State. United States of America. France Argentine Republic. Yugo Slavia. 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 Number of Notices Meats and Fats. Where from. served. 5,431 casks, &c. New Zealand 110 4,036 „ Australia 50 141 ,, South America 4 1,114 „ Other Countries 15 Irregular Certification of Lard. On 6th January, 1936, 114 casks of unrefined lard from Bulgaria arrived in the Regent's Canal Dock. On inspection these casks were found not to bear the Bulgarian Official Certificate and, therefore, in accordance with the Public Health (Imported Food) Regulations, a Notice to Export was served. On 18th January the consignment was duly exported in a ship sailing to Bremen. On 24th January this ship returned from Bremen, and had on board 114 casks of Bulgarian Lard stowed in exactly the same position as were those exported on the 18th, but these casks all bore the Bulgarian Official Certificate. It was suspected that these were, in fact, the same casks, and that the Certificates had been affixed in Bremen. The explanation offered was that there had originally been two consignments, one certificated for England and one uncertificated for Germany ; that the wrong consignment had been shipped in the first instance, and that the mistake had been corrected on return of the ship to Bremen. On careful examination of the casks, however, two, which had been opened for sampling on 9th January, were identified by the cooper's marks, which confirmed our suspicions and put an end to explanations. The matter was taken up with the Ministry of Health and the Bulgarian Legation. It did not appear that the importers were a party to the irregular proceedings, and therefore it was decided not to prosecute but to insist that the lard be sold as uncertificated lard for industrial purposes, and be not allowed to be used for human consumption. On 6th March the lard was released to a firm in Stockport for soapmaking, the Medical Officer of Health of Stockport having intimated his acceptance of the guarantees given. On 23rd March the Secretary of the Bulgarian Legation wrote as follows to your Medical Officer "I am glad to be in a position to-day to inform you that the competent "Bulgarian Authorities are proceeding with enquiries concerning the lard "in question. The official communication I received from Sofia states that "sanction will be taken against the author of the irregularity, and control "will be strengthened in order to avoid such deplorable incidents." 33 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. SHELLFISH. The new Order, under the Public Health (Shellfish) Regulations, 1934, referred to in my report for last year was issued on 23rd April, 1936. There have been no reports during the year of illness attributable to the consumption of shellfish from your area. In 1935 the Association of Port Sanitary Authorities forwarded to the Minister of Health a copy of the following resolution:— "That it is the opinion of the Association of the Port Sanitary Authorities of the British Isles that the present system of control of shellfish layings by closure is unsatisfactory as a Public Health measure and ruinous to the shellfish industry; that it has now been proved that shellfish can be efficiently cleansed by relaying in the case of oysters and mussels, and by steaming in the case of cockles and winkles, that the necessary apparatus can be established and operated on a self-supporting basis, and that, therefore, the time has now arrived when legislation might be introduced with advantage to both the Public Health and shellfish industry, requiring that only such shellfish (whether home produced or imported) as are certified by a responsible Authority to have been cleansed in this country by an approved method in a recognised establishment, should be sold for human consumption. At the Annual Meeting of the British Medical Association in 1936, after a paper by Dr. R. W. Dodgson, Director, Fisheries Experiment Station, Ministry of Agriculture and Fisheries, Conway, Caernarvonshire, the Section of Public Medicine forwarded a similar resolution to the Annual Representative Meeting who resolved that it should be sent to the Ministry of Health. Further experience in the cleansing of mussels at the stations at Conway and Lytham and of oysters at Brightlingsea have proved that this method of making shellfish safe for human consumption is practicable on a commercial scale, cheap and reliable. (3) SAMPLES OF FOOD EXAMINED DURING THE YEAR. (a) Bacteriologist— Date. 1936. Sample. Result of Analysis. Action taken. Jan. 15 Drinking Water General appearance—bright and clear. No visible deposit. None. 1. No. of micro-organisms on Gelatin (aerobically) (3 days) averaged 119 per cubic centimetre. Liquifying organisms 10 (about 16 minims). 2. No. of micro-organisms developing on agar (aerobically) at 98°F., 48 hours, averaged 126 per cubic centimetre. 3. Bacillus coli (typical) absent from 50 c.c. to 0.1 c.c. cubic centimetre of sample. 4. Coliform organisms, present in 20 c.c., but not lower. 5. Other organisms 'Streptococci absent in 50 c.c. to 0-1 c.c. J B. Welchi absent in 100 c.c. to 10 c.c. Coliform organisms, B.Fsecalis, Alk. type. Remarks— The sample of water was also examined for the presence of B.Typhosus. Result—No B. Typhosus present, or other organisms of the Enteric Group. This water is of good quality and free from signs of pollution. 34 Date. 1936. Sample. Result of Analysis. Action taken. May 4 Oysters, tinned Condition of sample—good. None. General appearance—good. 1. Number of micro-organisms developing on Gelatin (aerobically) at 68° F. (three days) averaged 1,103 per cubic centimetre. 2. Number of micro-organisms developing on Agar (aerobically) at 98° F. (48 hours) averaged 683 per cubic centimetre. 3. Bacillus coli (typical) absent from 50 to 0.0001 per cubic centimetre of sample. 4. Coliform organisms—nil. 5. Other organisms— B. Welchi—not present. Streptococci—not present. Plate cultures for Typhoid and Food Poisoning groups—negative. Remarks—A very satisfactory sample. June 10 Drinking Water Condition of sample—Good. General appearance—Bright and Clear. None. No. of micro-organisms developing on gelatin (aerobically) at 68°F. (3 days), averaged 120 per c.c. No. of micro-organisms developing on agar (aerobically) at 98°F. (48 hours), averaged 300 per c.c. Bacillus coli. (typical) absent from 50 to 0.001 c.c. of sample. Coliform organisms B. La aeorogenes present in 10 c.c. of water. Other organisms. Streptococci and B. Welchi not present. McConkey plates for Enteric GroupNegative. Remarks.—Although B. Coli (typical) is absent in 50 to 0.001 c.c. of the water, the presence of B. La aerogenes indicates that this water is only of fair quality. July 16 Canned Mussels Condition of sample—good. None. General appearance—Smells and tastes good. No. of micro-organisms developing on gelatin (aerobically) at 68°F. (3 days) averaged 1,263 per c.c. No. of micro-organisms developing on agar (aerobically) at 98°F. (48 hours) averaged 80 per c.c. Bacillus Coli (typical) absent from 50 to 0.001 c.c. of sample. Coliform organisms. Not present. Other organisms. Streptococci and B. Welchi.— not present. Remarks.—The bacteriological findings are satisfactory and indicate that the mussels are fit for human consumption. „ 20 Ship's Milk No. of bacteria per c.c.—All plates uncountable after 24 hours' incubation. Letter to Shipping Presence of Bacillus Coli in 1/10 c.c. (24 hours)— Acid and gas. Company concerned. Remarks.—This milk was curdled when received at the Laboratory; all plates were heavily overgrown after 24 hours incubation, and presumptive B. Coli was present in 1/10 c.c. of milk after 24 hours. Plate culture for typhoid and food poisoning group were negative. In my opinion this specimen of milk is unsatisfactory on account of its high microbic content and B. Coli. content. 35 Date. 1936. Sample. Result of Analysis. Action taken. July 21 Drinking Water Condition of sample—Slightly opaque, earthy smell. No. of micro-organisms developing on yeastrel agar (aerobically) at 68°F. (3 days) averaged 1,644 per c.c. Letter to Shipping Company concerned. No. of micro-organisms developing on yeastrel agar (aerobically) at 98°F. (48 hours) averaged 1,590 per c.c. Bacillus Coli (typical) absent in 50 to 0.00 c.c. of sample. Coliform organisms. B. Seudo Coli and B. Faecalis alkaligenes isolated from water. Other organisms. Streptococci and B. Welchi not present. Remarks.— In my opinion, this water is unsatisfactory. The microbe content is high, and B. Faecalis alkaligenes is present, which may well be the cause of the Gastro-Enteritis from which passengers and crew are said to have suffered. „ 21 Canned Asparagus Anerobic and aerobic cultures made. No growth on any of cultures. Asparagus—sterile. In my opinion, the contents of the tin have been adequately sterilised. None. Sept. 7 Canned Chicken Condition of Sample—Jelly liquified. Smells and tastes good. None. No. of micro-organisms developing on gelatin (aerobically) at 68°F. averaged 125 per c.c. No. of micro-organisms developing on agar (aerobically) at 98° F. averaged 165 per c.c. Bacillus Coli (typical) absent from 50 to 0.001 per c.c. of sample. Coliform organisms. Not present. Streptococci and B. Welchi not present. Other organisms. No liquifying colonies found on gelatin plates after 3 days. Remarks.— From a bacteriological point of view, this canned chicken is satisfactory. The liquefaction of jelly surrounding the chicken is not consequent on the action of a bacterial agent. Oct. 5 Canned Lobster Condition of sample—Good. None. No. of micro-organisms developing on gelatin (aerobically) at 68° F. (three days) averaged 380 per c.c. No. of micro-organisms developing on agar at 98" F. (48 hours) averaged 65 per c.c. Bacillus coli absent from 50 to 0.001 c.c. of sample. Coliform organisms—not present. Other organisms.—Streptococci and B. Welchi not present. Remarks.—This sample is of good bacteriological quality and fit for human consumption. Nov. 18 Bundle of Hog Bristles Agar plate cultures. Growth of gram-positivi cocci only. Negative for B. Anthrax. 2 guinea pigs were inoculated (1 pocket, 1 subcutaneous). Both guinea pigs alive and well on 23rd November, 1936. Result—Bristles are negative for anthrax. Result forwarded to Ministry of Health. Dec. 22 Brine from cask of gherkins. General appearance—Cloudy brownish coloured fluid acid. None. No. of micro-organisms developing on Gelatine (aerobically) at 68° F. (3 days) averaged 3,750 per c.c. No. of micro-organisms developing on Agar (aerobically) at 98° F. (48 hours) averaged 9,140 per c.c. B. Coli absent from 50 to 0.001 per c.c. of sample. Coliform organisms—not present. Other organisms—Streptococci and B. Welchi— not present. Remarks—The colonies are mostly yeast or B. subtilis type. There are no intestinal organisms present. 36 Date. 1936. Sample. Result of Analysis. Action taken. Dec. 29 Brine from tin of gherkins General appearance—Brownish fluid, acid p.h. 40. None. No. of micro-organisms developing on gelatin (aerobically) at 68° F. (3 days) averaged 7,430 per c.c. No. of micro-organisms developing on Agar (aerobically) at 98° F. (48 hours) averaged 720 per c.c. B. Coli absent from 50 to O.OOl per c.c. of sample. Coliform organisms—not present. Other organisms, Streptococci and B. Welchi— not present. Remarks—There are no intestinal organisms present. (b) Analyst:— 1936. Jan. 2 Turmeric (2) These two samples were found to contain 10 and 8 parts of lead per million respectively. Letter to Importer and Report to Ministry of Health. „ 8 Canned Fish (4) These samples on examination gave the following results:— None. Sample No. Lead, parts per million. 1 3 2 l 3 l 4 5 „ 9 Turmeric Contained 2 parts of lead per million. None. „ 9 Ginger Contained 6 parts of lead per million. None. „ 9 Sardines Contained 11 parts of lead per million. None. „ 9 Fruit Pulp (2) These samples were found to contain (1) 1,500 and (2) 1,550 parts of Sulphur Dioxide per million respectively. Sample No. 1 None. Sample No. 2, re-exported. „ 10 Curry Powder Contained 12 parts of lead per million. Reported to Ministry of Health. „ 10 Turmeric Contained 350 parts of lead per million. Ditto. „ 10 Chillies Contained 6 parts of lead per million. Ditto. „ 10 Coriander Powder Contained 2 parts of lead per million. Ditto. „ 14 Coated Bice This sample contained 0.24% of Talc. It is customary to allow 0.5 of this. None. „ 15 Sardines Contained 20 parts of lead per million. Consignment re-exported. „ 16 Sild in Tomato Contained 1.9 grains of tin per pound. Result reported to Medical Officer of Health for Southampton. „ 16 Fish (3) These samples contained 3, 1 and 2 parts of lead per million respectively. None. „ 16 Tunny Fish Contained 1 part of lead per million, and traces only of tin. None. „ 16 Tomato Extracts (2) These samples contained 12 and 10 parts of copper per million respectively. Both were found to be free from the presence of prohibited preservatives, and to contain traces only of tin. None. „ 23 Smoked Salmon Free from the presence of prohibited colouring matter and preservatives. None. „ 24 Grape Fruit Juice These samples on examination were found to contain 988 and 1,195 parts of Sulphur Dioxide per million. Letter to Importers. „ 24 Citrons in Brine Free from the presence of prohibited preservatives. None. „ 24 Smoked salmon Contained 258 parts benzoic acid per million Consignment re-exported. „ 30 Sardines Contained 12 parts of lead per million. Letter to Importers. 37 Date. 1936. Sample. Result of Analysis. Action taken. Jan. 31 Sardines Contained 17 parts of lead per million. Analysis in connection with investigation for Ministry of Health. „ 31 Sild Contained 5.33 grains of tin per pound. Ditto. „ 31 Sidra champagne Free from the presence of sulphite preservatives. None. Feb. 3 Sardines (6) Contained 17 parts of lead per million. Letter to Importers. „ 4 Salmon slices Free from the presence of colouring matter and preservatives. None. „ 5 Pineapple juice Free from the presence of colouring matter and preservatives. None. „ 5 Turmeric Contained 4 parts of lead per million. None. „ 5 Turmeric Contained 6 parts of lead per million. None. ,, 5 Tea Contained 18 parts of lead per million. None. „ 6 Bittersweet chocolate Free from the presence of prohibited preservatives. None. „ 6 Spinach (tinned) Free from presence of copper and contained 0.5 grain of tin per pound. None. „ 10 Orange pulp Contained 740 parts of sulphur dioxide per million. None. „ 13 Firmosa black tea Contained 5 parts of lead per million. None. „ 13 Orange peel and grapefruit peel. These samples contained 1,040 and 1,295 parts of sulphur dioxide respectively. None. „ 13 Cranberry jelly Contained 200 parts of benzoic acid per million. Free from metallic contamination. Letters to Importer and Ministry of Health. „ 13 Tinned shrimps Contained 2 parts of lead per million. Trace only of tin and no preservatives. None. „ 17 Herrings in mustard sauce. Contained 4 parts of lead per million. Trace only of tin and no preservatives. None. „ 17 Smoked salmon Free from presence of preservatives. None. „ 20 Anchovy sprats Free from presence of preservatives and prohibited colouring matter. None. „ 0 Cranberry sauce (2) These samples contained 40 and 230 parts of benzoic acid per million, respectively. Letters to Importer and Ministry of Health. „ 26 Tinned peas Free from presence of copper. Trace only of tin. None. „ 26 Sardines (2) Both samples contained 4 parts of lead per million. None. „ 26 Canned figs Free from the presence of prohibited colouring matter and also metallic contamination other than traces of tin. None. „ 26 Canned fish (6) These samples gave the following results:— None. Sample. Lead, parts per million. Brisling l Sild in oil 2 Sild in oil 1 Sild in oil 2 Sild in tomato 4 Sild in tomato 2 „ 26 Sardines (2) Both these samples contained 11 parts of lead per million. Letters to Importers. „ 28 Salmon (2) These samples were found to contain 0.5 and 0.6 grain of tin per pound respectively. None. „ 28 Sardines (2) These samples gave the following results:— Sample No. 1, None. Sample No. 2, Letter to Importers. Sample No. Lead, parts per million. l 9 2 18 „ 29 Orange Paste Free from the presence of prohibited colouring matter and preservatives. None. Mar. 2 Mint Free from arsenic, but in a somewhat dirty condition, although the sand and siliceous matter did not exceed 1%. None. „ 3 Cauliflower in Brine Contained 480 parts of sulphur dioxide per million. Reported to Ministry of Health and to the Medical Officer of Health, City of London. „ 3 Sardines Contained 7 parts of lead per million. None. 38 Date. 1936. Sample. Result of Analysis. Action taken. Mar. 3 Grapes Free from the presence of iodine. None. ,, 3 Sardines Contained 15 parts of lead per million. Letter to Importers. ,, 5 Smoked Sealachs (Salmon) Free from the presence of prohibited colouring matter and preservatives. None. ,, 5 Smoked Salmon Contained 400 parts of benzoic acid per million. Consignmen re-exported ,, 5 Sardines Contained 6 parts of lead per million. None. „ 5 Sardines Contained 11 parts of lead per million. Letter to Importer. „ 5 Sardines Contained 10 parts of lead per million. None. „ 7 Smoked Salmon Free from the presence of preservatives. None. „ 11 Eaisins Free from the presence of preservatives. None. „ 13 Sild Contained 0.5 grain of tin per pound. None. „ 13 Tinned Fish (3) All these samples were found to be free from the presence of preservatives. None. ,, 14 Fruit Pulp (2) The samples on examination gave the following results:— None. Sample. Sulphur Dioxide parts per million Strawberry 1,015 Blackcurrant 1,210 „ 18 Apple Juice (2) Both samples were found to be free from the presence of prohibited preservatives. None. „ 18 Tomatoes (4) Free from the presence of both lead and arsenic. None. „ 18 Smoked Sealachs Free from the presence of preservatives. None. „ 18 Grapes Free from the presence of iodine. None. „ 19 Thyme Free from the presence of arsenic and extraneous matter. None. „ 19 Sardines Contained 9 parts of lead per million. None. „ 20 Cauliflower (tinned) Free from the presence of prohibited preservatives. None. „ 23 Cauliflower in Brine Free from the presence of sulphite preservative. None. „ 24 Cake Flour This sample was marked "matured bleached with 'Beta Chlara" and the presence of chlorine therein was confirmed. Reported to Ministry of Health. „ 24 Sardines Contained 6 parts of lead per million. None. „ 24 Raspberry Pulp Free from the presence of prohibited preservatives. None. ,, 24 Cherries in Brine Contained 648 parts of sulphur dioxide per million. None. „ 24 Pilchards in Tomato Sauce Contained 0. grain of tin per pound and 3 parts of lead per million. Free from presence of copper. None. „ 24 Tinned Fish (9) These samples on analysis gave the following results:— None. Sample Tin, Grains per pound Lead, parts per million. l None 2 2 0.25 4 3 None 3 4 0.05 3 5 None 2 6 0.1 4 7 None 5 8 0.4 2 9 0.2 6 April 1 Sardines Contained 15 parts of lead per million. Letter to Importers. ,, 2 Pineapples The sample on examination was found to contain 6 parts of lead per million and 0.25 grain of tin per pound. In addition, it was observed that a small amount of gas was evolved on opening, and evidence of the presence of traces of alcohol. Detained. „ 6 Raisins Free from the presence of sulphite preservatives. None. „ 6 Lime Juice Free from the presence of sulphite preservatives. None. ,, 6 Swedish Blue Cheese Contained 0.25 grain of tin per pound. Free from the None. ,, 9 Tunny Fish presence of copper. Free from metallic contamination. None. „ 9 Kaviar Free from the presence of prohibited preservatives. None. ,, 9 Lime Juice (2) These samples on examination were found to contain nil and 5 parts per million of sulphur dioxide respectively. None. 89 Date. 1936. Sample. Result of Analysis. Action taken. April 9 Curry Powder Contained 16 parts of lead per million. None. „ 9 Guava Cheese Contained 0'25 grain of tin per pound. Free from the presence of preservatives. None. „ 9 Guava Jelly Contained 0.45 grain of tin per pound. Free from the presence of preservatives. None. „ 14 Sardines Contained 8 parts of lead per million. None. „ 14 Sardines Contained 6 parts of lead per million. None. „ 17 Smoked Sealachs (Salmon). Contained 7 parts of lead per million. Free from the presence of preservatives. None. „ 17 Smoked Salmon Free from the presence of preservatives. None. „ 17 Lokt-lax (Salmon) Free from the presence of preservatives. None. „ 17 Sardines Contained 4 parts of lead per million. None. „ 22 Sardines Contained six parts of lead per million. None. „ 22 Lemon Juice Contained 345 parts of sulphur dioxide per million. None. „ 22 Fish Paste (3) The samples on examination gave the following results:— None. Sample Lead, parts per million. Sardine 3 Salmon 3 Crab 3 All samples free from the presence of prohibited preservatives. „ 23 Turmeric (2) These samples on examination were found to contain two and three parts of lead per million respectively. None. „ 23 Herrings in Tomato Contained 530 parts of benzoic acid per million and three parts of lead per million. Consignment re-exported. „ 23 Orange peel Contained 715 parts of sulphur dioxide per million. None. „ 23 Dressed Crab (2) Sild in Oil (2) Kipper Snacks All samples found to be free from metallic contamination and from the presence of prohibited preservatives. None. „ 24 Sardines Contained 10 parts of lead per million. None. „ 24 Citrous Juice Free from the presence of prohibited preservative. None. „ 27 Turmeric Contained three parts of lead per million. None. „ 28 Orange Peel Contained 610 parts of sulphur dioxide per million. None. „ 28 Grapes Free from the presence of iodine. None. „ 30 Canned Cooked Peas Free from the presence of prohibited preservatives and colouring matter, including copper sulphate. None. „ 30 Canned Fish (10) These samples on examination gave the following results:— Samples 1—9, None. Sample Lead, parts per million. Tin, Grains per pound. Sample 10— Further samples drawn (see * below). 1. Crab 2 Trace 2. „ 2 3. „ 1 „ 4. „ 4 „ 5. „ 2 „ 6. Brislings 2 0.5 7. 4 0.6 8. Sild 2 0.9 9. „ 3 0.45 10. „ 2 2.4* May 5 Sild (3) These samples on examination gave the following results:— Sample No. 2 -—None. Sample No. Tin, Grains per pound. Samples 1 and 3, Consignments re-exported. l 3.04* 2 1.21 3 3.21 „ 5 Tomato Puree Contained 14 parts of copper per million. Free from the presence of prohibited preservatives. None. „ 7 Sardines Contained 11 parts of lead per million. Warning letter to Importer. „ 7 Anchovy Fillets Contained five parts of lead per million. None. ,, 8 Sardines Contained 28 parts of lead per million. Consignment re-exported. „ 8 Honey This sample on examination was found to be free from alcohol and yeast cells, and showed no signs of fermentation. The acidity was normal and no metals were detected except a minute trace of iron. None. „ 12 Lemon Barley Water Contained 245 parts of sulphur dioxide per million. None. „ 12 Sardines Contained 15 parts of lead per million. Warning to Importer. „ 14 Sild in Tomato Contained 1.46 grains of tin per pound. None. 40 Date. 1936. Sample. Result of Analysis. Action taken. May 16 Shrimp Paste Contained four parts of lead per million, and a trace only of tin. None. „ 16 Sardines (3) These samples on examination were found to contain ten, seven and five parts of lead per million, respectively. None. „ 16 Canned Fish (4) These samples on examination gave the following results:— None. Sample Lead, parts per million. Sild in Tomato 3 Sild in Oil 1 Sild in Oil 1 Kipper Snacks 1 In addition the samples were found to contain traces only of tin, and the Sild in Tomato were free from the presence of copper. „ 21 Sardines Contained nine parts of lead per million. None. „ 21 Canned Peas Free from the presence of prohibited colouring matter and preservatives. None. „ 21 Oranges Free from the presence of boric acid and foreign colouring matter on the skins. None. „ 21 Tallow (2) These samples on examination gave the following results:— None. id Sample marked. Free Fatty Acids, expressed as Oleic Ac (A) 0.71% (B) 0.71% „ 27 Sardines Contained 17 parts of lead per million. Letter to Importers. „ 27 Sardines Contained 7 parts of lead per million. None. „ 27 Canned Fish (5) These samples on examination gave the following results:— None. Sample Lead, parts per million Tin, Grains per pound Sild in Oil 3 0.4 Ditto 3 0.3 Ditto 2 0.1 Ditto 2 0.1 Dressed Crab 1 Trace „ 29 Sardines Contained 6 parts of lead per million. None. June 2 Blackberry Pulp Contained 1,268 parts of sulphur dioxide per million. None. „ 3 Vegetable Paste The sample is probably meant for use as a paste for sticking paper, etc., by mixing with cold water, and the figures obtained are consistent with those that would be given by the treatment of a farinaceous material with caustic soda and subsequently neutralisation with hydrochloric acid, dried and powdered. Letter to Importer. „ 5 Yeast Extract Free from the presence of arsenic. None. „ 23 Sardines Contained 8 parts of lead per million. None. „ 29 Sardines Contained 5 parts of lead per million. None. „ 30 Sugar These samples on examination gave the following results :— None. Sample No. Tin, Grains per pound l 0.21 2 1.29 3 0.33 4 0.83 5 0.58 „ 30 Apricot Pulp Contained 1,592 parts of sulphur dioxide per million. Result forwarded to Medical Officer of Health of Bermondsey. July 1 Sugar These samples on examination gave the following results :— Warning Letter to Importer. Sample No. Tin, Grains per pound. l 1.25 2 0.37 3 2.13 4 1.17 5 1.82 6 1.83 3 Sugar 1 1.04 None. 41 Date. 1936. Sample. Result of Analysis. Action taken. July 3 Apricot Pulp (2) These samples contained 1,485 and 1,470 parts of sulphur dioxide per million, respectively. None. „ 3 Cranberry Pulp Contained 195 parts of benzoic acid per million. Note.— Cranberries normally contain 550 to 600 parts of benzoic acid per million. None. „ 6 Sardines Contained 9 parts of lead per million. None. „ 7 Sage Free from the presence of arsenic. None. „ 7 Canned Fish (8) These samples on examination gave the following results:— None. Sample marked Herrings in Tomato Tin, Grains per pound. 0.3 Ditto 0.2 Ditto 0.92 Stewed Crab 0.15 Brislings 0.60 Sild in Oil 0.96 Ditto 0.6 Dressed Crab 0.5 The 3 samples of herrings in tomato were free from the presence of copper. „ 13 Sardines Contained 14 parts of lead per million. Letter to Importers. „ 16 Sugar (5) These samples gave the following results:— Sample No. 3 (1,041 bags) released under guarantee for refining only. Samples 1, 2, 4 and 5, None. Sample No. Tin, per pound. 1 0.16 2 0.08 3 2.10 4 0.68 5 1.13 „ 16 Canned Fish (6) These samples on examination gave the following results:— None. Sample No. Lead, parts per million. Tin, Grains per pound. l 3 0.22 2 2 0.19 3 1 0.20 4 2 1.42 5 1 None 6 2 0.42 „ 17 Tartaric Acid (4) On examination these samples gave the following results:— None. Sample No. Lead, parts per million l 4 2 4 3 4 4 4 „ 21 Sardines (2) These samples on examination gave the following results:— Sample No. 1, None. Sample No. Lead, parts per million. Sample No. 2, Warning Letter to Importers. 1 4 2 12 „ 21 Sardines Contained 2 parts of lead per million. None. „ 25 Sardines Contained 9 parts of lead per million. None. „ 27 Gruyere Cheese Free from the presence of Preservatives. None. „ 28 Gelatin Contained 30 parts of sulphur dioxide per million. None. „ 29 Canned Fish (7) On analysis these samples gave the following results None. Sample. Lead, parts per million. Tin, Grains per pound. Sild in Oil l 0.55 Ditto l 1.58 Ditto l 0.15 Ditto 2 0.27 Dressed Crab 1 None. Kipper Snacks 1 None. Peeled Shrimps 1 None. 42 Date. 1986. Sample. Result of Analysis. Action taken. Aug. 6 Sild (12) These samples on examination gave the following results:— Consignment re-exported under guarantee. Sample No. Tin, Grains per pound l 2.05 2 1.05 3 3.46 4 2.54 5 0.35 6 1.08 7 0.13 8 5.16 9 1.61 10 1.52 11 1.74 12 0.10 „ 12 *Sugar (5) 1 2.79 Consignment detained for further sampling (see also * below). 2 2.62 3 0.58 4 0.25 5 2.17 „ 12 Grapefruit in Brine Free from the presence of prohibited preservatives. None. „ 15 Canned Fish (6) These samples on examination gave the following results:— None. Sample. Tin Grains per pound. Lead parts per million. Herring Boes None 2 Sild 0.1 l Dressed Crab None l Sild 0.2 l Ditto 0.15 l Ditto 0.15 l „ 20 *Sugar (3) On examination these samples gave the following results. Consignment released (see also * above). Sample No. Tin, Grains per pound l 1.21 2 1.92 3 1.25 „ 27 Canned Peas Free from the presence of prohibited preservatives and colouring matter. None. „ 27 Cordials (3) These samples on examination gave the following results:— None. Sample. Sulphur Dioxide, parts per million. Benzoic Acid, parts per million. Orange Squash None 400 Lemon Squash None 371 Grenadilla 313 None „ 29 Canned Fish (4) These samples on examination gave the following results:— None. Sample. Tin, grains per pound Lead, parts per million. Sild 0.6 2 Ditto 0.5 1 Herrings in Tom ato 0.08 1 Ditto 0.04 1 The samples of Herrings in Tomato were found to be free from the presence of Copper. Sept. 10 *Canned Fish (6) 1. Sild 0.35 3 Samples Nos. 1, 2, 3 and 6, released. Samples Nos. 4 and 5 detained for further sampling, (see also * below.) 2. Ditto 0.20 4 3. Ditto 0.15 5 4. Ditto 2.54 3 5. Ditto 3.96 4 6. Dressed Crab 0.12 1 „ 10 Solid Glucose Free from the presence of arsenic and prohibited preservatives. None. „ 10 Sugar (2) Both samples were found to contain 0.08 grains of tin per pound. None. 43 Date. 1936. Sample. Result of Analysis. Action taken. Sept. 14 Cod Fillets Free from the presence of Preservatives. None. „ 14 Sardines Contained 5 parts of lead per million None. „ 15 Greengage Pulp Contained 1,700 parts of sulphur dioxide per million. Warning Letter to Importer. „ 15 †Confectionery (2) These samples on examination gave the following results:— Detained for further sampling (see also † below). Sample No. Lead, parts per million. Arsenic, parts per million 1 7 None. 2 2 None. „ 15 Apricot Pulp Prohibited colouring matter was not detected. Contained 1,450 parts of sulphur dioxide per million. None. „ 16 *Sild (2) These samples on examination gave the following results:— Consignment re-exported (see also * below). Sample No. Tin, Grains per pound 1 2.71 2 2.42 „ 17 Brislings Contained 0.25 grains of tin per pound. None. „ 22 † Confectionery This sample on examination gave the following results:— Consignment destroyed, (see also † above). Portion Lead, parts per million. Brown 16 Green 14 „ 23 *Sild (3) The above samples on examination gave the following results:— Consignment re-exported (see also * above). Sample No. Tin, Grams per pound. 1 3.21 2 2.13 3 2.04 „ 25 Smoked Salmon Contained 176 parts of benzoic acid per million. Besult forwarded to the Medical Officer of Health of Lambeth. „ 25 Smoked Salmon Free from the presence of preservatives. None. „ 25 Sealachs Contained 151 parts of benzoic acid per million. Consignment destroyed. „ 25 Haricot Beans Free from the presence of prohibited colouring matter. None. „ 25 Confectionery (3) These samples were found to contain 4, 4 and 5 parts of lead per million respectively. All were free from the presence of preservatives and prohibited colouring matter. None. „ 25 Sild (2) These samples on examination gave the following results:— None. Sample No. Tin, Grains per pound Lead, parts per million. l 0.91 l 2 0.25 l „ 25 Egg Spray Free from the presence of prohibited preservatives. None. „ 25 Canned Fish (8) These samples on examination gave the following results:— None. Sample. Tin, Grains per pound Lead, parts per million Sild in Tomato 0.1 I Sild in Oil 0.2 I Dressed Crab None I Sild in Tomato 0.15 2 Sild in Oil 0.14 1 Peeled Shrimps None 1 Herrings in Tomat 0.21 2 Sild in Oil 0.31 1 „ 28 Confectionery Contained 2 parts of lead per million. Free from arsenic. None. 44 Date. 1936. Sample. Result of Analysis. Action taken. Oct. 1 Makrelfilet in Tomato Free from the presence of preservatives. None. „ 1 Apricot pulp Contained 878 parts of sulphur dioxide per million. None. „ 1 Confectionery (3) Contained 2, 5 and 5 parts of lead per million respectively. None. „ 5 Sardines (2) Contained 10 and 8 parts of lead per million respectively. None. „ 6 Sardines Contained 20 parts of lead per million. Consignment re-exported. „ 8 Apricot Pulp Contained 1,820 parts of sulphur dioxide per million. Consignment re-exported. „ 8 Raisins (5) These samples on examination were found to contain 170, 187, 165, 110 and 176 parts of sulphur dioxide per million. None. „ 8 Gruyere Cheese Free from the presence of prohibited preservatives. None. „ 8 Nut Nougat Paste Free from the presence of prohibited preservatives. Contained 3 parts of lead per million. None. „ 8 Sugar of Milk Contained 2 parts of lead per million. Free from the presence of prohibited preservatives and other metallic contaminations. None. „ 9 Prepared Mustard Free from metallic contamination. None. „ 9 Canned Fish (9) These samples on examination gave the following results:— None. Sample. Tin, Grains per pound. Lead, parts per million. Sild in Tomato 0.15 2 Brislings in Oil None 2 Sild in Oil 0.12 3 Sild in Oil 0.08 None Brislings in Oil 0.65 None Peeled Shrimps None 2 Sild in Oil 0.28 1 Kipper Snacks 0.14 None Herring Roes None None „ 12 Tinned Sprats Contained 3 parts of lead per million None. „ 12 Herring Fillets Contained 2 parts of lead per million. None. „ 14 Goose Livers The fat on the top of the sample was removed and examined separately, and was found to contain 2.50 grains of tin per pound. The goose liver without this fat was found to contain 0.33 grains of tin per pound. Consignment re-exported. „ 14 Confectionery (2) These samples contained 2 and 3 parts of lead per million respectively. None. „ 16 Sild in Oil Contained 2 parts of lead per million and 0.12 grains of tin per pound. None. „ 16 Silverdine Fish Contained 3 parts of lead per million. None. „ 16 Canned Mushrooms Free from preservatives and metallic contamination. None. „ 16 Spinach (tinned) Free from prohibited colouring matter. None. „ 16 Haricots (tinned) Free from prohibited colouring matter. None. „ 21 Canned Fish (4) All samples were found to be free from preservatives and metallic contamination. None. 45 Date. 1986. Sample. Result of Analysis. Action taken. Oct. 23 Canned Fish (12) These samples on examination gave the following results:— None. Sample Tin, Grains per pound Lead, parts per million. Kipper Snacks None None Dressed Crab None 1 Sild in Oil 0.61 1 Sild in Oil 0.12 None Brislings in Oil 0.12 2 Peeled Shrimps None None Brislings in Oil 0.34 None Sild in Oil None 1 Sild in Oil 0.15 1 Sild in Oil 0.25 1 Sild in Oil None 1 Dressed Crab 2.75 None Result of analysis reported to the Medical Officer of Health of Brentford and Chiswick. „ 28 Dressed Crab Free from the presence of metallic contamination None. „ 29 Albumen Free from the presence of metallic contamination and prohibited preservatives. None. Nov. 4 Sardines Contained 8 parts of lead per million None. „ 6 Sardines Contained 3 parts of lead per million None. „ 6 Sardines (2) Contained 12 and 8 parts of lead per million respectively. None. „ 6 Cape Gooseberries Contained 1,370 parts of sulphur dioxide per million None. „ 21 Turkish Delight Contained 3 parts of lead per million. Free from the presence of preservatives. None. „ 28 Sea Salmon (smoked) (2) These samples contained 32 and 63 parts per million of benzoic acid, respectively. Consignment re-exported. „ 30 Edible molasses Contained 0.08 grain of tin per pound. Free from the presence of prohibited preservatives. None. „ 30 Canned sausages Free from the presence of prohibited preservatives. None. Dec. 1 Sardines Contained 6 parts of lead per million. None. „ 4 Sugar (3) These samples were found to contain 0'29, 0.08 and 0.08 grain of tin per pound respectively. None. „ 4 Tomato puree Free from the presence of copper. None. „ 8 Sardines Contained 8 parts of lead per million. None. „ 8 Anchovies Contained 5 parts of lead per million. None. „ 16 Tomato paste (2) Both samples were free from the presence of copper. None. „ 18 Herrings in tomato Both samples were free from the presence of copper and prohibited preservatives. None. „ 23 Salmon (3) All samples were free from the presence of prohibited colouring matter and preservatives. None. „ 30 Fruit pectin Free from the presence of sulphite preservatives. None. FERTILISERS AND FEEDING STUFFS ACT, 1926. The following samples were examined by the Agricultural Chemist:— Date. 1936. Sample. Result of Analysis. Action taken. Feb. 13 Groundnut Cake Expeller Oil 9.41% Besult of analysis forwarded to Medical Officer of Health, City of London. Albuminoids (protein) 45.50% Free from the presence of castor seed husk. Mar. 11 Alfalfa Meal Fibre 29.85% Besult of analysis forwarded to Medical Officer of Health, City of London. 26 Groundnut Expeller Oilcake. Oil 7.34% Result of analysis forwarded to Medical Officer of Health. City of London. Albuminoids (Protein) 53.44% Free from the presence of castor seed husk. April 9 Linseed Expeller Cake Oil 11.07% Result of analysis forwarded to Medical Officer of Health, City of London. Albuminoids (Protein) 28.88% 46 Date. 1936. Sample. Result of Analysis. Action taken. May 29 Dried blood Nitrogen 14.56% Besult of analysis forwarded to Medical Officer of Health, City of London. June 23 Alfalfa meal Fibre 28.0% Besult of analysis forwarded to Medical Officer of Health, City of London. „ 23 Alfalfa meal Fibre 28.0% Result of analysis forwarded to Medical Officer of Health, City of London. July 21 Tea seed cake Oil 4.80% Reported to the Ministry of Agriculture and Fisheries. Protein 7.14% The sample was very bitter to the taste and contained Saponin. Oct. 15 Alfalfa meal Fibre 30.5% Result of analysis forwarded to Medical Officer of Health, City of London. „ 15 Alfalfa meal Fibre 27.0% Ditto. „ 29 Crushed hoofs Nitrogen 14-59% Result of analysis forwarded to Public Control Department, London County Council. „ 30 Bone meal Nitrogen Phosphoric Acid (P205) 4.14% 17.67% Result of analysis forwarded to Agricultural Offices, Kent County Council. Nov. 4 Oilcake (5 samples) These samples on examination gave the following results:— Reported to Ministry of Agriculture and Fisheries and whole cargo exported to the Continent. Sample No. Water Oil Albuminoids 1. Nil. 6.96% 52.94% 2. Nil. 9.16% 50.13% 3. Nil. 7.76% 47.00% 4. 47.80% 2.00% 32.31% 5. 48.32% 2.72% 28.19% Samples Nos. 2 and 3 were smoke tainted, but otherwise I have been unable to detect anything of a deleterious nature in them. Samples Nos. 4 and 5 showed signs of decomposition, No. 4 having a particularly objectionable odour, No. 5 being not quite so bad. Both samples gave positive results for B. Coli communis (Presumptive Test) in 1 gramme. Dec. 23 Groundnut cake meal Oil 5.36% Result forwarded to Medical Officer of Health, City of . London. Albuminoids (Protein) 47.94% Free from presence of castor seed husks „ 23 Bone meal Nitrogen 3.85% Result forwarded to Medical Phosphoric acid 21.17% Officer of Health, City of London. THE INSPECTION OF CANNED FOODS Canning is a method of preservation of foodstuffs depending for its success on the destruction by heat of all organisms which may cause spoilage of the product and the subsequent exclusion of air. In the inspection of canned foods it is the duty of the food inspector to satisfy himself that these conditions have been achieved and maintained, that there is no significant metallic contamination of the contents of the can and that no prohibited preservatives or colouring matters have been added. For the two last mentioned investigations samples must be sent to the analyst, but on the general question of soundness the food inspector must rely on his own examination and it is because it seems to me that he has lost confidence in the ordinary methods of inspection and is too inclined to appeal to the bacteriologist and the chemist that I am presenting this paper. The same criticism has often been made of the medical student of the present day. He is trained in great hospitals where there is available every scientific aid to diagnosis and when he goes out into the world he lacks confidence in his own unaided powers of observation and deduction. The methods of inspection of canned foods are similar to those employed by a doctor in the physical examination of his patients : inspection, palpation, percussion and 47 auscultation. In these days of the apotheosis of surgery I may add "exploratory laparotomy" and Dr. Walton of Plymouth even recommends X-ray examination. Inspection is the first and most valuable procedure. As a student I was told again and again that "there is more missed by not looking than not knowing," and I would commend this truism to the notice of all food inspectors. Inspection reveals the quality, type and perhaps the age of the can; the concavity or convexity of the ends; the methods of sealing; staining as evidence of leakage; the presence of rust and of pinholes; evidence of venting and resoldering or the repair of seams; denting due to ill-usage and finally the particulars of the product as described on the label. Palpation is of value in ascertaining whether there is a good vacuum in the tin resulting in the ends being held firmly concave by the atmospheric pressure or whether the ends are slack or definitely bulging. Percussion is useful in the inspection of canned meat where the can should be in close apposition to the contents all round so that the note elicited on tapping is dull and non-resonant. A tympanitic or resonant note indicates the presence of gas inside the can. In products such as fruit and vegetables the cans are not quite full, a certain amount of head space being left. Percussion in such cans is not of much value. Auscultation is not carried out in the way a doctor would do it in the examination of a patient. The food inspector's method of auscultation consists in shaking the can close to his ear and listening to the sound, if any, thus produced. The value of shaking depends on the nature of the product. If it is a solid product packed dry a splashing sound would indicate liquefaction of the contents. Some canned marine products have normally a small quantity of fluid in the can and experience is necessary in differentiating normal from abnormal sounds on shaking. Comparison between various cans of the same pack is often useful. In canned fruit and vegetables the amount of head space can be estimated by shaking. What, in order to keep to the medical terminology, I have referred to as "exploratory laparotomy," of course, means opening up to look inside. This is a test of less value than you might think. In the first place it can only be applied to a limited extent, for every opened can is a wasted can so far as the merchant is concerned; secondly, it is not possible by inspection of the contents to detect metallic contamination or the presence of prohibited preservatives, and lastly, I contend that if after careful external examination of a can by the methods already described the food inspector is still suspicious as to the soundness of the contents he is justified in condemning it. I think it is of more value to open a can here and there as a check on a favourable external examination than to do so in the hope of confirming a suspicion of unsoundess. As regards X-ray examination, I studied the paper which Dr. Walton read before a Sessional Meeting of the Royal Sanitary Institute at Plymouth in February, 1935, but it seemed to me that there was neither need nor justification for this elaboration, believing as I do that the food inspector can, by his own observations, come to a decision which is correct from the consumer's point of view and not unreasonably hard on the merchant. There has been an enormous amount of research work in connection with every aspect of the canning of foods, in which the bacteriologist and the chemist have played a very important part, and the canner, who originally worked empirically, now works scientifically. Nevertheless he has not altered his criteria of soundness of his product and I would suggest that the criteria which have been his for so long should continue to be ours; we should not begin to mistrust them because occasionally a bacteriologist reports the contents of a condemned can to be sterile or the chemist tells us that a blown can is only a hydrogen swell. What the good canner aims at is the commercial sterilisation of the food and the obtaining and maintaining of a good vacuum in the container. I use the term "commercial sterilisation" because, though the canner used to think he got absolute sterilisations, we now know that in many cases he does not, and indeed that, with certain foods, he could not, without using a degree of heat 48 or a period of heating that would make his product unmarketable. By commercial sterilisation is meant such degree of heating as is necessary to prevent the development of bacterial spoilage of the food under the conditions in the container. It is, indeed, the failure to obtain absolute sterilisation that makes the maintenance of a good vacuum in the can so important. If we adopt these criteria we shall not go far wrong; we may occasionally be tripped up by the survival of the toxins of food poisoning organisms of the salmonella group, but we have no means of safeguarding ourselves against that contingency. Having decided to adopt the good canner's own criteria, let us stick to them through thick and thin. Let us not be put off by the suggestion that "though the can is all wrong the food is all right." We know that it is practicable to market in this country canned foods of all kinds from all parts of the world in such condition that they do not occasion the slightest anxiety to the most careful food inspector. If the cans give rise to suspicion as to the soundness of the contents 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 or storage and the obligation is on the manufacturers and merchants to ascertain what is wrong and to correct it, stimulated by the certain knowledge that they will not be allowed to sell their unsatisfactory cans for human consumption, and that their product will remain suspect and therefore subject to special examination, until they have established a reputation for reliability. By adopting this standard we are not in danger of prejudicing the nutrition of any section of the community; by departing from it we shall put the food inspector in an impossible position, we shall put the careful expert canner at a disadvantage in competition with the careless, inexpert one and, sooner or later, we shall be badly let down. I have here a number of cans illustrating the various conditions which the food inspector may encounter but before I show them to you I want to refer to a few special points. First of all the production and maintenance of a good vacuum. The canner has long recognised the importance of reducing to a minimum the amount of air enclosed in the can, whether in the liquid or solid contents or in the head space. This used to be achieved by venting the cans immediately they were removed from the retorts in which they were sterilised or "processed" and sealing the vent with solder when the air and steam had blown off. Now it is done before the processing by passing the filled but open cans through an exhaust box where the contents are heated by steam. The cans are immediately capped and sealed with the result that the contraction of the food and of the remaining air and the condensation of steam, on cooling, creates a partial vacuum. The degree of vacuum depends, of course, on the temperature at which the cans are sealed; thus sealing at 200°F. will give 16.5 inches of vacuum, while sealing at 70°F. will give only 1 inch. A well exhausted can shows 8 inches or more of vacuum when the can is cold. With some products, particularly meat, an exhaust box is not used but the cans which are already sealed except for a single vent-hole, are passed into a vacuum chamber in which 20 to 25 inches of vacuum are obtained by an exhaust pump. In this chamber the vent is closed with solder and the cans are then ready for processing. The food inspector, therefore, has the right to expect a negative pressure in every can and if there is no vacuum he can conclude that either air has leaked in or there has been gas production inside. There is never any difficulty with the obviously blown can with the ends definitely convex and as tight as a drum; but loss of vacuum is progressive and the tightly blown can has gone through the stages from a negative pressure of 8 inches or more, through the neutral point to slight positive and on to strongly positive pressure. If there is a negative pressure of any degree the food inspector will pass the can unless it is unsatisfactory in some other respect, but it is when the internal pressure has reached the neutral point or is slightly positive that he may be uncertain as to the action he should take. For cans in this condition the merchant has a number of terms such as "springer," "flipper," "puffy can" and "slack cap" and he considers that he is entitled to market them, albeit at a reduced price. He also talks of "overfilling," a term which is definitely misleading. You 49 cannot really overfill a can, for you cannot put a quart into a pint pot. What the merchant really means is that sufficient head space has not been left with the result that the generation of a very small amount of gas inside the tin causes an obvious loss of vacuum. The food inspector should, therefore, regard all these "springers," "flippers," "puffy cans," "slack caps" and "overfilled cans" as early stages of blowing and should deal with them on the principle that a "blown can is a bad can." When the pressure in the can is slightly positive it is useful to pierce the can or slightly open it with the key, under water. The demonstration of bubbles rising to the surface of the Avater usually settles any argument as to whether the can is blown or not. A loss of vacuum without development of positive pressure may, of course, be due to a leak which may be very small and even be temporarily sealed by the contents. It seems to be obvious, therefore, that we should regard loss of vacuum as justifying rejection. Now we must consider our great bug-bear, the "hydrogen swell." As you know, the majority of foodstuffs tend to attack the iron and tin of which the can is made, but this is particularly the case with certain fruits of low acidity. Apparently it is very difficult to get an absolutely perfect coating of tin on the sheet iron and there are, almost inevitably, some minute points where the iron is not covered. Moreover the tin-coating is liable to damage in the making of a can and in the great and sudden changes in the internal pressure during the processing and subsequent cooling of the filled and sealed can. Where there is the slightest defect in the continuity of the tin-coating a tin-iron couple is formed in the presence of an electrolyte, resulting in corrosion of the metal and the production of hydrogen. The activity with which this electrolytic action proceeds depends on the acidity of the contents and the presence of depolarising agents. There is a certain range of acidity between pH 3.5 and pH 4.5 which is most favourable to the process and in such cases the addition of a small quantity of citric acid to the syrup in the cans of fruit has been found to delay the development of hydrogen swells. Oxygen is a depolarising agent and this provides another reason for obtaining a good vacuum and therefore a minimum of oxygen in the can. Certain fruit pigments (anthocyanins) act as depolarisers and therefore such fruits as cherries, raspberries, loganberries, black currants, plums and greengages are particularly liable to give trouble. Lacquering of the inside of the cans curiously enough increases liability to the formation of hydrogen swells. It is impossible to get an absolutely unbroken coating of lacquer and apparently the action is concentrated at the exposed spots and because of the rapid corrosion of the iron there is grave danger of perforation of the can. Some coloured fruits become discoloured in unlacquered cans and therefore efforts are being made to obtain a perfect coating of lacquer so absolutely protecting the metal of the can from the contents. Promising results have been obtained by spraying with lacquer the inside of the cans after they have been made. The temperature of storage also influences the development of hydrogen swells, electrolytic action being retarded if the cans are kept cool. Time, too, is a factor and we probably should not see much of hydrogen swells if all canned fruits were consumed within a year of packing. The whole subject is very fully dealt with by Morris and Bryan, of the Cambridge Low Temperature Research Station in Special Report No. 40 of the Department of Scientific and Industrial Research ("The Corrosion of the Tin Plate Container by Food Products") to which I would direct the attention of the Medical Officer of Health and Pood Inspectors. However, what we are concerned with at the moment is not the problems of the canner but the action we should take for the protection of the consumer. It must be admitted that the contents of a can which is a genuine hydrogen swell are not very likely to be injurious to health for only in exceptional cases will there be a really serious degree of contamination of the food with tin; but on the other hand we cannot be sure that a blown can is a hydrogen swell without opening it and examining the contents and the inside of the can, and even if we find that one blown 50 can is a hydrogen swell we are not justified in concluding that every other blown can in the consignment is blown for that reason and that reason alone. Again, the contents are more or less deteriorated, the conditions varying from softness and loss of colour of the solids and opalescence of the syrup to complete disintegration of the food, and therefore the consumer is not getting the product in the really sound condition he is entitled to expect. Further, everybody who opens a can of food, whether in the home or an hotel or restaurant or elsewhere, should know that a blown can is a potentially dangerous can. This is the only safe rule; if we qualify it and say that hydrogen swells are harmless and allow them to go into consumption, we cannot expect the housewife or the cook to appreciate the difference between blowing from this cause and blowing from a bacterial cause and she may well get the idea that, after all, she need not worry if the can she is about to open is bulging at the ends, though of course she would be annoyed to receive a shower bath of syrup when she punctured the cap. It has been suggested that we should allow hydrogen swells to be vented and resealed. This in my opinion would be a most discreditable proceeding for apart from the uncertainty as to the cause of blowing, the can will certainly blow again unless it goes into consumption very quickly, but worst of all, once we admit the legality of venting blown tins, where is it going to stop and how are we to know when, where and under what circumstances it has been done. If we permit this why should not the retailer, going through his stock of canned goods and finding some blown, just vent them and reseal them. The merchant would not knowingly accept hydrogen swells from the canner neither would the retailer accept them from the merchant. Why then should they expect us or the consumer to accept them ? No, the canner must solve his own problem either by discovering how to prevent hydrogen swells or arranging for such conditions and time of storage as will ensure his product being retailed before symptoms of blowing are apparent, or discontinuing the canning of foods which are particularly prone to develop this trouble, for, after all, they are mainly luxury, rather than essential, foods. For our part, we must stick rigidly to the principle that a blown can is a bad can, and in support of this I may quote from the report on "The Corrosion of the Tin Plate Container by Food Products" to which I have already referred. On the very first page of the introduction the following sentence occurs in relation to hydrogen swells— "The contents of such cans are not necessarily harmful, but since bulging may also be due to bacteria or yeasts, they present a risk which no buyer is justified in taking." Another point in the inspection of canned food to which very close attention should be given is the "repaired" or "resoldered" can. It is true that a leak may be detected at the time of packing and be dealt with on the spot, but how are we to know whether the repair was effected then or at some latter stage in the history of the can ? Again in regard to soldered vents, the majority of food stuffs are now put up in sanitary-cap cans in which the lid is crimped on the exhausted can by a double-seamer machine, no solder being used and no vent being required. A soldered vent in such a can or more than one vent in the hole and cap type of can should excite suspicion that there has been blowing, venting and resealing. We are justified in refusing to pass any can in regard to which we have reason to suspect that the original sealing has been broken, even if the contents have been reprocessed subsequently. On page 175 of the Annual Report of the Chief Medical Officer of the Ministry of Health for the year 1933 the following paragraph occurs:— "Canned Foods. "Resoldered Cans.—From time to time canned foods, such as canned tomatoes and canned pineapples, are received at ports showing evidence of having been resoldered, and on further examination the cans may be found to be blown and their contents not sterile. It may be contended by the importers that the additional soldering has been carried out at the time of sterilisation or has been done to correct soldering deficiencies at the time of canning and has not been carried out at a later period in an endeavour to remedy subsequent defects which have arisen as a result of imperfect canning methods. In proper modern canning, however, adventitious soldering should 51 be unnecessary; and in view of the fact that unsound cans may be vented, resealed and reprocessed, there is justification for regarding resoldered cans with suspicion. Port Medical Officers have inquired what procedure they should adopt in regard to cans which show evidence of having been resoldered, and have been advised that such cans should be condemned." If a can is blown, the contents should not be allowed to go for human consumption in any form: There is, I believe, some lack of uniformity in dealing with blown tins of fruit pulp, which, I understand, are allowed to go for jam making on the grounds that the pulp will be boiled, killing any bacteria or yeasts and stopping fermentation. This seems to me quite wrong practice. In the first place there may be extensive detinning of the can and the dissolved tin will go into the jam; in the second place the contents are unsound and should therefore be condemned, and in the third place if the canner and the merchant can have blown cans for jam-making why should they go to the trouble and expense of preparing and packing their product in such a way that it will not blow before it is used ? Surely the good canner, as well as the general public, might reasonably complain if we permit blown cans of fruit or pulp to be used in the manufacture of jam. We may be accused of wasting useable food, but it is the canner not us, who is responsible for the waste just as it would be the jam manufacturer and not the consumer who would benefit if we allowed him to have the blown cans. I would take a similar view with regard to allowing blown tins of condensed milk to be used in the manufacture of toffee. I understand that it is the practice of some food inspectors to return blown cans to the cases when the proportion of unsound cans is not sufficient to warrant a complete examination of the consignment, the argument being that, since the decision on the sample examination is that the whole of the consignment is to be passed, none of the cans should be removed. While I admit that there would be, in the unexamined portion of the consignment, a proportion of unsound cans approximately equal to that in the sample examined and, therefore, a few unsound cans are being allowed to go forward, I hold very strongly that such unsound cans as actually come under the notice of the food inspector should be removed and condemned. So far I have only dealt with one or two special points in regard to the external inspection of canned foods, but even when cans appear to be quite sound we ought to have the contents examined from time to time for metallic contamination and the presence of prohibited colouring matters and preservatives. You all know the trouble there has been with lead in Portuguese sardines. The highest figure we have had in the Port of London is 78 parts of lead per million, and amounts over 20 parts per million were not infrequent. It is noteworthy that considerable variation has been found in the degree of contamination of the contents of different tins from the same consignment, and, therefore, we always take at least six tins from different cases. I believe that the contamination is mainly derived, not from the tin-plate containers or the solder with which they are sealed, but from the grills in which the Portuguese steam the fish. These grills are made of iron wire and were coated with solder containing a very high proportion of lead. Twenty-five consignments representing nearly 250,000 tins of sardines have been rejected in the Port of London and returned to the packers under guarantee that they would not be reshipped to this country, and the packers have been recommended to coat the grills with pure tin. Recent consignments have been very much more satisfactory, though the degree of lead contamination has not yet been reduced to the minimum. French sardines are not cooked in the same way, and a solder containing very little lead is used for sealing the cans, consequently they have given us no trouble. We have found lead in smaller quantities in a number of other canned products, for example, tunny fish 13 parts per million, paté-de-foie gras 10 parts per million, anchovies 8 parts per million, peeled shrimps 7 parts per million, crab paste 6 parts per million. Merchants have argued that the amount of lead in sardines is not dangerous to health, and have told me how many tins of sardines they themselves have eaten, 52 but when it is pointed out to them that lead is a cumulative poison, that much damage may be done before definite symptoms of poisoning can be diagnosed and that the trouble is not just the quantity ingested in sardines but the many small doses from many different sources, they see our point of view and are anxious to know what steps can be taken to eliminate lead from their products. A year or two ago I came across sample consignments of anchovy paste and mustard paste put up in collapsible tubes just like tooth paste. The former was found to contain 8 parts of lead per million and the latter 2 parts per million. I wrote to the importer and told him it was a most undesirable way of putting up foodstuffs, and I have not seen any more of it. Tin is another metal we must watch. In the Local Government Board Report of 1908, Buchanan and Schryver said: "It seems clear that, in any kind of canned foods, quantities of tin approximating to 2 grains to the pound are not only unusual and unnecessary, but also must be regarded with grave suspicion in consequence of the risk of irritant action of the tin they contain," and in his Annual Report of 1934, the Chief Medical Officer of the Ministry of Health, after referring to the foregoingexpression of opinion, says: "It would seem that this recommendation is amply justified, and that anything in excess of this limit is not only evidence of bad practice in canning or storing the goods, but is also undesirable on grounds of health." We have had a good deal of trouble with tin in canned sild from Norway, and have found as much as 5.4 grains of tin per pound. In some cases the containers were almost completely detinned the fish actually sticking to the inside of the can. In this connection I may mention that Norwegian brisling and shrimps have recently arrived in aluminium containers and have subsequently developed into hydrogen swells. Prohibited preservatives have been found in canned hors d'oeuvre from Sweden e.g., Koster Sills tit-bits in Mareira sauce; Koster tit-bits; Lukas herring tit-bits in onion sauce; fish rolls in lobster sauce; Kron anchovies; Pary herrings; herring tit-bits in Worcester sauce; Sport Kaviar; smoked sealachs and sliced smoked salmon, all contained either boric, benzoic or salicylic acid. On the other hand a short time ago I had some cranberry jelly analysed, and it was found to contain benzoate preservative equivalent to 200 parts of benzoic acid per million. I communicated with the Ministry of Health and Dr. Hamill drew my attention to an article in a German publication in which it was stated that cranberries may normally contain 550 to 600 parts of benzoic acid per million. Meanwhile I had sent the result of the analysis to the importer who forwarded it to the canners. The latter agreed with the findings but sent copies of two reports by C. P. Fellers, Ph.D., of the Massachusetts State College in proof of their contention that the whole of the benzoic acid present in the jelly was derived from the natural fruit, the normal benzoic acid content of cranberries having been found to vary between 0-035 and 0'095 per cent. In conclusion, I hope I have not created the impression that I am always suspicious of canned foods and that, therefore, I am suggesting unreasonable standards for inspectors. On the contrary, I have the greatest admiration for the scientific and technical skill with which the canning industry has overcome many and difficult problems. Being principally concerned with imports I have no first-hand knowledge of English canning, but I can certainly say that the canned foods from North America maintain a uniformly high standard. Some continental countries have not, in my opinion, yet reached such perfection, and it is for the most part their products which we have to watch so carefully. The best canners have set a high standard and we owe it to them, as well as to the consumers in this country, to see that only thoroughly sound and reliable canned foods are offered for sale. So far as we are concerned the consumer must have the benefit of the doubt every time and if we all work on this principle we shall have no difficulty, for the good canners accept our standards and those who are not so good can either improve their methods or lose their products or market them elsewhere than in the United Kingdom. There will be no scarcity of canned foods for there is available an abundance of the best. 53 ALIENS ORDER, 1920. Medical Inspection of Aliens. During the year 26,472 Aliens (excluding Alien Seamen) and 4,373 Transmigrants landed in the Port of London from vessels. Medical Certificates under the Aliens Order were issued in respect of 22 aliens as follows:— Lunatic, Idiot, or Mentally Deficient 9 Undesirable for Medical reasons 6 Physically incapacitated 6 Suffering from acute Infectious Disease 1 Total 22 TRAINING SHIPS. The six Training Ships now within the district of the Port of London Health Authority are as follows:— " Corn-wall" Lying at Denton. "Exmouth" „ Grays. "Warspite" „ Grays. "Worcester" „ Greenhithe. "Stork" ,, Hammersmith. "Triton" „ Gravesend. The following cases of Infectious Disease occurred on these vessels during the year:— T.S. "Stork" 1 case Scarlet Fever. T.S. "Cornwall" 1 case Scarlet Fever. Ditto 10 cases Diphtheria. T.S. "Triton" 1 case Measles. Ditto 1 case Mumps. Training Ship "Cornwall"—Immunisation against Diphtheria. Owing to the occurrence of a number of cases of diphtheria on the T.S. "Cornwall" your Medical Officer was requested to arrange for the immunisation of all the boys. The cost of the material was borne by the Home Office. The actual injections were given by Dr. J. A. Jones, one of your Assistant Medical Officers, who reports as follows:— Method. Three injections of 1 c.c. each, at fortnightly intervals, using T.A.F. A preliminary Schick Test was not undertaken, as the Home Office wished the immunising injections to be commenced at once. First Injection, 8th May, 1936. Number of boys on roll 170 „ „ injected 161 Of the remaining nine boys, four were in Denton Hospital, who, as they had been given A.D.S. received no injections in this series. One boy was licensed on the morning of the 8th, and received no injection. The other four were absent, having absconded, but were caught and received their injections the next day (9th), making a total of 165 injected. In this number, there were no general reactions, but local reactions were present in seventeen cases. In thirteen cases this amounted to swelling and tenderness only, whilst in the other four there was in addition slight redness. Second Injection, 22nd May, 1936. Number of boys on roll 161 ,, ., injected 151 Since the first injection another seven boys bad been licensed, and one sent to Borstal, accounting for the difference in number on roll. Two more boys were in Denton Hospital with Diphtheria, giving a total of six, two boys were home on leave, one boy sent to a Sanatorium and one absconded. This accounts lor the difference between the number on roll (161) and number injected (151). There were twenty-five local reactions, and in eight of these there was redness in addition to swelling and pain. The reactions were generally more severe than those following the first injections, but in no case was there lymphangitis. Two boys complained of malaise and headache, but neither had a local reaction or pyrexia. Six boys had reactions after both first and second injections. 54 Third Injection, 5th June, 1936. Number of boys on roll 164 „ „ injected 155 Of the 151 boys injected last time, two more had been licensed, but there were five new boys, and one returned from leave. Of the eight boys on the roll who did not receive injections, there were still six who had received A.D.S., one boy on leave and one absconded. Following these injections there were no general reactions and only nine local, all of which showed some redness. Of the nine, one boy had reactions with the previous two injections, one with the first but not the second, and two with the second but not the first injection. In the remaining five cases there had been no previous reactions. Throughout the series there were no reactions persisting for more than twenty-four hours. It was found in this series, as is customary, that the reactions were most numerous and severe following the second injection. It is proposed to complete the injections on the five new boys and the two boys on leave. All boys joining the ship in the future are to be immunised as they arrive. In two month's time it is proposed to Schick test all the boys in the ship, including those who have recently had diphtheria, but not been immunised. It is to be expected that the Schick test will show at least a 90 per cent. immunity to diphtheria. Any non-immune should be given a second series of injections and again tested until 100 per cent. immunity is obtained. This method of immunisation should prevent anything in the nature of an epidemic of diphtheria in the ship, but will not prevent isolated cases occurring in new boys until such time as they become Schick Negative (probably three months after joining). Active immunisation has no effect on the "Carrier" of Diphtheria, and is in fact only likely to increase the number of "Carriers." Table "A" Analysis. 1st Injection. 2nd Injection. 3rd Injection. Number on roll 170 161 164 Number injected 161 151 155 Licensed 1 7* 2* In Hospital 4 6 6 In Sanatorium — 1 1 Sent to Borstal — 1* — Absent on Leave — 2 1 Absconded 4 1 1 New Boys — — 5 *Not included in number on roll. Table "B " reactions. 1st Injection. 2nd Injection. 3rd Injection. First injection only 9 9 — — Second injection only 16 — 16 — Third injection only 5 — — 5 First and second injections 6 6 6 — Second and third injections 2 — 2 2 First and third injections 1 1 — 1 All three injections 1 1 1 1 17 25 9 Table "C." Group 1 Receiving 3 Injections 148 2 „ 2 „ (To be completed or Schick Tested) 1 (Leave). 3 „ 2 „ (Not to be „ „ „ „) 2 (Licensed). 4 „ 1 „ (To be „ „ „ „) 8 (5 New, 2 Hospital, 1 Leave). 5 „ 1 „ (Not to be „ ,, „ „) 11 (9 Licensed, 1 Borstal, 1 Sanatorium). 6 „ 0 „ (To be „ „ „ „) 4 (Hospital). 7 „ 0 „ (Not to be „ „ „ „ ) 1 (Licensed). Total number of boys included in series, 175. Results. During the week commencing 14th September, 1936, Dr. Jones carried out a Schick Test on all the boys who had been inoculated and who were still available, and reports as follows:— One of the boys in Group 5 of Table "C" above who had been licensed, returned to the ship, and his T.A.F. injections were completed, making the number in Group 1,149. For Schick Test purposes only Groups 1, 2, 4, and 6 have to be considered. 55 Position of Original Groups at time of Schick Test. Group 1. Receiving three injections of T.A.F. 149 boys. Of the 149 boys— 116 were Schick tested; 26 had been licensed; 3 had been sent to Borstal; 2 had absconded; 1 had been transferred; 1 was in Gravesend Hospital. Group 2. Eeceiving two injections of T.A.F. 1 boy. This boy was on leave at the time of third injection of T.A.F.; on return he was licensed, and his injections were not completed nor was he Schick tested. Group 4. Eeceiving one injection of T.A.F. 8 boys. The immunisation of the five new boys was completed, but one was subsequently licensed, and only four were tested. The two boys in hospital were Schick tested. The boy on leave was licensed on return. Group 6. Eeceiving no injections of T.A.F. 4 boys. These boys were in hospital at time of immunisation. One died in hospital, another was transferred to a land institution, the remaining two were tested. Available for Schick Testing— Group 1 116 boys „ 2 0 „ „ 4 6 „ „ 6 2 „ 124 boys out of original 175 boys. Method of Schick Testing. Messrs. Borroughs Wellcome & Co.'s products were again used. 0.2 cc. of Schick Test Toxin was injected intradermally into the right forearm, and 0.2 cc. of the Schick Control into the left forearm. The results were read twenty-four hours later, and again after a second twenty-four hours where necessary. The results obtained may be divided into four groups:— A. Negative. B. Negative and Pseudo. C. Positive and Pseudo Combined. D. Positive. Groups "A" and "B" indicate that the immunisation was successful, i.e., the boys are no longer susceptible to diphtheria. Groups "C" and "D" indicate that the immunisation has failed or been only partly successful, and a second series of injections with T.A.F. should be carried out on these boys. Eesults— A. Negative 95 B. Negative and Pseudo 17 C. Positive and Pseudo Combined 9 D. Positive 3 There are thus still twelve boys out of the 124 tested, susceptible to diphtheria. This represents an immunity of just over 90 per cent. This figure is rather lower than that usually obtained by this method of immunisation, but may be regarded as satisfactory. With one exception the boys exhibiting positive reactions had received the normal course of three injections of T.A.F., i.e., belonged to Group 1. It is to be expected that the twelve boys in Groups "C" and "D" are partially immune, but to assure 100 per cent. immunity, a second series of T.A.F. injections has been commenced. BYE-LAWS—OFFENSIVE CARGOES. Nine 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. Date. 1936. Name of Vessel. Owner. Infringement. Jan. 11 Ltr. "Ness" Cory Lighterage, Ltd. Carrying an offensive cargo, to wit, vegetable and other refuse, which was not properly and securely covered, so as to prevent any nuisance arising therefrom. „ 11 Ltr. "Tyne" Ditto Ditto. „ 11 Ltr. "Saturday" Ditto Ditto. „ 11 Ltr. "Treasurer" Ditto Ditto. 56 Date. 1936. Name of Vessel. Owner. Infringement. Mar. 3 Ltr. "Squirrel" Cory Lighterage, Ltd. . Carrying an offensive cargo, to wit, house refuse, which was not properly and securely covered so as to prevent a nuisance arising therefrom. „ 3 Ltr. "Commodus" Ditto Ditto. „ 10 Ltr. "Menelaus" Ditto Ditto. Oct. 7 Ltr. "Cambric" Ditto Carrying an offensive cargo, to wit, vegetable and other refuse, which was not properly and securely covered, so as to prevent any nuisance arising therefrom. „ 15 Ltr. "Megantic" Ditto Ditto. PARROTS (Prohibition of Import) REGULATIONS, 1930. 501 parrots, &c., came under the notice of your Officers during the year. 73 Notices were issued in respect of 132 parrots, &c. Number exported in respect of Notices served 127 Number destroyed (Notice served to export) 5 Number destroyed (Notice not served) 2 Number exported (not time to serve Notice owing to short stay of vessel) 3 Number admitted under Ministry of Health permits 863 Bodies of birds sent for investigation to the Ministry of Health 1 501 In addition, 11 parrots were reported as having died in vessels during the voyage, the bodies being destroyed before arrival in the Port. VISITORS TO THE POET HEALTH DISTRICT. During the period covered by this Report the following Medical Officers and Sanitary Inspector visited the Port of London to study the health administration either in general or in some particular aspect:— Dr. S. Eajendram of Ceylon. Dr. D. J. A. Sandrasagra of Ceylon. Dr. D. W. G. Faris of Malaya. Dr. Alberta of Santa Cruz de Tenerife. Dr. Ali Hasan El Ramli, Medical Inspector, Dakalieh Province, Egypt. Mr. D. A. Dick, Sanitary Inspector, Kenya and Uganda. VISIT OF THE HARVEIAN SOCIETY OF LONDON. On Saturday, 18th July; 1936, your Chairman entertained on board the s.y. "St. Katharine," kindly lent for the occasion by the Port of London Authority, some 50 members of the Harveian Society of London. The number of members desiring to accept the invitation of your Chairman far exceeded the number that could be accommodated on the "St. Katharine." It was therefore necessary for the Society to ballot for the 50 places, and your Chairman agreed, that if any of the first 50 subsequently found themselves unable to attend, they might be replaced by other members. There was thus a full complement of passengers when the "St. Katharine " left Tower Pier at 10 a.m., almost every branch of medicine being represented. 57 The "St. Katharine" made a tour of the Royal Docks and then proceeded down river to Gravesend, where the "Hygeia," the boarding launch, and the Hospital were inspected. As it was apparent that it would be impossible to give lengthy explanations to such a large party on the day of the visit, your Medical Officer had circulated a short summary of the work of the Port of London Health Authority to the guests, several days beforehand. The visitors took a very keen interest in all they saw. At luncheon Sir William Willcox, K.C.I.E., C.B., C.M.G., proposed the toast of the Corporation of the City of London, to which Mr. G. E. Withers replied. Your Chairman proposed the Harveian Society of London, and Sir Buckston Browne, F.R.C.S., F.S.A., replied. The toast of the Chairman was proposed by Mr. Herbert Easton. The "St. Katharine" arrived back at Tower Pier at 6.30 p.m., and the party dispersed with many expressions of appreciation of your Chairman's hospitality and of the work of your Worshipful Committee. 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 Health Authority during the year ended 31st December, 1936. The Acts and Regulations apply within the whole district under the jurisdiction of the Port of London Health Authority, including the River and Docks, as a "canal" for the purposes of the Acts "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." The navigation, in addition to the enclosed Docks, includes the following navigable tributary rivers 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 Eiver Brent. Hay's Dock. Hammersmith Creek. St. Saviour's Dock. Chelsea Creek. Part of the Grand Surrey Canal within the Grosvenor Dock. Surrey Commercial Docks. Limekiln Creek. Deadman's Dock. Bow Creek (River Lea). Deptford Creek (River Ravensbourne). Barking Creek (River Roding). Dartford Creek (Rivers Cray and Darenth). Rainham Creek (River Ingrebourne). The entrance to Gravesend Canal. Mucking Creek. Cliffe Creek. Thames Haven and Hole Haven. Yantlet and Coalmouth Creeks. Havengore Creek. Part of the River Medway and of the Swale. 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 Inspector Hundy, £325 per annum. Middle District Greenwich to Erith Inspector McDermott, £325 per annum. Lower District Erith to the seaward limits of the Port (including part of the River Inspector Beattie, £340 per annum. Medway). DOCKS. The Docks are divided into four districts, known as the Central, Eastern, Western and the Gravesend Districts. Central District West India Dock South West India Dock Poplar Dock Inspector Elward, £500 per annum. Millwall Dock East India Dock Surrey Commercial Dock Inspector Mackie, £325 per annum. 58 Eastern District ... Royal Victoria Dock Royal Albert Dock Inspector Madeley, £355 per annum. King George V Dock Inspector Wright, £340 per annum. Western District London Dock St. Katharine Dock Inspector Gray, £500 per annum. Regent's Canal Dock Gravesend District Tilbury Dock Left Shore of theRiver,fromPurfleetdown Inspector Edwards, £425 per annum. Right Shore of the River, from Northfleet down. INSPECTIONS. The total number of inspections for the year was 167, representing a nett number of 136 boats. The remainder—31—represents repeated visits by Inspectors of this Authority. The number of boats not conforming to the Acts and Regulations was 34 (inspected on 35 occasions), or 20.9 per cent. of the total inspections, the percentage for the previous five years being 15.4 per cent. New Boats Registered. Two new boats were registered during the year. One boat was re-registered owing to structural alteration. Infringements in respect of:— Notification of Change of Master. Nil. Absence of Certificate of Registration, 1936. Apl. 30 "Clun" Registered Port of London No. 560. May 5 "Misbourne" „ „ No. 561 Sep. 25 "Sun" „ Brentford No. 522. „ 25 "Moon" „ „ (number not known) „ 25 "Cygnus" „ „ No. 489. Oct. 1 "William" „ „ No. 441. „ 2 "Aynho" „ ,, (number not known) „ 2 "Ayr" ,, 2 " Countess",, Richmond No. 56. „ 2 " Holton" ,, Rickmansworth 74. „ 2 " Halsall" „ „ No. 79. „ 2 " Nestor" „ „ No. 93. „ 2 " Nutfield" „ „ No. 97. „ 9 " Pisces" „ Birmingham No. 1574. „ 9 " Puppis" „ „ No. 1575. ,, 16 " Bootes" ,, Brentford No. 569. „ 16 " Belerophon" „ „ No. 570. ,, 16 " Taygeta" „ Birmingham No. 1586. „ 16 " Triagulum" „ „ No. 1587. „ 23 "Beaver" „ „ No. 1434. „ 23 " Devon" „ „ No. 1483. „ 23 " Beverley" „ Brentford No. 597. „ 23 " Bexhill" „ „ No. 596. Dec. 8 " Franklin" „ Berkhamsted No. 338. Marking, &c. 1936. Jan. 10 "Ada" Registered Brentford No. 404. Apl. 30 " Clun" „ Port of London No. 560. May 5 " Misbourne" „ „ „ „ No. 561. Sept. 25 " Moon" „ Brentford (number not known) Oct. 1 " Rigal" 1 " Denebola " „ 2 "Aynho" .. 2 " Ayr" „ 16 " Taygeta"„ Birmingham No. 1586. „ 16 " Triagulum" „ „ No. 1587. 59 Certificate not Identifying Owner with Boat. Nil. Overcrowding. Nil. Partition Separating Sexes. Nil. Males over Age. Nil. Females over Age. Nil. Cleanliness. 1936. Sept. 24 "Capricorn" Registered Brentford No. 504. „ 25 " Liege" „ Uxbridge No. 495. Painting. 1936. Feb. 19 "Stanley" Registered Port of London No. 536. Sep. 24 " Capricorn" „ Brentford No. 504. Ventilation. Nil. Dilapidations (including defective bulkheads). 1936. Apl. 4 " Charles" Registered Brentford No. 210. Sept. 25 " Liege" „ Uxbridge No. 495. Oct. 9 " Durbar" „ Birmingham No. 1113. „ 9 " Una" „ Tring No. 110. „ 10 " Grange" „ Birmingham No. 1257. Removal of Bilge Water. Nil. Without Pump. Nil. No proper Water Vessel. 1936. Oct. 16 " Bootes " Registered Brentford No. 569. Double Bulkheads. Nil. Register. On the 31st December, 1936, there were 242 boats on the Register :— Propelled by Tugs and Oars 220 „ „ Steam 15 „ „ Motor 7 60 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. 1927 93 19 66 3.04 22.89 1928 79 13 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 1933 87 14 28 2.00 16.09 1934 79 16 39 2.45 20.25 1935 93 29 53 1.81 31.18 1936 136 49 80 1.63 36.03 I have the honour to be, Gentlemen, Your obedient Servant, CHAS. F. WHITE, Medical Officer of Health, Port of London. 61 SUMMARY OF CANAL BOATS FOR THE YEAR ENDED 31st DECEMBER, 1936. Jan. Feb. March. April. May. June. July. Aug. Sept. Oct. Nov. Dec. TOTAL. Total for Years 1931. 1932. 1933. 1934. 1935. New boats registered - - - 2 - - - - - - - - 2 9 2 - 1 2 Registration owing to structural alteration — — — - 1 — - - - - - - 1 — — - - - Registration for other purposes - - - - - - - - - - - - - - - - - - No. of Inspections 12 4 6 12 1 1 3 1 15 101 6 5 167 295 236 205 131 129 Conforming to Acts and Regulations 11 3 4 10 1 1 3 1 10 78 6 4 132 252 200 189 117 106 Infringements in respect of:— Registration — — 2 - — — — — - - — - 2 12 2 — — 2 Notification of change of Master - - - - - - - - - - - - - - - - - - Absence of Certificate 1 - - 1 1 - - - 3 18 - 1 25 23 7 6 6 6 Certificate not identifying owner with boat - - - - - - - - - - - - - - - - - - Marking, &c. — - - - 1 — — — 1 6 — - 9 4 4 2 2 3 Overcrowding — - — - — — — — — — — - — 2 — — — — Partition separating sexes — - — - — — — — — — — - — — — — — — Males over age — - — - — — — — — — — - — - — — — — Females over age — - — - — — — — — — — - — — — — — — Cleanliness — - — - — — — — 2 — — - 2 — — — — 1 Painting — 1 - - - — — — - - — - 1 3 6 2 - 1 Ventilation - - - - - — - - - - - - - 3 3 — - 3 Dilapidations (including defective bulkheads) — - — 1 — — - — 1 3 — - 5 13 18 7 7 10 Removal of bilge water — - — - — — — — — — — - — — — — — — Without pump — - — - — — — — — — — - — — — — — — Refusal to admit Inspector - - - - - - - - - - - - - - - - - - No proper water vessel — - — - — — — — — 1 — - 1 1 1 1 1 3 Double bulkheads - - - - - - - - - - - - - - - - - - Notification of infectious disease - - - - - - - - - - - - - - - - - - Detained for cleansing - - - - - - - - - - - - - - - - - - Proceedings taken — - — - — — — — — — — - — — — — — - Written cautions given — - 2 2 1 — — — 4 21 — 1 29 15 11 6 8 11 *Cautions attended to 1 3 — 6 — — 1 — — 10 1 2 24 24 13 9 12 15 Total registered by Port Health Authority since 1887 559 Cancelled 317 Actual number on Register, 31st December, 1936 242 * Includes cautions given during previous years and attended to during 1936. 62 APPENDIX I. MEDICAL INSPECTION. From 1st January to 31st December, 1936. (a) Gravesend. Jan. Feb. March April May June July August Sept. Oct. Nov. Dec. Total. No. Medically Inspected 149 162 160 175 189 169 177 195 169 205 246 193 2,189 No. of Passengers 1,768 1,560 2,155 2,590 2,600 4,815 5,484 5,257 3,648 2,616 1,596 2,333 36,422 No. of Crews 5,826 5,991 6,341 6,570 7,878 5,382 5,908 6,202 5,399 7,953 5,573 6,915 75,938 No. of Foreign Arrivals 1,005 981 1,082 1,021 1,162 1,128 1,242 1,252 1,186 1,131 1,106 1,115 13,411 (b) Sheerness. Jan. Feb. March April May June July August Sept. Oct. Nov. Dec. Total. No. Medically Inspected 12 8 11 9 17 24 21 21 19 22 21 15 200 No. of Passengers - - - - - - - - 1 — — — 1 No. of Crews 257 156 226 223 362 523 455 475 411 531 397 313 4,329 No. of Foreign Arrivals 47 48 53 50 57 69 65 69 65 67 72 57 719 APPENDIX II. Infectious Disease. disease. 1927. 1928. 1929. 1930. 1931. 1932. 1933. 1934. 1935. Mean Annual No. for 10 years ending 31st Dec., 1936. 1936. (a) Cases Reported: Cholera (including suspected cases) 6 5 2 1 1 3 — — — 1.8 — Yellow Fever (ditto) — — — — — — — — — — — Plague (ditto) — 2 1 — — — — — — 0.3 — Small-pox 14 8 22 11 14 14 4 11 4 11.1 9 Scarlet Fever 17 16 11 29 7 12 21 7 9 13.9 10 Diphtheria 13 13 17 9 16 10 7 13 5 11.9 16 Enteric Fever 36 72 46 25 23 23 29 23 16 32.2 29 Measles 21 47 48 50 11 25 26 38 41 32.3 16 German Measles 5 65 9 6 3 22 4 5 8 13.1 4 Erysipelas 2 4 4 2 2 2 1 2 2 2.3 2 Typhus Fever — — — — — — — — 1 0.1 — Continued Fever 2 2 — 1 - - - - - 0.5 — Relapsing Fever — 1 - - - - - - - 0.1 — Tuberculosis:- Pulmonary 82 86 126 116 147 135 148 114 133 120.7 120 Other kinds 1 4 7 4 4 4 1 9 1 3.5 — Other diseases (including Chickenpox) 667 499 653 904 1,118 791 460 516 647 679.8 543 Total 866 824 946 1,158 1,346 1,041 701 738 867 923.6 749 (6) Treated in Port Sanitary Hospital: Cholera (including suspected cases) - - - - - - - - - - - Yellow Fever (ditto) - - - - - - - - - - - Plague (ditto) - - - - - - - - - - - Small-pox 3* — 4 - - - - - - 0.7 — Typhus Fever — - — — — — — — 2* 0.2 — Scarlet Fever 5* 5 7 12* — 4 15 5 2 5.6 1 Diphtheria 6 9 5 3 1 4 4 2 1 4.9 14* Enteric Fever 6 20 23 9 4 9 6 11 6 10.3 9 Measles 7† 11 18‡ **12 — 1 2 13 10 7.9 5 Erysipelas - 1 - 1 — — — — — 0.2 — Parotitis — — — — 21 2 4 4 5* 3.7 1 Continued Fever - - - - - - - - - - - Other diseases (including Chickenpox) 20 29 30 19* 23* 33 22 21 26 25.9 36 Total 47 75 87 56 49 53 53 56 52 59.4 66 * Includes one contact. ** Includes three contacts. † Includes two contacts. ‡ Includes six contacts. 68 APPENDIX III.— Small-pox. Date. Name of Vessel. Where from. No. of Cases. Passenger or Crew Rating. How dealt with. 1986. (a) Landed from Vessels—Nil. (b) Died, Landed elsewhere or well on Arrival— Jan. 23 ss. "Prince Rupert City" Vancouver 4 Crew 1 Died. Landed at Vancouver. 3 Landed at Vancouver „ 30 ss. "Gaunless" West Africa 1 Crew Admitted to Hospital at Sapele. Mar. 14 ss. "Matra" Calcutta 1 Crew Landed at Suez. May 2 ss. "City of London" Calcutta 1 Crew Landed at Suez. „ 9 ss. "City of Adelaide" Rangoon 1 Crew Landed at Colachel. „ 10 ss. "Manipur" Calcutta 1 Crew Landed at Port Sudan. Total 9 (9 Crew) APPENDIX IV.— Scarlet Fever. Date. 1936. Name of Vessel. Where from. No. of Cases. Passenger or Crew Rating. How dealt with. (a) Landed from Vessels— Feb. 6 ss. "Port Gisborn" Sydney 1 Crew Admitted to Seamen's Hospital, Greenwich. Mar. 9 ss. "Ponzano" Malaga 1 Crew Admitted to Broak Hospital, Shooter's Hill, S.E. „ 25 Training Ship "Stork" Lying at Hammersmith. 1 Boy Admitted to North Western Hospital. July 17 ss. "Empress of Australia" Northern Cruise 1 Pass Admitted to Port Isolation Hospital, Denton. Aug. 9 Training Ship "Cornwall" Lying off Denton 1 - Boy (1 Passenger) Ditto. Total 5 (2 Crew) (2 Boys) (b) Died, Landed elsewhere or well on Arrival— Jan. 17 ss. "Ranchi" Yokohama 1 Pass Landed at Port Said. „ 31 ss. "Shropshire" Rangoon 1 Crew Landed at Rangoon. June 8 ss. "Britannic" New York 1 Pass Landed at Southampton. July 20 ss. "Georgic" New York 1 Pass Landed at Southampton. Aug. 16 ss. "Toward" Belfast 1 Crew (3 Passengers) Admitted to Hospital at Belfast. Total 5 (2 Crew) APPENDIX V.— Diphtheria. Date. 1936. Name of Vessel. Where from. No. of Cases. Passenger or Crew Rating. How dealt with. (a) Landed from Vessels— Jan. 10 Training Ship "Cornwall" Lying off Denton 1 Boy Admitted to Port Isolation Hospital, Denton. „ 17 Training Ship "Cornwall" Lying off Denton 1 „ Ditto. Mar. 22 Training Ship "Cornwall" Lying off Denton 1 „ Ditto. April 15 Houseboat "Mahatma" Lying at Canvey Island. 1 Pass Admitted to Sutton Ford Isolation Hospital. Carried forward 4 64 Diphtheria— continued. Date. 1936. Name of Vessel. Where from. No. of Cases Passenger or Crew Rating. How dealt with. Brought forward 4 April 29 Training Ship "Cornwall" Lying off Denton 1 Boy Admitted to Port Isolation Hospital, Denton. May 6 Training Ship "Cornwall" Lying off Denton 1 „ Ditto. „ 10 Training Ship "Cornwall" Lying off Denton 1 „ Ditto. „ 16 Training Ship "Cornwall" Lying off Denton 1 „ Ditto. „ 20 Training Ship "Cornwall" Lying off Denton 1 „ Ditto. June 15 Training Ship "Cornwall" Lying off Denton 1 „ Ditto. Sept. 5 Training Ship "Cornwall" Lying off Denton 1 „ (1 Passenger) Ditto. Total 11 (10 Boys) (b) Died, Landed elsewhere or well on Arrival— Jan. 29 ss. "Skiensfjord" Tamatav 2 Crew Landed at Freetown. Feb. 20 ss. "Sarpedon" Tsingtao 1 Pass Well on arrival. Sept. 21 ss. "Dunottar Castle" Hamburg 1 Pass Landed at Hamburg. Nov. 1 ss. "Baltrover" Gdynia 1 Pass Landed at Kiel Canal. Total 5 - (3 Passengers) (2 Crew) APPENDIX VI.— Enteric Fever. Date. 1936. Name of Vessel. Where from. No. of Cases. Passenger or Crew Rating. How dealt with. (a) Landed from Vessels- Jan. 1 ss. "Annie Johnson" San Francisco 1 Crew Admitted to Port Isolation Hospital, Denton. „ 7 ss. "Ausonia" New York 1 Crew Ditto. „ 23 ss. "Bangitata" Napier 1 Crew Ditto. Mar. 6 ss. "Mongolia" Brisbane 1 Crew Ditto. „ 13 ss. "Maria" Tallinn 1 Crew Ditto. April 24 ss. "Lexa Maersk" Gandia 1 Crew Admitted to Seamen's Hospital, Greenwich. „ 27 ss. "Nardana" Cairns 3 Crew Admitted to Port Isolation Hospital, Denton. July 27 ss. "Bedriff" Coastwise 1 Crew Admitted to Seamen's Hospital, Greenwich. Aug. 17 ss. "Garth Castle" Africa 1 Crew Admitted to Seamen's Hospital, Greenwich. Oct. 21 ss. "Strathmore" Bombay 1 Pass Admitted to Port Isolation Hospital, Denton. Nov. 14 ss. "Serbino" Calicut 1 Crew Admitted to Hospital for Tropical Diseases, W.C. 1. Deo. 23 ss. "Maloja" Bombay 1 — Crew (1 Passenger) Admitted to Port Isolation Hospital, Denton. Total 14 (13 Crew) 65 Enteric Fever—continued. 1936. Date. Name of Vessel. Where from. No. of Cases. Passenger or Crew Rating. How dealt with. (b) Died, Landed elsewhere or well on Arrival— Jan. 15 ss. "British Monarch" Montevideo 1 Crew Landed at St. Vincent. „ 24 ss. "Aeneas" Dairen 1 Crew Landed at Singapore. Feb. 19 ss. "City of Exeter" Madeira 1 Crew Landed at Durban. Mar. 9 ss. "Caduceus" Zarati 1 Pass Well on arrival. May 2 ss. "Mantola" Beira 1 Crew Landed at Plymouth. „ 15 ss. "Maloja" Brisbane 1 Crew Landed at Gibraltar. June 6 ss. "Britannic" New York 1 Crew Landed at Southampton for vation. July 31 ss. "Rawalpindi" Yokohama 1 Pass Well on arrival. Aug. 7 ss. "Hesperides" Chittagong 1 Crew Landed at Madras. Sept. 8 ss. "Csikos" La Romana 1 Crew Landed at Azores. „ 26 ss. "Nagpore" Calcutta 1 Crew Landed at Aden. Oct. 22 ss. "Umkuzi" Beira 1 Crew Landed at Teneriffe. Nov. 14 ss. "Serbino" Calicut 1 Crew Landed to Hospital in Liverpool. „ 20 ss. "Kaisar-I-Hind" Bombay 1 Pass Landed to Hospital in Gibraltar. Dec. 3 ss. "Oronsay" Brisbane 1 Pass (4 Passengers) Well on arrival. Total 15 (11 Crew) APPENDIX VII.— Measles. Date. 1936. Name of Vessel. Where from. No. of Cases. Passenger or Crew Rating. How dealt with. (a) Landed from Vessels— Jan. 21 Sea School Gravesend Boy Admitted to Port Isolation Hospital, Denton. „ 30 ss. "Dunluce Castle" Port Natal 1 Pass Admitted to London Fever Hospital, Islington, N. Mar. 6 ss. "Corfleet" Seaham Harbour 1 Crew Admitted to Port Isolation Hospital, Denton. June 6 ss. "Duquesa" Buenos Aires 1 Crew Ditto. Sept. 18 ss. "Wanda" Demerara 1 Crew Admitted to Seamen's Hospital, Greenwich. Oct. 5 ss. "Baltrover" Danzig 1 Pass Admitted to Port Isolation Hospital, Denton. Dec. 10 ss. "Strathmore" Bombay 1 Crew (2 Passengers) Ditto. Total 7 - (4 Crew) (1 Boy) (b) Died, Landed elsewhere or well on Arrival— Jan. 30 ss. "Dunluce Castle" Port Natal 3 Pass Well on arrival. Feb. 12 ss. "Domala" Calcutta 1 Pass Well on arrival. „ 27 ss. "Highland Princess" Buenos Aires 1 Pass Landed at Lisbon. July 2 ss. "Ormonde" Brisbane 1 Pass Well on arrival. „ 9 ss. "City of Paris" Durban 1 Pass Landed at Plymouth. Sept. 11 ss. "Naldera" Yokohama 1 Pass Well on arrival. Dec. 10 ss. "Strathmore" Bombay 1 Pass Landed at Plymouth. Total 9 (9 Passengers) 66 APPENDIX VIII.— German Measles. Date. 1936. Name of Vessel. Where from. No. of Cases. Passenger or Crew Rating. How dealt with. (a) Landed from Vessels— May 18 ss. "Beaverford" Montreal 1 Crew Admitted to Port Isolation Hospital, Denton. Dec. 27 ss. "Baltrover" Danzig 1 Pass 1 Passenger) Ditto. Total 2 (1 Crew) (b) Died, Landed elsewhere or well on Arrival— Mar. 25 ss. "Strathmore" Bombay 1 Pass Convalescent on arrival. „ 28 ss. "Barrabool" Brisbane l Pass Well on arrival. Total 2 (2 Passengers) APPENDIX IX.- Erysipelas. Date. 1936. 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— June 24 ss. "Umvoti" Beira 1 Pass Convalescent on arrival. Dec. 31 ss. "Highland Patriot" Buenos Aires 1 Pass Landed at Buenos Aires. Total 2 (2 Passengers) APPENDIX X.— Pulmonary Tuberculosis. Date. 1936. Name of Vessel. Where from. No. of Cases. Passenger or Crew Rating. How dealt with. (a) Landed from Vessels— Jan. 17 ss. "Banchi," Yokohama 1 Pass Admitted to Herbert Hospital, Woolwich. „ 20 ss. "Matiana" Australia 1 Crew Admitted to Seamen's Hospital, Greenwich. 30 ss. "Dunluce Castle" Port Natal 1 Crew Admitted to Seamen's Hospital, Greenwich. Feb. 7 ss. "Strathaird" Brisbane 1 Pass Proceeded home. „ 21 ss. "Comorin" Bombay 1 Pass Admitted to Royal Herbert Hospital, Woolwich. „ 24 ss. "Dunluce Castle" Beira 1 Crew Admitted to Seamen's Hospital, Greenwich. „ 27 ss. "Highland Princess" Buenos Aires 1 Pass Landed in care of Board of Trade. „ 27 ss. "Baradine" Brisbane 1 Pass Landed in care of Naval Authorities. Mar. 9 ss. "Viceroy of India" Bombay 1 Pass Proceeded to Mundsley Hospital, Norfolk. „ 12 ss. "Ormonde" Brisbane 1 Crew Admitted to Seamen's Hospital, Tilbury. „ 14 ss. "Lapwing" Mediterranean 1 Crew Admitted to Seamen's Hospital, Greenwich. Carried forward 11 67 Pulmonary Tuberculosis— continued. Date. Name of Vessel. Where from. No. of Cases. Passenger or Crew Rating. How dealt with. 1986. Brought forward 11 Mar. 18 ss. "Patroclus" Dairen 1 Crew Proceeded to Liverpool in care of Shipping Company. „ 20 ss. "Karkunda" Brisbane 1 Pass Proceeded home. „ 27 ss. "Mashobra" Calcutta 1 Pass Proceeded home. April 2 ss. "Eanpura" Bombay 1 Crew Admitted to Seamen's Hospital, Greenwich. „ 9 ss. "Rawalpindi" Yokohama 1 Pass Proceeded to Royal Naval Hospital, Chatham. „ 14 ss. "Fordsdale" New Plymouth 1 Pass Admitted to Seamen's Hospital, Royal Albert Dock. „ 14 ss. "Rangitiki" Port Chalmers 1 Pass Proceeded to Royal Naval Hospital, Chatham. „ 14 ss. "Durham Castle" Beira 1 Crew Admitted to Seamen's Hospital, Greenwich. „ 20 ss. "Viceroy of India" Bombay 1 Pass Proceeded to Royal Naval Hospital, Chatham. „ 20 ss. "Fordsdale" New Plymouth 1 Crew Admitted to Seamen's Hospital, Greenwich. „ 20 ss. "Otranto" Brisbane 1 Crew Admitted to Seamen's Hospital, Greenwich. „ 24 ss. "Corfu" Yokohama 1 Crew Transferred to "Viceroy of India" for repatriation. „ 26 ss. "Bendigo" Brisbane 1 Crew Admitted to Seamen's Hospital, Royal Albert Dock. „ 29 ss. "Georgic" New York 1 Crew Admitted to Seamen's Hospital, Royal Albert Dock. May 1 ss. "Strathnaver" Bombay 1 Pass Proceeded home. „ 4 ss. "Sithonia" Liverpool 1 Crew Admitted to Seamen's Hospital, Greenwich. „ 8 ss. "Shropshire" Rangoon 1 Pass Remained on board. „ 8 ss. "Ranchi" Yokohama 4 Pass Proceeded in care of Naval and Military Authorities. „ 9 ss. "Matra" Middlesbrough 1 Crew Admitted to Seamen's Hospital, Greenwich. „ 18 ss. "Dagomba" Lagos 1 Pass Landed in care of Board of Trade. „ 18 ss. "Buteshire" Australia 1 Crew Admitted to Seamen's Hospital, Royal Albert Dock. „ 18 ss. "Rolfe Jarl" Spain 1 Crew Admitted to Seamen's Hospital, Greenwich. „ 22 ss. "Naldera" Yokohama Pass Landed in care of Military Authorities. June 1 ss. "Viceroy of India" Bombay 2 Pass 1 landed in care of Military Authorities. 1 landed in care of Royal Air Force Authorities. „ 5 ss. "Carthage" Singapore 1 Pass Landed in care of Naval Authorities. Carried forward 40 68 Pulmonary Tuberculosis—continued. Date. Name of Vessel. Where from. No. of Cases. Passenger or Crew Rating. How dealt with. 1986. Brought forward 40 June 19 ss. "Rajputana" Yokohama 1 Pass Proceeded home. 1 Crew Admitted to Seamen's Hospital, Greenwich. „ 25 ss. "Kalleh" Kasko 1 Crew Admitted to Seamen's Hospital, Greenwich. „ 26 ss. "Mongolia" Brisbane 1 Pass Alien in transit to Sweden. „ 29 ss. "Hartington Court" Vancouver 1 Crew Admitted to Seamen's Hospital, Greenwich. July 3 ss. "Chitral" Yokohama 1 Pass Admitted to Royal Herbert Hospital, Woolwich. „ 30 ss. "Otranto" Brisbane 10 Pass Landed in care of Military Authorities. „ 31 ss. "Rawalpindi" . Yokohama 4 Pass Landed in care of Military Authorities. 1 Pass Proceeded home. Aug. 4 ss. "Remuera" New Zealand 1 Crew Admitted to Seamen's Hospital, Greenwich. „ 7 ss. "Mooltan" Brisbane 5 Pass Landed in care of Military Authorities. „ 9 ss. "Ausonia" Montreal 1 Crew Landed in care of Shipping Company. „ 16 ss. "Dunluce Castle" Beira 1 Pass Admitted to Seamen's Hospital, Greenwich. „ 19 ss. "Afric Star" Buenos Aires 1 Crew Proceeded home. „ 29 ss. "Ranchi" Hong Kong 1 Pass Landed in care of Naval Authorities. Sept. 11 ss. "Naldera" Yokohama 1 Pass Admitted to Seamen's Hospital, Greenwich. „ 18 ss. "Carthage" Brisbane 2 Pass 1 landed in charge of Naval Authorities. 1 landed in charge of Military Authorities. Oct. 9 ss. "Rajputana" Yokohama 4 Pass Landed in care of Military Authorities. Nov. 6 ss. "Ranpura" Penang 1 Pass Landed in care of Military Authorities. „ 6 ss. "Mashobra" Colombo 1 Pass Proceeded to Royal Naval Hospital, Devonport. „ 13 ss. "Mongolia" Brisbane 1 Pass Proceeded to a Nursing Home in London. 1 Crew Admitted to Seamen's Hospital, Tilbury. „ 20 ss. "Rawalpindi" Yokohama 7 Pass Proceeded to Royal Naval Hospital, Chatham. Dec. 3 ss. "Oronsay" Brisbane 1 Crew To attend Tuberculosis Clinic at Colindale, Hendon. „ 4 ss. "Corfu" Yokohama 1 Crew Proceeded home. „ 10 ss. "Strathmore" Bombay 1 Pass Proceeded to a Sanatorium. „ 18 ss. "Viceroy of India" Port Said 1 Pass Proceeded to Herbert Hospital, Woolwich. Carried forward 93 69 Pulmonary Tuberculosis— continued. Date. 1936. Name of Vessel. Where from. No. of Cases. Passenger or Crew Rating. How dealt with. Brought forward 93 Dec. 29 ss. "Jamaica Pioneer" Kingston 1 Pass (68 Passengers) Admitted to Seamen's Hospital, Greenwich. Total 94 (26 Crew) (b) Died, Landed elsewhere or well on Arrival— Jan. 2 ss. "Highland Brigade" Buenos Aires 1 Pass Landed at Las Palmas. Feb. 27 ss. "Baradine" Brisbane 2 Pass Landed at Plymouth. Mar. 8 ss. "Sabor" Brazil 1 Crew Died and buried at Las Palmas. „ 27 ss. "Mashobra" Calcutta 1 Crew Landed at Port Said. April 7 ss. "Highland Monarch" Buenos Aires 1 Pass Landed at Lisbon. „ 8 ss. "Bewledi" Timaru 1 Crew Died. Buried at Colon. May 2 ss. "Fushimi Maru" Yokohama 1 Crew Landed at Singapore. „ 22 ss. "Naldera" Yokohama 2 Pass Landed at Plymouth. June 19 ss. "Rajputana" Yokohama 1 Pass Landed at Aden. July 3 ss. "Chitral" Yokohama 4 Pass Convalescent on arrival. „ 16 ss. "Llanstepan Castle" Cape Town 1 Pass Landed at Port Said. „ 27 ss. "Highland Monarch" River Plate 1 Pass Landed at Lisbon. „ 30 ss. "Matiana" Beira 1 Pass Convalescent on arrival. Oct. 8 ss. "Highland Brigade" Buenos Aires 1 Pass Landed at Lisbon. „ 22 ss. "Umkuzi" Beira 1 Crew Landed at Durban. „ 23 ss. "Chitral" Yokohama 3 Pass Landed at Plymouth. Nov. 12 ss. "Matiana" Beira 1 Pass Convalescent on arrival. „ 15 ss. "Ascania" Montreal 1 Pass Died. Buried at sea. Dec. 14 ss. "Ascania" New York 1 Pass (21 Passengers) Landed at Havre. Total 26 (5 Crew) APPENDIX XI.—Pneumonia. Date. 1936. Name of Vessel. Where from. No. of Cases. Passenger or Crew Rating. How dealt with. (a) Landed from Vessels— Feb. 2 ss. "Balranald" Brisbane 1 Crew Admitted to Seamen's Hospital, Tilbury. „ 4 ss. "Eurypides" Brisbane 1 Pass Admitted to Seamen's Hospital, Royal Albert Dock. Mar. 30 ss. "Somme" Middlesbro' 1 Crew Admitted to Gravesend and North Kent Hospital. June 10 ss. "Clearpool" Montreal 1 Crew Admitted to Seamen's Hospital, Royal Albert Dock. „ 26 ss. "Mongolia" Brisbane 1 Crew Admitted to Seamen's Hospital, Tilbury. Oct. 2 ss. "Montrose" Madeira Cruise 1 Crew Admitted to Seamen's Hospital, Tilbury. Nov. 2 ss. "City of Paris" East Africa 1 Crew Admitted to Seamen's Hospital, Royal Albert Dock. Dec. 28 ss. "Mahronda" 1 Crew (1 Passenger) Admitted to Seamen's Hospital, Royal Albert Dock. Total 8 (7 Crew) 70 Pneumonia—continued. Date. 1936. Name of Vessel. Where from. No. of Cases. Passenger or Crew Rating. How dealt with. (b) Died, Landed elsewhere, or well on Arrival:— Feb. 14 ss. "Soekoboemi" Java 1 Pass Died. Buried ashore at Sabary. Mar. 15 ss. "Dumana" Calcutta 1 Pass Died. Buried at sea. April 9 ss. "Orontes" Brisbane 1 Pass Died. Buried at sea. „ 17 ss. "Pontypridd" Pernambuco 1 Crew Died. Buried at Pernambuco. „ 26 ss. "Bendigo" Brisbane 5 Pass 1 Died. Buried at sea. 2 landed at Aden. 2 landed at Plymouth. May 15 ss. "Maloja" Brisbane 1 Pass Died. Buried at sea. Nov. 19 ss. "Yewforest" Sunderland 1 Crew (9 Passengers) Died. Body landed at Gravesend for P.M. Total 11 (2 Crew) APPENDIX XII.— Influenza. Date. 1936. Name of Vessel. Where from. No. of Cases. Passenger or Crew Rating. How dealt with. (a) Landed from Vessels— Feb. 28 ss. "City of Melbourne" Rangoon 1 Crew Admitted to Seamen's Hospital, Tibury. Nov. 21 ss. "Gretavale" Port Said 1 Crew Attended Seamen's Hospital and returned to ship. Total 2 (2 Crew) (b) Died, Landed elsewhere or well on Arrival— Feb. 26 ss. "Helene" Kotka 1 Crew Convalescent on arrival. Mar. 18 ss. "Patroclus" Dairen 9 Crew All recovered. April 20 ss. "Gaelic Star" New Westminster 1 Pass (1 Passenger) Well on arrival. Total 11 (10 Crew) APPENDIX XIII.— Dysentery. Date. 1936. Name of Vessel. Where from. No. of Cases. Passenger or Crew Rating How dealt with. (a) Landed from Vessels— Jan. 24 ss. "Maloja" Australia 1 Pass Landed in care of Military Authorities. Mar. 22 ss. "Viceroy of India" Bombay 1 Crew Admitted to Hospital for Tropical Diseases, W.C. 1. June 6 ss. "Goodleigh" Almeria 1 Crew Admitted to Seamen's Hospital, Tilbury. Oct. 17 ss. "Alcides" Singapore 1 Crew Admitted to Port Isolation Hospital, Denton. Nov. 21 ss. "Umtata" Beira 1 Crew (1 Passenger) Admitted to Seamen's Hospital, Greenwich. Total 5 (4 Crew) 71 Dysentery—continued. Date. 1936. Name of Vessel. Where from. No. of Cases. Passenger or Crew Rating. How dealt with. (b) Died, Landed elsewhere or well on Arrival— Jan. 2 ss. "Orion" Brisbane 1 Pass Convalescent on arrival. „ 10 ss. "Strathnaver" Australia 1 Pass Landed at Port Said. May 3 ss. "Castlemoor" Manzanillo 1 Crew Landed at Durban. „ 7 ss. "Oronsay" Brisbane 1 Pass Well on arrival. Aug. 21 ss. "Strathnaver" Brisbane 1 Pass Well on arrival. „ 27 ss. "Calchas" Dairen 1 Crew (4 Passengers) Well on arrival. Total 6 (2 Crew) APPENDIX XIV.— Malaria. Date. 1936. Name of Vessel. Where from. No. of Cases. Passenger or Crew Rating. How dealt with. (a) Landed from Vessels— Mar. 30 ss. "Puma" Tiko 1 Crew Admitted to Seamen's Hospital, Royal Albert Dock. May 6 ss. "Umvuma" Beira 1 Crew Admitted to Seamen's Hospital, Greenwich. „ 18 ss. "Dagomba" Lagos 1 Crew Admitted to Seamen's Hospital, Greenwich. „ 20 ss. "Brenas" Tenerife 1 Pass Admitted to Hospital for Tropical Diseases, Endsleigh Gardens, W.C. 1. „ 31 ss. "Brenas" Las Palmas 1 Crew Admitted to Hospital for Tropical Diseases, Endsleigh Gardens, W.C. 1. June 26 ss. "Strathaird" Australia 1 Crew Admitted to Seamen's Hospital, Tilbury. July 27 ss. "Jamaica Producer" Kingston 1 Crew Admitted to Seamen's Hospital, Greenwich. Aug. 17 ss. "Edward Blydon " Opobo 1 Crew Admitted to Seamen's Hospital, Greenwich. Sept. 10 ss. "Albatross" Bastia 1 Crew Proceeded to Middlesbrough. Oct. 23 ss. "Nalgora" Karachi 1 Crew Admitted to Seamen's Hospital, Greenwich. Dec. 19 ss. "Euryades" Java 1 Crew (1 Passenger) Admitted to Seamen's Hospital, Royal Albert Dock. Total 11 (10 Crew) (b) Died, Landed elsewhere or well on Arrival— Jan. 3 ss. "Port Caroline" Bluff 1 Crew Well on arrival. „ 30 ss. "Gaunless" West Africa 3 Crew Well on arrival. Mar. 13 ss. "Batavier V" Rotterdam 1 Pass Well on arrival. „ 15 ss. "Calchas" Maji 1 Pass Well on arrival. „ 20 ss. "Clan MacNair" Calcutta 1 Crew Remained on Board. „ 25 ss. "Strathmore" Bombay 1 Pass Well on arrival. June 13 ss. "Statesman" Beira 2 Crew Well on arrival. 1 Pass Well on arrival. „ 29 ss. "Highland Chieftain" Buenos Aires 1 Pass Well on arrival. July 3 ss. "Chitral" Yokohama 1 Pass Landed at Marseilles. „ 21 ss. "Guinean" Burutu 3 Crew Well on arrival. „ 21 ss. "Mashobra" Calcutta 1 Pass Well on arrival. Oct. 23 ss. "Menin Ridge" Sfax 1 Crew Well on arrival. Dec. 19 ss. "Macgregor Laird" Warri 1 Pass Well on arrival. „ 20 ss. "Jonathan C. Holt" West Africa 4 Crew (8 Passengers) All well on arrival Total 23 (15 Crew) 72 APPENDIX XV.— Chicken-pox. Date. 1936. Name of Vessel. Where from. No. of Cases. Passenger or Crew Rating. How dealt with. (a) Landed from Vessels— Jan. 17 ss. "Ranchi" Yokohama 1 Pass Admitted to Port Isolation Hospital, Denton. „ 24 ss. "Maloja" Australia 1 Crew Admitted to Port Isolation Hospital, Denton. Feb. 7 ss. "Strathaird" Brisbane 1 Crew Admitted to Port Isolation Hospital, Denton. „ 20 ss. "Strathaird" (In dock) 1 Crew Admitted to Port Isolation Hospital, Denton. Mar. 19 ss. "Marwarri" Calcutta 1 Crew Admitted to Port Isolation Hospital, Denton. April 2 ss. "Ranpura" Bombay 1 Crew Admitted to Port Isolation Hospital, Denton. May 1 ss. "City of Cairo" Glasgow (To join "City of Paris" in London.) 2 Crew Admitted to Port Isolation Hospital, Denton. „ 2 ss. "City of London" Calcutta 1 Crew Admitted to Port Isolation Hospital, Denton. „ 2 ss. "Moldavia" Mediterranean Cruise. 1 Pass Allowed to proceed Home by private conveyance. „ 9 ss. "City of Adelaide" Rangoon 1 Crew Admitted to Port Isolation Hospital, Denton. „ 13 ss. "City of Adelaide" Rangoon 1 Crew Admitted to Port Isolation Hospital, Denton. Nov. 30 ss. "Ausonia" Montreal 1 Pass Admitted to Port Isolation Hospital, Denton. Dec. 21 ss. "Aurania" New York 1 Pass (4 Passengers) Admitted to London County Council Park Hospital. Total 14 (10 Crew) (b) Died, Landed elsewhere or well on Arrival— Jan. 26 ss. "Umkuzi" Durban 1 Crew Landed at Dunkirk. Feb. 14 ss. "Mandasor" Calcutta 1 Crew Well on arrival. „ 15 ss. "Bhutan" Maji 1 Crew Landed at Colombo. Mar. 8 ss. "City of Ripon" Calcutta 1 Crew Well on arrival. April 3 ss. "Moldavia" Brisbane 1 Crew Landed at Port Said. „ 28 ss. "Mulbera" Calcutta 1 Crew Landed at Aden. „ 29 ss. "Georgic" New York 1 Pass Landed at Southampton. May 3 ss. "Akaroa" Auckland 1 Pass Landed at Southampton. „ 5 ss. "Huntsman" Calcutta 1 Crew Landed at Madras. „ 11 ss. "Tacoma Star" Porta Alma 2 Pass Well on arrival. „ 22 ss. "Naldera" Yokohama 1 Pass Landed at Marseilles. „ 24 ss. "Balranald" Brisbane 1 Pass Landed at Hobart. Oct. 22 ss. "Umkuzi" Beira 2 Pass (8 Passengers) Well on arrival. Total 15 (7 Crew) 78 APPENDIX XVI.—Mumps. Date. 1936. Name of Vessel. Where from. No. of Cases. Passenger or Crew Rating. How dealt with. (a) Landed from Vessels— Nov. 19 Gravesend Sea School Gravesend 1 Boy Admitted to Port Isolation Hospital, Denton. Total 1 Boy (b) Died, Landed elsewhere or well on Arrival— May 22 ss. " Staffordshire " Rangoon 1 Pass. Well on arrival. June 7 ss. " City of Havre " Baltimore 1 Pass. Well on arrival. „ 15 ss. " Ausonia " Montreal 1 Pass. Landed at Havre. Oct. 9 ss. " Rajputana " Yokohama 1 Pass. Convalescent or arrival. Total 4 (4 Passengers) APPENDIX XVII.—Miscellaneous Diseases (Classified). Landed from Vessels. Died, Landed elsewhere or Well on arrival. Landed from Vessels. Died, Landed elsewhere or Well on arrival. OTHER INFECTIOUS DISEASES. DISEASES OF THE SKIN. Whooping Cough 1 P. 8 P., 2 C. Baker's Dermatitis 1 c. — Dermatitis 1 c. — TROPICAL DISEASES. Impetigo 3 P., 1 C — Beri-Beri 2 C. 1 C. Rash 1 C. — Shingles — 1 c. Hepatitis 1 C. — Kala Azar — 1 C. DISEASES OF THE CIRCULATORY SYSTEM. Schistosomeasis Mansoni 1 P. — Aortic Aneurism — 1 c. Undulant Fever — 1 P. Heart Failure — 4 C., 3 P. CATARRHAL DISEASES. Cerebral Haemorrhage — 1 P. Bronchial Catarrh 1C. — Coronary Thrombosis — 2 P. Mitral Disease of Hear — 1 P. Tonsillitis 5 P.,1 C. — Myocarditis — 2 P. Ditto and Asthma — 1 P. RHEUMATIC CONDITIONS. Myeloid Leukemia — 1 P. Nil. Syncope — 1 c. , Vincent's Angina 4 C. — SEPTIC CONDITIONS. DISEASES OF THE RESPIRATORY SYSTEM. Axillary Adenitis 1C. — Bronchitis 1C.,1P. 4 C., 4 P. Femoral „ 1 P. — Inguinal 2 C. — Cancer of Lung — 1 P. Septic Knee 1 C. — Pleurisy 2 P., 2 C 1 C. „ Throat 1 C. — Pulmonary Fibrosis 1 P. — Septicaemia 1 P. — Sinusitis 1 C. — DISEASES OF DIGESTIVE SYSTEM. NERVOUS AND MENTAL DISORDERS. Appendicitis — 1 C. Catarrhal Jaundice — 1 c. Apoplexy — 1 c. Carcinoma Ventriculi . — 1 p. Cerebral Embolism — 1 p. Dyspepsia 1 c. — Epileptiform Fit 1 c. — Enteritis 1 P., 3 C 50 P and C., 4 C. Infantile Paralysis — 1 p. Maniac Depression 1 p. — Gastric Haemorrhage . 1 C. — Neurasthenia 1 p. — Gastro Enteritis 1 P. 1 P. Sciatica 1 c. — Jaundice 1 P. — Tumour of Brain — 1 p. Peritonitis — 1 C. 74 Miscellaneous Diseases (Classified)—continued. Landed from Vessels. Died, Landed elsewhere or Well on arrival. Landed from Vessels. Died, Landed elsewhere or Well on arrival. DISEASES OF THE GENITO-URINARY SYSTEM DISEASES OF THE EYE. Conjunctivitis 1 c. — Trachoma 1 c. — Paget's Disease of Nipple 1 P. — DISEASES OF BONES AND JOINTS. Parametritis — 1 P. Pyelitis and Uraemia 1 c. — Arthritis Post Dysenteric — 1 c. Retention of Urine 1 c. — OTHER DISEASES (not classified). Uraemia — 1 P. Diabetes — 1 p. INJURIES. Exophthalmic Goitre — 1 p. Heat Stroke — 1 C., 1 P. Lumbago — 1 c. Injury 1 C. 4 C. Pyrexia 1P., 6 C. 4 C. APPENDIX XVIII.—Venereal Diseases. Number of Crew. Cases report Passengers. Syphilis 62 11 Gonorrhoea 259 26 Soft Sore 53 5 Climatic Bubo 13 3 387 45 Total 432 APPENDIX XIX.—Hospital. Number of Cases Admitted, Cost of Maintenance, &c. Patients remaining in Hospital on 31st December, 1935 1 Admitted. Discharged. Died. Remaining under treatment Chicken-pox 15 15 — — Diphtheria 15 14 1 — Enteric Fever 9 6 2 1 Measles 7 6 — 1 Mumps 1 1 — — Scarlet Fever 1 2 — — Typhus Fever (suspected) — — — — „ „ (contact) — — — — Other Diseases 18 17 1 — Total 66 61 4 2 Remaining in Hospital on 31st December, 1936 … … … 2 Total number of days' treatment during the year … … … 983 Average number of days' treatment for each case … … … 14.6 Average daily number of patients in Hospital … … … 1.8 Average daily cost of maintenance per patient … … … 1s. 7½d. Average total cost of maintenance per patient … … … £1 3s. 10d. 75 APPENDIX XX.—Return of Rats Caught and Destroyed during 1936. 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. Dec. Total. Millwall Dock— Warehouses 57 59 37 40 72 56 43 60 36 47 47 21 575 Vessels while in dock 48 104 103 44 115 128 285 20 86 41 133 183 1,290 Surrey Commercial Dock— Warehouses 13 14 6 38 30 36 40 31 36 29 6 7 286 Vessels while in dock 168 17 31 5 27 10 14 9 28 59 13 110 491 Regent's Canal Dock— Warehouses 28 61 34 27 35 24 24 30 40 50 30 27 410 Vessels while in dock 10 6 — 48 — — — — 1 — — — 65 St. Katharine's Dock— Warehouses 56 112 79 62 163 119 88 116 86 119 83 80 1,163 Vessels while in dock — — — — — — — — — — — — — London Dock— Warehouses 42 96 55 33 26 46 36 66 58 67 40 32 597 Vessels while in dock — — 2 — — — — — 4 — — — 6 Royal Albert Dock— Warehouses 14 37 37 8 10 4 2 14 11 16 17 5 175 Vessels while in dock 10 19 27 2 4 74 7 10 1 1 — 57 212 Royal Victoria Dock— Warehouses 72 45 78 45 50 17 35 30 46 70 46 13 547 Vessels while in dock 23 34 52 81 38 14 26 31 169 252 141 25 886 King George V. Dock— Warehouses 16 18 16 17 24 7 7 11 15 10 14 15 170 Vessels while in dock 1 — 41 — 16 — 4 — — — — — 62 West India Dock— Warehouses 37 54 25 21 39 13 32 65 40 85 44 24 479 Vessels while in dock 34 105 32 18 41 56 57 77 68 61 41 4 594 East India Dock— Warehouses 4 5 1 — — — 1 6 24 5 — — 46 Vessels while in dock 3 227 21 16 — — — — 12 — — — 279 Tilbury Dock— Warehouses 23 34 51 52 86 69 50 69 41 57 21 15 568 Vessels while in dock 6 12 18 26 2 33 20 24 — 7 13 105 266 River— While in River 6 3 45 93 17 95 39 334 81 104 817 Totals 671 1,062 746 628 871 723 866 708 1,136 976 770 827 9,984 Total from 1st January to 31st December, 1936:— In Dock Warehouses 5,016 On Vessels while in Dock and River 4,968 Total 9,984 76 APPENDIX XXI. BACTERIOLOGICAL EXAMINATION OF RATS DURING 1936. Source. Total Examined. Black Rats. Brown Rats. Species Unknown. Mice. Rats Infected with Plague. Found Dead. Trapped Poisoned, &c. Found Dead. Trapped, Poisoned, &c. Found Dead. Trapped, Poisoned &c. Found Dead. Trapped. Poisoned, &c. Vessels 983 2 968 — 13 — — — — Nil. London Dock 219 — 119 1 99 — — — — Nil. St. Katharine Dock 258 — 173 — 85 — — — — Nil. Regent's Canal Dock 47 — 41 — 6 — — — — Nil. Surrey Commercial Dock 106 — 12 1 93 — — — — Nil. Poplar Dock 3 — 3 — — — — — — Nil. West India Dock 148 — 137 — 11 — — — — Nil South West India Dock 94 — 49 — 45 — — — — Nil. East India Dock 11 — 5 — 6 — — — — Nil. Royal Victoria Dock 80 — 10 — 70 — — — — Nil. Royal Albert Dock 69 1 49 — 19 — — — — Nil. King George V. Dock 133 — 130 — 3 — — — — Nil. Tilbury Dock 77 — 12 — 65 — — — — Nil. Millwall Dock 280 2 170 — 108 — — — — Nil. Totals 2,508 5 1,878 2 623 — — — — Nil. APPENDIX XXII. INTERNATIONAL SANITARY CONVENTION. Deratisation Certificates. The number issued during the period covered by this Report was 137 :— Date. 1936. Name of Vessel. Reason for Deratisation. Action taken. No. of Rats reported found dead after Fumigation or Trapping. Jan. 4 mv. " Rangitiki " Owner's request for Certificate. Fumigated with Hydrogen Cyanide. Nil. „ 10 ss. " Rolf Jarl " „ „ 3 „ 10 ss. " Avra " 99 99 6 by fumigation. 5 by trapping. „ 15 ss. " Jiul" Rat infested Fumigated with Sulphur Dioxide. 148 by fumigation 20 by trapping. „ 17 mv. " Dunster Grange " Owner's request for Certificate. 99 Nil. „ 20 ss. " Tabaristan " Rat infested Trapping 29 „ 24 ss. " Oronsay " Owner's request for Certificate. Fumigated with Hydrogen Cyanide. Nil. Feb. 1 ss. " Rangitata " 99 99 Nil. „ 1 ss. " Orsova " 99 99 Nil. „ 1 ss. " Baronesa " 99 Fumigated with Sulphur Dioxide. 6. „ 2 ss. " Beaverhill" 99 Fumigated with Hydrogen Cyanide. 34 mice. „ 5 ss. " Dunluce Castle " Rat infested 99 23 by trapping, 57 by fumigation. „ 7 ss. " Baharistan " 99 Trapping 27. „ 8 ss. " Rotorua " Owner's request for Certificate. Fumigated with Hydrogen Cyanide Nil. „ 8 mv. " Bonnington Court " Rat infested Fumigated with Sulphur Dioxide. 52. „ 12 ss. " Durham " Owner's request for Certificate. Fumigated with Hydrogen Cyanide. Nil. „ 14 mv. " El Argentino " 99 Fumigated with Sulphur Dioxide. Nil. „ 27 ss. " Balkan " Rat infested 19 44 by trapping, 183 by fumigation. 77 Deratisation . Certificates—continued. Date. 1936. Name of Vessel. Reason for Deratisation. Action taken. No. of Rats reported found dead after Fumigation or Trapping. Feb. 27 ss. " Duquesa " Owner's request for Certificate. Fumigated with Sulphur Dioxide. Nil. „ 27 mv. " Rangitane " „ Fumigated with Hydrogen Cyanide. Nil. „ 28 ss. ' Ingoma „ „ 7 mice. Mar. 7 ss. " Port Wyndham " „ Fumigated with Sulphur Dioxide. Nil. » 14 ss. " Jervis Bay " „ Fumigated with Hydrogen Cyanide. 13 rats and 17 mice. „ 15 ss. " Marquesa " „ Fumigated with Sulphur Dioxide. Nil. „ 21 ss. " Ormonde " „ Fumigated with Hydrogen Cyanide. Nil. „ 24 ss. " Orm Jarl " Rat Lifested „ 21 „ 25 mv. " Edward Blyden '' „ Trapping 21 „ 26 ss. " Navarino " „ Fumigated with Sulphur Dioxide. 38 by fumigation 3 by trapping. „ 27 mv. " Upwey Grange " Owner's request for Certificate. „ Nil. „ 28 ss." Remuera " „ Fumigated with Hydrogen Cyanide. Nil. „ 30 ss. " Lochkatrine " Rat infested „ 33 April 4 ss. " Beaverford " Owner's request for Certificate. Fumigated with Hydrogen Cyanide. 2 „ 8 ss. " Auk " Rat Infested Fumigated with Sulphur Dioxide. 46 „ 8 ss. " Hardwicke Grange " Owner's request for Certificate. „ Nil. „ 12 ss. " Port Denison " „ „ Nil. „ 14 ss. " City of Oxford " Rat Infested „ 24 „ 17 ss. " Kent " Owner's request for Certificate. Fumigated with Hydrogen Cyanide. Nil. „ 18 ss. " Beaverdale " „ „ 25 „ 18 ss. " Orontes " „ „ 22 „ 23 ss. " Buahine " Owner's request for Certificate. Fumigated with Hydrogen Cyanide. Nil. 25 ss. " Beaverburn " „ „ 51 Mice. „ 25 ss. " Princesa " „ Fumigated with Sulphur Dioxide. Nil. „ 30 ss. " Dorset " „ Fumigated with Hydrogen Cyanide. Nil. May 3 mv. " Empire Star " „ „ 4 by trapping, 11 by fumigation. „ 5 mv. " Port Dunedin " „ Fumigated with Sulphur Dioxide. Nil. „ 8 ss. " Arnfinn Jarl " „ Fumigated with Hydrogen Cyanide. Nil. „ 10 mv. " Mary Slessor " Rat Infested „ 14 by trapping, 25 by fumigation. „ 14 mv. " Rabanl '' „ „ 25 „ 16 ss. " Orama Owner's request for Certificate. „ Nil. „ 18 mv. " Bajamar " Rat Infested Fumigated with Sulphur Dioxide. 41 „ 21 ss. " Inanda " Owner's request for Certificate. Fumigated with Hydrogen Cyanide. Nil. „ 25 mv. " Brenas " Rat Infested Fumigated with Sulphur Dioxide. 27 „ 30 mv. " Betancuria " Owner's request for Certificate. Fumigated with Sulphur Dioxide. 25 mice. „ 30 mv. " Macgregor Laird " „ Fumigated with Hydrogen Cyanide. 20 June 4 ss. " Pakeha " Rat Infested Fumigated with Sulphur Dioxide. 36 „ 6 mv. " Rangitata " Owner's request for Certificate. Fumigated with Hydrogen Cyanide. Nil. „ 6 ss. " Orsova " „ „ Nil. „ 8 ss. " Rodney Star " „ „ Nil. 78 Derati bation Certificates—continued. Date. 1936. Name of Vessel. Reason for Deratisation. Action taken. No of Pats reported found dead after Fumigation or Trapping. June 13 ss. " Port Hunter " Owner's request for Certificate. Fumigated with Sulphur Dioxide. Nil. „ 16 ss. " Hororata " „ Fumigated with Hydrogen Cyanide. 30 „ 18 ss. " Bazan " Rat Infested Fumigated with Sulphur Dioxide. 52 „ 20 mv. " Henry Stanley " „ Fumigated with Hydrogen Cyanide. 58 July 4 ss. " Orford " Owner's request for Certificate. Fumigated with Hydrogen Cyanide. Nil. „ 4 mv. " Rangitane " „ „ Nil. „ 6 ss. " Georgios Kyriakides " Rat infested „ 95 „ 8 ss. " Castilian " „ Trapping 18 „ 9 mv. " Jamaica Progress " Owner's request for Certificate. Fumigated with Hydrogen Cyanide. 20 „ 12 mv. " Edward Blyden " „ „ 22 „ 14 ss. " Stuart Star " „ „ Nil. „ 15 sv. " Ponape " Rat infested Fumigated with Sulphur Dioxide. 131 by trapping. 71 by fumigation. „ 18 ss. " Middlesex " Owner's request for Certificate. Fumigated with Hydrogen Cyanide. Nil. „ 21 mv. " Otaio " „ „ Nil. „ 23 ss. " Rotorua " „ „ Nil. „ 29 mv. " Dunster Grange " „ Fumigated with Sulphur Dioxide. Nil. „ 29 ss. " Remuera " „ Fumigated with Hydrogen Cyanide. Nil. „ 30 ss. " Cumberland " „ „ Nil. Aug. 7 ss. " Gibraltar " „ Fumigated with Sulphur Dioxide. Nil. „ 8 ss. " Ormonde " „ Fumigated with Hydrogen Cyanide. Nil. „ 12 ss. " Ingoma " „ „ Nil. „ 12 ss. " Rad " „ Fumigated with Sulphur Dioxide. Sailed before count could be made. „ 12 ss. " Dunstaffnage " „ „ Nil. „ 15 ss. " Salamaua " Owner's request for Certificate. Fumigated with Hydrogen Cyanide. Nil. „ 19 ss. " Baronesa " „ Fumigated with Sulphur Dioxide. 1 „ 20 ss. " Jamaica Producer " „ Fumigated with Hydrogen Cyanide. 6 „ 22 ss. " Oronsay " „ „ Nil. „ 22 ss. " Dunluce Castle " Rat infested „ 20 by trapping. 7 by fumigation. „ 24 ss. " Port Adelaide " Owner's request for Certificate. Fumigated with Sulphur Dioxide. Nil. „ 27 ss. " Auk " „ „ 39 „ 27 ss. " Jamaica Pioneer " „ Fumigated with Hydrogen Cyanide. 15 „ 28 mv. " Rangitiki " „ „ Nil. Sept. 4 ss. " Box Hill " „ Fumigated with Sulphur Dioxide. Nil. „ 4 ss. " Alexandra " Rat infested „ 110 „ 5 ss. " Elstree Grange " Owner's request for Certificate. „ Nil. „ 11 mv. " El Argentino " „ „ Nil. „ 12 ss. " Lackenby " Rat infested „ 105 „ 15 ss. " Dunrobin " Owner's request for Certificate. „ Nil. „ 19 ss. " Port Bowen " „ „ Nil. „ 23 ss. " Clan Ogilvy " „ Fumigated with Hydrogen Cyanide. Nil. „ 20 ss. " Duquesa " Owner's request for Certificate. Fumigated with Sulphur Dioxide. Nil. „ 25 ss. " Ruahine " „ Fumigated with Hydrogen Cyanide. Nil. 79 Deratisation Certificates—continued. Date. 1936. Name of Vessel. Reason for Deratisation. Action taken. No. of Rats reported found dead after Fumigation or Trapping. Sept. 26 ss. " Sambre " Rat infested Fumigated with Hydrogen Cyanide. 86 „ 27 ss. " Tolten " Owner's request for Certificate. „ Nil. „ 80 ss." Hellenic " Rat infested Fumigated with Sulphur Dioxide. 17 by trapping, 37 by fumigation. Oct. 7 mv. " Rangitata " Owner's request for Certificate. Fumigated with Hydrogen Cyanide. Nil. „ 10 mv. " Upwey Grange " „ Fumigated with Sulphur Dioxide. Nil. „ 17 ss. " Otranto " „ Fumigated with Hydrogen Cyanide. 4 „ 22 ss. ' Traveller „ „ Nil. „ 28 ss. " Dimitrios G. Thermiotis " Rat infested Fumigated with Sulphur Dioxide. 25 by trapping, 72 by fumigation. „ 31 ss. " Orford " Owner's request for Certificate. Fumigated with Hydrogen Cyanide. 3 „ 31 mv. " Port Townsville " „ Fumigated with Sulphur Dioxide. Nil. Nov. 2 ss. " Port Hardy " „ „ Nil. „ 4 ss. " Port Nicholson " „ „ Nil. „ 4 ss. " Inanda " „ Fumigated with Hydrogen Cyanide. Nil. „ 5 mv. " Rangitane " „ Nil. „ 7 mv. " Bajamar " „ Fumigated with Sulphur Dioxide. 48 „ 8 ss. " Princesa " „ „ Nil. „ 14 ss. " Almeda Star " „ Fumigated with Hydrogen Cyanide. Nil. „ 20 ss. " Despina " Rat Infested „ 36 „ 20 mv. " Brenas " Owner's request for Certificate. Fumigated with Sulphur Dioxide. 33 „ 28 ss. " Ormonde " „ Fumigated with Hydrogen Cyanide. Nil. „ 29 ss. " Jamaica Progress " „ „ 8 Dec. 2 ss. " Surrey " „ „ Nil. „ 5 mv. " Betancuria " „ Fumigated with Sulphur Dioxide. 16 mice. „ 5 ss. " Remuera " „ Fumigated with Hydrogen Cyanide. Nil. „ 5 ss. " Panagiotis Th. Coumandaros." Rat infested „ 55. „ 10 ss. " Aristides L. Goulandris " „ Fumigated with Sulphur Dioxide. 42 by trapping, 54 by fumigation. „ 12 mv. " Georgic " Owner's request for Certificate. Fumigated with Hydrogen Cyanide. Nil. „ 12 mv. " Mary Slessor " „ „ 39. „ 13 mv. " Highland Princess " „ „ Nil. 15 ss. " Tower Ensign " „ Fumigated with Sulphur Dioxide. Nil. „ 16 ss. " Port Denison " „ „ Nil. „ 17 ss. " Beaverhill " „ Fumigated with Hydrogen Cyanide. 105 mice. „ 19 ss. " Moldavia " Rat infested „ 84. „ 19 ss. " Marquesa " Owner's request for Certificate. Fumigated with Sulphur Dioxide. Nil. „ 22 mv. " Rabaul " Rat infested Fumigated with Hydrogen Cyanide. 75. „ 24 ss. " Orion " Owner's request for Certificate. „ Nil. „ 31 ss. " Rotorua " „ „ Nil. Deratisation Exemption Certificates.—The number issued during the year was 1,025. 80 APPENDIX XXIII.—General Summary, and Analysis, of the Sanitary Inspections Vessels, &c., in the Port of London for the year ended 31st December, 1936. Foreign. Coastwise. Inland Navigation. Shore Premises. Sick Seamenreferred to Hospital Water Barges. Steam. Sail. Steam. Sail. Steam. Sail. Lighters (uninhabited) CanalBoats 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, 1935. New Barges. Condemned. Use discontinued. Previously with- drawn and since resumed work. No. in District 31st December, 1936. 11,105 5611 1,308 28 3 — 2,786 154 336 461 70 33 202 2 10 157 — 5 625 43 109 167 7 2 6,070 177 1,089 200 12 — — — — — 12 Inspections. Docks and River. No. Nationalities. No Total Inspections from 1st January to 31st St. Katharine 184 American 247 BRITISH 9,603 December. 1936:— London 1,226 Brazilian 1 Foreign 1,133 Regent's Canal 566 Bulgarian 9 Belgian 181 Coastwise 3,247 Millwall 896 Dutch 1,294 Danish 419 Inland Navigation 1,151 West India 939 Danzig Free State 4 Premises on shore 6,070 Poplar 156 Egyptian 5 Total 21,601 East India 209 Egyptian 79 French 59 Victoria 874 Finnish 626 German 630 Royal Albert 1,145 Greek 153 Cleansing of Crew's Quarters, &c.:— King George V ... 743 Hungarian 3 Surrey Commercial 2,042 Italian 47 Total No. of Vessels from 1st January to 31st December, 1936 1,6 Tilbury 1,137 Japanese Latvian 123 51 Gravesend District Lithuanian 1 1.803 Mexican 1 River—* Upper District 2,035 Norwegian and Swedish 1,670 Number of Vessels inspected:— In the Launches— Panama 10 „Middle „ 1,578 Polish 15 „ *Lower „ 1,801 Portuguese 55 " Howard Deighton" 1,801 Russian 138 „ Medway Roumanian 11 Spanish 13 "Frederick Whittingham " 3,613 Total Vessels 15,531 Yugo-Slavakian 78 "James Howell" Shore Premises 6,070 Shore Premises 15,531 6,070 Total 5,414 Total 21,601 In the Docks, &c. 16,187 Total 21,601 Total 21,601 *Upper District extends from Greenwich to Teddington. *Middle „ „ „ „ Erith. *Lower „ „ „ Erith to outer limits of the Port of London.  1927. 1928. 1929. 1930. 1931. 1932. 1933. 1934. 1935. 1936. Y early Average for the 10 years ending 31st Deo., 1936. Total number of Inspections of vessels from— "Foreign" 11,806 12,345 12,186 12,489 11,071 11,090 12,025 10,052 11,685 11,133 11,588.2 " Coastwise," " Inland Navigation," and other Inspections 11,427 9,947 8,880 8,613 9,429 9,883 9,525 10,804 10,826 10,468 9,980.2 Total 23,233 22.292 21,066 21,102 20,500 20,973 21,550 20,856 22,511 21,601 21,568.4 81 APPENDIX XXIV. NUMBER OF NUISANCES ON VESSELS REPORTED AND DEALT WITH during the year ended 31st December, 1936. Description of nuisances. January. February. March. April. May. June. July. August. September. October. November. December. Totals. Smoke Nuisances :— Number of complaints received 3 6 6 5 7 1 — — 1 5 — 2 36 Number of recurrences reported — — — — — — — — — — — — — Offensive Cargoes (Bye-laws):— Number of Infringements reported 4 — 3 — — — — — — 2 — — 9 Structural and other Defects:— Ventilation 6 5 5 6 5 4 10 7 3 7 6 6 70 Lighting 28 26 45 19 37 35 24 19 16 27 39 37 352 Heating 25 34 56 22 30 21 15 14 20 26 34 38 335 Bare iron in crew's quarters 2 1 4 — 1 — — — — — 1 1 10 Leaky decks, hawse-pipes, cable casings, &c 13 6 30 4 19 22 13 10 13 4 19 22 175 Defective bulkheads and floors 13 11 27 16 24 16 13 16 11 13 14 19 193 Sanitary conveniences 20 15 16 11 19 12 13 15 10 14 9 17 171 Ship's gear or stores stowed in crew's quarters — — 2 — — — — — — — — 1 3 Foul bilges and peaks — — — — — — — — — — — — — Storage of drinking water (dirty or defective tanks) 3 3 4 2 5 2 2 2 2 3 4 2 34 Dirty quarters 129 149 156 112 186 121 142 138 146 203 152 169 1,803 Verminous quarters 7 10 10 8 14 10 5 12 13 12 21 10 132 Accumulation of offensive matter 4 13 3 6 1 2 3 1 9 8 2 3 55 Miscellaneous Nuisances 7 9 35 14 9 11 12 9 6 21 21 24 178 Totals 264 288 402 225 357 257 252 243 250 345 322 351 3,556 Total number of vessels on which sanitary defects were reported 194 226 246 153 282 179 210 210 184 279 230 260 2,643 Total number of vessels on which sanitary defects were remedied 177 213 216 143 273 168 198 187 177 291 208 241 2,492 (Includes Orders made in previous years and reported carried out during 1936.) NUMBER OF NUISANCES IN THE RIVER REPORTED AND DEALT WITH during the year ended 31st December, 1936. Offensive condition of River Water — — — — — — — — — — — — Totals — — — — — — — — — — — — 82 APPENDIX XXV. NUMBER OF NUISANCES ON SHORE PREMISES REPORTED AND DEALT WITH during the year ended 31st December, 1936. 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 — 1 — — — — — — — — — — 1 Lighting — 1 — — — — — — — — — — 1 Heating — — — — — — — — — — — — — Dilapidations 1 4 2 1 1 3 — — 5 — — — 17 Sanitary Conveniences 1 1 2 2 1 3 — 1 1 — — — 17 Water Supply — — — — — — — — — — — — — Dirty Premises 150 118 99 79 118 81 68 65 75 113 63 08 1,089 Accumulation of Offensive Matter — 1 — — 2 2 2 — — 3 — — 10 Drainage 4 2 3 2 3 2 3 2 5 — — — 26 Miscellaneous Nuisances 1 5 3 2 1 2 — — 3 2 2 2 23 Totals 157 133 109 86 126 93 73 68 89 122 65 63 1,184 Number of shore premises on which sanitary defects were reported 155 132 108 84 126 86 73 68 88 122 65 63 1,170 Number of shore premises on which sanitary defects were remedied 151 129 109 82 124 86 81 67 83 126 65 63 1,166 83 APPENDIX XXVI.—Description of Meat Destroyed. Year. Beef. Mutton and Lamb. Veal, Pork, Offal. Tinned. Smoked and Salted, &c. Total. Tons. cwts. qrs lbs. Tons. cwts. qrs. lbs. Tons. cwts. qrs. lbs. Tons. cwts. qrs. lbs. Tons. cwts. qrs. lbs. Tons. CWt3. qrs. lbs. Pork and Veal— 3 9 2 8 1927 311 12 0 2 263 4 1 13 Offal— 0 2 0 6 Nil. 605 12 2 16 27 4 2 15 Pork and Veal— 0 6 1 22 1928 7 1 0 3 155 18 3 6 Offal— 0 0 1 26 4 17 2 13 184 6 1 13 16 1 3 27 Pork and Veal— 0 13 2 12 1929 8 17 3 4 367 12 1 8 Offal— N il. 0 15 3 27 391 16 3 27 13 17 1 4 Pork and Veal— 1 10 0 25 1930 21 12 0 16 52 18 0 21 Offal— 0 4 1 27 1 0 2 27 95 17 2 4 18 11 3 0 Pork and Veal— 1931 1 14 1 16 65 4 2 24 1 2 0 15 0 1 2 19 0 10 2 20 81 12 3 22 Offal— 12 19 1 12 Pork and Veal— 0 6 2 16 1932 3 19 3 15 56 8 3 9 Offal— 1 3 3 22 0 2 2 19 72 6 3 12 10 4 3 15 Pork and Veal— 1 10 2 8 1933 2 19 1 7 18 3 0 13 Offal— 0 0 2 19 0 1 1 3 28 18 3 3 6 3 3 9 Pork and Veal— 0 15 2 4 1934 10 10 3 20 17 14 1 21 Offal— 1 5 3 9 33 0 2 15 67 2 2 12 3 15 0 27 Pork and Veal— 1 9 2 19 1935 15 2 1 15 15 17 3 16 Offal— 7 16 0 11 0 19 1 23 48 10 0 27 7 4 2 27 Pork and Veal— 1 3 0 20 1936 15 11 0 18 18 3 3 5 Offal— 0 17 2 21 0 12 2 12 49 11 3 23 13 3 2 3 Total for ten years 399 1 0 4 1,031 6 1 24 141 14 3 8 11 12 3 20 42 1 2 19 1,625 16 3 19 84 APPENDIX XXVII.—New Buildings and Sanitary Works. Date Plans Date work reports submitted. Works. as completed. ROYAL ALBERT DOCK— May, 1935. New fresh water hydrants for use of ships fitted through- 9th January, 1936. out the length of the Quay on North side. VICTORIA DOCK— — New sanitary convenience at Rank's Mills, South side. 20th July, 1936. EAST INDIA DOCK— March, 1936. Remodelling of private urinal at No. 13 Warehouse, South 28th March, 1936. side. MILLWALL DOCK— — Newbrickbuildingcontainingthreeprivate pedestal closets, 23rd June, 1936. four public seats over glazed trough, and a four-stall urinal, west of Central Granary. SOUTH WEST INDIA DOCK— — A pedestal water closet with two-gallon flush, and concrete 9th January, 1936. floor for use of police at London Graving Dock Gate. March, 1936. New Lascar latrine of approved type at South side, South April, 1936. Dock. SURREY COMMERCIAL DOCK— February, 1936. Fresh water and lavatory basins fitted in Delivery Office, 10th March, 1936. Canada Yard. TILBURY DOCK— October, 1936. New building containing two pedestal closets, a two-stall 31st December, 1931 urinal, two lavatory and one kitchen sink to Dockmaster's Office. APPENDIX XXVIII. DOCKS WITHIN THE JURISDICTION OF THE PORT OF LONDON SANITARY AUTHORITY. Docks. Water Area. Lineal Quavase. 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 85 APPENDIX XXIX. POWERS. The work of the Port of London Health 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 Health Authority. CONSTITUTION OF THE AUTHORITY. Public Health (London) Act, 1891.—(Repealed by Public Health (London) Act, 1936, from 1st October, 1936) Public Health (London) Act, 1936 1st October, 1936. 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. & 0. 1922, No. 781. London Port Sanitary (Additional Powers) Order, 1922 18th July, 1922. S.R. & 0. 1923, No. 812. London Port Sanitary (Additional Powers) Order, 1923 16th July, 1923. S.R. & 0. 1933, No. 803. The Port of London (Assignment of Powers) Order, 1933 11th August, 1933. 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.—(Repealed by Public Health (London) Act, 1936, from 1st October, 1936, so far as it relates to the Port of London.) City of London (Various Powers) Act, 1922. Part IV. Section 30. City of London (Various Powers) Act, 1933. Part III. Sections 6 and 7. S.R. & 0. 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. & 0. 1910, No. 1165. Prevention of Epidemic Diseases Regulations as to Plague, Destruction of Rats, 1910 10th November, 1910. S.R. & 0. 1912, No. 1226. Public Health (Cerebro-spinal Fever and Acute Poliomyelitis) Regulations, 1912 15th August, 1912. S.R. & 0. 1918, No. 67. Public Health (Notification of Infectious Diseases) Regulations, 1918 19th January, 1918. S.R. & 0. 1926, No. 972. Public Health (Notification of Puerperal Fever and Puerperal Pyrexia) Regulations, 1926 31st July, 1926. S.R. & 0. 1927, No. 1207. Infectious Diseases (London) Regulations, 1927. 22nd December, 1927. S.R. & 0. 1930; No. 299. Parrots (Prohibition of Import) Regulations, 1930 24th April, 1930. S.R & 0. 1933, No. 38. The Port Sanitary Regulations, 1933 4th February, 1933. 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. & 0. 1923, No. 451. The Canal Boats Order, 1922 10th July, 1922. S.R. & 0. 1925, No. 843. Canal Boats (Amendment) Regulations, 1925 9th June, 1925. S.R. & 0. 1931, No. 444. Canal Boats (Amendment) Regulations, 1931 26th May, 1931. 86 FOOD. Public Health (Regulations as to Food) Act, 1907. S.R. & 0.1924, No. 1432. Public Health (Meat) Regulations, 1924 (Part IV) 20th December, 1924. S.R. & 0. 1925, No. 775 ) 1926 No 1577 Health (Preservatives, &c., in Food) ' ' ( Regulations 1928. 1927, No. 577 ) S.R. & 0. 1925, No. 273. Public Health (Imported Food) Regulations, 1925 23rd March, 1925. S.R. & 0. 1933, No. 347. Public Health (Imported Food) Amendment Regulations, 1933 ... ... ... ... ... ... ... 25th April, 1933. S.R. & 0. 1926, No. 820. Public Health (Imported Milk) Regulations, 1926 6th July, 1926. SHELLFISH. S.R. & 0. 1934, No. 1342, Public Health (Shellfish) Regulations, 1934 ... 7thDecember, 1934. S.R. & 0. 1935, No. 1221. The Medway (Shell-Fish) Regulations, 1935 ... 11th December,*1935. RATS AND MICE. Rats and Mice (Destruction) Act, 1919. SMOKE ABATEMENT. Public Health (Smoke Abatement) Act, 1926.—(Repealed by the Public Health (London) Act, 1936, from 1st October, 1936, so far as it relates to the Port of London.) ABATEMENT OF NUISANCES and REMOVAL OF REFUSE. Public Health (London) Act, 1891.—(Repealed by Public Health(London) Act, 1936, from 1st October, 1936.) Public Health (London) Act, 1936 ... 1st October, 1936. FERTILISERS AND FEEDING STUFFS. Fertilisers and Feeding Stuffs Act, 1926. S.R. & 0. 1932, No. 658. Fertilisers and Feeding Stuffs Regulations, 1932 ... 11th August, 1932. S.R. & 0. 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. & 0. 1923, No. 1095. Dangerous Drugs (No. 3) Regulations, 1923 ... 10thSeptember, 1923ALIENS. S.R. & 0. 1920, No. 448. The Aliens Order, 1920. IMPORTATION OF CATTLE. Ministry of Agriculture and Fisheries Animals (Importation) Order, 1930, dated 4th November, 1930. Part IIT, Article 22 ; Part IV, Articles 23, 24 and 25. Ministry of Agriculture and Fisheries Animals (Landing from Ireland, Channel Islands and Isle of Man) Order, 1933, dated 17th January, 1933. Part II, Article 17. 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. 3. With respect to Houseboats used for human habitation within the limits of the Port of London. 00 PORT OF LONDON HEALTH ADMINISTRATION ACCOUNT. Dr. EEYENUE ACCOUNT for Year ended 31st March, 1937. Cr. £ s. d. £ s. d. £ 8. d. £ s. d. Salaries—Medical Officer, Deputy and Assistants 5,758 15 4 Contribution from General Rate 14,961 17 0 Travelling Expenses—Ditto 106 4 0 Contribution from Ministry of Health 14,767 18 6 Salaries—Inspectors 5,946 11 7 Sundry Fees 85 0 6 Uniforms, Travelling Expenses—Inspectors 215 19 4 Proceeds, Sale of Unsound Food 123 5 9 Clerical Assistance :— Deratisation Receipts 2,200 11 0 Salaries 2,472 18 9 Miscellaneous Receipts 7 2 11 Other Expenses 64 0 0 Repayment by Hospital Patients 46 18 7 Assistant Rat Officers:— 2,536 18 9 Reimbursement of Damage to Launchehes 95 16 3 Salaries 1,067 3 8 Other Expenses 91 2 1 Provision and Maintenance of Hospital:— 1,158 5 9 Capital Expenditure 1,250 14 9 Rent, Rates, Taxes and Insurance 204 2 10 Furniture, Equipment and Renewals 87 11 10 Repairs 76 16 5 Heating, Lighting and Cleansing 382 19 0 Interest on Loans 516 13 9 Salaries—General 382 10 2 Nursing 543 4 7 Domestic 142 5 2 1,067 19 11 Cost of Food 209 5 5 Drugs and Medical Requisites 38 11 9 Uniforms 20 12 1 Miscellaneous 54 11 7 Expenses oe Launches:— 3,909 19 4 Wages 4,113 2 11 Uniforms 103 5 7 Upkeep and Running Expenses 1,560 17 0 Capital Expenditure 1,139 7 11 Interest on Loans 236 18 4 7,153 11 9 Laboratory Facilities, Chemical and Bacteriological Examinations 249 11 0 Examination and Analysis of Food 259 18 6 Disinfections 104 17 7 Office Expenses:— Rent, Rates, Water, Taxes and Insurance 285 19 4 Furniture and Equipment 2 4 5 Repairs 16 8 3 Lighting, Heating and Cleansing 182 17 9 Printing and Stationery 445 7 11 Postages, Telegrams, Telephones 287 14 7 1,220 12 3 Part Proceeds of Sale of Unsound Food returned to Consigless 102 11 5 Expenses of Delegates to Congresses 146 15 5 Miscellaneous 11 13 6 Legal Expenses 25 7 5 National Insurance 63 8 3 Corporation's Contribution to Pension Funds 2,419 9 4 Central Administration Charges 898 0 0 32,288 10 6 £32,288 10 6 Chamber of London July, 1937. Charles Skipper & East Ltd., London