Ac. 4369 Plon77 125 CORPORATION OF LONDON PORT HEALTH AUTHORITY ANNUAL REPORT OF THE MEDICAL OFFICER OF HEALTH To 31st DECEMBER, 1969. To be presented, 14th January, 1971. CONSTITUTION AND JURISDICTION The governing body of the City of London, the Corporation of London, was originally constituted the Sanitary Authority of the Port of London by Section 20 of the Public Health Act, 1872. The cost of administration was met from the Corporation's private funds for close on fifty years, when it became rate (and grant) aided. By the Public Health (London) Act, 1936, the term "Port Sanitary" was changed to "Port Health", and the Port Health district is further defined by that Act as the "Port of London as established for the purposes of the law relating to the Customs of the United Kingdom" and by the Public Health Act, 1936 as "the Port as established for the purposes of the enactments relating to the Customs". The Public Health (London) Act 1936 was repealed by the London Government Act 1963 but Section 89 (1) of that Act defined the Port of London as "the Port of that name established for the purposes of the enactments relating to customs or excise" In accordance with the provisions of the London Port Health Authority Order 1965 made under Section 41 (1) of the London Government Act 1963 the Corporation of London shall have jurisdiction as Port Health Authority— (a) as respects functions, rights and liabilities of a local authority under the enactments mentioned in Part I of Schedule I of the Order over all waters within the Port and over such part of the district of any riparian authority as comprises the whole of any wharf and of the area within the gates of any dock and the buildings thereon respectively, forming part of or abutting upon the Port. (b) as respects any other functions, rights and liabilities assigned to them, within the Port (The Port of London established for the purposes of the enactments relating to customs or excise.) The limits of the Port of London for the purposes of the enactments relating to customs or excise were originally defined by a Treasury Minute dated 1st August, 1883. They commence at high water mark in the River Thames at Teddington Lock, in the County of Surrey, and extend down both sides of the said 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 Goalmouth Creek, thence across the said River Medway to the western-most point of the piece of land winch forms the eastern side of Stangate Creek, or, in other words, the north-west point of Fleet Marsh and 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 Watercourses 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. Following upon the extension of the area of jurisdiction of the Port of London Authority by the Port of London Authority (Extension of Seaward Limit) Act 1964 the area of jurisdiction of the Corporation of London as Port Health Authority was similarly amended by Section 31 of the City of London (Various Powers) Act 1965 which added at the end of the definition of "Port of London" in Section 89 (1) of the London Government Act 1963 the following words: "together with all such waters between the seaward limit of the Port as so established ai,d imaginary straight lines drawn from latitude 51° 37' 00" north, longitude 00° 57' 19" east (Foulness Point in the County of Essex) to latitude 51° 46' 05" north, longitude 01° 20' 32" east (Gunfleet Old Lighthouse) and thence to latitude 51° 26' 36" north, longitude 01° 25' 30" east and thence to latitude 51° 24' 55" north, longitude 00° 54' 21" east (Warden Point in the County of Kent) as are for the time being within the territorial waters of Her Majesty's dominions." The Portof London Authority with which the Port Health Authority works in close co-operation was established as the administrative body of the Port of London including the docks and tideway of the River Thames, by Act of Parliament in 1909. PORT AND CITY OF LONDON HEALTH COMMITTEE (as at 31st December, 1969) Chairman Christopher Selwyn Priestley Rawson, J, P. Deputy Chairman Herbert Twyneham Pike, Deputy Aldermen The Rt. Hon. The Lord Mayor, Lt. Col. Sir Ian Frank Bowater, Kt., D.S.O., T.D., D.Sc. Sir Denis Henry Truscott, G.B.E., T.D. Alan Pearce Greenaway Robin Danvers Penrose Gillett, R.D. Commoners Anthony Wallinger Goodinge Ernest Gorden Duffett, T.D. Arthur Patrick Mills Samuel Sheppard, O.B.E. Charles George Hayes, Deputy Thomas Cuthbert Harrowing, Deputy Thomas Hugh Clifford Amies Arthur John Osborn James Mansfield Keith, T.D. Lt. Col. Charles George Surtees Shill Eric Frederick Wilkins, C.B.E., Deputy Sir Stanley Graham Rowlandson, Kt., M.B.E., J.P., G.L.C. Matthew Henry Oram, T.D., M.A. Dennis Gordon Fisher William Ian Baverstock Brooks Charles Wheeler Baker Alan Francis Gordon Stanham, Deputy Henry Wimborn Horlock, M.A. William Harold Wylie-Harris, Deputy Stanley Edward Cohen, C.B.E. Dr. James Cope William George Alfred Harries Major Henry Duckworth, J.P. William Samuels, Deputy Percy John Dyter Cyril Edward Baylis David Ivor Evans, T.D., J.P., Deputy Ronald Arthur Ralph Hedderwick Victor Allcard, Deputy Sir Thomas Kingsley Collett, Kt., C.B.E., Deputy Lady Donaldson, J.P. Donald Eustace Erlebach, Deputy. To:- THE RIGHT HONOURABLE THE LORD MAYOR, ALDERMEN AND COMMONERS OF THE CORPORATION OF LONDON. My Lord Mayor, Lady and Gentlemen, I have the honour, as Medical Officer of Health for the Port of London, to submit my Annual Report for the year ending 31st December 1969. This report has, as usual, been prepared in accordance with the directive given by the Secretary of the Ministry of Health in November 1963. I wish to express my appreciation of the invaluable assistance which has been given by the numerous individuals and organisations whose work is so closely allied with ours in the Port. The co-operation which is displayed is of the utmost importance in carrying out the multitude of operations in which we are involved. I also wish to record my gratitude to the Chairman and Members of the Port and City of London Health Committee, and to the staff of the Department. During the year I had the honour to deliver the 3rd Monckton Copeman Memorial Lecture on Medicine on the River Thames at the Society of Apothecaries Hall. I have appended a copy to this Report, as the topic may be of interest. I have the honour to be, Lady and Gentlemen, Your obedient Servant, W.G. SWANN, M.D., B.Sc., Medical Officer of Health, Port and City of London. 2 SECTION 1 - STAFF (As at 31st December, 1969) TABLE A Name of Officer Nature of Appointment Commenced Service Any Other Appointment held MEDICAL STAFF W.G. SWANN, M.D.,B.Ch, B.A.O., B.Sc., D.P.H., D(Obst), R.C.O.G., D.P. ., Medical Officer of Health A. January, 1964 Principal School Medical Officer, and Acting Chief Welfare Officer City of London. Medical Inspector of Aliens and Commonwealth Immigrants. D.T. JONES, B.Sc.,M.B., B.Ch.,D.C.H.,D.P.H. ,D.C.T. Deputy Medical Officer of Health March, 1958 (Deputy) ditto A.E.L. de THIERRY, M A., M.B. .B.Chir., D(Obst), R.C.O.G., D.P.H. Medical Officer March, 1967 Medical Officer City of London Medical Inspector of Aliens and Commonwealth Immigrants. W.T. ROUGIER CHAPMAN, V.R.D.,M.R.C.S., L.R.C-P. Senior Assistant Port Medical Officer January, 1962 Medical Inspector of Aliens and Commonwealth G.W. ASTON, L.M.S.S.A. Assistant Port Medical Officer October, 1962 Immigrants ditto R.G.S. WHITFIELD, D.S.C., B.A., M.R.C.S., L.R.C.P. Assistant Port Medical Officer (Part-time) December, 1966 ditto R.F. ARMSTRONG, L.R.C.P., L.R.C.S., Ed., L.R.F.P.S., Glas. ditto June, 1963 ditto R.M. BEST, M.B., B.S.,(Lond.) ditto April, 1964 ditto R. TILLEY, M.R.C.S., M.R.C.P., D.P.H, ditto July, 1969 ditto K.C. MORRIS, M.R.C.S., L.R.C.P. ditto September, 1967 - H.M. WILLOUGHBY, V.R.D., & Bar.,M.R.C.S.,L.R.C.P., D.P.H., D.T-M. & H, Consultant in Infectious Disease and Quarantine Procedures October, 1962 Medical Inspector of Aliens and Commonwealth Immigrants J.A. JONES, M.B.,Ch.B., D.P.H. ditto October, 1962 ditto W.T.G. BOUL, M.B.E.,M.D., Ch.B.,D.P.H. ditto March, 1957 ditto Occasional Medical Inspectors of Aliens and Commonwealth Immigrants. DR. D.J. AVERY DR. J. OAKLEY DR. W. STOTT DR. M.J. CATTON DR. R.D. SUMMERS DR. D.W. KEYS DR. R.N. HERSON DR. W.N. WHITSESIDE DR. D. JENKINS DR. B. DALTON DR. H.C. MAURICE WILLIAMS, O.B.E. DR. G.J. LEYDEN DR. P. ROUGH DR. J.F. BUCKLEY DR. P.J.R. WALTERS PUBLIC ANALYST Dr. H.A. WILLIAMS, Ph.D., (Lond.) M.ChemA., F.R.I.C., A.C.G.F.C., F.C.G.I., F.R.S.H. AGRICULTURAL ANALYST. Dr. J.H. HAMENCE, O.B.E., Ph.D., A.C.G.F.C., F.R.I.C. DEPUTY AGRICULTURAL ANALYST P.S. HALL, B.Sc., M.Chem.A., F.R.I.C. 3 Name of Officer Nature of Appointment Commenced Service Any other Appointment held ADMINISTRATIVE STAFF (Port and City of London) R.C. RATLIFF Chief Clerk March, 1930 - E.V. SMITH Deputy Chief Clerk October, 1938 C.W.R. BETTS First Assistant Clerk April, 1926 - F.B. OSBORN, A.M.R.S.H. Senior Assistant May, 1952 - R.H. COLLINS, L.M.R.S.H. ditto January, 1963 - D.J. FLOOD ditto March, 1963 - A.J.O. MOORE ditto April, 1964 - Mrs, D.M. SHEPHERD First Class Assistant April, 1965 - S.C. DARLINSON ditto April, 1964 - Miss M.L. GURNEY ditto May, 1939 - R.G. HEMING ditto August, 1965 - R.G. RUTTER ditto July, 1968 - D.M. HADDON ditto November, 1968 - R.G. FARRELL ditto July, 1965 - Mrs. I.H. HAMBLIN General Grade Assistant October, 1957 - Miss M.J. GOOLD ditto October, 1969 - Miss J.M. DOVE ditto March, 1968 - Mrs. E.J.A. MORROW ditto March, 1968 - Miss J.E. NEWSON ditto June, 1966 - Miss S.C. DUNN Shorthand Typist August, 1967 - Miss H.E. FOX ditto August, 1969 - Miss B, LOVATT ditto November, 1969 - H.T. LLOYD Senior Messenger November, 1968 - J.A. LAMBERT Messenger/Driver November, 1968 - G. HAMMOND ditto March, 1968 - PORT HEALTH INSPECTORS A.H. MARSHALL, M.A.P.H.I. Chief Port Health Inspector March, 1953 T.C.H. ROGERSON, M.A.P.H.I. Deputy Chief Port Health Inspector October, 1951 - A.C. GOOD, J.P., M.R.S.H. Divisional Port Health Inspector September, 1951 - P.A. TRAYNIER, F.R.S.H., M.A.P.H.I. ditto October, 1950 - L.N. TOPE, M.A.P.H.I. ditto August, 1946 - W.C.B. GILHESPY, M.A.P.H.I. ditto January, 1960 - W.M. WALKER Senior Port Health Inspector October, 1954 - A.W. BUCHAN, M.A.P.H.I. ditto July, 1955 - J.A. STOKER, M.A.P.H.I. ditto June, 1963 - P.G. PRITCHARD, M.A.P.H.I. ditto June, 1965 - A. GAME, M.A.P.H.I. ditto August, 1961 - F. SPENCER Port Health Inspector March, 1957 - R.W. GWYER, M.R.S.H., M.A.P.H.I. ditto March, 1960 - J.I. ECKERSALL, M.A.P.H.I. ditto June, 1966 - P. ROTHERAM, M.A.P.H.I. ditto June, 1967 - G.J. BULL ditto June, 1967 - J.C. STRACHAN, M.A.P.H.I. ditto June, 1968 - W.R. LEECH ditto June, 1969 - J.D. EDWARDS, M.A.P.H.I. ditto June, 1969 - A.E. TERRIBILE ditto June, 1969 — R.H. HEAD Meat Inspector April, 1964 — K.B. WILSON Technical Assistant (Authorised) December, 1968 - STUDENT HEALTH INSPECTORS J.E. OAKLEY Student Health Inspector June, 1967 - A.M. GIBBS-MURRAY ditto June, 1967 - C. FISH ditto June, 1967 — S.A. MONK ditto September, 1967 — G.S. HAYNES ditto September, 1968 - RODENT CONTROL STAFF Technical Assistants W.G. STIMSON, L.M.R.S.H., M.R.S.H. Chief Technical Assistant February, 1946 - E.C. WATKINS Senior Technical Assistant June, 1929 - C. STOCKTON ditto June, 1940 — D.J. DAVIS ditto August, 1941 — H.A. BAXTER Technical Assistant/ Class I June, 1945 — G.CLARK ditto January, 1949 — A.L. SOUTHWOOD ditto January, 1949 — A.T. EVANS ditto January, 1953 — C.E.W. EASTMAN ditto April, 1954 — W.T.S. PARKINSON Technical Assistant/Class II June, 1966 - Rodent Control Scheme J.W.R. KENNEDY Technical Assistant/Class I December, 1963 - P.F. CARTER Technical Assistant/Class II March, 1966 — H, BROWN ditto August, 1966 — D.S. SOUTHWOOD ditto June, 1969 — A.D. FARRANT ditto June, 1969 — R.G. BUNGAY ditto September, 1969 — 4 Name of Officer Nature of Appointment Commenced Service Any other Appointment held LAUNCH CREWS C.R. SIMONS Navigator (Senior) August, 1938 - W.G.A. KING Navigator (Dep. Senior) September, 1939 - H.J. MASON Navigator August, 1946 - M.J. EAST ditto September, 1954 - R.H. SIMMONS ditto November, 1960 - G. CUNNINGHAM ditto September, 1957 - W.M. McKEE ditto January, 1967 - K. GITTENS Engineer (Senior) January, 1955 - R.N. WALKER Engineer (Dep. Senior) April, 1964 - W. SIMMONS Engineer May, 1955 - B. JACOBS ditto April, 1956 - C. HOLLMAN ditto December. 1969 - A.R.L. POTTER Deckhand July, 1945 - E ALEWOOD ditto January, 1947 - A. RUSSELL ditto August, 1961 - P. RAYNER ditto November, 1960 - D. SIMMONS ditto December, 1963 - D.L KIELL ditto February, 1965 - S. HOLMES ditto March, 1967 - V.T. COOK ditto January, 1969 - J.C. WRIGHT ditto April, 1966 - D.L. WEBSTER Acting Deckhand September, 1968 - P CORNELIUS Deckboy September, 1968 - V.T. CHAPPELL ditto January, 1969 - I.J. ARROWS ditto December, 1969 - K.J. STAMMERS ditto December, 1969 - R.R HOPKINS ditto December, 1969 - T P REGAN ditto December, 1969 - T.L. MACKIE, M.I.N.A..F R.S.H . Supervisory Engineer of Launches November, 1968 - LAUNCHES — Date acquired "ALFRED ROACH" 1948 "HUMPHREY MORRIS" 1962 "VICTOR ALLCARD" 1965 "FREDERICK WHITTINGHAM" 1934 CORPORATION OF LONDON PORT OF LONDON HEALTH AUTHORITY GUILDHALL, E.C.2. TEL: 01 - 606 3030, 5 SECTION II AMOUNT OF SHIPPING ENTERING THE DISTRICT DURING THE YEAR TABLE B Ships from Number Net Tonnage Number Inspected Number of ships reported as having, or having had during the voyage, infectious disease on board. by the Port Medical Officer By the Port Health Inspector Foreign Ports 31,772 70,123,000 971 12,235 62 Coastwise 14,104 15,088,000 14 1,235 8 Total 45,876 85,211,000 985 13,470 70 SECTION HI CHARACTER OF SHIPPING AND TRADE DURING THE YEAR TABLE C Passenger Traffic - foreign | Number of Passengers — Inwards 87,145 travel only Number of Passengers — Outwards 98,967 Cargo Traffic Principal Imports All types of produce and Principal Exports merchandise Principal Ports from which ships arrive. The Port of London trades with all parts of the world. SECTION IV INLAND BARGE TRAFFIC There were some 3,700 lighters, with an aggregate tonnage of 370,000 tons, registered by the Port of London Authority during the year. These lighters, which operate throughout the port and its environs by way of creeks and canals, are of varied design. Some are all-purpose general cargo carriers, whilst others are specialised craft designed for the carriage of bulk raw sugar, bulk liquids and refrigerated cargoes. The bulk liquid lighters have steam heating coils built into their tanks and some of the refrigerated cargo lighters are fitted with refrigeration plant. During the year the number of lighters employed within the Authority's district has continued to decrease. As in previous years, this reduction has mainly been brought about by the amalgamation of fleets and the scrapping of old and uneconomical units. The carriage of food in lighters, barges and other vessels is controlled by the provisions of the Food Hygiene (Docks, Carriers, etc.) Regulations, 1960. A careful watch is kept on the cleanliness of those lighters used for this purpose, so that, as far as possible, any contamination of the food is eliminated. SECTION V WATER SUPPLY (1) Source of Supply No change (2) Reports of tests for contamination No change (3) Precautions taken against contamination of hydrants and hosepipes No change (4) Number and sanitary conditions of water boats and powers of control by the Authority No change 6 There were five reports of contamination in samples drawn from hydrants during the year of which three samples were associated with newly laid water mains to the new quay extensions in Tilbury Dock. The samples were drawn prior to the berths becoming operational The supply of water to shipping was withheld until a potable standard was achieved. The remaining two cases of hydrant contamination were discovered during the normal course of routine sampling. There were sixteen reports of contamination in samples derived from standpipes and twenty-seven reports of contamination from the ends of delivery hoses used to supply ships. The cause of the contamination of standpipes and supply hoses, which was also discovered during the course of routine sampling, was investigated as a matter of normal procedure No attributable cause was discovered and it was assumed that the contamination had been introduced through unhygienic handling of the watering equipment. No ship was supplied with "unfit" water There were six reports of contamination in the distribution supplies on board ships. These samples were drawn mainly from fresh water taps over galley and messroom sinks. The source of supply to these taps is derived from domestic fresh water storage" contained in double bottoms and peak tanks. Six samples of fresh water drawn directly from storage tanks were found to be fit for drinking. The possible sources of contamination in the cases of the domestic supply were investigated The most likely causes were considered to be the possible introduction of contaminated water or the incorrect use of engineroom pumps used in the filling or topping up of the fresh water gravity feed tanks or the transfer of fresh water for the purpose of adjusting the stability or the trim of the ship. In each case the standard practice of cleaning followed by chlorination of the tanks and supply lines was adopted. Due regard is paid to the co-operation this Authority has received from other United Kingdom and Continental Ports through the interchange of adverse fresh water sampling reports in respect of those ships where some degree of contamination in the fresh water on board was discovered subsequent to departure for another United Kingdom or Continental Port. This interchange of information enables follow-up visits to be made by the Port Health Authorities concerned and enables remedial measures to be taken before the ship sails. Seven samples drawn from the tanks and standpipes and three samples drawn from the end of delivery hoses of the water boats purveying fresh water in the Port showed contamination. In each case the standard procedure of tank cleaning and/or chlorination of the tank and supply hoses was carried out. The 85.89% of "satisfactory", "good" and "excellent" results in the fresh water supplies in the District as shown in Table 2 compares reasonably well with the percentage figure obtained in previous years, The number of "unsatisfactory" and "suspicious" samples, however, proves the necessity to exercise constant vigilance over fresh water supplies to shipping by taking 400/450 samples per annum. TABLE 1 FRESH WATER SUPPLY SAMPLES - SUMMARY 1969 HYDRANTS STAND PIPES DELIVERY HOSE ENDS TOTALS Unfit Unsat. Suspic. Satis. Good Excell. Unfit Unsat. Suspic. Satis. Good Excell. Unfit Unsat. Suspic. Satis. Good Excell. Royal Victoria Dock 1 - - 8 _ _ - - - - - 1 5 2 2 1 20 Royal Albert Dock - - - - 8 - - - - - 4 - - 1 4 2 7 - 26 King George V Dock - - 1 1 7 2 - 3 2 1 5 - - - 7 1 6 i 37 Tilbury Dock - - 3 - 39 14 - - - - - - - 3 - - 3 - 62 West India Dock - - - - 4 - - - 5 - 55 - - - 2 3 4 - 73 Mill wall Dock - - - - - - - 3 2 1 7 - - - 1 - 1 - 15 Surrey Com. Dock - - - - 2 - - - 1 - 22 - - - - - - - 25 River Districts - - - - 15 1 - - - - 8 - 1 1 1 - 23 2 52 Isle of Grain Area - - - - - - - - - - - - - - - - 2 - 2 TOTALS - 1 4 1 83 17 - 6 10 2 101 - 1 6 20 8 48 4 312 Water Boats TANKS STAND PIPES DELIVERY HOSE ENDS - 2 1 - 24 2 - - 4 - 24 3 - 2 1 - 36 - 99 GRAND TOTAL 411 7 TABLE 2 FRESH WATER SUPPLY SAMPLE TOTALS & PERCENTAGES Unfit Unsat. Suspic. Satis. Good Excel] Totals Hydrants - 1 4 1 83 17 106 Stand Pipes - 6 10 2 101 119 Delivery Hose Ends 1 6 20 8 48 4 87 Water Boats - 4 6 - 84 5 99 Totals 1 17 40 11 316 26 411 Percentages 0.24 4.14 9.73 2.68 76.89 6.32 100 85.89 Distribution aboard ships— Of 60 samples drawn in the crew and passenger accommodation and galleys on board ships:— 6 were excellent 45 were good 3 were satisfactory and 6 were suspicious Storage aboard ships- Of 6 samples drawn direct from ships storage tanks:— 2 were excellent 2 were good and 2 were satisfactory Port Installations- Of 72 samples drawn from dock offices, dock canteens, drinking fountains, etc.:— 4 were excellent 63 were good 2 were satisfactory and 3 were suspicious River Thames Passenger Launches— 46 samples were drawn under the Food Hygiene (General) Regulations, 1960 from licensed bar taps and storage tanks on board River Thames Passenger launches:- 35 were good 5 were suspicious 5 were unsatisfactory and 1 was unfit Standards used in the Port of London Quality Excellent Good Satisfactory Suspicious Unsatisfactory Unfit Plate count per ml. Nil Less than 100 Less than 300 More than 300 More than 300 Coliforms per 100 ml. Nil Nil Nil Less than 5 More than 5 More than 5 and including faecal coli. SECTION VI PUBLIC HEALTH (SHIPS) REGULATIONS 1966 1. List of Infected Areas (Regulation 6) Arrangements for the preparation and amendment of the list, the form of the list, the persons to whom it is supplied, and the procedure for supplying it to those persons:— NO CHANGE 8 1. (a) International Vaccination Certificates (Regulation 9 (3) ) NO CHANGE 2. Radio Messages (a) Arrangements for sending permission by radio for ships to enter the district (Regulation 13) and (b) Arrangements for receiving messages by radio from ships and for acting thereon. (Regulation 14 (1) (a) and 14 (2) ). As from 1st September, 1969, the London Port Health Authority was formally designated, by the Department of Health and Social Security, for the receipt and transmission of radio messages to and from ships prior to arrival in the District, under Regulation 12 of the Public Health (Ships) Regulations 1966. 3. Notifications otherwise than by radio (Regulation 14 (1) (b) ) Arrangements for receiving notifications otherwise than by radio and for acting thereon:— NO CHANGE 3(a) Maritime Declaration of Health (Regulation 16) NO CHANGE 4. Mooring Stat ion (Regulations 22 to 30) Situation of stations and any standing directions issued under these Regulations:— NO CHANGE 5. Arrangements For — (a) Hospital accommodation for infectious diseases (other than smallpox — see Section VII):- NO CHANGE (b) Surveillance and follow up of contacts — NO CHANGE (c) Cleansing and disinfection of ships, persons, clothing and other articles:— NO CHANGE Very Large Crude Carriers (V.L.C.C.S) The continued operation of these vessels produced no difficulty in health control during 1969. The agreed procedures for health clearance and the provision of Declarations of Health by Masters, not only of the V.L.C.C's but also of the lightening vessels, were applied in each case. After lightening, on some occasions, the V.L.C.C. berthed in the Port of London, and on other occasions proceeded to another Port to discharge the balance of her cargo. Summary of V.L.C.C. Movements affecting the Port Health \uthority during 1969, (see map) (a) V.L.C.C's arriving direct to Thameshaven District (Thameshaven and Coryton) 10 (b) V.L.C.C's arriving after lightening at Lyme Bay 4 (c) " " " at Seine Bay 3 (d) " " " at Rotterdam 3 Health Declarations for vessels in category (a) were presented by the vessels' Masters in the usual way on arrival in the Port, while Declarations for vessels in category (b) were presented by the Masters of the lightening vessels which were the first to arrive within the Port. Vessels lightened on the Continent — categories (c) and (d) - and then proceeding to London carried out normal Health Declaration procedure on arrival. No cases of infectious disease were reported on any vessel engaged in this traffic during the year. In the same period other vessels were also lightened at Lyme Bay, but neither they nor their lightening ships entered this Port. The largest single cargo of bulk oil discharged in the Port of London during 1969 was 137,000 tons which was part of a V.L.C.C's cargo which arrived during August, the ship concerned being the s.s. "Bulford" from Kuwait. 9 LIGHTER ABOARD SHIP DEVELOPMENT. "LASH SHIPS'' This aspect of seaborne cargo carriage was briefly referred to in last year's report and it was stated at that time that amongst the possible reception ports in the United Kingdom, the River Medway was being seriously considered. In fact the world's first lash ship M/V "ACADIA FOREST" arrived in the Medway to discharge "lash lighters" on the 4th December, 1969. She berthed at No. 2 Buoy within the jurisdiction of this Authority, having arrived from New Orleans via Rotterdam. Following the receipt of health clearance and the issue of pratique, discharging operations were commenced. The vessel has a carrying capacity of 73 x 450 ton loaded lighters. On her first visit to London she discharged 28 lighters all of which contained baled wood pulp. These lighters were then distributed to various wharves in the river by tugs. The lighters had originally been loaded in various "mill ports" along the length of the Mississippi River,part of which is an endemic sylvatic plague area. They were all inspected for evidence of rodent activity, and any other health problem that could be associated with this form of transport. No rodent infestations or health hazards were encountered. M/V ACADIA FOREST" of Kristiansand was built in Japan and operates under the management of the Central Gulf Steamship Corporation of the United States of America. She is 860 feet long, has a beam of 107 feet, and a draft of 37 feet when fully laden to her 43,500 ton capacity. The vessel is expected to carry out a monthly service to the River Medway, and further similar ships are already on order. As this new trade develops it could well be that "lash lighters" containing food commodities will, in due course, arrive in the port. This form of importation will present the same problems as the control of containers carrying foodstuffs, and will have to be dealtwith in a similar way. The 43,500 ton "ACADIA FOREST", the first ship of its kind in the world which carried 80 floating container—barges. A 510 ton mobile gantry crane on board ship lifts the barges out of the hold and lowers them into the water at the stem of the vessel. They are linked together and towed by a tug and leader barge to riverside wharves without the use of expensive deep water docks. 11 A tug (rear) and a leader barge (front) manoeuvre a "train" of container-barges to a riverside wharf. Photographs by United Press International MEDICAL INSPECTIONS AT GRAVESEND Jan. Feb. Mar. Apr. May June July Aug. Sept. Oct. Nov. Dec. Total No. of Vessels Boarded 70 79 90 77 96 93 76 79 75 76 92 82 985 No. of Passengers Medically Inspected (Inc. Commonwealth and Alien Passengers) 1 3 5 - 3 11 7 12 1 4 5 2 54 No. of Crew Medically Inspected 9 4 2 3 10 2 3 1 - 6 9 5 54 DENTON HOSPITAL Although Denton Hospital was taken over by the South East Metropolitan Regional Hospital Board under the National Health Service Act, 1946, the Port Health Authority continues to exercise, through the Senior and Assistant Port Medical Officers, the medical supervision of cases admitted to the Hospital. The nursing and administrative control lies with the Dartford Group Hospital Management Committee. The number of cases admitted to Denton Hospital in 1969 was as follows:— Influenza 3 Chickenpox 4 Tonsillitis 1 Malaria 1 Infective hepatitis 1 Mumps 1 Rubella 3 Typhoid 2 16_ 12 SECTION VII SMALLPOX 1. Name of Isolation Hospital to which smallpox cases are sent from the District. Long Reach Hospital is situated on the south bank of the River Thames about eight miles above Gravesend. The hospital consists of 10 ward blocks capable of accommodating 170 patients but, except in cases of emergency, only three ward blocks (2 of 20 beds and 1, a cubicle ward, of 10 beds, total 50 beds) are kept available for immediate use. The hospital includes residential quarters for the staff and laundry, although the administration and staffing is carried out from Joyce Green Hospital, Dartford. 2. Arrangements for transport of such cases to that Hospital by ambulance giving the name of the Authority responsible for the ambulance and the vaccinal state of the ambulance crews. A case or cases of smallpox would be removed from the vessel by one of this Authority's Ambulance launches and conveyed ashore via the pontoon at Denton and from thence conveyed by road ambulance direct to Long Reach Hospital. The Port Health Authority would be responsible for the vaccinal state of their Ambulance Launch crews, while the vaccinal state of the Road Ambulance personnel would be the concern of the ambulance authority, the Greater London Council. 3. Names of smallpox consultants available. Dr. W.T.G. Boul, M.B.E. Dr. A. Melvin Ramsey Dr. C.F.L. Hill Dr. G.D.W. McKendrick Dr. E. O'Sullivan Dr. J.C. McEntee Dr. H.S. Banks Dr. J.C. Blake Dr. E.H. Brown Dr. J.D. Kershaw Dr. H.P. Lambert 4. Facilities for laboratory diagnosis of smallpox. Facilities are available at the Virus Reference Laboratory at the Central Public Health Laboratory, Colindale, N.W.9. SECTION VIII VENEREAL DISEASE Information as to the location, days and hours of the available facilities for the diagnosis and treatment of venereal disease among merchant seamen under International arrangements including in-patient treatment and the steps taken to make these facilities known to seamen:— NO CHANGE SECTION IX CASES OF NOTIFIABLE AND OTHER INFECTIOUS DISEASES ON SHIPS TABLE D Category: Cases landed from ships from foreign ports. Disease Passengers Crew No. of ships concerned Chickenpox 5 1 3 Encephalitis 1 - 1 Gastro-enteritis 3 - 3 German measles - 1 1 Infective hepatitis 1 2 3 Influenza 1 2 2 Leprosy - 1 1 Malaria - 1 1 Measles 5 - 1 Miscellaneous 1 1 2 Mumps 1 0 1 Pneumonia 2 1 3 Scabies - 4 2 Scarlet fever 2 1 2 Tuberculosis : Pulmonary 1 6 7 Typhoid or Paratyphoid Fever - 4 3 TOTALS 23 25 36 13 Category: Cases which have occurred on ships from foreign ports but have been disposed of before arrival. Disease Passengers Crew No. of ships concerned Dysentery - 1 1 Gastro enteritis 340 26 3 German measles 4 - 1 Infective hepatitis - 6 6 Influenza - 87 4 Malaria - 4 2 Measles 24 - 2 Mumps 2 - 1 Scabies - 3 1 Tuberculosis : Pulmonary - 4 4 Whooping cough 1 - 1 TOTALS 371 131 26 Category: Cases landed from ships arriving coastwise. Disease Passengers Crew No. of ships concerned Influenza - 2 1 Gastro enteritis - 1 1 Pyrexia of unknown origin - 1 1 Scabies - 1 1 Venereal Disease - 2 2 TOTALS NIL 7 6 Category: Cases on coastwise ships which have been disposed of before arrival. Disease Passengers Crew No. of ships concerned Miscellaneous (Tonsillitis) - 1 1 Typhoid fever - 1 1 TOTALS NIL 2 2 Category: Cases remaining on board after the ship's arrival. Disease Passengers Crew No. of ships concerned Dysentery - 1 1 German measles - 3 1 Influenza - 10 6 Miscellaneous 2 4 5 Scabies - 2 2 Food Poisoning - 3 1 Venereal Disease - 2 2 TOTALS 2 25 18 14 The following table gives a comparative picture of infectious diseases over the past twelve years:— Disease 1960 1961 1962 1963 1964 1965 1966 1967 1968 1969 (a) Cases reported on Ship's arrival Amoebiasis - - - - - - 4 1 - - Anthrax - - - - - - - - - - Cerebrospinal Fever (epidemic Cerebrospinal meningitis) - - - - - - - - 1 - Chickenpox - - - - - - 8 19 20 9 Cholera (including suspected) - - - - - - - - - - Diphtheria 1 2 - - - - - - - - Dysentery - - - - - - *1 2 3 2 Encephalitis (acute) - - - - - - - - - 1 Enteric (Typhoid or Paratyphoid) Fever 1 - 2 2 - 6 8 - - 5 Enteritis - - - - - - 1 - 14 - Erysipelas - - - - - - - 1 - - Food Poisoning (or suspected) - - - - - - - 7 51 1 German Measles 8 12 14 6 14 3 - 11 7 8 Infective Hepatitis/Infective Jaundice - - - - - - 1 9 8 9 Leprosy - - - - - - 1 - - 1 Leptospirosis - - - - - - - - - - Malaria (including suspected) - - - - - - *1 - 12 6 Measles 109 35 60 68 43 22 15 26 4 29 Meningitis (acute) (or Suspected) - - - - - - - - - 1 #Mumps - - - - - - - - 2 3 Ophthalmia Neonatorum - - - - - - - - - - Plague (including suspected) - - - - - - - - - - Pneumonia acute primary - - - - - - - - 3 4 Polioencephalitis (acute) - - - - - - - - - - Poliomyelitis (acute) - - - - - - - - - Relapsing fever - - - - - - - - - - Scarlet Fever (or Scarlatina) 1 - 1 - - - - - - 3 Smallpox (including suspected) 1 2 5 1 2 1 — — — — Tetanus — - - - - - - — — — Tuberculosis — pulmonary 39 26 33 24 17 9 19 5 8 11 Tuberculosis — non-pulmonary - - - - - — — 1 - - Typhus Fever - - - - - - - - - - Whooping Cough — — — — — — — — - - Yellow Fever (including suspected) — 1 - - — — — - - - Other diseases (including chickenpox up to and including 1965 only) 956 303 258 198 146 276 100 42 1 468*c TOTALS 1116 381 373 299 222 317 158 124 134 561 This figure includes 366 cases of gastro enteritis from 3 ships and 87 cases of influenza from 4 ships (b) Total cases admitted to Hospital including those reported after arrival I960 1961 1962 1963 1964 1965 1966 1967 1968 1969 Amoebiasis - - — - - — 4 2 — - Anthrax — - - - — — — — — — Cerebrospinal Fever (epidemic Cerebrospinal meningitis) - - - - - - - - - - Chickenpox - — — — — — 7 5 5 4 Cholera (including suspected) — - - — — — - — — — Diphtheria 1 - - - - — — - — - Dysentery (including suspected) 1 1 4 9 4 3 4 7 — — Encephalitis (acute) — — — — — — — — — 1 Enteric (typhoid or paratyphoid) Fever 3 — 2 1 — 5 2 1 1 4 Enteritis - — — — — - 1 — 1 — Erysipelas — — - — — — — — — — #Food Poisoning (or suspected) - — — — — — — — 2 1 German Measles — — — — — — 3 1 1 1 Infective Hepatitis/Infective Jaundice - — — — - — 1 1 6 4 Leprosy — — — — — - 1 — — 1 Leptospirosis - — - — — — — — — — Malaria (including suspected) — — — — — — 1 3 4 2 Measles 10 11 11 7 11 2 2 — — — Meningitis (Acute) (or suspected) — — — - — — — — — 1 Mumps 9 3 4 3 1 2 — — 1 1 Ophthalmia Neonatorum — — — — — — — — — — Plague (including suspected) - - - - - - - - - - Pneumonia, acute primary - — — — — — — — 2 2 Polioencephalitis (acute) — - — - — — — — — — Poliomyelitis (acute) — — — — — - - — — — Relapsing Fever — - - - — - — — — — Scarlet Fever — — 1 — — — 1 — — 3 Smallpox (including suspected) — — 3 1 1 — — — — — Tetanus — — — — — — — — -r- _ Tuberculosis — pulmonary — — — — — — 15 11 5 9 Tuberculosis — non pulmonary — — - — - - - - — - Typhus Fever — — — — — — — — — — Whooping Cough — - — — — - — - - - Yellow Fever (including suspected) — — — — — — — — — — Other diseases {including chickenpox up to and including 1965 only) 86 65 86 86 72 44 - 5 - 4 TOTALS 110 80 111 107 89 56 42 36 28 38 *Same case — final diagnosis was multiple myelomatosis #Table amended 1966 15 (i) Typhoid Fever A vessel arrived in London on 21st June and on 23rd June a seaman reported sick and was admitted to St. Olave's Hospital. Subsequently he was transferred to Hither Green Hospital and a provisional diagnosis of typhoid fever was confirmed. On 25th June one of your Assistant Medical Officers, visited the ship and offered T.A.B. vaccine to all the remaining crew, of whom 18 accepted the offer. Certain members of the crew left the vessel on her arrival in London and they were "followed up", one Englishman via the local medical officer of health and the seamen who were returning to their homes on the Continent via the Department of Health and Social Security who also sent information to Brazil, from whence the vessel came. One further crew member reported sick on 26th June and he too, was admitted to hospital as a suspected case of typhoid fever. This diagnosis was not confirmed. A Stewardess who had returned to Denmark notified her husband (the ship's cook) that she was ill at home with symptoms similar to those of typhoid fever. The outcome of the illness is not known. On 26th June specimens of food and water were taken and on 27th June faecal and urine samples were taken from all except one crew member. The vessel sailed for the East German port of Rostok on 27th June and. through the good offices of the Port of London Authority, a telex message, giving full details, was sent to the Port Medical Officer at Rostock. (As the U.K. has no diplomatic contact with the East German Democratic Republic it was not possible to send details through the Department of Health and Social Security as is more usual). All the faecal and urine samples proved negative and. again through the good offices of the Port of London Authority, a further telex was sent to Rostok on 3rd July notifying them of this. On 9th July a final telex was sent notifying that the water and food samples had also proved negative. As the vessel was proceeding to Kotka and Stockholm information was also relayed to those ports. On 16th July it was found that the vessel was returning to the port of Hull and full details were sent by letter to the Medical Officer of Health of Hull. No further cases of illnesses were reported. Your Medical Officer is pleased to report this example of co-operation afforded by the Port of London Authority telex service. A suitable letter was sent to the Port of London Authority Director General. (ii) Typhoid Fever A vessel arrived in London on 31st July from Panama City. Two members of the crew were reported as sick and taken to Denton Hospital for further examination. In view of the symptoms a provisional diagnosis of typhoid fever was made and the men transferred to Joyce Green Hospital for further tests. Typhoid fever was confirmed. In the meantime the vessel was visited in Surrey Dock and a full investigation of other crew members carried out, together with examination of samples of the fresh water supplies. Fumigation of the ship's hospital, cabins and lavatories took place, and the vessel was kept under daily surveillance until she sailed for Leningrad on 4th August. Three members of the crew who had proceeded home to Germany were "followed up" through the Department of Health and Social Security. Results of examinations of stool, urine and water samples were negative and full information was passed to Leningrad Port Health Authority and the Department of Health and Social Security. No further cases of sickness were reported. (iii) ? Typhoid Fever On the 13th November a message was received to the effect that a seaman from a vessel had discharged himself from hospital on the 11th November and that the man had called at the office of the Shipping Agents to make arrangements for his flight home to Denmark. Subsequently the Shipping Agents had received a message to say that the man might have been suffering from typhoid fever. The agents were concerned about possible contact with office staff. This was the first indication to the Authority that there was a seaman in the Port thought to be suffering from typhoid fever. By the time the information was received the man had reached London Airport and was ready to board the aircraft. The Medical Unit at London Airport was alerted as was the Department of Health & Social Security. The man was seen on board the aircraft, but insisted on continuing his flight. 16 As the vessel was still in Port the rest of the crew were seen and offered TAB vaccination. Only one accepted. Urine samples were collected from all the crew and one faecal sample and all sent for examination. The drinking water was also sampled and submitted for examination. Details of the crew members who had left the ship were obtained and forwarded to the Department of Health & Social Security. The hospital reported that they had been unable to make a proper diagnosis as the man had refused to stay and proper tests had not been undertaken. Strong representations were made that this Authority should have been informed at the earliest possible moment and it is hoped that similar instances will not recur. Subsequently the samples which had been submitted were found to be negative and the Department of Health & Social Security were so informed. This case illustrates the problems involved in international travel in that, without firm evidence that a person is suffering from a serious infectious disease, it is sometimes difficult to take preventive action in the time available. PUBLIC HEALTH (SHIPS) REGULATIONS 1966 - INFECTIOUS DISEASE A vessel arrived in London on 28th September and no mention was made of there being any sick person on board. Subsequently it became apparent that a member of the crew had reported sick in Rotterdam, received some treatment from a doctor there and was still ill in his bunk when the vessel was boarded by the Medical Officer on duty at Gravesend. This was discovered when a telex message was received from the Port Medical Officer of Rotterdam notifying your Medical Officer that the crew member's doctor had taken a faecal specimen which was positive for Salmonella typhimurium. The man was admitted to Rush Green Hospital and faecal and urine samples were taken from all the crew of the vessel. Samples of food and water were also taken. The vessel sailed before the results were known. When received they showed that two members of the crew were excreting Salmonella typhimurium and one other member was excreting a different Salmonella of Group B. The food and water samples were satisfactory. The results of the investigation were notified to the Port Medical Officer at Bremen, which was the next port of call and a copy sent to the Port Medical Officer of Rotterdam. Information was also sent to the Medical Officer of Health of the areas to which four passengers had gone on leaving the vessel. The matter was referred to the Comptroller and City Solicitor with regard to the fact that the Master answered "NO" to all the Questions on the Declaration of Health and also denied verbally that there was any sick person on board. Subsequently proceedings were instituted against the Master of the vessel. SECTION N OBSERVATIONS OF THE OCCURRENCE OF MALARIA ON SHIPS Two cases of Malaria were reported in seamen admitted to hospital after the arrival of their ships during the year under review. Four cases occurred in 1968. SECTION XI MEASURES TAKEN AGAINST SHIPS INFECTED OR SUSPECTED OF PLAGUE No ships infected with plague (or suspected plague) arrived during the year. SECTION XII MEASURES AGAINST RODENTS IN SHIPS FROM FOBEIGN PORTS (i) Procedure for inspection of ships for rats The Port Health Authority employs an experienced and competent team of seventeen Rodent Inspectors, who exercise control measures on all ships and shore premises within the Port area under the supervision of the Port Health Inspectors. 17 The Rodent Inspector's first duty is to visit all ships arriving in his district as soon as possible after arrival and search for evidence of rodents. Priority is given to ships which have arrived from plague endemic areas. Further visits to these ships are made during the discharge of cargo to ascertain the degree of infestation on board, if any, and to ensure that reasonable measures are adopted to reduce the number of rodents on board to a negligible number and prevent any rodents escaping ashore. His second duty is the inspection of ships in his area for the specific purpose of issuing Deratting or Deratting Exemption Certificates or Rodent Control Certificates. The Rodent Inspector's third duty is the inspection of shore premises and lighters for signs of rodent infestation. The Port Health Authority has continued to operate a Rodent Control Scheme inaugurated twenty-eight years ago, covering all the docks and including all the premises of the Port of London Authority on behalf of that Authority and premises of tenants of the Authority on behalf of the occupiers. (ii) Arrangements for the bacteriological examination of rodents with special reference to rodent plague including the number of rodents sent for examination during the year. All dead rats to be examined for evidence of plague are promptly dispatched in cylindrical aluminium containers with a screw cap to the Public Health Laboratory at County Hall. Specimen rats are placed in polythene bags previously dusted with gammaxene powder to kill any parasites, labelled and placed inside the cylinder for delivery by hand. During the year forty-two rats were sent to the Laboratory at County Hall and were examined for plague with negative results. (iii) Arrangements in the district for deratting ships, the methods used and if done by a commercial contractor, the name of the contractor. (a) The burning of sulphur at the rate of 31bs per 1,000 cubic feet of space for a minimum period of 6 hours. This method is seldom used now in the Port of London. (b) The generation of hydrocyanic acid gas by various methods. For the destruction of rats a minimum concentration of H.C.N. at the rate of 2 ozs per 1,000 cubic feet of space is required with a minimum of two hours exposure. (c) Sodium-fluoroacetate ("1080") and "Warfarin" The employment of "1080" as a rodenticide has been regularly used throughout the docks for some time with highly satisfactory results. The prohibition on the use of "1080" and "1081" (Sodium Fluoroacetamide) except in ships and sewers, which was imposed in June 1965 has continued in force. A substantial number of ships have been deratted by "1080" in preference to the use of cyanide resulting in a considerable saving of time and cost to the ship owner. (d) Trapping. This method is seldom used except as an expedient to eliminate isolated rats and/or to secure specimens for the laboratory. (e) Methyl Bromide Methyl bromide is a gas at ordinary temperatures but can be liquefied by pressure, and it is in the liquid form in the cylinders in which it is usually distributed. The gas is heavier than air, consequently heavy concentrations are often found at floor level in the early stages of a treatment. Apart from this density effect, the gas has greater powers of penetration than most other fumigants in common use and this applies not only to penetration into commodities but also through walls and sealing materials. A high standard of maintenance and sealing is necessary in rooms to be used for fumigations using methyl bromide. The penetrating powers of methyl bromide the absence of smell the lack of immediate symptoms of poisoning and the long term effect of poisoning make it essential that adequate precautionary measures should be taken at all stages from the manufacture of the fumigant to the declaration of freedom from danger at the conclusion of operations. The precautionary measures and the additional precautions for the treatments of ships which are to be followed are laid down in a Home Office Pamphlet dated 1960. The fumigation of ships by methyl bromide usually for disinsection purposes occurs only occasionaly in the Port of London. This very effective and lethal fumigant is not difficult to disperse after an operation. 18 Its use is somewhat complex in that some countries particularly the United States and Canada require a certificate to be produced by the Master of a ship prior to the loading of grain to state that the ship is free from insects or has been disinsected by an approved fumigant. such as methyl bromide. This applied particularly in the case of Khapra beetle infestations. No such certificates can be obtained in the United Kingdom and therefore in order to satisfy the requirements of a particular port and to avoid possible delay in loading. the vessel is fumigated with the appropriate amount of methyl bromide. This is entered on the De-Ratting certificate which then serves the dual role of showing that the vessel has been de-ratted and disinsected. The exposure to the gas depends on the concentration and on the period and purpose of the exposure. For example, 16 oz. of liquid per 1.000 cu.ft. for 24 hours for insect infested bones has been used; for Khapra Beetle infestations the United States Authorities stipulate 48 oz. per 1,000 cu.ft. for 24 hours or 96 oz. [Per 1 000 cu.ft. for 12 hours; in United Kingdom ports, 32 oz. per 1.000 cu.ft. for 24 hours is usual. Such concentrations are more than adequate for eradication of any rodent or insect life present in the vessel. The following are the names of the firms approved for carrying out the deratting of ships:— Etoxin Ltd.. Contra-Pest Service Ltd.. Rentokil Laboratories Ltd. (iv) Progress in the Rat Proofing of Ships No Change. RODENT CONTROL MEASURES CARRIED OUT ON LIGHTERS Rodent control measures on lighters have been carried out during the year. Of the 2,686 lighters inspected for rodent indications, 1,825 were inspected on the Upper and Middle River District, the remaining 861 inspections being carried out in the respective dock groups. By referring to the attached table. it will be observed that there has been a slight increase in the number of lighters requiring treatment but the average number of rats recovered after treatment is the lowest yet recorded. During the past ten years 42.021 inspections of lighters have been carried out and only 1.7% of these required treatment. The Importance of Rodent Control on Lighters Dangers to health and to prevent the spread of disease Rats and mice are suspected carriers of disease and their presence represents a potential health hazard by virtue of the contamination of stored human food they eat and foul. Food poisoning and other infections may be spread to man by his consumption of rat contaminated foodstuffs. There is the danger of bubonic plague transmitted to man by fleas, particularly the rat flea, Xenopsylla cheopis. This flea will accept man as an alternative host and transmit the disease to him. Rats also carry one form of Typhus, Endemic Typhus which is transmitted to man by fleas. Weil's Disease (Leptospiral Jaundice) is transmitted to man by direct or indirect contact with rats and their infected urine. Economic Rurden Damage to food supplies merchandise and structures Rats and mice are prolific breeders. It is essential, therefore that the most efficient control measures are used. The ultimate aim of any operation carried out is to exterminate every single rat, not leaving any residue rats, as these will soon multiply and cause a reinfestation. Rat Suppressive Measures Fumigation and poisoning — no change Cleanliness and hygiene — no change Harbourage and rat-proofing — no change The methods of de-ratting employed throughout the year were:— F umigant s Rodenticides 1. Sulphur Dioxide Sodium mono-fluoroacetate 2. Methyl Bromide The method of treatment is determined by the condition and degree of infestation of the lighter at the time of inspection. 19 During the year, ten of the rats recovered from treated lighters were sent to the Public Health Laboratory, County Hall, for routine bacteriological examination. Pasteurella pestis was not isolated from any specimen. During the course of the year, 336 lighters were fumigated with Methyl Bromide for insect control and, as the dosage required varies from twenty to thirty ounces per 1,000 cubic feet according to the species of insect pest present, the chemical properties of Methyl Bromide and the exposure period required for this fumigant is more than adequate to destroy any rats that may be in the lighter at the time of fumigation. The number of dumb lighters trading within the Port of London Health Authority's jurisdiction, year ending 1969, are as follows:— Open Lighters 1,526 Hatched Lighters 1,370 Insulated Lighters 145 Refrigerated Lighters 5 Tank Lighters 248 Grating Lighters 24 Contractors Lighters 63 Pontoon Lighters 44 Punt Lighters 14 Canal Lighters 241 TOTAL 3,680 As in the past, every assistance has been received from the lighterage industry in the efforts to reduce rats to a minimum in these craft. SUMMARY Number of Lighters Inspected 2,686 Number of Lighters Without Any Evidence of Rat Infestation 2,452 Number of Lighters with negligible Fresh or Old evidence. No Action Taken 149 Number of Lighters treated for Rats 85 Number of dead rats recovered after treatment 263 Number of rats sent for bacteriological examination P/pestis. All results were negative 10 TABLE SHOWING FIGURES AND STATISTICS FOR THE PAST TEN YEARS Year No. of Lighters Inspected % of Lighters without any Evidence % of Lighters with negligible fresh or old Evidence No Action Taken % of Lighters Treated for Rats No~ of Dead Rats recovered after Treatment Average No. of Rats recovered per Lighter Treated 1960 7207 86.3% 12.4% 1.3% 552 5.9 1961 6366 84.9% 13.5% 1.6% 848 8.1 1962 3793 86.8% 11.7% 1.5% 483 8.5 1963 5408 89.0% 9.4% 1.6% 732 8.4 1964 2062 91.7% 6.0% 2.3% 195 4.0 1965 4565 79.0% 19.5% 1.5% 377 5.4 1966 3294 90.1% 8.5% 1.4% 172 3.7 1967 3153 92.1% 6.1% 1.8% 277 4.9 1968 3487 92.2% 6.0% 1.8% 248 3.9 1969 2686 91.3% 5.5% 3.2% 263 3.1 Average 1960-1969 4,202 87.5% 10.8% 1.7% 415 5.6 20 TABLE E Rodents destroyed (bodies recovered) during the year in ships and in shore premises. (1) On Vessels Number of. Jan Feb. Mar. April May June July Aug. Sept. Oct. Nov. Dec. Total Black Rats 23 32 61 56 33 41 24 126 75 26 12 29 538 Brown Rats - - - - - - - - - - - 3 3 Rats Examined 4 2 2 3 7 6 3 6 2 2 2 3 42 Rats infected with Plague - - - - - - - - - - - - - (2) In Docks, Quays, Wharves and Warehouses Number of Jan. Feb. Mar. April May June July Aug. Sept. Oct. Nov. Dec. Total Black Rats 22 18 15 122 26 61 14 24 36 27 15 8 388 Brown Rats 28 27 74 59 40 34 27 43 61 51 58 45 547 Rats Examined — — — 2 - 1 - - — - 1 — 4 Rats Infected with Plague - - - - - - - - - - - - - 905 Mice were also destroyed, 148 in ships and 757 in shore premises. TABLE F Deratting Certificates and Deratting Exemption Certificates Issued during the Year for Ships from Foreign Ports. NO. OF DERATTING CERTIFICATES ISSUED After Fumigation with After Trapping After Poisoning with "1080" Total Number of Deratting Exemption Certificates Issued Total Certificates Issued HCN Other Fumigants 1. 2. 3. 4. 5. 6. 7. Nil Nil Nil 15 15 878 893 21 RETURN OF RATS CAUGHT AND DESTROYED DURING YEAR 1969 Jan, Feb, Mar, Apr, May June July Aug, Sept, Oct, Nov, Dec Total LONDON DOCKWarehouses 16 8 6 4 2 - - - - - - - 36 Vessels - - - - - - - - - - - - - SURREY COMMERCIAL DOCK Warehouses - - - 112 1 1 13 - 13 - - - 140 Vessels - 2 - - - - - - - - - - 2 REGENT'S CANAL DOCKWarehouses - - - - - - - - 10 - 2 - 12 Vessels - - - - - - - - - - - - - WEST INDIA DOCK Warehouses 9 7 20 14 12 35 23 36 32 10 15 4 217 Vessels - - - - - - - - - 2 1 24 27 MILLWALL DOCKWarehouses 6 9 10 9 24 21 4 20 2 19 23 1 148 Vessels - - - - - 5 - - - - - 1 6 ROYAL VICTORIA DOCKWarehouses 9 8 44 35 22 23 14 30 25 40 28 31 309 Vessels 8 2 - 3 1 18 4 - 3 - - - 39 ROYAL ALBERT DOCK Warehouses 7 4 8 7 4 4 - 2 14 5 2 10 67 Vessels 3 3 6 4 2 3 - - 2 - - 3 26 KING GEORGE V DOCK Warehouses - 1 4 - 1 - - - 1 - - - 7 Vessels - - - - - - - - - - - - - TILBURY DOCK Warehouses 3 8 2 - 1 2 - 41 20 4 3 7 91 Vessels - 2 30 43 - 3 4 - - 3 3 1 89 RIVER - Vessels 12 23 25 12 29 14 3 55 50 21 8 8 260 TOTALS 73 77 155 243 99 129 65 184 172 104 85 90 1,476 PREVENTION OF DAMAGE BY PESTS (APPLICATION TO SHIPPING) ORDER 1951-56 During the year 23 Rodent Control Certificates were issued to coastwise ships as provided for the terms of the Prevention of Damage by Pests (Application to Shipping) Order 1951-56. 22 SECTION XIII INSPECTION OF SHIPS FOR NUISANCES TABLE G Inspection and Notices Number of vessels visited by Port Health Inspectors 13,470 Number of vessels on which sanitary defects were found, and details reported to the Master, Owners and/or Board of Trade 223 Number if Statutory Notices served Nil Number of Informal Notices served 26 Number of vessels on which sanitary defects were remedied 207 Summary of Structural and other Defects Nature of Inspections No. of Defects Inadequate Ventilation 3 Defective lighting — Natural — — Artificial 1 Defective or Insufficient Heating 4 Dampness — Condensation 2 — Leaking Decks — — Leaking Ports, Decklights etc. - — Leaking Sideplates 1 — Leaking Hawse or Chain Pipes — — Defective of Obstructed Floor Drainage 6 — Water lodging on top of Peak Tanks 1 Defective — Bulkheads 6 — Floors 12 — Doors 3 — Chain pipes — — Bunks — — Clothes Lockers — — Food Lockers 5 - Food Storage 10 — Cooking Arrangements 22 Defective or Uncleanly Drinking Water Storage 3 Water Closets — Obsolete 3 — Defective 32 — Foul or choked 37 — Inadequate Flush 23 Wash Basins — Defective 17 — Foul 9 Neglected Paintwork or Distemper 46 Absence of Washrooms 1 of Messrooms — Misappropriation of Crew Spaces 1 Verminous Quarters 182 Miscellaneous 45 TOTAL 469 General Summary Analysis of the Sanitary Inspections etc. in the Port of London for the year ended 31st December, 1969. Type of Vessel/Premises inspected Defect ive To be cleaned Foreign Going: Steam 12,230 237 230 Sail 5 — Coastwise: Steam 1,235 13 11 Sail - — — 13,470 250 241 Inland Navigation: Steam 255 6 6 Sail — — — Lighters 185 — 3 Canal Boats: — — — Shore Premises 6,595 63 54 7,035 69 63 TOTAL 21,505 319 304 23 Areas where Foreign Going and Coastwise vessels were inspected. Dock and River No. of Inspections Regents Canal 23 Surrey Commercial 1,489 No. of Vessels inspected in Launches West India 1,209 Millwall 691 Poplar 2 922 ('Victor Allcard' Royal Albert 828 ('Humphrey Morris' Royal Victoria 731 King George V 399 2,695 ('Frederick Whittingham' Tilbury 2,520 ('Alfred Roach' Upper River 1,246 3,617 Middle River 1,449 Lower River 922 9,853 No. of Vessels inspected in Docks etc. Medway 1,158 Thameshaven 803 TOTAL 13,470 13,470 Countries of Origin of Foreign Going vessels inspected No. of Inspections No. of inspections Argentina 17 Brought Forward 10,650 Belgium 188 Israel 54 Brazil 7 Italy 62 Bulgaria 17 Jamaica 2 Burma 11 Japan 45 Chile 4 Kenya 1 China 18 Korea 1 Cuba 38 Kuwait 16 Curacoa 1 Lebanon 15 Cyprus 54 Liberia 261 Denmark 475 Malta 1 Dutch Guiana 1 Malaysia 3 Ethiopia 15 Nigeria 50 Finland 247 Pakistan 28 France 147 Panama 79 Formosa 4 Peru 2 Germany 2,585 The Philippines 5 Ghana 68 Poland 152 Great Britain 4,506 Portugal 38 Greece 440 Rumania 34 Netherlands 1,638 Singapore 4 Iceland 17 Somalia 2 India 123 South Africa 41 Indonesia 1 Spain 164 Iran 7 Sudan 7 Iraq 16 Sweden & Norway 1,312 Eire 5 Switzerland 4 10,650 Turkey 58 Uganda 10 United Arab Republic 13 United States of America 44 Uruguay 1 U.S.S.R. 247 Yugoslavia 64 Total 13,470 During 1969 Port Health Inspectors referred 20 sick seamen to Hospital. SECTION XIV PUBLIC HEALTH (SHELLFISH) REGULATIONS 1934 Oyster Industry. This continued in the same way as in previous years. The Industry is being carried out within the Authority's jurisdiction in the waters of the River Roach, Barling Creek, Paglesham Pool and the Middleway which forms part of the Havengore Creek, all in the County of Essex. 24 The various layings are worked by three companies, and in addition, the Fisheries Laboratory of the Ministry of Agriculture, Fish and Food at Burnham on Crouch has an interest in various layings in the area, for research purposes. In the early part of the year one producer requested 'Certificates of Purity' to be issued as required by the French Authorities to cover export consignments Routine sampling was carried out and the samples submitted to the Public Health Laboratory, Chelmsford for examination. Two such consignments were dealt with in this way and on each occasion the oysters were reported as 'Satisfying the standards laid down by the Worshipful Company of Fishmongers'. In recent years there has been a large increase in the population in this part of Essex, and this increase has created problems with sewage disposal in the areas adjacent to the River Roach and its tributaries. Whilst there has, to date, been no report of any person suffering from infection, or other disease attributable to shellfish consumption, this particular hazard will have to be closely watched and action taken under the Public Health (Shellfish) Regulations, 1934 if considered necessary. The towns adjacent to the waters used by the oyster industry, namely Rochford and Rayleigh, are conscious of the problems associated with over-loading the various sewage systems which eventually outfall into the River Roach, and schemes are underway to improve the various effluents. Rochford Rural District Council covers an area virtually enclosing all the waters of the Roach and has recently carried out works of improvement to various purification plants. A detailed survey is proposed early in 1970. Cockle Industry The cockle industry at Leigh on Sea produced no problems during the year. The eight approved establishments continue to operate and visits were made from time to time to ensure that the requirements of the 1936 Shellfish Order were being complied with. The experimental suction type dredge used for gathering cockles reported previously as being used by one of the cockle firms, proved successful and its use has now spread to most of the firms engaged in this trade. No report of sickness following the consumption of cockles originating from the Leigh Sheds was received during the year. Mussels At the request of the Ministry of Agriculture, Fisheries and Food, Fisheries Laboratory, at Burnham on Crouch, the Authority assisted a shellfish survey into the presence of algal toxin. Samples of mussels were collected from the foreshore at Southend between the 8th April and the 29th September at two weekly intervals and these were sent by post to the Fisheries Laboratory for examination. Duringthe course of the survey thirteen samples were submitted, and none contained toxin. The following is an extract from a paper entitled 'Mussel Toxicity in Great Britain 1969' prepared by P.C. Wood, Esq., of the Ministry of Agriculture, Fisheries and Food Laboratory at. Burnham-on-Crouch, Mr. Wood has kindly agreed that this extract may be printed:— 'During 1968 an outbreak of paralytic shellfish poisoning affected 85 persons in north-east England (McCollum et al. 1968, Wood and Mason 1968, Wood 1968). As a result of this incident it was decided that during 1969 the levels of toxicity should be determined in (a) shellfish from the same general area, and (b) shellfish taken from the principal areas in England and Wales where bivalves were being exploited commercially. (a) Toxicity in the north-east. During the winter of 1968 arrangements were made to support the toxicity determinations with field observations which biological laboratories situated in the north-east would make if unusual biological events again became evident. The staff of these laboratories (Department of Agriculture and Fisheries for Scotland, Marine Laboratory, Aberdeen; Dove Marine Laboratory, Cullercoats; Welcome Marine Laboratory, Robin Hood's Bay) and also fishery officers and fishermen were asked to report unusual conditions, such as dis-coloured or highly phosphorescent water, and Mr. G. Robinson of the Scottish Marine Biological Association, Oceanographic Laboratory, Edinburgh, agreed to give special attention to Continuous Plankton Recorder samples taken from the area. 25 (b) Shellfish toxicity in other areas. At the time of writing (4 August 1969) a total of 116 samples of shellfish have been taken since March from 18 stations situated in areas of shellfish production on the coasts of England and Wales, between the River Humber in the east and Morecambe Bay in the west. Wherever possible, mussels have been taken, for these are among the most important accumulators of toxin; in other areas only cockles, oysters and escallops have been available. Toxin characteristic of that occurring in the north-east has not been detected in any of these samples. However, the normal acid extracts prepared from certain shellfish (usually oysters) have killed mice overnight, but without neurotoxic symptoms. This is believed to be caused by the presence in the extracts of heavy metals, mainly copper and zinc, accumulated by the shellfish. Tests are continuing.' SECTION XV MEDICAL INSPECTION OF ALIENS AND COMMONWEALTH IMIGRANTS 1. List of Medical Inspectors holding warrants of appointment at the 31st December, 1969 — Dr W.G. Swann, Dr D.T. Jones, Dr. W.T. Rougier Chapman, Dr. G.W. Aston Dr R.F. Armstrong, Dr. R.M. Best, Dr. H.M. Willoughby, Dr. J.A. Jones Dr W.T.G. Boul, Dr. D.J. Avery, Dr. W. Stott, Dr. M.J. Catton, Dr. R.D. Summers Dr. D. Jenkins, Dr. D.W. Keys, Dr R.G.S. Whitfield, Dr. A.E.L. de Thierry, Dr. J. Oakley Dr. R.N. Herson, Dr. B. Dalton, Dr. W.N. Whiteside, Dr, H C Maurice-Williams Dr, G.J. Leyden, Dr. D P. Rough, Dr. J.F. Buckley, Dr. D.J.R. Walters Dr. R. Tilley. 2. Other staff engaged on the work:Clerical staff at the central office. 3. Organisation of the work:— Aliens and Commonwealth Immigrants are examined by one of the above panel of doctors at the request of an Immigration Officer. The majority of ships carrying immigrants are dealt with by the Boarding Medical Officers but a part-time Medical Inspector may be called in to deal with a particular ship. Since the inception of the Commonwealth Immigrants Act the larger passenger ships have been boarded at Ports of call prior to their arrival in London as noted below. 4. Aliens Arrivals (a) Total number of arriving ships carrying aliens 2,197 (b) Total number of aliens — (i) arriving at the port 38,808 (ii) medically examined 93 (c) Certificates issued 1 Commonwealth Immigrant Arrivals (a) Commonwealth citizens subject to control 5,876 (b) Commonwealth citizens examined 364 (c) Certificates issued Nil Ships were boarded by members of the panel of doctors at the following ports:- Cherbourg 1 Lisbon 2 Rotterdam 3 Madeira 1 London 106 113 5. Medical examination of aliens and Commonwealth immigrants is carried out on board ship. SECTION XVI MISCELLANEOUS Arrangements for the burial on shore of persons who have died on board ship from infectious disease. NO CHANGE 26 CLEAN AIR ACTS, 1956 and 1968 THE DARK SMOKE (PERMITTED PERIODS) (VESSELS) REGULATIONS, 1958 The policy of the Authority in relation to either dark or black smoke, in taking remedial steps to abate emissions immediately they are observed has continued throughout the year. Black smoke contraventions of the Regulations in the case of two Greek registered vessels and one British registered vessel occurred during the year. There were dark smoke contraventions of the Regulations in respect of two British vessels. Notices were served accordingly. The reasons for these contraventions were fully investigated and in view of the explanations received, no legal action was taken. However, warning letters were sent to each owner. In the case of the two Greek vessels, the Greek Consul was informed of the contraventions. One application relating to the chimney height of a new mill complex being established in Tilbury Dock was dealt with during the year. THE TRANSPORT OF REFUSE BY LIGHTERS Routine visits to the refuse loading wharves and the regular inspection of the lighters employed in this trade, were continued throughout the year. One refuse loading wharf closed down in the early part of the year. This leaves a total of 8 riverside loading wharves and 2 enclosed loading docks still in operation, at the end of the year. The first part of the modernisation which commenced at one of the loading wharves last year has been completed. Work on the final stage is still in progress. When fully operational this wharf, together with the riverside refuse depot due to be constructed by the Greater London Council at Battersea should greatly facilitate the loading of refuse lighters. There has been an improvement in the loading of refuse at the other wharves with a slight reduction in the amount of refuse spilt into the river. This has mainly been due to modernisation already carried out by the Greater London Council and to the closure of the obsolete loading wharves. During the year proceedings were instituted on three occasions against one of the refuse lighter companies, for contraventions of the Authority's Refuse Byelaws. HOUSEBOATS The decline in the houseboat population referred to in 1968 continued during the year. The continued extension of Benfleet Urban District Council's refuse tip into the moorings at Benfleet Creek (West), made it impossible for the most boats to survive; although vacated, they could not be moved and eventually were demolished and buried under the refuse. By the end of the year there was no evidence that any boat on this mooring could still be occupied, unless of course the owners could find it possible to move them to a more favourable position. None of these boats, however, have consent to moor and it is most unlikely that the only two boats that might be worth moving will survive much longer. At the end of 1969 in the Benfleet and Canvey Island area, there were only 6 Houseboats used for human habitation, 2 in permanent occupation, 2 used as week-end boats, 1 used as a club house by a local yacht club and 1 unauthorised mooring of a boat in Benfleet Creek, Ferry Road which appears to be used as a workshop. Upper River Areas. There are 142 houseboats moored in the Upper Reaches of the River between London Bridge and Teddington. This is an increase of 11 over 1968. DANGEROUS DRUGS During the year seven certificates authorising the purchase of scheduled Dangerous Drugs were issued under the Dangerous Drugs (No. 2) Regulations, 1964, Regulation 13 (2) of which is as follows: — (a) The master of a foreign ship which is in a port in Great Britain shall be authorised to procure such quantity of drugs and preparations as may be certified by the medical officer of health of the port health authority within whose jurisdiction the ship is or, in his absence by the assistant medical officer of health, to be necessary for the equipment of the ship until it reaches its home port. 27 (b) A person who supplies a drug or preparation in accordance with a certificate given under this paragraph shall retain the certificate and mark it with the date on which the drug or preparation was supplied and keep it on his premises so as to be at all times available for inspection. FOOD HYGIENE (GENERAL) REGULATIONS 1960/62. The annual survey of the River Thames passenger-carrying launches, was carried out by the Board of Trade in the early part of the year. At the same time all necessary repairs, renewal of fittings and the thorough cleaning and repainting of these launches is attended to. The fresh water storage tanks are also cleaned and together with the distribution system, chlorinated prior to use. During the year, the first passenger carrying catamaran service in the United Kingdom commenced operation on the river. There are six floating catering establishments and twenty launches operating within the Authority's District, to which the above Regulations are applicable. They were regularly inspected during the year and the standard of food hygiene continued to be highly satisfactory. Of a total of 52 water samples drawn from the launches and their watering points during the year, adverse results were obtained on 12 occasions. In each case the source of contamination was traced and eliminated. In the year a total of 143 inspections were carried out under the Regulations. No proceedings were instituted, minor infringements being corrected at the time of the inspection. THE OPENING OF THE NEW QUARANTINE AND BOARDING STATION AT DENTON HOSPITAL The Corporation's new quarantine and boarding station was opened by the Right Honourable the Lord Mayor on 15th December 1969. Some two or three years ago it became apparent that serious consideration had to be given to the question of the establishment of a new boarding station. This was made necessary by the fact that the boarding station then in use, which was a converted hulk, the "Hygeia" lying in the river off Gravesend, had reached the end of its useful life and would before long be unsafe. Furthermore, the character of trade in the port was changing rapidly and the centre of gravity of the port was moving downstream, which necessitated alterations to the quarantine control system to enable greater control to be exercised over vessels entering the estuary of the river, but not coming up as far as Gravesend. After much discussion and consultation it was decided that the best results could be obtained by going ashore to establish the new boarding station, and by establishing it in a place where the following criteria might be met:— 1. There must be easy access to and from the river at all stages of the tide. 2. Such access must be privately owned by the Port Health Authority, because patients suffering from infectious diseases would be landed there. 3. The boarding station would be the focus of the medical control system and would therefore need to house the master set of the medical radio net, one end of the land-line link with the Thames Navigation Service Operations Room at Gravesend and also, of course, the ordinary G.P.O. telephones by which the radio messages passed via the stations at North Foreland and Niton are received by the boarding medical officers. 4. It is obviously a great benefit for the cubicle accommodation to be near the boarding station, particularly in foul weather which in the past has made travel between the old boarding station and the hospital very difficult at times. For all these reasons, the obvious choice was Denton Hospital which is about a mile down river from Gravesend, on the South Bank. Prior to 1948 the Corporation of London owned the Port of London Isolation Hospital at Denton on the south bank of the River Thames, about one mile down-river from Gravesend. It was at one time a very busy place, but following the decline in the number of cases of serious infectious disease entering the port the hospital became progressively less fully occupied and the number of buildings was reduced, while the standard of the remaining buildings was upgraded in keeping with modern practice. As a result, when the hospital was handed over to the National Health Service in 1948 it was made up of one large block, which included the administrative and domestic elements and eight cubicles set in a separate wing, and a second block consisting of 28 two dormitories, each intended to hold eight beds, and having its own domestic and cooking arrangements. The idea was to use the cubicles for the normal sporadic cases of various infectious diseases, while in the event of a major outbreak of one infectious disease on a ship, the dormitories would be brought into use and a complete cordon sanitaire could be thrown around the dormitory block, should this be necessary, without involving the rest of the hospital. Since 1948 there has been a further decline in the incidence of serious infectious disease in the port, and it became apparent some years ago that the domitory block was no longer fulfilling any useful purpose. By agreement with the local hospital authorities a lease was taken and conversion was commenced. In addition, the old jetty and pontoon at which patients had been landed, and which had for some years been in need of a major overhaul, was replaced with a much longer and more up-to-date structure. The new jetty is designed so that the biggest of the Authority's launches can come alongside at all states of the tide and in all weathers, and moorings are provided for the launches down-river of the jetty. The jetty itself leads to a door in the wall which protects the hospital from the easterly and north-easterly gales, which can be very severe during the winter months. The possibility of any member of the public having any contact with the operation of bringing an infectious patient ashore is therefore reduced to an absolute minimum. The boarding station provides accommodation for the following purposes:— (a) Living and sleeping quarters for the boarding medical officer on watch. (b) A working office for the Port Health Inspector who covers the lower river district and who uses one of the two launches based at Denton. (c) Living quarters for the launch crews on watch. (d) Office accommodation for the Senior Navigator and the Senior Engineer of the launch fleet. (e) Kitchen accommodation capable of providing adequate hot meals for all these men. (f) An operations room which can be in immediate contact by radio, land-line or telephone with any of the other branches of the Port Health Authority, other agencies working in the port, or any ship in the river. It is proposed that launches operating from Denton will cover the whole of the lower river down to Sea Reach. Masters of ships intending to berth below this will be required to report to the boarding medical officer on watch, via the new radio arrangements, and, if the doctor is satisfied, the ship will be allowed alongside her berth, where further health checks will be carried out by officers of Her Majesty's Customs and by Port Health Inspectors. If, however, the doctor considers it necessary, he has the capacity to go down-river and board the ship before she arrives off her berth, even though the latter may be in the Medway or at one of the other oil installations on the north shore of the estuary, carry out any investigations that are necessary, transfer any patients from ship to launch, and take them back for hospitalisation at Denton. Radio receiving and transmitting port The Department of Health and Social Security has now formally accepted the Corporation's application for the Port of London to be designated as a radio transmitting and receiving port under Section 12 of the Public Health (Ships) Regulations 1966. This is the first and only Port Health Authority in the United Kingdom to be authorised in this way. The new boarding and quarantine station at Denton has been linked with the Thames Navigation Service at Gravesend. Accordingly the Medical Officer on watch can talk direct to a ship whether he is in the hospital or on a launch at the time. The Port Medical Officer will thus be able to question the Master on the state of health of his ship and if this consultation is satisfactory the Port Medical Officer may permit him to take his ship alongside, but quarantine control will not be relaxed until the ship has been boarded by an officer of Her Majesty's Customs who will re-check the Maritime Declaration of Health and any other relevant documents and, if satisfied, grant pratique. If the Port Medical Officer is not satisfied by his radio discussion with the Master he will, in co-operation with the Thames Navigation Service, instruct the Master on what action he should take and will, if necessary, proceed down river himself to carry out any necessary investigations. If the customs officer on boarding the ship at the berth is not satisfied he will not grant pratique but will notify the Port Medical Officer who will take any necessary action. 29 Radar Radar equipment has been fitted to the Port Health launches "Humphry Morris" and "Victor Allcard" to facilitate navigation in conditions of bad visibility. NEW TILBURY GRAIN TERMINAL This installation constructed for the Port of London Authority commenced operating early in 1969. The first 1,000 ton barge on the Thames, the "MERIDIAN", called at the 900 feet long jetty on the 8th January to be followed by the Coaster "CLARITY" with 825 tons of grain from Amsterdam a week later. The first ocean going ship "M/V TREVAYLOR" arrived on the 18th March with a cargo of South African maize and from that time the new terminal became fully operational. Up to the end of the year 37 vessels had arrived with imported grains, their cargoes amounting to some 868,000 tons. Grain cargoes from the following producing areas have been discharged: Canada, U.S.A., Australia, Eastern Europe and South Africa, these falling into three main types: wheat, soya beans and maize. Imported grains received into the Storage Silos (Capacity 105,000 tons) are redelivered to the various receivers by one of the following methods of distribution:— 1. Coasters To other U.K. Ports 2. Lighters To various Thameside Premises and Wharves 3. Road Throughout the Country 4. Rail " " 5. Flour Mills at Tilbury via Direct Overhead Feed Elevator. During the year under review, the grain terminal jetty became a very busy area. Apart from the ocean bulk carriers (ships of up to 65,000 tons can be handled) numerous coasters, motorised barges and lighters were constantly being loaded or discharged, or waiting their turn to commence operations. As was to be expected with this type of trade, trouble with rodents soon became a problem. Staff involved with the terminal had to devote a great deal of time in keeping the various infestations to a minimum. Treatments, inspections and calls to the terminal became a daily routine and eventually a detailed survey was undertaken and recommendations made as to additional rat-proofing measures to be carried out in certain parts of the structure. The various rodenticides at present available leave a lot to be desired when dealing with this type of premises. The laying of poison baits to complete a full treatment may take several days, and many hours are spent on each minor infestation sometimes with very little result, especially when adequate alternative food material is available. Whilst every endeavour will continue to be made to contain the various infestations that will become established, earnest consideration will have to be given to the use of other poisons, preferably liquids, which would work admirably in the dry atmosphere associated with grain handling establishments. By the end of the year the terminal was handling 60,000 tons of grain per week. It is anticipated that this figure will be exceeded during 1970 with a further increase in the number of vessels involved in the trade. DISEASES OF ANIMALS ACT 1950 & ASSOCIATED ACTS Mr. G.S. Wiggins M.R.C.V.S. Veterinary Officer for the City of London, has submitted the following report:— The administration of the Diseases of Animals Act 1950 in regard to the importation of animals is the responsibility of the Corporation for the whole of Greater London under the terms of the London Government Act 1963. 30 Two new Orders, affecting the importation of animals, came into operation during the year. The Exotic Animals (Importation) Order 1969 imposes a general prohibition on the importation of such animals which are prescribed in the Order and requires any such animals brought to Great Britain in contravention of the Order (with exceptions) to be slaughtered. The Importation of Dogs and Cats (Amendment) Order 1969 extends the quarantine period for imported dogs and cats from six to eight months. Some difficulty has been experienced with regard to the holding of imported animals which are awaiting transport to quarantine or in transit at the airport and, in view of this and the fact that restrictions have now been extended to exotic animals, the Port and City of London Health Committee agreed in principle to the Corporation setting up proper facilities for handling these animals. Diseases of Animals Act — Importations Numerous cases occurred of dogs and cats arriving at Heathrow Airport without the necessary import licence of the Ministry of Agriculture, Fisheries and Food. Arrangements were made for 107 dogs and 47 cats to be placed into quarantine kennels. There were two instances of animals arriving dead at the airport. Post mortem examinations were carried out and reports submitted to the airlines concerned. The animals were two Himalayan bear cubs and a pekingese dog and the causes of death were due to heart failure which in the case of the bears followed the development of pneumonia and in the case of the dog may have been predisposed by being contained for a long period or by thrombus formation on the heart valves. The airline which carried the dog was also informed that the container in which the animal had travelled was of a very poor construction. In November an assistant at the R.S.P.C.A. Animal Hostel, Heathrow, was bitten by a dog which was in transit. The assistant received hospital treatment and the animal was detained for ten days, following which, having remained healthy, it was allowed to continue its journey. A visit was made to West India Dock in June, concerning the importation of ten cheetahs which were destined for various zoos in this country. The animals were all very fit and the cages well constructed. Importation of Dogs and Cats Order 1928 In February it was reported that a dog had been imported in contravention of the above Order and was being kept at an address in Chelsea. A similar case occurred in July when information was received that a cat had been illegally imported from Hong Kong. In both instances extensive enquiries were made, in the latter case the assistance of the Veterinary Authorities and Police in Manchester being enlisted, but despite this, due to lack of evidence it was decided that no action could be taken in either case. Two cases occurred of dogs escaping from their containers whilst in transit at Heathrow Airport. In the first case, which occurred in May, the dog was free for two days and was therefore placed into a quarantine ktnnel for ten days. The second dog was re-captured after ten minutes and allowed to continue its journey on condition that a health report be furnished after ten days. Enquiries were carried out in several cases, concerning the alleged illegal importation of animals at the Port of Dover. In May it was reported that a dog had been illegally landed and brought to London. The animal was traced and arrangements made for it to be placed into quarantine. In December it was reported that the owner of a dog, having previously stated that she threw the animal overboard as the vessel on which she was travelling entered Dover, altered her story and admitted having brought the dog into the country. The animal had since been brought to London. Also in December, enquiries were carried out concerning a dog which was discovered in a parked vehicle in Adeline Place, W.C.1., and was suspected of being illegally imported at Dover. In each of these cases reports were sent to the authorities in Dover. There were two cases in September of dogs escaping or running loose from vessels in the Port of London. In the first instance a dog escaped from the m.v. 'Gerda Smits', berthed at Poplar Dock. It was re-captured and returned to the vessel, but from enquiries it transpired that the animal had been taken ashore on previous occasions and it was, therefore, decided that proceedings should be instituted. The second case concerned a dog which was allowed to run loose from the m.v. 'Vava' at West India Dock. Cautionary letters were addressed to the Master and Agents for the vessel. A yacht which had been berthed at Tower Pier with several dogs on board during 1968, returned this year and was visited in September. The dogs, as before, were kept on a lower deck from which there was no possibility of escape; they were in good condition. 31 Following a report that the Order was not being complied with in that a dog was allowed to walk from an aircraft to the passenger lounge at Heathrow Airport, letters were addressed to the airlines concerned. Animals (Sea Transport) Order 1930 - Horses (Sea Transport) Order 1952 To ensure that the terms and conditions of the above Orders were complied with, numerous visits were made to the docks in connection with the exportation of animals to various countries. The animals comprised 11 pigs, 3 donkeys, 1 pony, 8 cattle, 8 horses and 12 calves and were exported for exhibition, breeding, racing and riding. In some cases instructions were given that humane killers and ammunition must be obtained before animals could be allowed to travel and these instructions were carried out. Export Certificates Requests were received from fourteen firms for certificates of health to enable them to export various commodities. 107 certificates were issued. Rabies Order 1938 As a result of the case of rabies in a dog in Camberley, Surrey, many enquiries were received from the general public and investigations carried out into suspected cases of the disease in the London area. In one case a restriction notice was served on a dog which had been in contact with another dog that had since died. This was withdrawn after tests on the dead dog had proved negative for rabies. Several restriction notices were served by the Ministry of Agriculture, Fisheries and Food and checks were made to ascertain that these were being conformed to. FOOD INSPECTION 1969 The total amount of foodstuffs detained for examination and either condemned as unfit for human consumption and destroyed or otherwise disposed of under guarantee and supervision was 2094 tons 4 cwt. 2 qrs. 5 lbs. The following is a summary showing methods of disposal:— Weight 1969 Comparable Weight 1968 Tons Cwts. Qrs. Lbs. Tons Cwts. Qrs. Lbs. Burnt 51 9 2 8 74 11 2 4 Buried 496 13 1 7 779 14 0 17 Contractor 17 13 1 20 36 12 1 19 *Other Districts 155 8 2 11 195 12 2 21 *Animal Feeding 1214 0 2 4 188 19 3 26 Re Exported 158 19 0 11 307 10 1 24 Totals 2094 4 2 5 1583 1 0 27 Items marked * were released with the agreement of and under the supervision of local Medical Officers of Health. Of the 2094 tons listed above the principal items and methods of disposal consisted of:— Burnt Tons Cwts 309 Tins, 285 Cartons, 15 Jars of fruit, fish, meat, vegetables, pulps, juices - burst, blown, leaking and broken 1 16 7 Bags Lentils — Contaminated sweepings 2 40 Bags, 72 Boxes and Cartons beans - Rodent damaged, stained and wasty 1 18 205 Bags Onions — Oil stained, loose collected, wet and crushed 12 56 Boxes Potatoes — Wasty.. 11 1905 Baskets, 159 Cartons, 40 Packages Tomatoes — smashed, broken, wasty and oil stained 15 0 112 Cartons, 29 Trays and 7 Cases Melons — Wasty, smashed and broken 1 8 112 Bags Figs — Vermin infested, wet and stained 1 10 35 Cartons Apples — Contaminated by hydraulic fluid 11 Quantity Bananas — Wasty and fire damaged 19 3 9 Cartons Cheese — Dock water damaged 2 1 Cask Ginger — Gross contamination 2 65 Cartons Spaghetti - Vermin infested 16 32 Burnt (Cont'd) Tons Cwts 10 Cartons Soutzoukko — Mouldy 3 8 Baskets Calabashs — Wasty 2 12 Bags Flour — Faecal contamination 15 18 Bags Sugar — Sweepings 13 6 Cartons Curry Mix — Uncertificated 2 9 Cartons Eggs — Broken and crushed 1 7 Cartons Egg Albumen — Extraneous contamination 3 1 Case Mixed Foodstuff — Damaged and contaminated 1 7 Cartons Dairy Produce — Oil stained, dock water and rodent damaged 2 16 Pieces of Beef — Rejected Ship stores 3 Buried 24,707 tins, 3694 cartons, 1620 Jars of fruit, fish, meat, vegetables, pulps and juices — burst blown, leaking and broken 105 3 150 Cartons Frosting Mix — Contained prohibited colouring matter 16 53 Bags. 61 Cartons. 15 packets Rice — Loose collected, sweepings, dirty, wet damaged and contaminated with bird droppings and refuse water 2 2 60 Cartons, 9 Packets Macaroni Products — Flood damaged and oil contaminated 14 16 Cartons Spaghetti — Damaged and infested 4 4 Bags Maize Sweepings — Extraneous contamination 5 86 Cartons and 13 Boxes Cheddar Cheese — Heat and dock water damaged 2 4 5 Bags Flour — Bilge water damaged 3 1 Bag Gram Dall — Rodent damaged and contaminated 1 6 Bags Desiccated Coconut — Burst and rodent contaminated 4 24 Bags and Quantity of Shelled Almonds — Dirty, sweepings 1 8 17 Cases Walnut Kernels — Smashed and contaminated 9 35 Cartons, 2 Bags Prunes — Mouldy, contaminated, loose collected, sweepings 11 1 Cask Raspberries, 1 Cask Cranberries — Burst, damaged and contaminated 4 6 Cartons Honey — Rodent damaged and contaminated 1 5 Baskets Ginger in Syrup — Contaminated 5 24 Boxes Dates — Damaged, extraneous contamination 12 24 Boxes Sultanas — Oil contaminated and wet stained 5 450 Cartons Fruit Salad — Blown 3 12 1245 Cases, 300 Boxes, 793 Crates and Quantity Melons - Loose collected, wasty and damaged 33 14 Quantity of Banana Waste — Wasty 46 18 22 Cartons and 2 Containers Apples — Crushed and wasty 1 12 35 3arrels and 1 Cask Orange juice — Dock water damaged & unfit 4 0 1 Drum Lemon juice — Dirt contaminated 2 5 Casks Raspberry Pulp and Apricot pulp — Sour and mouldy or contaminated 1 5 1 Hogshead Bitter Orange Pulp — Extraneous contamination 4 6 Cartons Dried Apricots — Wet stained 1 28 Cartons Oranges — Crushed 9 4 Cartons Chochos — Wet and wasty 2 2 Bags Marjoram — Dock water damaged 1 7 Bags Anardana (Pomegranate seeds) — Insect infested 10 287 Baskets Tomatoes — Wasty 2 1 14 Barrels, 3 casks Pickles, Chutney and Mango Chutney — Burst and contaminated 15 1 Barrel Onions in Brine — Broken, Brine leaked away 2 329 Cases, 11 Cartons, 1039 Bags and quantity of onions — Diesel oil stained, wet, sprouting, crushed, loose collected and decomposing 24 9 12 Bags new, 42 Cases sweet, 203 Bags potatoes and 400 bundles ready cooked potatoes — Wasty and unsound 16 17 2 Fibre bags dehydrated Potato — Broken, contents contaminated 10 12 Bags and quantity of Lentils - Loose collected badly stained and contaminated 19 269 Bags Peas, Beans and Seeds — Loose collected, sweepings, wet and mouldy, dirty and contaminated 11 18 11 Part Bags Lima Beans — Contaminated hold sweepings 11 33 Buried (cont) Tons Cwts 7 Cartons, 19 Packages Pickled Radish - Torn and contents leaking 1 2 Cartons Cocoa Butter — Dock water damaged 1 2 Cases Warian — Insect infested 1 2 Packages Pickled Beef — Unwholesome 1 15 Cartons Turkey Roll — Unwholesome 6 5 Blocks Frozen Whalemeat — No official certificate 1 7 Cartons Frozen Prawns — Sweepings, gross contamination 1 Various ships stores — Unfit 2 8 9 Cartons Lamb Livers — Soft and putrid 3 4043 Chests and 1 Bag Tea and 2 Chests Tea Fannings — Dock water, wet and vermin damaged, mouldy and contaminated 225 9 Contractor Various quantities of meat and offal including 365 lambs and also 12 cartons of butter, unfit for human consumption 17 13 Other Districts 486 Cartons Pineapple slices — Rusted and leaking cans, released for sorting 8 13 57 Cartons Currants — Wet damaged and mouldy, Released for reconditioning 14 460 Bags Rice — Beetle infested, released for rebagging and cleaning 23 18 113 Bags Tapioca Flour — Damaged bags, dirty, released for industrial purposes 4 12 54 Bags Sugar sweepings — Released for industrial use 3 1 3106 Cartons and 511 boxes Cheese — contaminated with photographic chemicals, heat damaged, released for processing 58 7 10 Boxes Bombay Duck — Insect infested, released for fumigation and cleaning 10 49 Bags Groundnuts in shell — Insect infested, released for testing Decorticator 1 19 347 Bags white pea beans — Wet damaged, released for sorting 15 15 181 Cartons Beef Livers — Unfit, released for sterilization and pet food manufacture 4 17 99 Cartons boneless veal — Prohibited meat, released for sterilization and pet food manufacture 2 15 Quantity of Yeast — Unwholesome, released for destruction 14 15 276 Chests Tea — 235, Wet damaged, released for reconditioning. 41 contaminated with palm oil, released for examination by local authority 15 8 , Animal Feeding 154 Bags Flour — Wet damaged and extraneous contamination 9 12 635 Cartons, 20 bags Grain Flour/Dhall — Wet damaged, mouldy 11 16 Quantity of wheat — River water and wet damaged 1170 0 115 Bags Rice - Rodent damaged and contaminated 5 15 25 Bags Maize Sweepings — Contaminated with extraneous matter 1 6 63 Cartons Macaroni — Water contaminated and mouldy 15 93 Cartons, 18 Bags milk powder — Dock water contaminated, dirty, damaged, burst and wet bags 2 10 40 Bags Lentils — Wet damaged 2 0 139 Bags Peas — Loose collected, sweepings, heavy extraneous contamination, wet damaged, mouldy 6 1 6 Bags Michigan Pea Beans — Water damaged 2 253 Bags Groundnuts in shell — 3, sweepings. 250, Contained aflatoxin 3 5 12 Sacks Bleached Almonds — Loose collected and dirty 14 Re-exported 76 Cartons Hoummous Sesame Dip — Contained excess lead and prohibited preservative 1 0 3 Cartons Fish roepaste — Contained prohibited preservative and colouring matter 1 20 Cartons Radish and Seaweed - Contained prohibited preservative and colouring matter 5 34 Re-exported (cont) Tons Cwts 45 Cartons Pate de Foie Gras — No official certificates 10 2 Cases Bean Paste — Contained prohibited preservative 2 20 Cases oyster and 3 cases Sweet and Sour Sauce — Fermenting and contained prohibited colouring matter and preservative 19 20 Cartons Tehina Sauce — Contained excess lead and prohibited preservative 6 848 Cartons Tomato Puree — Contained excess mould 22 15 13 Cases Chilli Sauce — Contained Prohibited colouring matter and preservative 6 60 Barrels Soy Sauce — Contained prohibited preservative 1 10 50 Cartons Garlic Spread — Contained prohibited preservative 12 140 Cartons Vegetable Pate — Contained prohibited preservative 1 3 25 Cartons mustard — Contained prohibited preservative 5 5 Cases Chilli Powder — Contained prohibited colouring matter 1 60 Cases Curry Powder — Contained prohibited colouring matter 1 16 20 Cartons Squid in Juice - Contained Excess Tin and Lead 8 224 Cartons Raspberries in Syrup — Contained prohibited colouring matter 5 12 93 Casks Raspberry Pulp — Contained excess preservative 2 6 455 Cases Dessert Toppings — Contained prohibited colouring matter and preservatives 2 8 20 Cases Soft Drink Powder — Contained prohibited Emulsifier 5 107 Cartons Confectionery — Contained prohibited colouring matter 2 11 800 Bags Groundnuts in shells — Aflatoxin contaminated 10 0 41 Cartons Various Japanese Foodstuffs — Contained prohibited colouring matter and preservative and no official certificates 16 2 Cartons Chick Peas with Bacon — No official certificates 1 6 Cartons Curry Roux and Hayashi Roux — No official certificates 1 15 Cartons Sliced Bacon — Incorrectly certificated 3 81 Casks Hog Casings — No official certificates, 1 Container sheep Casings — Incorrectly certificated 11 7 23 Cases and 16 Cartons Tinned meat and Meat Products — No official certificates 1 5 750 Cartons unrendered Pig Fat — Prohibited Meat (scraps and trimmings) 20 8 2211 Cartons Boneless Lamb and 365 Cartons Boneless Beef — Prohibited Meat (scraps and trimmings) 69 4 The following figures have been given by the Port of London Authority and acknowledgement is made for their help. The figures are in respect of the year 1969 and are tonnages of foodstuffs landed on their quays and handled by them during the year. Meat, chilled and frozen 436,694 Dairy produce 17,058 Fresh and frozen fruit 156,166 Fresh and frozen vegetables 46,383 Dried fruit and nuts 17,942 Canned and bottled foods 130,726 Grain.and animal feedstuffs in bulk 952,277 Grain, flour, animal feedstuffs and seed in bags 34,445 Tea 60,334 Other foodstuffs not included above 46,149 1,898,174 Taking the total weight of items in the first table as 2,094 tons, the amount dealt with expressed as a percentage of imports for the same period equals .11%. FOOD SAMPLING Sampling — Public Analyst During the year 509 samples were sent to the Public Analyst as follows:— Sample Satisfactory Unsatisfactory Action Shrimps 2 0 Shrimp cocktail 1 0 Shrimp cream 1 0 35 Sample Satisfactory Unsatisfactory Action Minced prawns in spice 1 0 Stuffed carp 1 0 Angel liver 1 0 Incorrect label — letters to merchant and local M.O.H. Tuna fish 1 0 Squid slices 1 0 Squid in juice 0 1 Contained excess lead and tin — re-exported Fish sambal 1 0 Curried fish 1 0 Curried cockle shell 1 0 Seafood roll 0 1 Contained excess preservative — released as trade sample Contained prohibited colouring matter — re-exported Caviar substitute 0 1 Corned beef sausage 1 0 Beef curry and rice 1 0 Dried beef sausages 1 0 Sliced dried beef 1 0 Pork luncheon meat 1 0 Incorrect label — letter to merchant Chopped ham and pork 1 0 Pork and beans in sauce 0 1 Contained insufficient meat — released as samples for U.S. Forces Chopped liver 1 0 Sausages in brine 1 0 Spiced haslet 1 0 Meat masala 1 0 Incorrect label — letters to merchant and local MOH Boneless chicken 1 0 Duck pate with orange 1 0 Incorrect label —letters to merchant and local MOH Fried duck 1 0 Edible gelatin 1 0 Superfine ghee 1 0 Green peas 1 0 Brussel sprouts 1 0 Broad & Kidney beans 3 0 Cut green beans 1 0 High tin content—letters to merchant and local MOH Refried beans 1 0 Celery hearts 1 0 Vegetable tinda 1 0 Karela in brine 0 6 Contained excess tin — 5 destroyed, 1 re-exported Molokhia (leaves) 1 0 Kibbled onions 1 0 Wah Loong (dried vegetable) 1 0 Incorrect label — letters to merchant and local MOH Instant mashed potato 1 0 Foul Medames 1 0 Salted Chinese Turnip 1 0 Pickled lettuce 1 0 Pickled cabbage 1 0 Bottled prepared vegetable 1 0 Russian salad 1 0 Garden eggs in brine 1 0 Preserved harar 1 0 Pickled radish & vegetable 0 2 Contained prohibited preservative — re-exported Incorrect label — letter to merchant Preserved vegetables 1 0 Preserved radishes 1 0 Red bean curd 1 0 36 Sample Satisfactory Unsatisfactory Action Gooseberries/Cherries/ Strawberries in syrup 4 0 Cocktail cherries 0 2 Contained prohibited colouring matter — 1. Destroyed 1. Letter to merchant and local MOH Ripe olives 2 0 Fruit cocktail 2 0 Bitter melon 1 0 Melon salad 1 0 Sliced ginger 0 1 Contained prohibited colouring matter and preservative — re-exported Peeled tomatoes 1 0 Dates 2 0 Stuffed oranges 1 0 Incorrect label—letters to merchant and local MOH Prunes 1 0 Sultanas 0 1 Oily taint—letter to local MOH, merchant informed Infested with beetles and larvae — destroyed Anardana (pomegranate seeds 1 1 Dried apricots 1 0 Dehydrated bananas 1 0 Dehydrated peach slices 1 0 Preserved fruit 3 0 Citrus peel 3 1 Contained excess preservative — letters to merchant and local MOH Date jam 1 0 Preserved amla and apple 2 0 Incorrect label — letters to merchant and local MOH Grass Jelly 1 0 - Chutney/Pickles 12 2 Contained prohibited preservative 2. re-exported 1. Incorrect label — letters to merchant and local MOH Peppers 3 0 Dehydrated peppers 1 0 Pepper — Ground 0 1 Adulterated with ground rice — re-exported Gourmet powder 1 0 Incorrect label — letters to merchant and local MOH Spice powder 1 0 Chilli powder 2 1 Contained prohibited colouring matter — re-exported Curry powder 5 1 Contained prohibited colouring matter — re-exported Chinese mustard 1 0 Water chestnuts 1 0 Shelled pistachio nuts 1 0 Almond coconut 1 0 Groundnuts 41 4 Aflatoxin contaminated 1. released for compounding into animal food. Honey 4 1 3. Re-exported Contained excess lead — letters to merchant and local MOH 37 Sample Satisfactory Unsatisfactory Action Cake and frosting mixes 9 3 1. Contained prohibited colouring matter — destroyed 1 Contained insufficient butter fat — letter to merchant 1 Contained prohibited emulsifier — letter to merchant and local MOH 2 Incorrect label — letters to merchant and local MOH Chocolate mousse mix 0 1 Contained prohibited colouring matter—letters to merchant and local MOH Sour cream chocolate fudge mix 1 0 Pancake mix 2 0 Angel food de luxe mix 0 1 Contained prohibited emulsifier — re-exported Blueberry muffin mix 1 0 Flavoured puddings 4 1 Contained prohibited colouring matter — released for research work only Chocolate fudge and strawberry instant breakfasts 2 0 Incorrect labels — letters to merchant and local MOH 6.Contained prohibited colouring matterre-exported 2 Contained prohibited preservative — re-exported Contained prohibited colouring matter — destroyed Dessert Toppings 2 8 Gelatin desserts 6 1 Whisky sour cakes 1 0 Brandy cakes 1 0 Rum cakes 1 0 Panettone cake 1 0 Southern Pecan Pie 1 0 Cherry pie filling 1 0 Crepes Suzettes 1 0 Quick jelly mix 1 0 Butter and sugar mixture 1 0 Orange fruit filling case 1 0 Orange nectar 0 Frosting cream 0 Raspberry bits 1 0 Scented pan masala 1 0 Soutzoukko (confectionery) 0 1 Attacked by mould — destroyed Contained prohibited colouring matter — destroyed Contained prohibited colouring matter — re-exported Incorrect label —letter to merchant and local MOH Contained prohibited colouring matter re-exported Bubble gum 6 1 Sweets 13 3 Assorted glace fruits 1 0 Fruits and candies 0 1 Confectionery bars 1 0 Nougat sticks 1 0 Fruit dragees 1 0 Whistle snacks 1 0 38 39 Sample Satisfactory Unsatisfactory Action Candy kits 0 3 Contained prohibited colouring matter — re-exported Rum grog mix 1 0 Mai Tai mix 0 1 Contained prohibited colouring matter — letter to local MOH Root beer 1 0 Incorrect label - letters to merchant and local MOH Jal Jeera 1 0 Incorrect label — letters to merchant and local MOH Canned drinks 1 2 Contained prohibited preservative — released as trade samples. Soft drink mix 0 2 1 Contained prohibited colouring matter — destroyed 1 Contained prohibited emulsifier — re-exported Soft drink powders 1 0 Drink mix straws 1 0 Soya bean milk 1 0 Fermented milk 1 0 Incorrect label — letters to merchant and local MOH Lard 4 0 Fruit pulp 5 0 Apricot puree 1 0 Incorrect label — letter to merchant Sate puree 0 1 Contained prohibited preservative — re-exported Tomato puree 2 1 Contained excessive mould — re-exported Tomato paste 11 2 Contained excessive mould — re-exported Chilli paste 1 0 Incorrect label — letter to merchant Hydrolised vegetable paste 1 0 Liverwurst paste 1 0 Toast paste 1 0 Sweetened sesame paste 1 0 Fruit Juices 8 0 1 Incorrect label —letters to merchant and local MOH Blackcurrant concentrate 1 0 Syrup 2 2 Contained prohibited preservative — destroyed Smorgas spread 1 0 Asparagus spread 1 0 Batter mix powder 1 0 Onion powder 2 0 Custard powder 1 0 Mustard powder 0 1 Contained insufficient allylisothiocyanate letters to merchant and local MOH Worcestershire sauce 2 0 Sesame sauce 1 0 Mayonnaise sauce 3 0 Hot sauce 1 0 Chilli sauce 5 1 Contained prohibited preservative and colouring matter — re-exported Soy sauce 6 1 Contained prohibited preservative — re-exported Mushroom soy sauce 1 0 Incorrect label —letters to merchant and local MOH Ground bean sauce 1 0 Tartar sauce 1 0 Seasoning sauce 2 0 1 Incorrect label—letters to merchant and local MOH Sample Satisfactory Unsatisfactory Action Hoi Lin sauce 1 0 Tehina sauce 1 1 Contained excess leadre-exported Barbecue sauce 2 0 Basil sauce 1 0 Fish sauce 1 0 Incorrect label — letters to merchant and local MOH Clam sauce 1 0 Fish flavoured sauce 1 0 Oyster flavoured sauce 4 0 2 Incorrect label — letters to merchant and local MOH Sherry, rum and brandy sauces 3 0 Incorrect labels —letters to merchant and local MOH Chunky apple sauce with spice 1 0 Curry sauce mix 1 3 1 Incorrect label — letters to merchant and local MOH 3 Contained up to 34% animal fat but uncertificated 2. destroyed 1. re-exported Relish 1 1 Contained prohibited preservative — destroyed Mayonnaise & Assorted dressings 1 4 Contained prohibited preservative — released as trade sample Thousand Island dressing 0 1 Contained prohibited preservative — re-exported Wine vinegar 2 0 Rice vinegar 1 1 1 Incorrect label—letters to merchant and local MOH 1 Contained insufficient acetic acid —letters to merchant and local MOH Fish gravy 1 0 Incorrect label —letters to merchant and local MOH Mayonnaise, mustard and horse radish 0 3 Contained prohibited preservative — released for sale as foreign ship's stores. Kangaroo tail soup 1 0 Artichoke soup 1 0 Asparagus soup 1 0 Oxtail soup 1 0 Turtle soup 1 0 Tomato soup with rice 1 0 Asparagus soup with rice 1 0 Beef soup mixes 0 2 Contained insufficient meat — letter to merchant Mustard 0 1 Contained prohibited preservative — re-exported Preserved mustard 1 0 Incorrect label —letters to merchant and local MOH Bean curd chilli 1 0 Hoummous sesame dip 0 3 Contained prohibited preservative — re-exported Hummus 2 0 Vegetable pate 0 1 Contained prohibited preservative — re-exported Prepared seaweed 1 0 Incorrect label—letters to merchant and local MOH Radish and seaweed 0 1 Contained prohibited preservative — re-exported Horseradish dip mix 1 0 Vegetable shortening 1 0 Shortening mix 1 0 Fallafel mix 1 0 Incorrect label - letters to merchant and local MOH 40 Sample Satisfactory Unsatisfactory Action Ravioli in tomato sauce 1 0 Noodles 5 0 Vermicelli 1 0 Incorrect label—letters to merchant and local MOH Mexican curry roux and hayashi roux 0 2 Contained up to 34% animal fat but uncertificated re-exported Savoury biscuits 2 0 Cream substitute 1 0 Cheese with ham 0 1 Contained excess water and incorrectly labelled — letters to merchant and local MOH Parmesan cheese 1 0 Cocoa butter substitute 1 0 Preserved eggs 1 0 Meat tenderizer 1 0 Pure vegetable ghee 1 0 Incorrect label —letters to merchant and local MOH Natural Wood Smoke Flavouring 1 0 Vanilla flavouring 1 0 Coffee 1 0 Tea 11 1 Contained excess extraneous mineral particles — released for blending purposes only Tea substitutes 3 0 1 Incorrect label—letters to merchant and local MOH Flour 21 9 2 Contained no chalk — letters to merchants. 7 Contained insufficient or excess chalk — 5. released for re-mixing 2. letters to merchants Bread improver 2 0 Not labelled —letter to merchants Water 3 0 Water (Ice from frozen carcases) 2 0 Animal feeding stuffs 12 0 Pet food 1 0 Sampling — Bacteriological Samples Satisfactory Unsatisfactory Action Chilled beef cuts (370 from Argentina 6 from Brazil) 374 2 Salmonella contaminated — notified to Ministry of Agriculture, Dept. of Health and Social Security and other local authorities Minced beef (Australian) 15 0 Veal and fillet steaks 7 1 Salmonella contaminated — destroyed Meat products 8 0 Frozen prawns/Shrimps 366 0 9 High plate counts — Letters to merchants Canned shrimps 2 8 Contents breaking down — destroyed Frozen crabmeat 3 0 Frozen lobster meat 6 0 Jellyfish 1 0 Seafood roll 1 0 Dried whole egg 34 0 Frozen whole egg 121 0 Dried egg albumen 558 2 Salmonella contaminated — destroyed 41 Sample Satisfactory Unsatisfactory Action Dried egg yolk 3 0 Duck egg 1 0 Egg coating powder 1 0 Vegetable pate 0 1 Salmonella contaminated — re-exported Desiccated coconut 4 0 Parmesan cheese 6 0 Pet food 1 0 Water 4 0 WINE STORAGE - B WAREHOUSE. SHEERNESS This small warehouse for the storage of wine in fibreglass tanks (classified by the trade as vats) came into operation in 1969. The Staffestein tanks are cylindrical in shape, approximately 20-feet in height and 6-feet in diameter, and are supported off the ground by eight iron pegs. The tanks are slightly opaque and hold some 4,900 galls, of wine. Although all the tanks appear to be of the same dimensions there is a slight variation in storage capacity. At present there are ten tanks installed in two incomplete rows, with a gantry running between the rows to give access to the top of the tanks. When the rows are completed there will be sixteen tanks on either side of the building. In addition to the draw-off taps and access covers, there is a stainless steel pipe, called a 'rousing' pipe, fitted perpendicularly to each tank. Connections can be made from the top and bottom of the tank to the pipe so as to allow the wine to circulate or 'rouse', as it is known. The tanks when new had first to be 'pickled' with wine before being used for storage. Subsequently, when each is emptied the tank is washed and steamed before refilling. No detergents or sterilizing agents are ever used. The tanks will be used ultimately to hold wine pumped direct from ship, although at present wine (e.g. sherry) from butts is pumped into the tanks for storage, and later from the tanks to road bowsers for transportation to a London bottling plant. Wine at present is only being held in these tanks for about a month on average. This saves a considerable amount of space, cost in renting stowage for barrels of wine, and also time in filling a road bowser. Previously a bowser was filled by pumping out a number of required barrels. CONTAINER TRAFFIC As was expected this form of cargo transportation continued to expand dramatically again during 1969. The container terminals operating by the end of 1968 at Tilbury all increased their throughput during the year and some additional international trades were attracted to the terminals. Unfortunately, the dock workers refused to work on the new Overseas Container Terminal at 39 Berth, Tilbury, which was scheduled to become operational in May. This fact, no doubt, caused the deferred development of three other similar berths. These four berths did not therefore contribute in any way to the Container workings at Tilbury during 1969. Despite this fact, the total number of imported containers carried by the major operators rose from 19,500 in 1968 to over 45,000 in 1969. (See Tables I and II). Although none from Australia was imported direct through 39 Berth when the new service was introduced in May, an enormous number of these were, in fact, handled through 43 berth. These containers were transhipped from the Continent by small continental feeder ships which were not affected by the ban imposed by the Tilbury dockworkers. A separate report on the operation of 43 Berth follows. The year saw the arrival of further new purpose-built container tonnage to the operational berths. The number of these arrivals reported in the 1968 Annual Report (557) increased to 944,. (see Tables I and II) and whether large or small they all had the same common factor, a very short stay in port. 42 The large ocean container ships were fortunate if they remained in Port for 24 hours, and 12 hours was more usual. The small continental carriers usually arrived and sailed in three or four hours. This fact is emphasised by the number of small container ships arriving at the "short sea container berth" (No. 43) during the year. There were, in fact, 679 of these arrivals and nearly half a million tons of cargo was handled — imports and exports. Over 42,000 containers were handled on this berth alone; 24,500 carried imports and of these 5,588 contained foodstuffs. It is anticipated that the present ban on the Australian Terminal at 39 Berth will be lifted early in 1970. Once this has been done it is reasonable to assume that the other berths awaiting development will, in fact, be completed and become operational. From experience gained to date, the control of containerised foods occupies a great deal of time of the Officers engaged in this type of food control. Manifest documentation is necessary and exceedingly important in the efficiency of carrying out the statutory duties imposed on the Authority by the Imported Food Regulations 1968, and they continue to increase. The expansion in this type of traffic at Tilbury coupled with the possible introduction of "shift working" during 1970 will place an increasing burden on the existing staff and consideration will have to be given to the employment of additional Port Health Inspectors if the efficiency of the service is to be maintained. 43 Berth Operations The joint O.C.L./A.C.T. Australian Service using containers for the transportation of both general cargo and foodstuffs was inaugurated this year with the arrival of the "ENCOUNTER BAY" at Antwerp on the 14th May, 1969. Because of labour difficulties at Tilbury, which made the new 39 Container Berth idle, the initial container vessel and subsequent vessels were obliged to discharge their containers either at Antwerp or Rotterdam, thus requiring the transhipment of all London containers by feeder ship service through the 43 (E.U.R.) Berth at Tilbury. A total of 21 Container Vessels arrived at Continental Ports during 1969. The total number of food containers dealt with at Tilbury is shown in Table III. Throughout the period of operation an average 10% examination has been carried out of all non-refrigerated containers. In respect of Frozen Meats, both edible and inedible, the % examination has been between 50% and 100% and has been visual. During this first 7 months of operation, many difficulties have arisen in the examination of containers because of labour difficulties in handling. These, however, in the main have been overcome with the assistance and co-operation of both the Shipping Companies and the Port of London Authority. This first period has, therefore, provided invaluable experience in the handling of containerised foods from Australia. TABLE I Types of Container Terminal, showing Total Container Imports compared with Total Food Container Imports. Tonnages are approximate. 1969 TYPE OF BERTH Total Containers Imported Total Food Containers Imported Total Tonnage All Containers Total Tonnage Food Containers Total Number Arrivals OCEAN CONTAINER TERMINAL HANDLING SOME SHORT SEA TRADERS 10,130 1,280 130,200 14,000 109 SHORT SEA CONTAINER TERMINAL ALSO RECEIVING TRANSHIPPED AUSTRALIAN CONTAINERS 24,500 5,588 223,500 80,000 679 SCANDAN AVIAN FERRY TERMINAL 9,881 253 114,000 2,150 118 CONVENTIONAL BERTH ALSO HANDLING SOME CONTAINERS 1,329 680 10,000 6,000 38 TOTALS 45,840 7,801 477,700 102,150 944 43 TABLE II Summary of Shipping Arrivals into Tilbury 1969, Discharging Containers, Major Operators. 1968 Figures in Brackets. FROM Number of Arrivals Number of Containers No. of Food Containers Re marks CONTINENTAL PORTS 560 (399) 22,100 (5,631) 5,429 (1,417) From May included Australian Containers transhipped from Rotterdam or Antwerp from 21 Ocean Carriers from Australia. Tilbury received all refrigerated boxes ex. O.C.L./Act Service, and all Containers for London and Southern England plus some others. NORTH AMERICA AND CANADA 108 (103) 11,159 (5,554) 1,920 (742) Canadian Service commenced in May. One major conventional cargo Liner Company commenced operating Container Vessels to Tilbury in August. EAST GERMANY AND FINLAND 119 (29) 2,400 (670) 159 (87) No change SCANDANAVIA 118 (80) *9,881 (7,583) 253 (219) * Includes Flats, No change OTHERS 39 300 40 Included ships from Spain and Portugal 1969 TOTALS 944 45,840 7,801 44 TABLE III 1969 Summary of Food Containers received at Tilbury via joint O.C.L./A.C.T. Australian Service FIRST NORTH BOUND ARRIVAL 14.5.1969. North-bound Voyages, 1969 TOTAL FOODS/ SHIP FROZEN MEAT EDIBLE FROZEN MEAT INEDIBLE DAIRY PRODUCE CANNED FRUITS CANNED MEATS FRESH FRUITS DRIED FRUITS FROZEN EGG FLOUR WHEAT GLUTEN HONEY MILK POWDER PEAS WINES RICE GELATINE CASINGS BEER MEAT EXTRACT/ GHEE XS.147's Undertakings Etc., ACT OCL A O A O A O A O A O A O A O A O A O A O A O A O A O A O A O A O A O A O A O A O Encounter Bay 01 110 359 1 1 - - 1 10 50 186 - 3 52 98 - 19 6 9 - 4 - 26 - 1 - 1 - - - - - - - - - - - - - - - 1 Act. 1 02 130 205 1 1 2 - - - 56 23 2 - 53 150 12 1 6 6 - - - 12 - - - - - 2 - 10 - - - - - - - - - - - - Flinders Bay 03 147 264 3 12 3 - 6 2 57 38 4 14 52 116 10 25 9 15 - - 3 17 - - - - - - - - - 25 - - - - - - - - - Act. 2 04 190 248 4 - 3 - - - 110 78 6 6 40 32 13 46 4 6 1 - 1 17 5 1 - - - - 3 - - 49 - 2 - - - 1 - - - - Encounter Bay 05 37 131 - - - - - - 23 92 5 11 - 8 2 3 6 6 - - - 7 1 2 - - - - - - - 2 - - - - - - - - - - Botany Bay 06 18 4 - - - - - - 14 3 - - - - - - - - - - - - - - - - - - 4 - - - - 1 - - - - - - - - Act. 1 07 49 19 - - - - - - 29 8 1 - - 2 3 4 13 3 - 1 1 - - - - - - - 1 - - 1 - - - - i - - - - - More ton Bay 08 18 69 - - - - - - 14 39 1 - 1 2 - 8 - - - - - 11 1 4 - - - - - 1 - 3 - - - - - - - 1 1 - Flinders Bay 09 74 51 - - - - - - 40 30 - 3 3 - 9 14 1 - - - - - 3 1 - 1 - - - 2 - - - - - - - - - - 18 - Discovery Bay 10 72 87 - - - - - - 22 - 5 45 - - 35 14 - 4 - - - 3 1 3 - - - - 4 9 - 5 - - 1 2 - - - 2 - - Act. 2 11 108 92 18 - 3 - 6 - 53 38 2 - - 1 24 16 - - - - - 15 3 1 - - - - 1 3 - 18 - - - - - - - - - - Encounter Bay 12 60 95 - - - 1 - - 45 26 - 3 1 - - 53 6 - - - - 7 4 - - - - - - - 1 1 - - - - - - - - 3 2 Aust. Endeavour 13 69 44 15 7 5 2 - 3 30 15 - - 10 2 3 - - - 1 2 - 2 4 5 - - - - - - - 4 - - - - - 2 - - 1 2 Botany Bay 14 71 62 16 3 4 1 - 14 41 24 - 2 - 3 3 - - - - - - 6 5 4 - - - - - - - - - - - - - - - - - - Act. 1. 15 123 93 17 13 1 - - 12 83 34 - 2 - 4 6 6 - - - - 1 5 1 8 - - - - - - 14 2 - - - - 2 5 - - - 5 Moreton Bay 16 81 34 17 2 3 - - - 48 8 2 - - - 8 7 - - - - - 5 2 8 - - - - - - - 3 - - - - - 1 - 1 1 - Flinders Bay 17 78 71 20 13 2 1 - 10 41 10 1 - - - 12 9 - - - - - 8 1 4 - - - - - - - 14 - - 1 - - 1 - - - 2 Discovery Bay 18 107 69 22 16 2 - - 2 77 20 - 1 - - - - - - - - 3 2 - 2 - 14 - - - - - 6 - - - - - - - - 1 5 Act. 2 19 59 42 20 14 2 - - 3 17 7 1 - - - - - 2 2 - - - 1 2 2 12 10 - - - - 2 - - - - - - - - - 1 3 Encounter Bay 20 71 67 19 12 3 - - 11 17 16 2 - - - - - 3 3 - - 3 8 4 4 18 10 - - - - 1 - - - - - - 1 - - 1 3 Aust. Endeavour 21 52 59 20 11 4 - - 2 16 30 4 - - - - - - - - 1 3 6 2 7 - - - - - - 1 1 - 1 - - - - 1 - 1 - 1724 2165 193 105 37 5 13 69 883 723 36 89 212 418 142 225 56 54 2 8 15 158 39 57 30 36 - 2 13 25 17 144 - 4 2 2 3 11 1 4 28 23 45 FAST TURNABOUT AT UNITED STATES LINES BEBTH A United States Lines container ship docked at No. 40 Berth, Tilbury Docks at 23.20 hours on Sunday, 7th December, Ten minutes later the first container had been unloaded and by 09.15 hours next morning, 320 containers had been handled to and from the ship. By 09.35 hours, just over 10 hours after the ship docked, it had sailed. Freight-Liner Terminal at Tilbury In June, the Port of London Authority's new maritime freight liner terminal at Tilbury came into operation. It is linked to British Rail's Freightliner Service. The terminal has been developed to deal with the movement of containerised import and export food and goods between Tilbury Docks and those inland container depots which are served by the railway network. The system started working with teams of 14 men, on shift duty, who load and unload, and also operate the truck-trailer service to and from the berths. INSPECTION OF IMPORTED MEATS The following tables give details of the meats which have been dealt with by the Authority during the year. TABLE II Imported Food Regulations, 1968 Examination for Fitness for Human Consumption. COMMODITY COUNTRY Beef Livers Other Beef Offals B/in and B/Less Beef Sheep and Lamb B/Less Mutton and Lamb Sheep and Lamb Offals B/Less Veal Pork and Offals Chilled Beef Cuts Other Meats ARGENTINE 760 15 224 - — — — — 455 93 AUSTRALIA 424 - 299 100 365 - 2 5 - 95 BRAZIL 20 - 21 - - - - - - - CHINA - - - - - - - - - 90 CANADA 20 30 - - - - - - - - NEW ZEALAND 487 86 608 4,337 495 40 - 20 - - U.S.A. - 15 - - - - - - - - URUGUAY — 5 — - - - - — — EIRE — - 30 - - - - - - - RUMANIA - 5 — - — - - - — — S.W. AFRICA - 5 - - - - - - - - TOTALS 1,711 161 1,182 4,437 860 40 2 25 455 278 WEIGHTS T T T T T T Qtrs Cwt. T T (Approx.) 43 4 28 150 22 1 3 14 12 7 TOTAL WEIGHT 250 TONS (Approx.) TOTAL PACKAGES 9151. 46 TABLE I The Meat (Staining and Sterilization) Regulations, 1960. The Meat (Sterilization) Regulations, 1969. Investigation and Disposal of Pet Foods. Commodity Packages Approximate Weight Tons Inedible Meats and Offals 547,391 13,685 Horse meat 238,782 5,970 Kangaroo 18,805 470 Whalemeat 9,818 245 Venison 414 10 TOTALS 815,210 20,370 TABLE III Damaged Meats detained in Royal Docks and subsequently reconditioned by other Local Authorities or at Smithfield Market COMMODITY B/in or B/L Beef Hares No. of Packages 739 650 Approx. Weight 43 Tons 8 Tons TOTAL WEIGHT (APPROX.) 51 TONS - TOTAL 1,389 Packages TABLE IN Damaged Meats etc., detained in No. 6 Cold Store for Destruction or Beconditioning COMMODITY Sheep and Lambs Sheep and lamb Offals B/in and B/Less Beef Beef Livers Other Offals Various Packages Packages 7,405 12 761 292 494 736 Approx. Wt. tons 120 ¼ 20 7½ 12½ 19 TOTAL WEIGHT (APPROX.) 179¼ TONS - TOTAL 9,710 Packages TABLE V Meat rejected by U.S.A. — detained at other Cold Stores pending inspection of samples at No. 6 Cold Store COMMODITY B/Less Beef B/Less Mutton B/Less Veal B/Less Lamb Lamb Cuts Packages 26,557 18,063 99 2,333 1,312 Approx. Wt. (Tons) 664 452 2½ 58 33 TOTAL WEIGHT (APPROX.) l,209½ TONS - TOTAL 48,364 Packages FERTILISERS AND FEEDING STUFFS ACT. 1926 FERTILISERS AND FEEDING STUFFS REGULATIONS. 1960 and 1968 Twelve samples of Feeding Stuffs were submitted to the Agricultural Analyst. No sample of fertiliser was sent. All the samples were found to be within the limits of variation permissible under the Regulations. As from the 1st July 1969, Dr. Jack Hubert Hamence, O.B.E., Ph.D., M.Sc., M.Chem.A., F.R.I.C., was appointed Agricultural Analyst for the Corporation in the room of Dr. H.A. Williams, Ph.D. (Lond.) M.Chem.A., A.C.G.F.C., F.R.I.C., F.R.S.H., and Mr. Philip Sydney Hall, B.Sc., M.Chem.A., F.R.I.C., was appointed as Deputy Agricultural Analyst for the Corporation. STUDENTS AND VISITORS Student Public Health Inspectors Eight student public health inspectors were employed by the Authority. Three completed the course and obtained the Diploma of the Public Health Inspectors Education Board and were subsequently appointed as Port Health Inspectors with the Authority. 96 student public health inspectors from other local authorities and technical colleges received instruction in port health work. 47 Visitors A considerable number of doctors and public health inspectors from home and foreign government departments and local authorities and students from a variety of colleges visited the port during the year. The overseas countries sending visitors included Tanzania, Russia, Malaysia, Nigeria, Israel, Denmark, Sudan and Iraq. POWERS The principal Acts of Parliament and Statutory Instruments affecting the work of the Port Health Authority of the Port of London are:— ABATEMENT OF NUISANCES AND REMOVAL OF REFUSE London Government Act, 1963 Noise Abatement Act, 1960 Public Health Act, 1936 Public Health Act, 1961 Public Health (Recurring Nuisances) Act 1969 ADMINISTRATION City of London (Various Powers) Act, 1965 Local Government Act, 1933 London Government Act, 1963 London Port Health Authority Order, 1965 Public Health Act, 1936 Public Health Officers Regulations, 1959 ALIENS Aliens Order, 1960 Aliens Order, 1968 Ministry of Health Instructions to Medical Inspectors, 1955 CANAL BOATS Canal Boat Regulations, 1878 to 1931 Public Health Act, 1936 Public Health Act, 1961 COMMONWEALTH IMMIGRANTS Commonwealth Immigrants Act, 1962 and 1968 Commonwealth Immigrants (Exemption from Restrictions on Landing) Order, 1968 Hovercraft Act, 1968 Ministry of Health Instructions to Medical Inspectors, 1968 CONSTITUTION OF THE AUTHORITY City of London (Various Powers) Act, 1965 London Government Act, 1963 London Port Health Authority Order, 1965 Public Health Act, 1936 CREW ACCOMMODATION Public Health Act, 1936 Public Health Act, 1961 DANGEROUS DRUGS Dangerous Drugs (No. 2) Regulations, 1964 FERTILISERS & FEEDING STUFFS Fertilisers and Feeding Stuffs Act, 1926 Fertilisers and Feeding Stuffs Regulations, 1960-1964 Fertilisers and Feeding Stuffs Regulations, 1968 48 FOOD Antioxidant in Food Regulations, 1966 Arsenic in Food Regulations, 1959 and 1960 Artificial Sweeteners in Food Regulations, 1967 Artificial Sweeteners in Food Regulations, 1969 Bread and Flour Regulations, 1963 Colouring Matter in Food Regulations, 1966 Emulsifiers and Stabilisers in Food Regulations, 1962 Fluorine in Food Regulations, 1959 Food (Control of Irradiation) Regulations, 1967 Food and Drugs Act, 1955 Food Hygiene (Docks, Carriers etc.) Regulations, 1960 Food Hygiene (General) Regulations, 1960 and 1962 Ice Cream (Heat Treatment etc.) Regulations, 1959 and 1963 Imported Food Regulations, 1968 Lead in Food Regulations, 1961 Liquid Egg (Pasteurisation) Regulations, 1963 London Government Act, 1963 Meat (Staining and Sterilisation) Regulations, 1960 Meat (Sterilization) Regulations, 1969 Mineral Hydrocarbons in Food Regulations, 1966 Preservative in Food Regulations, 1962 Public Health.(Imported Milk) Regulations, 1926 Soft Drinks Regulations, 1964 Soft Drinks (Amendment) Regulations, 1969 FUMIGATIONS Hydrogen Cyanide (Fumigation of Buildings) Regulations, 1951 Hydrogen Cyanide (Fumigation of Ships) Regulations, 1951 HOUSEBOATS City of London (Various Powers) Act, 1933, Part III, Sections 6 and 7 Essex County Council Act, 1952, Section 212 INFECTIOUS DISEASES Health Services and Public Health Act, 1968 London Government Act, 1963 Public Health Act, 1936 Public Health Act, 1961 Public Health (Fees for Notification of Infectious Diseases) Order, 1968 Public Health (Infectious Disease) Regulations, 1968 Public Health (Prevention of Tuberculosis) Regulations, 1925 Public Health (Ships) Regulations, 1966 Public Health (Ships) (Amendment) Regulations, 1968 Regulations as to the notification of Plague as an infectious disease, 1900 Regulations for preventing Plague by the destruction of Rats etc., 1910 RATS AND MICE Hovercraft Act, 1968 Poisons (No. 2) Rules, 1968 Prevention of Damage by Pests Act, 1949 Prevention of Damage by Pests (Application to Shipping) Order, 1951 Prevention of Damage by Pests (Application to Shipping) (Amendment No. 2) Order, 1956 Public Health (Ships) Regulations, 1966 Public Health (Ships) (Amendment) Regulations, 1968 SHELLFISH Medway (Shellfish) Regulations, 1935 Order dated 23rd April 1936 made by the Port Health Authority under the Public Health (Shellfish) Regulations, 1934 in respect of a 'prescribed area' in Essex. Order dated 25th July 1957 made by the Port Health Authority under the Public Health (Shellfish) Regulations, 1934 in respect of a 'prescribed area' in Kent. Public Health (Shellfish) Regulations, 1934 and 1948 CLEAN AIR Clean Air Act, 1956 Clean Air Act 1968 Clean Air (Arrestment Plant) (Exemption) Regulations 1969 Clean Air (Commencement No. 1) Order 1968 49 Clean Air (Emission of Dark Smoke) (Exemption) Regulations 1969 Clean Air (Height of Chimneys) (Exemption) Regulations 1969 Clean Air (Measurement of Grit and Dust) Regulations, 1968 Clean Air (Prescribed Forms) Regulations 1969 Dark Smoke (Permitted Periods) Regulations, 1958 Dark Smoke (Permitted Periods)(Vessels) Regulations, 1958 Public Health Act, 1936 Smoke Control Areas (Authorised Fuels) Regulations, 1969 BYE-LAWS Bye-laws have been made by the Port Health Authority 1. For preventing nuisances arising from barges or vessels carrying offensive cargoes. 2. For removing to hospital any person suffering from dangerous infectious diseases, and for the 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. PUBLICATIONS (1) Handbook of Poultry Inspection. (2) Clean Food Handling 50 APPENDIX The third Monckton Copeman Memorial Lecture (entitled "Medicine and the River Thames") delivered by W.G. Swann, M.D., B.Ch., B.A.O., B.Sc., D.P.H., D(Obst), R.C.O.G., D.P.A., on 6th February 1969 at The Apothecaries'Hall, Blackfrairs Lane, E.C.4. I count it a signal honour to have been invited to deliver the third Monckton Copeman Lecture My two predecessors in this task came from the staff of the central Government Department concerned with health as did Monckton Copeman so that I am the first Medical Officer of Health of a Local Authority to undertake this distinguished duty, I have no doubt that it is_ one more instance of the privilege of the office that I hold that this lot has fallen to me. Although Dr. S. Monckton Copeman was engaged as a Medical Officer in Central Government he, of course, had close contacts, interests, and associations with local government. The theme given to me for this paper is "Medicine and the River Thames". First of all what can one say of the Thames and its inevitable association with the life and culture of London including medicine? Whether one goes back to the earliest times and conjectures whether the name London was derived from the early Celtic Llyn don which means the lake fortress or whether one agrees with the great John Evelyn when he writes "In fact the City of London is built on a sweet and most agreeable eminency of ground at the north side of a goodly well conditioned river towards which it had an access by a gentle easy declivity", there is this closest of links between City and River. It is said that the Nile is Egypt and Egypt is the Nile. One has only to fly by plan from Cairo to Luxor or Aswan to vividly realise this — the real Egypt is a mere green strip on either side of the Nile — the rest an arid sandy wilderness. The lifeof London is not so physically correlated with the Thames as this, nevertheless culturally, economically and in a great number of ways they are both bound up in the bundle of life. The Royal Charter of King James I states: "It is notorious that the river of Thames is so necessary, commodious and practicable to the City of London that without the said river our City could not long subsist, flourish or continue." In the Library of the Port of London Authority is a document signed by the Rt. Hon. John Burns, P.C., containing the story of the Canadian from the banks of the Great St. Lawrence and an American from the banks of the great Missouri who asked, rather derisively, John Burns' comparative view of the St. Lawrence, the Missouri and the River Thames. He replied: "The St. Lawrence is mere water, the Missouri i's muddy water, the Thames is liquid history." A lot of this history is intimately concerned with medicine and health. Edward Chamberlayne in his "Present State of England" 1682 (a sort of Whitaker's Almanack) says: "In the most excellent situation of London the profound wisdom of our ancestors is very conspicuous and admirable. It is seated in a pleasant evergreen valley, upon a gentle rising bank in an excellent air, in a wholesome soil mixed with gravel and-sand upon the famous navigable river Thames, at a place where it is cast into a crescent, that so each part of the City might enjoy the benefit of the river, and yet not be far distant one from the other; about sixty miles from the sea; not so near, that it might be in danger of surprise by the fleets of foreign enemies or be annoyed by the boisterous wind and unwholesome vapours ot the sea; yet not so far but that by the help of the tide every 12 hours ships of great burden may be brought into her heaving bosorm Chamberlayne in speaking of the Thames excelled himself in admiration: "The river whereon is seated the great city, for its breadth, depth, gentle, straight even course, extraordinary wholesome water, and tides, is more commodious for navigation than any other river in the world The river opening eastwards towards Germany and France, is much more advantageous for traffic than any other river of England. Mrs. C. Fox-Smith has put the commercial life on the River in doggerel verse, thus: "All alone I went a-walking by the London Docks one day, For to see the ships discharging in the basins where they lay; And the cargoes that I saw there they were every sort and kind, Every blessed brand of merchandise a man could bring to mind: There were things in crates & boxes, there was stuff in bags & bales, There were tea-chests wrapped in matting,there were Eastern looking frails There were baulks of teak and greenheart, there were stacks of spruce and pine, There was cork and frozen carcasses and casks of Spanish wine There was rice and spice and coconuts and rum enough was there For to warm all London's innards up and leave a drop to spare." So much for the Thames and its situation in relation to the City. What about medicine? I think I cannot do better than remind you that the "Doctourpf Phisick" described by Chaucer, set out from the "Tabard" on the south bank of the Thames in Southwark with the other pilgrims bound for St. Thomas' shrine at Canterbury about 1380: "There was also a Doctour of Phi si k In all his world ne was ther non him'lyk, To speke of Phisik and of Surgerye". The Doctors of the 14th century were as prone to talk "shop" as some of their modern counterparts. Next Chaucer informs us — "For he was grounded in astronomye", Astrology was then an essential element in medical knowledge and the stars were consulted in diagnosis and treatment. He used mystical modes of treatment such as amulets and charms,.The doctrine of signatures i.e. giving those plants having some slight resemblance to parts of the human body or to some prominent sign of disease for the relief of the organs or disease which they resembled was in use. The treating of images in order to affect the original of the image was in practice among witches and probably used by the profession — "He knew the cause of every malady, Were it of cold or hete or moyst or drye" here is an allusion to the Hippocratic humoural pathology developed by Galen In his allusions to gold Chaucer indicates that the priest-physician was fully as fond of his fees as are any of his successors. It is axiomatic that a Medical Officer of Health make mention of pollution of the Thames in relation of medicine and health. This subject could occupy a series of lectures so that I will merely touch upon some salient points. It would appear that from time immemoriam the Thames was the recognised depository for all forms of waste and filth. We know that in the year 1297 every inhabitant of the City of London was made responsible for maintaining the cleanliness of the frontage of his own dwelling and the throwing of refuse and dirt into the lanes and streets was prohibited with grave penalty as early as 1309. It was then considered that the thing to do was to deposit it in the Thames or elsewhere outside the Town — so the problem of river pollution was present from the earliest times. In 1345 special cognizance was taken of this. The water of Dowgate Dock was so contaminated and unserviceable that carters were employed as scavengers to cleanse it of dung and dirt and an endeavour was made to keep it cleansed on penalty of imprisonment. We read that Edward III informed the Mayor & Sheriffs how he observed "dung and other filth accumulated in divers places in the City upon the bank of the River as well as fumes and abominable stenches arising and he commented that the corruption therefrom if tolerated constituted a great peril as well to the person dwelling in the City as to nobles and others passing along the river. An Order was made which required "for the saving the body of the river and preserving the quays, for loding and unloding, as also for avoiding the filthiness that is increasing in the river and upon the banks of the Thames to the great abomination and damage of the people that no refuse or other filthy rubbish was to be thrown into the Rivers Thames and Flete or into the ditches around the City Walls — all was to be carted outside the City. Again the King complains in 1372 to the Mayor, Sheriffs and Aldermen that "rushes, dung, refuse and other filth and harmful things" are thrown into the Thames obstructing the River that great ships are not able to come up to the City; The King's writ enjoins amendment and prevention of this intolerable state of affairs "so behaving yourselves in this behalf that we shall have no reason for severely taking you to task in respect thereof; and this, as we do trust in you and as you would avoid our heavy indignation and the punishment which as regards ourselves you may incur, you are in no wise to omit". Throughout the earlier half of the last century sewage disposal was based upon a statute of Henry Vlll's time amended under William and Mary. Commissioners of Sewers were constituted with the duty of providing and maintaining sewers and drains in their districts. But the increased population since the 16th and 17th century rendered any provisions made totally inadequate. There were five Commissioners in the mid century and their work was completely inefficient to deal with the sewerage of their respective districts. It was still a fact that the Thames was always there and it was an easy way of disposing of sewage which was a practice so often followed that the sewers discharged directly into the river without any previous treatment whatever. They were usually discharged at low tide because at high tide the outlets were closed and the sewage dammed back. With the receding tide the sewage flowed out and was deposited along the banks of the river rendering them foul and offensive, to be carried up the river again with the incoming tide and so on ad infinitum, so that the River in the City became indistinguishable from sewage itself. In addition many sewers and drains were defective and improperly laid and in such disrepair that they leaked into the subsoil creating what were virtually extended cesspools. There was no survey in order to interrelate the sewers of each of the five districts, so that between one district and another adequate inclines were not provided to ensure the gravitation of the sewer from one district of the whole area to another for lack of a general plan, and sewage will not flow up-hill. They were thoroughly incompetent bodies. Instead of constructing new systems to deal with the evergrowing population's needs, mill streams, ditches, streams were converted into and used as open sewers all ending up in the River Thames the greatest sewer of all. So we can well imagine that state of the River Sydney Smith described in a letter to Countess Grey dated 19th November 1834, "He who drinks a tumbler of London water has literally in his stomach more animated beings than there are men, women and children on the face of the globe". Michael Faraday took an active interest in the state of pollution of the Thames. His career was closely associated with the River Thames. He was born in London just south of it; he grew up and worked for more than 50 years in London just north of it. He carried out some of his most significant experiments at Woolwich a few miles downstrean and he spent his last years at Hampton Court a few miles upstream. He describes an experiment to detect the natural effects of the earth's magnetic field conducted across Waterloo Bridge thus "Experimented today at Waterloo Bridge by leave of Mr. Bridell, the Secretary. Stretched a long copper wire on the Parapet of the Bridge on the Western side. It extended from the toll house, Strand side, over six arches and to the sixth pier (these arches are each 140 feet, the piers each about 15 or 20 feet) it was therefore about 960 feet long. One of the plates very clean, was fastened to a wire and let down to the river directly at the toll house. The end of the wire was taken into the toll house by the window. The other plate, fastened to a similar wire, was let down into the river at the sixth pier, the other end being connected with the wire just mentioned. The end of the long horizontal wire was taken into the toll house and thus these two ends being connected by cups of mercury with the galvanometer wire the whole became one wire from plate to plate: and the current was completed by the water between the plates, which being in motion up or down was expected to produce by magneto-electric induction currents rendered sensible at the galvanometer, and so on." In 1855 he hit the headlines when he sent a letter to The Times calling attention to the dangerous state of the river, which he described as "a real Sewer". Steaming up the Thames one day in a penny boat — one of the fastest forms of transport at that time — he was appalled at its offensiveness. Wetting some white cards to make them sink easily, he dipped pieces into the river at each pier. They disappeared from sight at once in the 'opaque pale brown fluid' although the sun was shining brightly, proof enough of the impurity of the water. Shortly afterwards Punch issued a cartoon of Faraday giving his card to Father Thames holding his nose in the stench and he noted that if matters were remedied more lives might be saved then by Humphrey Davy's Safety lamp- The menace of pollution and the stench from it permeated the precincts of the Palace of Westminster, so much so during the parliamentary debate on 27th June 1858 memorable for the "great stink" the penetrating nauseating stench from the Thames made even the Houses of Parliament unbearable. Hansard records that during the debate to reinforce the case for the appointment of a central medical officer the hard pressed Minister found the climax of his case in the "pestitential state of the river which flowed close by and which really might soon be a terror to this house". It is interesting to reflect on the contrast of inspiration which led to the discovery of the pulmonary and systemic circulations — the water pump at London Bridge undoubtedly had a place in the latter, i.e. the systemic circulation. In connection with the pulmonary circulation, we find it announced in a work of theology — Christianismi Restitutio, where we have the first authentic account of the pulmonary circulation. Servetus' main theme is concerning the Holy Spirit — the allpervading spirit immanent in creation in all its manifestations. He could have subscribed to the Victorian poets' aphorism that he who understands the flower in the crannied wall is able to understand what God and men are. To know the movement of the blood might well lead to knowledge of movement of the stars. He who understands all about the breathing of man has understood the breath of God, i.e. the spirit of God for did He not in the beginning breathe into man's nostrils the breath of life and he became a living soul. This allied to the other Hebrew doctrine that the soul or life or breath is in the blood. How appropriate that it should be located in something which moves and cruises through the body. This might well have led to postulate the full circulation. In contrast Harvey's inspiration for the systemic circulation was much more mundane and practical, viz. the water-pump at London Bridge. In 1582 Peter Morris completed the first waterwheel at London Bridge, having been granted a lease of the first arch on the northern side. To this German or Dutchman (Stow seemed uncertain of his nationality for he described him as both) belongs the distinction of being the first to provide a supply of water to London houses by mechanical means. His water-wheel was connected to pumps and was so successful that a second arch was leased to him. Until that time the City Corporation was the only body supplying water to the people of London and for this purpose conduits were built to bring water from springs in the suburbs. In 1236 the Lord of the manner of Tyburn granted to the citizens and their successors liberty to convey water into the City by leaden pipes. The springs which promoted this water were in the neighbourhood of what is now Stratford Place, Oxford Street. Writing of this period, Stow tells us that "certain merchants, strangers of Cities beyond the seas, to wit, Amiens, Corby and Nele, for priviledges which they enjoyed in this city, gave £100. towards the charges for conveying water from the town of Teybourne". In 1439 the Abbot of Westminster granted to the Corporation certain springs in the manor of Paddington but, the population increasing, the City obtained an Act of Parliament in 1543 empowering it to bring water from Hampstead by conduit. These conduits terminated in cisterns which were themselves usually referred to as "conduits" and Stow in his survey gives a detailed list of them. In Elizabethan times, therefore, one was either compelled to fetch water from the conduit or to buy it off the Water Bearers, through the majority fetched it in buckets from the Thames. There were, however, certain influential persons who prevailed upon the City Corporation to allow them to tap the conduits and to run a private water supply to their house, using narrow leaden pipes. In such cases the City was said to have granted a "quill" to these people. The Water Bearers had their own Guild, known as the "Brotherhood of Saint Cristofer of the Waterbearers" with a hall that stood where Liverpool Street Station is today. After 60 years the guild was dissolved when the Water Bearers came under the control of the City Chamberlain.At the beginning of the 17th century Parliament authorised the construction of an aqueduct for bringing water to London from Chadwell and Anwell in Hertfordshire. These powers were not used and eventually Hugh Myddleton offered to undertake the work at his own expense provided he be allowed to keep any profits. To this the City agreed and the aqueduct known as the New River came into being though not before Myddleton had come into conflict with many landowners who tried to have the Act empowering the aqueduct repealed. To add to his difficulties, when almost within sight of London, his money ran out and he could get no further backing. He appealed to James I to help him and the King agreed on conditions that profits of the enterprise were to be shared between them 50-50. So the New River was completed discharging its precious liquid into a converted pond at Clerkenwell. Myddleton was created a baronet but the company was not the immediate success that had been hoped. Charles I realising this, agreed to surrender his inherited share in the New River Company for a perpetual rent of £500. known as the "King's Clog". This payment later reduced by the deduction of Land Tax is still made each year to the Crown by the Metropolitan Water Board. The New River Company, having completed its aqueduct first began distributing water in 1613 and for this ourpose used wooden water mains but the New River Company did not prevent the London Bridge waterworks from prospering. Peter Morris's first two water wheels weredestroyed in theGreatFire in 1666 but it was notlong before four new wheels were in operationsupplying water to houses in Southwark as well as in the City. These waterworks however greatlyendangered navigation through the Bridge and despite the efforts of eminent engineers such as Brindley and Smeaton who designed water wheels to mitigate this, there came the time when by Act of Pariiament the wheels were dismantled. Harvey was Lumleian Lecturer in 1615. By a strange chance the notes of his lecture of 17 April 1616 found their way into the British Museum where they were discovered in 1886, written originally in a mixture of Latin and English and contain the following:- "It is plain from the structure of the heart that the blood is passed continuously through the lungs to the aorta as by two clacks of a water bellows to raise water. It is shown by application of a ligature that the passage of blood is from the arteries to the veins. Whence it follows that the movement of the blood is constantly in a circle and is brought about by the beat of the heart. It is a question therefore whether this is for the sake of nourishment of the heart, the blood cooled by warming the limbs being in turn warmed by the heart". This is the first analogy of the heart to the water pump. The device of the water pump appears to have provided an essential concept in Harvey's eventual discovery though this is not mentioned in his classic paper. Quarantine In August 1709 the first of several orders in Council enacted what was to be the continuous quarantine policy for England placing a quarantine on all ships and persons from infected areas to be performed in prescribed places. No one should board these ships without a licence and no Master should go on shore or permit any passenger or member of his crew to do so without a licence: otherwise the ship was forfeited to the Queen. Persons going on shore were to be returned to quarantine. After detention the ship could be certified and proceed on its way: after quarantine also the cargo would be opened and aired. These remained the rules for more than 100 years. The infected areas in 1721 included all ships from the Mediterranean in view of the plague in Marseilles and district. There were stern and precise penalties for violation. Continued evasion made the offenders liable to the death penalty as felons. The King could take preventive steps such as establishing lazarets or erection of lines about infected places and prohibit persons or goods passing the same or the burning of specified goods liable to quarantine. If plague appeared on a ship northward of Cape Finistere the commander was under order to head for New Grimsby in the Scilly Islands and required to remain there during the King's pleasure. This was repealed in 1756 but St. Helen's Pool in the Scilly Islands was specified the appointed place in lieu of New Grimsby. Ships were required to perform quarantine at Malta and other specified ports. In 1765 government provided £5,000. maximum towards building a lazaret. After 1st January 1789 every ship liable to quarantine must hoist a signal in case of falling in with another ship or within 4 leagues of the British Coast. This signal should consist of a large yellow flag by day and a light by night at the "Main Top Mast Head". On 28th July, 1800 Parliament passed an act for erecting a lazaret on Chetney Hill, Kent, which I will describe later. Beginning 10th October 1806, the signal from an infected vessel must be by day a yellow and and black flag and fly by night two lanterns one above the other. It was not till 181 I that the death penalty was abolished as a penalty for quarantine offences. The notion of specific contagion for epidemic diseases on which quarantine was based was challenged as originating in ignorant and credulous times and without adequate foundation. In 244 years, 140 without quarantine, no disease had been imported into England by ships, persons or goods. Were the plague contagious quarantine could not in every instance have kept it out. The contagionist theory of "susceptible persons, susceptible goods, susceptible seasons, susceptible countries" and the belief that the plague possessed the faculties of self-operation, sleeping, walking, resuscitative with many other properties equally marvellous were equally absurd. It was claimed by the antagonists that the laws increased sickness, mortality and fear, impeded science, produced immorality, obstructed commerce, navigation and travel, cost £200,000 a year, was "anti-commercial, anti-social and anti-Christian". On the other side, it was said that Parliament should run no risks until a sponger case was made. One of a certain Dr. Maclean's opponents was astonished to find that his wild theories were again to be broached. Although the manner of introducing plague was not always traceable it was too much to be called upon to believe that Dr. Maclean when shut up in the plaguehospital at Constantinople was "infected by the southwest wind". All the doctors authorities "thefable of the Council of Trent included" were to be found in pamphlets distributed against the Government's quarantine policy in 1721. One stout anti-contagionist, the most zealous of Maclean's medical coadjutors, had exemplified the soundness of his theory "by catching a non-contagious fever and communicating it to four individuals who nursed him in succession." A General Robert Wilson attributed the plague to wholly atmospheric influences, denied that clothes carry infection and insisted that government allay fear by freeing the enforcement of quarantine. Robert Peel queried why, if atmospheric influences causes the plague an army division passing through an infected village didn't succumb Wilson replied that plague acted mostmysteriously and people in motion in contrast to stationary persons seldom took it. Jospeh Hume affirmed that quarantine principles were incorrect and emphasised the differing opinions of physicians. The Statute was passed in 1824. Although England abolished plague quarantine in 1841 this statute was to remain in force. The government did not practice strict enforcement but the law sanctioned restrictions on goods and persons likely to convey infection. Subsequent acts conferred further powers and the Public Health Act 1875 in its essential character did not differ and consolidated these. Medical opinion inclined strongly against quarantine during the middle years of the century — yellow fever, cholera, plague, typhus, being appraised as non-contagiaus. But by 1878 the tide was turning and the idea of quarantine once more in good standing. Lessons seen here are — the threat and awareness of disease, the steady penetration of the state into lives of its subjects, thestress of public welfare over private right and the progress of investigation and reasoned opposition. Hospitals As well as the individual practitioners of medicine what about the Hospitals associated with the Thames? They are so numerous, like the Tropical Hospital and in particular its predecessor near Greenwich or the present Seamen's Hospital at Greenwich. I am sure the local libraries of Barking and Bermondsey or Erith etc, would have a wealth of interesting and valuable material. St. Thomas's and Millbank and Guy's and so on. Then there are the naval aspects of medicine associated with Greenwich and Chatham. This would prove too extensive so I will make mention of but two "hospitals" both associated with the public health aspect of medicine. The first is the one and only true lazaret in connection with International Quarantine which was built in England. It was the Chetney Hill Lazaret. Building commenced in 1801 and it was demolished in 1816. It cost nearly £| million at today's money values but was never finished nor fully used. In the 18th century countries tried to protect themselves from bubonic plague by Quarantine as I have described. This was done at ports and frontiers in buildings called lazarets or lazarettoes after Lazarus the leper. The Quarantine Station for London was originally in the Thames. In 1709 was moved to StangateCreek in marshes near the mouth of theMedway inhabited only by a few oysterfishermen... No lazaret was built. Passengers remained on ship and merchandise was aired on the river bank. By 1750 this became inadequate. Cotton imports from Egypt had increased, "foul Bills" were more common and English merchants complained that the French and Italians were over-charging for the use of their lazarets. They demanded an English lazaret. In 1752 the Admiralty selected the site - a small unoccupied hill of 29 acres jutting out into Stangate Creek — called Chetney Hill. The Government, however, reused the money. Instead in 1755 they provided 5 old men-of-war ships to act as floating lazarets. The merchants were annoyed and got the support of the Prime Minister, William Pitt who himself came from a merchant family. The seven years war 1756-63 intervened but in 1764 plans of a lazaret were approved and money voted to buy the land, but it was not taken over till 1772. However the work did not start tor another 30 years because since about 1740 plague had nearly disappeared from Europe, More American and less Egyptian cotton was being imported and the old men-of-war were proving adequate and cheap. In the 1790*s things changed. Napoleon's Italian campaign of 1796-97 closed all lazarets to English shipping except Malta and Yellow fever broke out in Philadelphia and New York and cotton cargoes for England now got "foul" Bills of Health. In 1800 Parliament agreed to a proper lazaret and provided £65,000. Work started in 1801 and the main building was more or less completed in 1806 at a cost then of £100,000., but was never in full use because it was too expensive as compared to disused men-of-war, so it was demolished and the materials sold Denton Hospital. The Second Hospital I will mention is Denton Hospital at Gravesend which was provided by the Corporation of London in 1883 as an Infectious Diseases Isolation Hospital to deal withcases found on ships entering the Port. It was of course taken over by the Minister of Health in 1948 but the Medical Officers of the Port Health Department of the Corporation who board incoming vessels in connection with the prevention of the importation of infectious disease still act as the Medical Officers of this Hospital and it is still solely used for its original purpose. Before leaving the subject of Hospitals I would mention that Dr. Monckton Copeman undertook an interesting investigation into an epidemic skin disease that occurred at Bethnal Green Infirmary and at the City of London Infirmary at Bow in 1893- Dr. Copeman records his indebtedness to the Assistant Medical Officer of the City of London Infirmary for notes of cases which he had under treatment. In this connection it is interesting to note that circumstances have not changed over much with regard to medical records,for Monckton Copeman politely remarks "although these notes are not i n • -a 11 respects as full as could be wished, still as they gave me some detailed account of the more prominent symptoms which obtained among the patients suffering from this disease, I think it desirable to place them on record here", which he does in respect of some 9 cases and makes observations concerning temperature charts of the City of London cases annexed to the report, in addition to pathological investigation as to the probable cause being staphylococcus alba. • There are other matters of publichealth interestwhich are worthy of brief mention. Hardly any greater sanitary gift could have come to the poorer mi 11 ions of the nation than that steady cheapening of their daily bread which the Corn Importation Act of 1846 secured to them, and in the same session of Parliament the notable act which enabled Local Authorities to establish public baths and washhouses was passed. This admirable act, specially in the interests of the labouring classes, was mainly due to the exertions of an association for Promoting Cleanliness which had been founded two years previously and which, first, by an instructive trial of Free Baths and Washhouses in the neighbourhood of London Docks, led the public to see how greatly such establishment were needed and how readily they could be made self-supporting. I want to make brief mention of two City Livery Companies. (I) Society of Apothecaries The Apothecaries'Hal I in which we are seated is a Livery Hall with a long standing association with Medicine. It stands on its original site after its destruction in the Great Fire of London, and its court room, great hall and parlour were rebuilt on much the same lines. When purchased, the River Bank was not far from the Hall. It would correspond to the centre of Queen Victoria Street today where the railway bridge crosses it. The neighbourhood of the Hall has of course been much altered.As well as having geographical proximity to the Thames, the River played quite a part in the activities of the Apothecaries. At the time when they first assumed their livery and for nearly 200 years after, the waterway of the Thames provided the most appropriate route by which pageants such as the installation of the Master or the Lord Mayor's Show proceeded. It is well to remember the importance attached to the training of the apprentice to recognise drugs and to practise the complicated methods then used in compounding and dispensing medicines. Hence the importance of the herborising excursions, undertaken under the auspices of the Society of Apothecaries. The apprentice during his servitude handled and dispensed drugs in his Master's shop but attended the herborising excursions and in the physicks garden on the Thames at Chelsea to study botany. These excursions took place on certain days each year. The apothecary had to have to wide and intimate knowledge of the simples from which so many of his medicaments were prepared. To learn to recognise a great variety of plants the apprentice must go 'asimpling'. When the company had its own Hall these educational expeditions were arranged regularly and with efficiency, and once a year there was a general simpling day and later six each summer. The first was led by the Master who bore the cost of providing the dinner In later years the demonstration of plants by expert botanists became a regular practice especially after the Orangery had been built at Physick Garden. The Garden Committee of the Company consisted of Livery Men with a profound knowledge of botany. From them demonstrators were always available to teach on the outings on the long summer days in the woods and fields which lay in their natural beauty so near the City, so that this played a part in the training of the apprentices in addition to the herborising excursions to the Physick Garden, Of course the name Physick Garden used at the time to describe all the botanic gardens did not refer specially to the physick of doctors. It was used in the old phylosophical sense of physic as belonging to nature or natural science, It meant a garden in which botany as a branch of natural science might be studied or taught. The gardens at both Kew and Oxford were so named at first. That it persisted at Chelsea was due to its association with the Apothecaries. A physick garden was a necessity for the Society of Apothecaries for the education of apprentices as well as the honour and dignity of the Society. In 1673 the Society rented a ground by the riverside at Chelsea and built on it a house for its new barge. By 1676 it had a brick wall provided to enclose it. Nectarines of all sorts, apricots, plums, cherries and peaches were planted and a fine water gate was placed in the encircling wall to the south of the riverside. Flanking the gate four rare cedars of Lebanon were planted. Two of these were cut down in 1771 to gain space for more plants but two remained and were admired by all who visited the gardens. The chairs of the Master and Wardens now in use were made in 1812 and 1842 from the wood of the trees that were cut down. The gardens soon became famous and Dr. Hans Sloan was closely associated with it. (2) Fishmongers' Company The second Livery Company which I wish to mention is the Fishmongers, one of Twelve Great Companies of the City of London and among the most ancient of City Guilds — it has an unbroken existence for more than 700 years. The Fishmongers of London are known to have been an organised community long before Edward I in A.D. 1272 granted them their first Charter. That Charter and others granted in the reigns of Edward II and Edward III provided that no fish could be sold in London except by the 'Mistery of Fishmongers'. They also limited the markets at which fish could be sold in the City and made it the duty of the Wardens of the Mistery to oversee the buying and the selling of fish to ensure that none but fish of sound quality was offered for sale. In this respect we encounter the Public Health aspect of their functions. Later Charters formally incorporated the Company and laid down rules for its governance and the regulation of trade. They were granted in the reigns of Richard II, Henry V, Henry VI, Henry VII, Henry VIII, Edward VI, Mary, Elizabeth I and James I. The fourteenth century was a period of great expansion for the Fishmongers. With the granting of their Charters, their wealth and influence increased enormously and they took a very prominent part in the affairs of the City. They had secured the enjoyment of a complete monopoly of the sale of fish — one of the chief necessities of life in the Middle Ages. The Fishmongers were required to furnish three ships for the Royal Navy in the reign of Edward I and on his return from the successful war in Scotland, they furnished him with a most imposing pageant. A similar pageant was made by the Guild in the reign of Edward II on the birth of the young Prince who afterwards became Edward III. They caused a boat to be fitted out "in the guise of a great ship with all manner of tackle that belongs to a ship and it sailed through Chepe as far as Westminster". The Fishmongers there presented the ship to the Queen and then "all well mounted and costumed very richly" escorted her through, the City on her departure to Canterbury on pilgrimage. In the reign of Edward III the Company made a substantial contribution to the cost of the Hundred Years' War with France. From the beginning to the end of the fourteenth century the inhabitants of the City of London were largely concerned with the vexed question whether there should be free trade in food or not and the Fishmongers were at the head of what were known as the Victualling Guilds, whose interests in retaining their monopolies were opposed by the Craft Guilds who wanted free trade in food, but not in the goods they manufactured themselves. The monopoly was challenged unsuccessfully in the reign of Edward II (1307 - 1327") but was confirmed by the Charters of Edward III (1327 - 1377). In the year 1381, thePrime Warden of the Fishomngers Company, Sir William Walworth, slew WatTyler, the leader of the Peasant's Rebeliion, in Smithfield Market when he was threatening the life of the young king (Richard II). Two years afterwards, an influential Lord Mayor of London, John of Northampton, who was the leader of the free trade party, persuaded the Common Council of the City of London to declare that the Fishmongers were not entitled to monopolise the fish trade and that decision was confirmed by Parliament. In the new Charter granted to the Company by Richard II in 1399, all their privileges were restored and they were given license to elect six Wardens which is the present number. Until the end of the fourteenth century the Fishmongers had their own Court of Law (Leyhalmode) at which all disputes relating to fish were adjudged by the Wardens, whether such disputes were between members of the Company amongst themselves or with "foreigners" i.e. nonmembers of the Guild. The Fishmongers appear to have lost their monopoly in the 15th century, and although their history is not perhaps so full of incident in later centuries it embodies a record of duties performed and many intersting sidelights on historical events. The Company's present-day duties are still very largely concerned with the Fishing Industry and the Fish Trade. Under the Charter of James I the Company's officials (known as "fishmeters") examine all fish coming into London and condemn that which is bad. In cases where bad fish is exposed for sale, the Company institute proceedings under the Food and Drugs Act, 1955 against the offenders. In addition to the powers granted to them by Charter, the Company has statutory powers under the Salmon and Freshwater Fisheries Act, 1923, the Fisheries (Oyster, Crab and Lobster) Act, 1877, the Sea Fishing Industry Act, 19 38 etc Another part ot the Company's work is concerned with the salmon and freshwater fisheries of the country and the import of salmon etc. from abroad. For many years the Company has prosecuted offenders against the Salmon and Freshwater Fisheries Act for illegal methods of fishing and for marketing during the Close Times. An important aspect of the Company's work is concerned with shellfish. Samples of oysters, mussels etc. coming to the City of London from Great Britain and from abroad are regularly examined by the Company's Bacteriologist and when they do not come up to the Company's standard their sale is prohibited and enquires are instituted at the source of supply. So that while the Company's Charter applies only to the City of London, the benefit of its control in guarding against the spread of such disease as typhoid fever by shellfish extends to the whole of the British Isles. The Company's Hall has been on its present site near the North Western corner of London Bridge on the bank of the Thames since 1434 when the site was acquired from Lord Fanhope — it had previously been inhabited by such .prominent fishmongers as Sir John Lovekyn and Sir William Walworth. The Hall on this site was destroyed by the Great Fire of 1666 — it was succeeded in 1671 by a building designed by Edward Jarman. When London Bridge was rebuilt to the west of its old site it was necessary to put the bridge foot on part of the site of Fishmongers' Hall and the whole Hall was therefore pulled down. The present Hall, finished in 1834 was designed by Henry Roberts who had working in his office Gilbert Scott. Country Life has described the result of their work in these words "Gilbert Scott's collaboration with Roberts began and ended with Fishmongers Hall with the result that Roberts never carried out as considerable building again, nor Scott so good a one". Individual doctors associated with the Thames It is appropriate that I should refer to Sir John Simon the first M.O.H. of the City of London. He was a renowned pathologist and surgeon before he was appointed M.O.H. It might be thought that being the M.O. of the City he would have few, if any associations with the Port and the Thames, in particular. It is not so: he was socatholicin his interests in environment public health measures that he took a great interest in port health matters as well as City affairs. He was appointed M.O.H. on 19th October 1848. He was not long in office till cholera became epidemic in 1849 from drinking the barely filtered diluted sewage water of the Thames or the New River. In addition contaminated hands and flies infected food in the overcrowded dirty City of London.John Simon thought thatcholera was non contagious and caused by inhalation of contaminated stench from putrid decomposed matter. He also thought that the diarrhoea if treated in the early stage by constipating medicine could be prevented from developing into acute cholera. So his preventive measures in removing filth was right for the wrong reason, but in flushing the sewers into the Thames to get rid of it, the epidemic was extended by contaminating the water supply. His policy was the same as Chadwick's in so far as incessant flushing of the sewers into the river was concerned. In the I840's there were 3 theories concerning the etiology of infection. There was the germ theory that infection was due to a living organism. This theory had been reformulated by Henle in 1840 and naturally stressed the contagiousness of disease. It was supported by the empirical work of men like John Snow and William Budd but lacked conclusive experimental proof. The second theory was that of spontaneous generation of disease within the blood. This was a chemical theory and naturally denied contagion. Thirdly there was the atmospheric theory. This was vague. It was that under certain circumstances the atmosphere became charged with an epidemic influencewhich in turn became malignant when it became embued with exhalations of organic decomposition. The resulting gases or maisma produced diseases. Florence Nightingale and Chadwick held to this theory throughout their lives. John Simon dismissed Henle's theory as unproven and he considered the phenomena of infectious diseases to be essentially chemical. He found it impossible to accept John Snow's theories and his empirical proof of the water borne contagion of cholera though he was aware of the dangers of impure water: he was scrupulously careful in evaluating evidence and was not open to be convinced easily. In the late I870's Simon was able finally to accept specific contagion as the cause of infection. He declared "the true cause of each metabolic contagion must either be or must essentially include a specific living organism able to multiply its kind". He tended if anything from now on to overstress the germ theory of disease. On 12th June 1849 Simon had to report to the Court of Common Council that cholera had struck in some of the dirty, fly infested haunts of the East London district. I will deviate at this point to mention how interested Monckton Copeman was in flies as carriers of infection and what an ally he would have been for Simon. Copeman made ingenious attempts to record scientific observations of flies at different places as comparable as possible. He set up observation centres and fly-collecting stations. The latter were in most cases private houses. It was necessary to obtain the co-operation of the occupiers. In this connection he states that experience in London has shown that no difficulty is experienced in this respect. The centres were places selected where large quantities of house refuse or stable manure was deposited, in investigations conducted in London during the previous two years, all operations were carried out with as much uniformity as possible. Criteria for uniformity were enunciated by him with regard to selection of collecting stations. These criteria had regard to a ground floor location, fairlylighred, preferably with sunny aspect, neither specially clean nor dirty, not done up within the previous 6 months, not near other accumulations of refuse or manure, nor in the vicinity of shopswnere articles of food were sold, and so on. He gave details of the fly traps to be used and one recommended for uniformity of use was a fly paper known as "The Fly Cemetery" coatedwith a specially tenacious "honey-gum". Directions as to the use of the fly paper were given and where and how it should be hung. A scheme for the collection of fly papers at regular intervals of 24,48 antj 72 hours and arrangements for replacement was instituted. Counting of flies after sorting and so on was described, as well as curves plotted of catches and comparisons made with curves representing incidence of deaths from epidemic enteritis and enteric fever. A method of marking flies is described. This was used to facilitate the accumulation of accurate information regarding range of flight of flies vertically and horizontal ly. "Spot" maps of the centres on which were super-imposed locations by means of dots of houses invaded by epidemic enteritis or enteric fever respectively were made. Metereological Data as to the air and soil temperature, rainfall, direction and force of the wind, duration of bright sunshine, persistence of rainy weather were kept. If a species of fly trapped was unknown this was elucidated by arrangement with the British Museum Natural History, South Kensington. Monckton Copeman also carried out an interesting study in an endeavour to answer thequestion "do flies hibernate?" As far as flies and cholera were concerned Sir John Simon insisted that his inspectorate was entirely insufficient in this emergency and that the establishment should be immediately enlarged. The police also should help by inspecting every house in the poorer areas of the City and report on a special form each nuisance that they found. Simon attended daily at Guildhall with the Clerk issuing orders to abate the statutory nuisances. 30 citizens had already died from cholera in the last week of June. The Court had trebled the nuisance inspectorate and during the summer enforced the works that Simon had ordered. The clearance of a vast amount of removable filth undoubtedly reduced opportunities for contact spread of the disease. He had urged on the Board of Guardians to prepare for the epidemic by adopting the measures advocated by the General Board of Health. This included the provision of cholera wards and places of refuge for evacuees from cholera infected houses, mortuaries and medical relief of the poor. The method of house visitation was to be instituted in the poorer areas in order to find out and treat any premonitory diarrohoeal symptoms of cholera. The Court of Common Council established in July a special health committee of 12 members with powers to spend sums in medical relief. Deaths increased in the last weeks of July from 30 to 39 and then leapt to 68. Simon insisted that the sewers should be incessantly flushed into the River and that the sewage strewn docks and mudbanks of the Thames should be cleansed. Sewer flushing into the river aggravated the epidemic. After a lull in early August the cholera suddenly became water borne. There were 82 deaths in the week ending 18th August and 100 in that ending September 1st. In the Metropolis at large nearly 2,000 people a week were dying by the end of the month. The headline of the Times appeared "We must cleanse or perish". The large London Hospitals were packed with cases of cholera and had to close their doors to sufferers seekingadmission. On 3rd September the Health Committee finally agreed and allowed the M.O. to set up a hospital and provide medical assistance to the Poor Law M.Os. out of the City's own funds. We see Simon's co-ordination of preventive and curative action by appointing 10 Assistant M.Os. to help the Poor Law doctors. However the Court of Common Council failed to ratify the Committee's action when they met on 7th September so that the Hospital project was not approved and Simon had to dismiss his medical assistants. In this week over 94 people had died of cholera in the City — 2,200 in the Metropolis. The General Board of Health sent their medical inspector on 13th September to insist that the City act in place of the recalcitrant Guardians. Part of the meeting took place in the Mansion House where the Lord Mayor lay in bed struck down himself with sickness. Immediate compliance with the inspectors requests was given. The Times came out strongly in support of the M.O.H. and blamed the City Authorities for having ignored Mr. Simons impressive and strenuous warning by imposing all sorts of obstacles and delays to the M.Os. efforts, and even if we are not greatly mistaken suppressed portions of them while in the end they had to adopt his recommendations. The 10 temporary Medical Assistants were re-appointed and worked in conjunction with the Poor Law M.Os. 5,000 families were visited and freely treated if found to be suffering with premonitory diarrhoes. The City Burial grounds overcrowded at the best of times were as a consequence of the cholera epidemic receiving more corpses than ever before. Simon issued orders and attempted to prosecute for the misuse of these burying grounds and was again supported by the Times. Its leader referred to them as "consecrated cesspools". Ironically as Simon's visitations got under way the cholera epidemic began to diminish. Cholera deaths in the City fell from 60 in the 3rd week in September to 1 9 a fortnight later. Between 9th June and 17th October 854 had died in the City whereas in London as a whole 14,601 had so perished and in England and Wales 72,180. Simon in his first annual report demanded a better water supply for the City. This was to be achieved by providing an intercepting sewage system to prevent the Thames from constant pollution and he envisaged an agricultural use of the sewage. Simon sometimes himself venturing down the sewers, secured the laying of outfall culverts in the Thames and the filling up of some of the small docks. (By 1854 the square mile was the only part of London with a complete workable sewerage system in no small part due to the efforts of the M.O.H.) He was an advocate of an unrestricted supply of water. That is a constant supply in place of the existing intermittent and uncertain delivery of water and in addition i.e. universal, a cistern in every home and on each floor of tenements, as well as every court its stand cock for cleansing and every privy an abundant supply for flushing. It was not so easy to secure an adequate water supply; however in the same year 1854 the common stand cock system was abolished and every house in the City had a daily supply of water of some kind. As well under the Water Act of 1852 The New River Company covered its reservoirs and filtered its water so securing a purer and safer supply, but the quantity was still inadequate and intermittent. But as regards the Thames the Act was much less satisfactory. The Companies were to cease to draw water from the Thames below Teddington after 1855 and these conditions were so qualified as to be exempt from liability, so that the deaths of many Londoners in the cholera epidemics of 1854 and 1866 were not prevented. As far as the 1854 epidemic was concerned, Simon commented "less suffering in the City of 1854 than in the City of 1849, less in the City clean than in the City dirty, less in the City cared than in Metropolis neglected". 211 people died from the disease in the square mile as against 728 in 1849. Though the epidemic reached major proportions south of the Thames though milder than in 1849 the number of deaths being about one quarter less. But in the City reduction in mortality was about three quarters less than in 1849 though with its high density population and numerous sewage outlets it was at much greater risk than other parts of London. Simon told the Court of Common Council "But against those threatened injuries, at least one good was to be counted. Unlike the rest of the Metropolis the City had a sanitary government. For some years you had been giving care to the physical conditions of public health. You had paved and sewered the City, even through its courts and alleys. You had established daily scavenging. You had almost abolished cesspools. You had put water within the reach of all. You had done something (little was in your power) against overcrowding. You had set on foot the periodical inspection of houses with a view to better cleanliness". Yet his scientific caution is seen in what follows, "I can give you no logical certainty that you have saved even a single life. We must wait for scientific insight, the fruit of larger observation to adjudicate on such cases as our own. Ample pains as you have taken to deserve that cholera should space your population, there can be given no present demonstration that this happy result has been the unconditional effect of your sanitary labours", so he refused to deduce from the apparent correlations between their sanitary reforms and successful avoidance from cholera. Yet Simon held and shewed from the mortality of the City that sanitary endeavours reduced such diseases. "Links of cause and effect may, in the particular instance, be beyond our means of demonstration" he said "but we know as universal truth that similar reults are the promise of similar exertions and, confident in this practical knowledge, we may waive the impossible proof to accept the suggestive lesson. I believe that through your timely exertions many human lives have been saved and much human suffering averted". In retrospect we can applaud Simon's tentative claims and his caution in not making dogmatic scientific judgments but have to reject his atmospheric notions. As so frequently since, he did then what was right for the wrong reasons. The cholera epidemic south of the River was severe and widespread because waterborne, but North of the Thames the New River Water supply was now filtered so that the cholera never became so extensively waterborne but rather transmitted by direct contact or flies — so that the removal of filth and refuse to prevent organic decomposition helped to remove the means of transmitting the disease. He was cheered by the Court when he finished his report. Charles Kingsley when he read the cholera report in his newspaper, wrote of Simon "verily the days are coming when as the Prophet says 'a man shall be more precious than fine gold' — your efforts are helping towards this good end". The Times reported "Mr. Simon speaks as a practical man who is not willing to go an inch beyond that which he has with his own eyes recognised for truth. He had not enforced general laws on a priori notions but had done in each instance exactly as much as was needful. The credit he tacitly claims, he has fairly won". The Public Health Bill of 1858 made provision for the appointment of a Medical Officer to the General Board of Health and Simon was the obvious man for the job. He had shewn himself to be a practical and able exponent of preventive medicine in local government, so the first M.O.H. of the City became the first but not the last M.O.H. to be appointed medical officer of the central government health department. We find in Simon's conception of a single central health department legislating to the level o* the acceptable findings of medical science in the field of public health in which he included "care for the physical necessities of human life". So in this department he envisaged control not only of water supply and drainage but he mentions other matters concerned with the River such as the regulation of emigrant ships, quarantine and preventive vaccination, ailments of London dockers. In fact he set up his enquiry as the result of a case at St Thomas's Hospital and this was the first of a series of government investigations into industrial health which he was to initiate. Now as Medical Officer of the Board, Simon prepared a report on cholera concerning the question of the connection between the outbreaks and sewage contaminated water supply. This was his definite reply to this great sanitary question. In 1855 the Committee for Scientific Studies had refused to confirm any definite connection between the two and asked for research into the problem. John Snow had already given a report of practical proof in the wellknown Broad Street Pump outbreak, and William Farr had carried out an epidemiological analysis of 1854 in South London as affected by the water supply. Simon's report elaborated these investigations and covered both epidemics of 1848 - 49 and 1853 - 54 and the half million living south of the Thames supplied by two different water companies (Southwark and Vauxhall — and the Lambeth). The Lambeth supply had its source of intake at Ditton whereas the Southwark Company still pumped unfiltered water from the Thames at B attersea purveying perhaps the filthiest stuff ever drunk by a civi li sed community. Lambeth Company deaths were 37 per 10,000 and for the Southwark Company 130 per 10,000 i.e. population drinking dirty water suffered 3Zi times the mortality of the population drinking different water. From these and other facts Simon proved conclusively the danger of drinking faecalised Thames water during cholera outbreaks. He reached this conclusion empirically and statistically by retrospective examination of the evidence without much understanding of the nature of cholera, contact infection or isolation of the specific organism. He concluded that this was one cause — he still thought the atmospheric theories remained plausible. He drew the practical conclusion that sewgae should be diverted from the river to land. Following the memorable great stink of 1858 when the nauseating al l-pervading stench from the Thames made the purlieus of Westminster barely endurable — (Adderley states the nearby Thames 'might soon be a terror to this house') — Simon set William Ord to report on the stinking state of the Thames and its effects on health. In 1862 - 3 he appointed another specially commissioned expert Dr. Robert Barnes of the Naval Medical Service to investigate the prevalence in the mercantile marine of scurvy. Barnes showed that the disease persisted because employers deliberately ignored imperative dietary provisions of the Merchant Shipping Act, 1854. In his Sixth Report, Simon demanded "particular inspectional regard for the enforcement of the law". The Merchant Shipping Act, 1867 sponsored by the Board of Trade established a medical inspectorate of mercantile marine as Simon desired and eradicated the suffering he had condemned. Again in 1865, faced with the prospect of a fourth European epidemic of cholera, Simon guessed how effective in the light of the new scientific knowledge would 'the paper plausibilities of quarantine' prove. He maintained that contagions current on the Continent of Europe should be deemed virtually current in England, so he demanded greater powers for local authorities over the individual and his actions to limit the spread of infectious diseases, such as compulsory removal to isolation hospitals, transfer of dead bodies to mortuaries, disinfection of infected articles and conveyances, and prevention of infected persons appearing in public places or using public conveyances. This, he held would be more effective than any national quarantine. Travelling from the Near East and Mediterranean rather than from the Baltic as formerly, cholera appeared in England in the late summer of 1865. Next spring isolated outbreaks occurred in ports, including London where there was heavy emigrant traffic, and the outbreak by July was generally epidemic throughout the country and reached its climax in August especially as a water borne epidemic in East London, but rapidly subsided and was mild compared to the three earlier epidemics, though even in this 14,378 died. Simon presided over this major outbreak and rigidly refused to impose a general quarantine but used the powers of the Disease Prevention Act, extending it to the whole country and helped local action. Simon sought to set up a research team into the treatment, biochemistry, symptoms and communicability of cholera with the aid of seven eminent London doctors, and made a demand on the Treasury for a £2,000. grant for this purpose. Benjamin Disraeli, then Chancellor of the Exchequer, granted only £1,000. stating "Mr. Simon is energetic but requires supervision". Four items of the research scheme had to be abandoned for lacks of funds — so experience nowadays in this field has had good precedents. Thudicum's biochemical studies and Sanderson's work on communicabi lity were published in the Annual Report of 1867 with an epidemiological analysis by J. Netten Radcliffe of the origin of the cholera outbreak in East London, and an account by Simon of the international cholera conference at Weimar. The moral Simon drew was that 'excremental sodden earth, excremental-reeking air and excrement tainted water' still remained for him the causes of the diseases. Until filth was removed and water purified, cholera and typhoid would continue to kill their thousands. 'It is to be hoped' he concluded 'that as the education of the country advances this sort of thing will come to an end, that so much preventable death will not always be accepted as a fate; and that for a population to be thus poisoned by its own excrement will some day be deemed ignominious and intolerable'. The Sanitary Act of 1866 came as a result of Simon's work which the Times declared 'introduces a new sanitary era'. 'Nearly the whole credit of this achievement' the Lancet affirmed 'is due to the untiring energy and to the great tact and judgment of Mr. Simon'. The Times said "great honour is due to Mr. Simon to whose zeal, ability and public spirit we are indebted for this Act.A public servant who has for years struggled with all the difficulties that attend a cause which only appeals to plain and solid utility, who has mastered the great mass of details which accumulate on such a subject, who has perseveringly kept that cause before the minds of men in office, and coped energetically with that spirit in public life which is always putting off and thrusting aside plain useful objects for the benefit of questions which have fashion or party to support them - a public officer who has done this important work deserves the publ icgratitude." Port In 1872 another notable step in the sanitary evolution of London was taken under the threat of another cholera invasion from the Continent and the creation of an authority for the protection of the metropolis against the importation of disease by sea from foreign countries or from home ports. "It is now acknowledged" wrote the Port medical officer of health Dr. Harry Leach in his first report "that as a natural result of the insular position of the kingdom and the vast extent of our commerce, the sanitary condition of shipping and of the floating population must exercise a considerable influence on the health of the country as regards the importation and transmission of epidemic diseases. The urgent advisability of using all means to prevent the introduction of disease into this the largest port in the world is sufficiently apparent."One sanitarv inspector was appointed to assist Dr. Leach who was supplied with a rowboat to enable him to carry out the inspection of ships lying in all parts of the River. Hitherto the prevention of the importation of the various sorts of diseases into London by vessels trading to the port of London from all quarters of the world had been confined to the Officers of H.M. Customs and was of the most superficial and inadequate character. The Authority today has four motor launches, 8 Boarding Medical Officers (2 full and 6 part time) 20 Public Health Inspectors and 17 Assistants. The district assigned to the Port of London Sanitary Authority extended from Teddington Lock to the North Foreland, and was 88 miles in length. It included 8 sets of docks and 13 creeks. In the section of the river lying between London Bridge and Woolwich Arsenal Pier, about 10 miles in length, there was in those days a constant average of no less than 400 vessels of all descriptions moored on both sides of the river, more than 90% of which had crews on board. The creeks were more or less occupied by barges containing manure, street sweepings, gas liquor, bones and other varieties of foul cargoes in as much as depots for the storage of these materials existed on the banks. And lying in the docks there was an average of between 6 to 700 vessels over none of which had the Sanitary Authorities on the sides of the river any control whatever. There was a most unsatisfactory condition of tnmgs and left long open to the practically unchecked importation of infectious and contagious diseases of every kind. By provisional order of the local government board the Corporation of London was constituted the Sanitary Authority of the Port of London issued on the 17th September 1872 and renewed the 15th March 1873 and was made responsible not only for taking proper steps under Orders in Council to prevent the introduction of cholera and the other quarantinable infectious diseases but was required also to carry out within its allotted area the provisions of the various Nuisances Removal Acts and the Prevention of Diseases Act for England and the Sanitary Act of 1866. Its authority extended only to things afloat. Whatever was landed came within the province of the local Sanitary Authority except things landed in the docks and things in Bond which were under the control of H .M. Customs. The work was undertaken at considerable expense by the Corporation out of City's Cash and at no charge to the ratepayer and a medi cal officer of health for the Port and some inspectors were appointed. It is the duty of the Port medical officer "to inspect before landing all emigrants that arrived in the port from the continent for purposes of trans-shipment and to isolate all suspected cases and to carry out all special orders in Council relating to the prevention of cholera or other epidemic diseases". He was also charged with the duty of inspecting at Gravesend any cases of sickness on inward bound vessels reported to the authority by the officers of H.M. Customs. As to the prevention of the importation of epidemic diseases other than cholera, reliance was placed upon a speedy and proper examination of vessels as soon as possible after they had come to moorings. A large proportion of these vessels required constant general inspection. Among the other duties fumigation and disinfection of vessels also clothing were not the least important. For isolation of the sick a hospital ship was maintained at Gravesend. The work done by the Port Authority was in spite of many limitations and difficulties considerable and the inspection of thousands of ships, the cleansing and fumigation of foul and infected vessels, the removal to hospital of seamen suffering from contagious or infectious disease and thedrsinfection of clothing were sanitarily of the greatest advantage to the inhabitants of the metropolis In 1882 the limits of the Port of London were extended seawards and in the following year the powersof the Port Sanitary Authority were extended by the Diseases Prevention Metropolis Act 1883. Most of the powers of an urban sanitary authority under the Public Health Act of 1875 were conferred upon it and the medical officer of health reported that he believed the legal part of the Authority would be found amply sufficient for the sanitary control and supervision of the Port. The Authority extended its attention now to the inspection of imported meat. It was a matter of the first importance to watch carefully the food supply of the people. The trade of frozen meat had been rapidly growing and from time to time large quantities arrived in unsound condition which it was most necessary should be prevented going to the market, and food in general came under surveillance with the introduction of Imported Food Regulations. I will refer to Monckton Copeman's association with Port Health work. In consequence of the rapid diffusion of cholera throughout Russia in the summer of 1892 an emergency survey of the chief English Ports and Riparian Sanitary Districts was instituted by the Board in July 1892. The objects of the survey were to ascertain (a) the state of preparedness of the Authorities of Maritime Districts to deal with ship-borne cholera, and (b) to advise these Authorities as to the action necessary, to be taken to carry out the Board's Cholera Orders. This emergency survey was completed by the end of October, and Dr. Monckton Copeman was one of the officers to whom it was entrusted. In consequence of the unsatisfactory character of the then current arrangements in many of the districts visited and in view of the continued prevalence of cholera in Europe, it was considered desirable that a more detailed and deliberate survey of the whole coast line should be undertaken early in 1893 and again Dr. Copeman was engaged in this survey work and made a detailed enquiry with respect to the general administration of the Port Sanitary Districts on the section of coast line allotted to him. Before proceeding to a District he was supplied with definite queries as to several matters to which his attention was to be directed, such as the constitution and limits of jurisdiction of the Authority; the amount and character of shipping trade; means of communication (rail or water) between port and inland districts; the character of administration as regards routine inspection of vessels and arrangements for detecting and limiting the spread of infectious diseases generally; efficiency of special arrangements to carry out the Board's Cholera Orders. He was also furnished with Ordnance Maps and Admiralty Charts of the districts he was to survey. It is revealing to consider some of Dr. Copeman's personal remarks concerning the Inspectors of Nuisances in individual reports, e.g. of one he writes "He appears to carry out his duties fairly well as far as he understands them. He is unfortunately so completely deaf that he can only hear with the aid of an ear trumpet and then even with difficulty". What a revealing statement concerning John Stevenson of whom it was written as well as the subject of thismemorial lecture. How kindly and considerate in view of the grave disability of deafness. But Dr. Copeman could be equally incisive and forthcoming. In one instance in which the inspector was also a Civil Engineer and Borough Surveyor and Water Works Engineer and Inspector of Nuisancesalso to the Urban Sanitary District, he reports "This officer appears to have little or no knowledge of the duties of his post as Inspector of Nuisances to the Port Sanitary Authority. The other appointments which he holds in the town take up the greater part of his time and in consequence he neglects altogether his duties in connection with the port". In conclusion I wish to express my gratitude for my nomination to the honourable position of Monckton Copeman Lecturer 1969 and to you, my hearers, for your patient listening.