92.75 sou Borough of Southward ANNUAL REPORT OF THE Medical Officer of Health FOR THE YEAR 1935. William Stott, m.b., b.s., d.p.h., Medical Officer of Health, Administrative Tuberculosis Officer, Administrative Officer for Maternity and Child Welfare. LONDON : Crusha & Son, Ltd., Tottenham, Enfield and Wood Green. H.H. 667.8 INDEX. A. Page. Acts and Bye-laws (Additional) 47 Acute Influenzal Pneumonia 121 ,, Primary Pneumonia 121 Additional Maternity Services 1 Ambulance Services 26 Ante-Natal Clinics 34 Area of Borough 7, 9 Agricultural Produce (Grading and Marking) Act 82 Artificial Cream Act, 1929 106 B. Bacteriological Specimens 26, 102 Bakehouses 53, 105 Births 7, 9, 15 ,, Illegitimate 7, 15 Birth-rates 7, 9, 10, 11 Black Smoke 48 Blind Persons Act, 1920 122 Brushmakers 52 Butter and Margarine Factories 106 Butchers' Shops 75 C. Cancer 14, 121 Census, 1931 8 Cerebro-spinal Fever 121 Chemical and Bacteriological Examinations 26 Clinics 27,31 -34 Common Lodging Houses 43 Convalescent Treatment 29 Coroners' Court 57 Cowsheds 105 D. Day Nurseries 29 Deaths 7, 11, 12, 14 Deaths, Causes of, Table 14 ,, Infants 15, 16 ,, In Public Institutions 12, 14, 19 ,, In Wards 17 ,, Zymotic Mortality 22 Death Rates 7,11,12,13,17 Density of Population 9 Diarrhoea 120 Dinners for Expectant Mothers 29 ii Page Diphtheria 118 ,, Prevention 27, 118 ,, Schick Test 119 Disinfection 126 Disposal of Unsound Food 88-99 Dressmakers, Milliners, etc. 52-53 E. Eating Houses 53, 80, 81 Encephalitis Lethargica 121 Enteric Fever 118 F. Factories and Workshops 51, 53 Food and Drugs, Tables of Samples . . 109-112 ,, ,, (Adulteration) Act, 1928 106 ,, Inspection and Tables 75-100 G. General Hospitals 27 H. Health Services, Hospitals, etc. 26, 27 ,, Visitors, Summary 36, 37 ,, Visiting 38 House-to-House Inspections 69 Housing 61-72 Houses let in Lodgings 48 Home Workers, Table 52 I. Ice Cream Premises 53, 75-80 Imported Food Regulations 83 Infant Life Protection 30 ,, Mortality 7, 11, 15, 27 ,, ,, of Illegitimates 7 Infectious Diseases, Control of 117-122 Influenza 121 Informal Samples 113 Inhabited Dwellings 7 Inspections L. Laboratory Facilities 26 Laundries 51 Legal Proceedings 45, 46-107, 108 L.C. C. Genera] Powers Act, 1928 (Sec. 28) 49 iii M. Page Maternity and Child Welfare 28, 31 Maternal Mortality 29 Measles 120 "Merchandise Marks" Act 82 Midwifery and Maternity Services 28 Milk and Dairies (Amendment) Act, 1922 101-105 Order, 1926 102 ,, (Special Designations) Order 102 Milksellers 101 Mortality Statistics 7, 11 Mortuary 57 Municipal Day Nursery 29 N. Notices served 44 Notifiable Diseases 123 Notified Births 39 Nursing in the Home 26, 27 O. Offensive Trades 105 Ophthalmia Neonatorum 122 Orthopaedic Clinics 30 Outlying Deaths 12 P. Part-time Officers 25 Population 8 ,, in Wards 9 Poliomyelitis 121 Puerperal Fever 7 ,, Pyrexia 7 ,, Sepsis, Deaths 7 Public Cleansing 43 ,, Health Officers 25-26 ,, ,, (Condensed Milk) Regulations, 1923 and 1927 106 ,, ,, (Preservatives in Food) Regulations 85-86, 87 ,, ,, (Dried Milk) Regulations, 1923-7 106 ,, Vaccinators 26 R. Rag Flock Acts, 1911 and 1928 49 Rateable Value 7 Rats and Mice (Destruction) Act 54 Reception House, Families Admitted 124, 125 Registered Births and Deaths 18 ,, Workshops 53 iv S. Page Sale of Food and Drugs Acts 107-113 Scabies 56 Scarlet Fever 117 Schick Test and Inoculation against Diphtheria 118-119 Slaughterhouses 75 Smallpox 117 Smoke Abatement 47 Southwark Invalid Kitchens Society 29 Sputum, Examinations of 26 Statistics and Social Conditions 7 Still Births 7, 39 Sunlight Treatment 29 T. Tailoring 52 Tuberculosis 127-141 U. Underground Bakehouses 51 Unsound Food 88-99 V. Vaccination Officers' Return 40 „ Officers 26 Venereal Disease Clinics 27 Verminous Persons and Children 56 ,, Rooms and Bedding 55 Vital Statistics, Summary of 7 ,, ,, Table 20-21 W. "Ward Distribution 9 Water Supply (P.H. Act, Sec. 48) (L.C.C. G.P. Act, 1907) 50 Whooping Cough 120 Workshops (Women's) 53 Works Completed 44 Z. Zymotic Mortality 22 Borough of Southwark. Public Health Department, Town Hall, Walworth Road, S.E.17. To His Worship the Mayor, Aldermen and, Councillors. Sir, Ladies and Gentlemen, I have pleasure in submitting my Annual Report for the year ending 1935. The year has been one of progress and extreme activity. Soon after coming into power the present Council decided to increase the activities of the Health Department in all its branches. The Maternity and Child Welfare Scheme was enlarged and provision was made for: — (1) Maternity beds at the L.C.C. Lambeth Hospital. (2) "Home Helps" scheme was revised. (3) Convalescent treatment for mothers following confinement. (4) Specialists to assist medical men in difficult cases of confinement. (5) Maternity nurses for those unable to afford both doctor and a nurse. (6) Home nursing arrangements for children under five years suffering from pneumonia, bronchitis, whooping cough, measles, diarrhoea, etc. Provision was also made for the building of new maternity centres in suitable districts to replace the present hired halls, one of which— Villa Street—is at present in course of construction. By this means the scope of the work performed at the present centres will be able to be considerably augmented. The Tuberculosis Service was increased by the appointment of a part-time assistant tuberculosis officer. A dental service was commenced at the dispensary. 2 A small X-ray plant was installed to assist the medical officer in diagnosis, and in order that every contact, particularly children could be screened. Housing.—It was decided to accelerate house-to-house inspections and accordingly 3 additional temporary sanitary inspectors and 2 clerks were appointed for the purpose. In October preparations were made for the overcrowding survey to commence on November 1st, and an additional temporary staff of clerks and survey assistants numbering 60 in all were appointed. Health Propaganda.—The scope of this part of the work has been increased by the issue of a handbook to every householder which gives in detail the activities of the Health Services of the Borough and other useful hints for the health of the household; likewise by the systematic distribution of handbills from suitably placed containers in the various municipal libraries and public baths. Rats and Mice Destruction Act.—An intensive rat campaign was commenced in October, a Sanitary Inspector being wholly occupied in the duty of inspecting premises, vacant, land, etc., and taking all necessary action under the Act. A vast amount of work has already been done in rat-proofing of premises and the relaying or abolition of defective drains, etc. Disinfection.—The work of disinfection and cleansing of verminous persons and effects has so enormously increased during the past few years that the station in King James's Street was totally inadequate to meet the demands made upon it. Accordingly the Council decided upon a plan of re-construction and this is now in oourse of progress. Mortuary, Colliers Rents.—As a result of a report I made on the inadequacy of the post-mortem room and doctor's accommodation at the mortuary, the Council carried out certain improvements both to the structure and equipment, and they are to be congratulated on the fact that they possess a mortuary unequalled in London. Lastly, but not least, it has become increasingly evident that the present Health Department was inadequate for the housing of the staff, and abundantly so during the last twelve months. My staff seeks shelter in vacant committee rooms, cloak rooms and passages, and is scattered over the Town Hall. As a result the Council decided upon a bold plan of erecting a new building adjoining the Town Hall, on the site at present occupied by shops fronting on to Walworth Road and houses 3 fronting on to Larcom Street. This new building will be known as the "Health Services Department," and will house the Health Staff, Tuberculosis Department, Maternity and Child Welfare Centre, Borough Analyst's Department and several new services. From the above few remarks it must be quite evident to anyone that the Staff of the Health Department is working at very high pressure, and at times find it somewhat trying. Had it not been for the ready advice and assistance received from the Chief Officers of the Council and the loyalty of my staff my task would have been impossible. I would here like to place on record my appreciation of the support received from the chairmen and members of the committees on which I serve. From the health point of view the year under review may be regarded as a good one. Whilst the birth rate still remains at the minimum, the death rate is the lowest on the records of the Borough. Out of the total of 1937 deaths, 914 occurred in persons over 65 years of age. The principal cause of death was heart disease which accounted for 518 deaths. Following this was cancer with 284 deaths, pneumonia 150, and tuberculosis 146 deaths. The Infant Mortality Rate of 66, whilst not the lowest on record, indicates an improvement and shows that our efforts in the Maternity and Child Welfare services are being rewarded. The absence of measles plays an important part in this rate. The total infant deaths was 152. The principal cause of death in infants still remains—congenital malformations, debility and prematurity. These conditions, which caused 54 infant deaths, have never been lowered by any method yet practised in a Maternity and Child Welfare scheme. There is no doubt that fatalities of this nature will always occur, but in my view many can be prevented when public opinion is such as will demand it. The other chief causes of infant mortality in this Borough are pneumonia and bronchitis which accounted for 44 deaths, and whooping cough which caused 15 deaths. These conditions are due to infections and environmental causes. 4 Maternal Mortality Rate of 2.9 per 1,000 births is highly satisfactory and speaks well for those who are responsible for the care of expectant mothers and their safe delivery. The incidence of infectious diseases was lower than for many years, and at no time did we experience an epidemic. Further details on the above remarks will be found in the body of the report. I have the honour to be, Sir, Ladies and Gentlemen, Yours obediently, W. STOTT. SECTION A. Statistics and Social Conditions of the Area. 7 STATISTICS AND SOCIAL CONDITIONS OF THE AREA. Area (in acres) 1,132 Population (estimated, 1935) 156,100 Number of inhabited houses (end of 1935) according to rate books 27,810 Rateable value £1,329,108 Sum represented by penny rate £5,192 SOCIAL CONDITIONS. The population is chiefly a working-class one, and a large proportion are employed in the printing and manufacturing trades, whilst others are engaged as waterside labourers or casual workers. The unemployment figures, according to the Board of Trade Gazette, show a slow but steady decrease, the latest figures being 5,626 males, 1,823 females and 175 juveniles, a total of 7,624 as against 9,125 last year. VITAL STATISTICS. Total. M. F. Live Births—Legitimate 2,225 1,144 1,081 Birth Rate, 14.8 Live Births—Illegitimate 90 49 41 Still Births, 83. Rate per 1,000 total births, Deaths 1,937. Death rate, 12.4 Deaths from Puerperal Causes:—7. Deaths Rate per 1,000 (Live and Still Births). From Puerperal fever 2 0.83 From other Puerperal causes 5 2.07 Death rate of infants under 1 year of age per 1,000 live births:— Legitimate 63 Illegitimate 122 Deaths from Measles (all ages) 1 Do. Whooping Cough (all ages) 15 Do. Diarrhoea (under 2 years of age) 26 8 POPULATION. According to the returns supplied by the Registrar-General, the population of this Borough has again been depleted by 3830, persons. How far this figure is correct is difficult for one to say, but there is no doubt that many families have been removed from the Borough as a result of the Housing activities generally, including overcrowding and slum clearance. It is a matter of concern from the financial aspect, and I fear that there will be still further depletion during the next two or three years. I feel, however, that when the demolished areas are rebuilt and families re-housed, we shall see the population figure again rising; not to the same extent as it was some few years ago, but certainly on its present level. The population figures of all the Metropolitan Boroughs are at present in a state of fluxion. The population of the several divisions of the Borough at each Census since 1851, and also the estimated population for 1922, 1923, 1924, 1925, 1926, 1927, 1928, 1929, 1930, 1931, 1932, 1933, 1934 and 1935 are as follows:— Newington. St. George's. St. Saviour's and Christchurch. 1851 64,816 51,824 35,731 1861 82,157 55,510 36,169 1871 88,691 56,083 31,294 1881 107,831 58,652 31,628 1891 115,663 59,740 27,116 1901 121,863 60,998 23,319 1911 116,819 55,782 19,316 1921 114,987 52,114 17,303 1922 116,683 52,996 17,541 1923 117,200 52,690 17,574 1924 117,500 52,610 17,604 1925 118,300 52,980 17,720 1926 118,120 52,760 17,720 1927 115,500 51,650 17,100 1928 113,850 50,730 16,720 1929 112,350 49,900 16,250 1930 112,350 49,900 16,250 1931 107,692 48,552 15,451 1932 105,873 47,836 15,191 1933 103,240 46,646 14,814 1934 100,250 45,294 14,386 1935 97,849 44,209 14,042 9 The Ward distribution was as follows:— TABLE 1. WARD. Area in Acres. Population. Persons to the Acre. Males. Females. Total. St. Mary 127 10,064 10,019 20,083 158 St. Paul 133 8,026 8,341 16,367 123 St. Peter 146 11,224 11,892 23,116 160 St. John 118 11,974 12,808 24,782 210 Trinity 109 6,833 6,668 13,501 120 St. Michael 93 8,965 8,605 17,570 190 St. Jude 97 5,652 5,889 11,541 120 St. George 99 7,436 7,662 15,098 152 Christchurch 77 3,282 2,980 6,262 81 St. Saviour 133 3,573 4,207 7,780 58 Whole Borough 1,132 77,029 79,071 156,100 138 BIRTHS. The number of Births registered in the Borough during 1935 was 1,553 of which 797 were males, and 756 females. This represents a birth-rate of 9.9 per 1,000 inhabitants. The number of births registered in the individual parishes was as follows:—Newington, 694; St. George the Martyr, 365; Christchurch and St. Saviour's, 494. Of the 1,553 births registered in the Borough 266 were transferred away, the permanent residence of the parents being outside the Borough. 1,028 births occurring in various lying-in and other institutions outside the Borough, but belonging to Southwark parents, were notified to me by the Registrar-General. When the 266 ' 'outward'' transfers are deducted and the 1,028 "inward" transfers are added to the 1,553 births actually registered in the Borough, the net amount of births belonging to Southwark for the year is found to be 2,315. This gives a corrected birth-rate of 14.8. 10 TABLE 2. Birth.rate for the last Thirty Years for the Three Divisions of the Borough as formerly existed. Newington. St. George's. St. Saviour's and Christchurch. Whole Borough. 1906 29.0 30.5 25.2 29.1 1907 29.1 29.2 25.1 28.7 1908 28.7 28.6 23.2 28.1 1909 27.7 27.5 23.0 28.3 1910 28.2 28.1 24.3 27.8 1911 29.0 31.7 27.9 29.6 1912 29.0 30.7 28.0 29.4 1913 31.8 32.7 26.0 31.5 1914 29.7 31.4 25.5 29.7 1915 28.8 30.2 29.2 29.2 1916 28.4 27.1 24.4 27.6 1917 25.2 24.8 20.2 24.6 1918 21.8 21.0 18.4 21.3 1919 24.1 23.6 16.8 23.2 1920 32.1 32.2 28.5 31.8 1921 27.7 28.7 21.3 27.3 1922 24.0 25.5 24.3 24.4 1923 23.9 25.4 23.7 24.3 1924 22.0 23.6 22.4 22.5 1925 20.1 23.9 21.1 21.2 1926 19.9 21.6 18.1 20.2 1927 18.6 20.6 17.4 19.0 1928 18.0 21.1 19.4 19.2 1929 17.4 20.1 17.1 18.1 1930 16.0 18.6 16.4 16.8 1931 16.2 18.8 16.5 16.9 1932 15.3 17.7 16.9 16.2 1933 13.8 14.6 15.5 14.2 1934 14.5 15.6 16.2 14.9 1935 15.1 15.1 11.9 14.8 11 TABLE 3. Number of Births and Deaths belonging to each Ward, with the Birth and Death Rates, also the Infantile Mortality Rate, 1935. WARD. Births. Infantile Mortality. Deaths. Males. Females. Total. Birth-rate. Males. Females. Total. Death-rate. St. Mary 161 135 296 14.7 51 166 105 271 13.5 St. Paul 127 136 263 16.1 84 104 113 217 13.3 St. Peter 187 149 336 14.5 48 158 116 274 11.9 St. John 204 206 410 16.5 61 165 130 295 11.9 Trinity 88 89 177 13.1 56 86 62 148 10.9 St. Michael 123 122 245 14.0 82 136 105 241 13.7 St. Jude 110 92 202 17.5 67 68 67 135 11.6 St. George 111 108 219 14.5 87 97 78 175 11.6 Christchurch 35 44 79 12.6 50 48 43 91 14.5 St. Saviour 47 41 88 11.4 80 54 36 90 11.7 Borough 1193 1122 2315 14.8 66 1082 855 1937 12.4 12 DEATHS. 1,307 deaths were registered in the sub-districts of the Borough during 1935. 5 Southwark residents died in the street, or on the way to hospital. 808 deaths occurred in Public Assistance Institutions, the various hospitals, and other public places for the treatment of the sick found within our boundaries. These deaths in institutions comprised 231 belonging to Southwark and 577 to other sanitary districts. The number of inhabitants belonging to the Borough dying away from home—that is, outside our boundaries in the various hospitals and infirmaries—was 1,207. When the 577 deaths of those persons who were non-parishioners, but who died in our Borough, have been deducted, and the 1,207 "outlying" deaths added, the actual or "corrected" number of deaths belonging to the sanitary area is found to be 1,937, of which number 1,082 were males and 855 females. The death-rate, when calculated on this "corrected'' number, is 12.4 per 1,000 inhabitants for the whole Borough for the year 1935, as against a rate of 13.5 for 1934. The percentage of persons dying away from Southwark in relation to the total number of deaths belonging to the Borough was 62.3. The principal localities in which the "outlying'' deaths occurred are as follows:— Lambeth Hospital 349 St. Giles' Hospital 256 Rotherhithe Hospital 156 East Dulwich Hospital 48 St. Thomas's Hospital 47 King's College Hospital 14 Belgrave Hospital 6 Royal Waterloo Hospital 23 General Lying-in Hospital 6 Mental Hospitals 89 In the Street and other Institutions 213 1,207 13 TABLE 4. Death Rates for the last Thirty Years for the Three Divisions of the Borough as formerly existed. Newington. St. George's. Christchurch and St. Saviour's. Whole Borough 1906 17.8 18.5 17.5 18.0 1907 17.6 19.3 16.4 18.0 1908 16.1 17.2 14.3 16.3 1909 15.8 18.6 16.6 16.7 1910 15.9 15.6 16.5 15.9 1911 17.3 19.7 21.1 18.4 1912 15.8 18.5 17.4 16.8 1913 16.5 20.0 20.2 17.9 1914 16.5 19.6 20.7 17.8 1915 19.3 23.4 22.0 20.8 1916 16.5 18.4 17.3 17.1 1917 17.9 19.5 17.9 18.3 1918 22.9 23.7 23.1 23.2 1919 14.6 16.1 15.5 15.1 1920 14.4 14.6 12.9 14.4 1921 14.3 14.6 13.1 14.3 1922 15.2 16.1 15.4 15.5 1923 12.2 13.6 13.7 12.8 1924 13.5 15.3 15.1 14.2 1925 12.4 13.8 15.5 13.1 1926 12.3 13.3 14.1 12.7 1927 13.0 14.3 13.3 13.4 1928 12.3 13.4 13.8 12.7 1929 15.1 16.5 16.2 15.6 1930 12.6 12.8 11.2 12.5 1931 13.7 14.5 15.6 14.0 1932 13.2 12.9 13.6 13.1 1933 14.1 13.4 14.4 13.9 1934 12.9 14.6 14.2 13.5 1935 12.3 12.0 13.0 12.4 14 TABLE 5. Deaths belonging to the Sanitary Area, with the Causes of Death at all Ages during 1935. Causes of Death. Nett Deaths at the subjoined ages of "Residents" whether occurring within or without the District. I nstitutions. All Ages. 0. 1. 2. 5. 15. 25. 35. 45. 55. 65. 75. All causes 1937 - - - - - - - - - - - - 1. Typhoid and Paratyphoid Fevers - - - - - - - - - - - - - 2. Measles 1 - - 1 - - - - - - - - - 3. Scarlet Fever 2 - 1 1 - - - - - - - - - 4. Whooping Cough 15 6 9 - - - - - - - - - - 5. Diphtheria 14 - 3 4 7 - - - - - - - 1 6. Influenza 13 - - 1 1 1 2 - 5 - 2 1 - 7. Encephalitis Lethargica 4 - - - 1 - - - 2 1 - - 1 8. Cerebro-Spinal Fever 5 2 I 1 1 - - - - - - - 6 9. Tuberculosis of Respiratory System 130 1 - 1 1 19 19 21 22 34 11 1 14 10. Other Tuberculous Diseases 16 3 2 1 2 3 1 2 - 2 - - 11 11. Syphilis 10 2 - - - - - - 4 2 1 1 2 12. Gen. Paralysis of Insane, Tabes Dorsalis 12 - - - - - - 1 4 5 2 - - 13. Cancer, Malignant Disease 284 - - - 1 1 5 14 55 74 86 48 137 14. Diabetes 21 - - - - 2 - - - 5 9 5 7 15. Cerebral Haemorrhage etc. 84 - - - - - 1 3 3 28 31 18 36 16. Heart Disease 513 - - - 3 7 8 15 34 71 166 209 146 17. Aneurysm 8 - - - - - - - - 2 5 1 6 18. Other Circulatory Diseases 70 - - - - - - - 3 13 22 32 21 19. Bronchitis 63 5 1 - 1 1 1 2 9 10 15 18 32 20. Pneumonia (all forms) 150 43 6 2 2 5 1 5 20 19 28 19 74 21. Other Respiratory Diseases 13 - - - - - 2 - 4 3 4 - 4 22. Peptic Ulcer 28 - - - - - 3 4 6 8 7 - 9 23. Diarrhoea, etc. 28 23 2 1 - - - 1 - - 1 - 27 24. Appendicitis 9 - - - 2 2 - - 1 2 2 - 8 25. Cirrhosis of Liver 3 - - - - - - - - 2 - 1 1 26. Othor Diseases of Liver 9 - - - - - - - 2 2 3 2 3 27. Other Digestive Diseases 42 2 - 2 1 2 2 4 7 8 5 9 9 28. Acute and Chronio Nephritis 93 - - - 1 1 1 - 9 16 36 29 78 29. 2 - - - - - 2 - - - - - 1 30. Other Puerperal Causes 5 - - - - - 4 1 - - - - 4 31. Congenital Debility and Malformation, including Premature Birth, etc. 58 57 - 1 - - - - - - - - 37 32. Senility 19 - - - - - - - - 1 2 16 4 33. Suicide 20 - - - - - 4 4 4 4 4 - 7 34. Other Violence 54 — — 2 9 3 4 6 4 9 10 7 25 35. Other Defined Diseases 138 8 1 1 5 11 11 9 20 27 22 23 97 36. Causes (ill defined) 1 - - - - - - - 1 - - - - Totals 1937 152 26 19 38 58 71 92 219 348 474 440 808 15 TABLE 6. BOROUGH OF SOUTHWARK. INFANT MORTALITY, 1935. • Nett Deaths from stated causes at various ages under 1 Year of age. CAUSE OF DEATH. Under 1 week. 1-2 Weeks. 2-3 Weeks. 3-4 Weeks. Total under 1 month. 4 weeks and under 3 Months 3 Months and under 6 6 Months and under 9 9 Months and under 12. J Total Deaths under 1 Year. All causes 33 9 7 4 53 25 31 27 16 152 Measles - - - - - - - - - - Diphtheria - - - - - - - - - - Whooping Cough - - - - - 2 - 3 1 6 Diarrhoea - - - - - 3 8 7 5 23 Enteritis - - - - - - - - - - Influenza - - - - - - - - - - -erebro-Spinal Fever — — — — — 1 — 1 — 2 Scarlet Fever - - - - - - - - - - Phthisis - - - - - - - 1 — 1 Other Tuberculosis - - - - - - 1 1 1 3 Congenital Malformations 6 3 1 — 10 3 3 3 — 19 Premature Birth 25 4 2 — 31 3 — 1 — 35 Atrophy, Debility and - - - - - - - - - - Marasmus — — — — — 2 1 — — 3 Atelectasis - - - - - - - - - Erysipelas - - - - - - - - - - Syphilis — 1 — — 1 1 — — — 2 Rickets - - - - - - - - - - Meningitis — 1 — — 1 — — — — 1 Laryngitis - - - - - - - - - - Convulsions - - - - - - - - - - Gastritis - - - - - - - - - - Intussusception - - - - - - - - - - Dentition - - - - - - - - - - Dermatitis - - - - - - - - - - Bronchitis - - - - - 1 2 1 1 5 Pneumonia — - - - - - 2 - - 2 Broncho-Pneumonia — 4 3 7 8 10 8 4 37 Lobar-Pneumonia - - - - - - 2 - 2 4 Suffocation (overlying) - - - - - - - - - - Accident (other) - - - - - - - - - - Nephritis, Acute - - - - - - - - - - Icterus Neonatorum - - - - - - - - - - Septic Pyaemia - - - - - - - - - - Otitis and Mastoiditis - - - - - - 1 - - 1 Other Causes 2 - - 1 3 1 1 1 2 8 Not classified above - - - - - - - - - - 33 9 7 4 53 25 31 27 16 152 Legitimate 2225 Nett Births in the year Illegitimate 90 Legitimate Infants 141 Nett Deaths in the year Illegitimate Infants 11 16 TABLE 7. DEATHS OF INFANTS UNDER ONE YEAR OF AGE. The deaths of Infants under one year of age to 1,000 births were 66 during the year 1935. The deaths under one year of age to 1,000 births for the last thirty years were as follows:— 1906 144 1921 90 1907 142 1922 79 1908 131 1923 68 1909 119 1924 71 1910 115 1925 77 1911 145 1926 70 1912 105 1927 61 1913 115 1928 70 1914 123 1929 81 1915 132 1930 57 1916 98 1931 61 1917 111 1932 72 1918 124 1933 63 1919 95 1934 77 1920 86 1935 66 The average Infantile death rate for the last thirty years is 95. 17 TABLE 8. Death Rates for the various Districts for the last Ten Years (1925.1931) and 1932, 1933, 1934, 1935. Ward. 1925. 1926. 1927. 1928. 1929. 1930. 1931. 1932. 1933. 1934. 1935. St. Mary 12.8 12.2 13.5 13.7 16.2 13.6 16.4 14.0 14.7 13.6 13.5 St. Paul 12.7 12.0 12.7 11.8 15.9 11.6 14.2 12.5 14.7 13.4 13.3 St. Peter 11.9 12 3 10.8 9.1 12.3 10.1 11.0 12.6 13.3 13.2 11.9 St. John 13. 8 13.0 13.6 13.4 17.1 14.4 11.7 13.4 12.8 12.5 11.9 Trinity 11.7 13.4 16.1 13.3 14 9 13 8 13.9 13.3 16.5 11.6 10.9 All Saints 13.2 10.9 11.6 11.5 13.8 11.7 14.5 — — — — St. Michael 15.6 14.2 14.6 14 7 17.2 13.7 15. 5 15.0 14.2 15.2 13.7 St. Jude 12.9 12.6 16.1 13.4 18.2 13.3 15.3 12.7 14.8 16.0 11.6 St. George 12.4 12.9 12.6 11.8 14.5 11.5 12.4 10.7 11.4 12.9 11.6 Christchurch 18.2 16.6 13.3 16.5 17 5 13.4 18.0 17.7 15.7 16.8 14.5 St. Saviour 12.9 11.8 13.2 11 4 15 0 92 12.6 10.2 13.4 12.2 11.7 18 TABLE 9. Births and Deaths Registered in the Sub-Districts of the Borough in 1935. First Quarter. Second Quarter. Sub-Districts. Births. Deaths. Sub-Districts. Births. Deaths. Male. 1 Female. Male. Female. Male. Female. Male. Female. Newington 94 100 82 83 Newington 99 92 69 70 St. George the Martyr, West 47 38 27 26 St. George the Martyr, West 44 58 32 27 Christchurch and St. Saviour 72 62 92 46 Christchurch and St. Saviour 61 68 75 53 Totals 213 200 201 155 Totals 204 218 176 150 Third Quarter. Fourth Quarter. Newington 91 82 48 50 Newington 76 60 67 81 St. George the Martyr, West 61 46 24 19 St. George the Martyr, West 39 32 47 29 Christchurch and St. Saviour 57 68 89 47 Christchurch and St. Saviour 56 50 80 44 Totals 209 196 161 116 Totals 171 142 194 154 Births. Deaths. M. F. M. F. In 1st Quarter 213 200 201 155 In 2nd Quarter 201 218 176 150 In 3rd Quarter 209 196 161 116 In 4th Quarter 171 142 194 154 Totals 797 756 732 575 19 TABLE 10 Showing the number of Deaths that occurred in Public Institutions in the Borough during the year 1935. Institution. In 1st Quarter. In 2nd Quarter. In 3rd Quarter. In 4th Quarter. During Year. Newington Institution 69 56 33 48 206 Christchurch do. — — — — Evelina Hospital 11 10 8 20 49 Guy's Hospital 127 114 126 116 483 60, Lambeth Road 2 3 5 (Catholic Nursing Hume} Royal Eye Hospital - - - — — All Saints' Hospital 9 12 8 10 39 Other Addresses .. 4 10 7 5 26 Total 220 204 185 199 808 20 21 TABLE 11. Vital Statistics of Separate Localities (1922-1935). BOROUGH OF SOUTHWARK. Names of Localities . 1. St. Mary's Ward. 2. St. Paul's Ward. 3. St. Peter's Ward. , 4. St. John s Ward. 5. Trinity Ward. 6. All Saints' District. Year. Population estimated to middle of each year. Births registered. Deaths at all ages. Deaths under 1 year. Population estimated to middle of each year. JBirths registered. Deaths at all ages. Deaths under 1 year. . Population estimated to middle of each year. Births registered. Deaths at all ages. Deaths under 1 year. Population estimated to middle of each year. j Births registered. Deaths at all ages. Deaths under 1 year. Population estimated to middle of each year. Births registered. Deaths at all ages. Deaths under 1 year. Population estimated to middle of each year. Births registered. Deaths at all ages. Deaths under 1 year. 1922 22,882 448 366 47 19,362 386 302 27 17,370 408 239 35 19,218 554 317 49 16,315 456 275 35 21,536 546 275 31 1023 22,934 524 335 41 19,429 408 237 23 17,458 375 175 18 19,314 513 247 37 16,409 449 215 31 21,656 534 225 32 1024 22,992 461 330 31 19,479 396 282 34 17,502 326 210 29 19,364 498 271 31 16,451 418 243 26 21,712 485 256 33 1925 23,154 440 298 35 19,561 363 248 21 17,619 329 210 27 19,538 451 269 46 16,566 354 194 26 21,862 441 244 30 1926 23,119 417 283 34 19,532 399 235 30 17,592 308 217 14 19,509 446 253 20 16,451 358 222 15 21,827 420 239 33 1927 22,598 373 304 25 19,100 360 243 18 17,204 272 186 20 19,077 424 259 18 16,174 337 261 12 21,347 381 247 31 1928 22,274 427 305 24 18,827 276 223 21 16,960 259 166 19 18,806 414 252 35 15,942 302 212 19 21,041 370 243 23 1929 21,981 347 357 18 18,579 330 295 18 16,736 297 206 26 18,559 378 317 36 15,732 288 235 19 20,763 315 287 29 1930 21,981 327 300 19 18,579 285 216 16 16,736 247 169 11 18,559 371 268 21 15,732 280 217 18 20,763 292 243 16 1931 21,677 350 355 22 18,353 309 261 16 16,714 230 184 12 19,112 344 223 20 15,352 243 213 16 17,223 277 256 17 1932 21,730 .{47 304 22 17,709 236 221 16 25,016 360 316 26 26,810 429 359 23 14,608 253 194 18 # m # . . # 1933 21,190 284 311 26 17,269 229 254 11 24,389 287 325 12 26,147 406 334 19 14,245 214 235 15 # . , # . . 1934 20,576 317 280 23 16,769 l'3<; 224 14 23,683 321 312 21 25,390 367 317 20 13,832 210 161 12 m # , . . a 1935 20,083 296 271 15 16,367 263 217 22 23,116 336 -74 16 24,782 410 295 25 13,501 177 148 10 * * 7. St. Michael's Ward. 8. St. Jude's Ward. 9. St. George's Ward. 10. Christchurch Ward. 11. St. Saviour's Ward. 1922 20,795 517 362 40 14,012 273 215 27 18,189 562 275 40 8,389 184 150 9 9,152 242 119 23 1923 20,683 522 293 47 13,939 341 199 23 18,068 476 224 36 8,401 217 134 14 9,173 199 107 10 1924 20,644 442 345 42 13,912 342 214 19 18,045 458 244 31 8,424 207 162 13 9,180 187 104 14 1925 20,788 468 324 44 14,018 334 181 18 18,174 463 227 34 8,478 197 154 15 9,242 177 119 13 1926 20,702 425 294 39 13,961 311 176 25 18,097 405 234 34 8,480 170 141 13 9,240 151 109 8 1927 20,264 434 295 20 13,666 265 220 23 17,720 364 223 28 8,183 155 109 8 8,917 143 118 12 1928 19,903 404 292 28 13,523 290 181 21 17,304 410 205 13 8,000 152 132 15 8,720 172 99 7 1929 19,577 338 337 33 13,302 279 242 28 17,021 386 246 30 7,775 150 136 16 8,475 128 127 10 1930 19,577 366 268 24 13,302 246 174 17 17,021 316 195 17 7,775 119 104 5 8,475 148 78 8 1931 19,385 317 300 20 12,796 272 196 17 16,747 330 207 20 6,943 125 125 9 8,598 131 108 10 1932 19,012 313 286 29 12,487 207 158 24 16,337 327 175 21 6,774 127 120 10 8,417 130 86 8 1933 18,538 268 264 17 12,177 174 180 19 15,931 239 181 12 6,606 114 104 8 8,208 116 110 8 1934 18,001 251 273 28 11,824 199 189 24 15,469 257 199 26 6,415 107 108 8 7,971 126 97 8 1935 17,570 245 241 20 11,541 202 135 14 15,098 219 175 19 6,262 79 91 4 7,780 88 90 7 22 TABLE 12. Deaths in the Sanitary Area from the principal Zymotic Diseases in the various Wards for 1935. [WARD OR DISTRICT. Smallpox. Measles. Scarlet Fever. Diphtheria. Whooping Cough. Enteric Fever. Diarrhoea. St. Mary - - - - 4 - 3 St. Paul - - - 3 1 - 3 St. Peter - - - 2 2 - 3 St. John - - - 3 1 - 3 Trinity - — 1 1 2 — 1 St. Michael - 1 — — 1 — 4 St. Jude - — 1 1 1 — 3 St. George - — — 3 1 — 4 Christchurch - — — - 1 — 1 St. Saviour - — — 1 1 — 1 Borough - 1 2 14 15 — 26 TABLE 13. ZYMOTIC MORTALITY FOR THE SANITARY AREA, 1935. Showing the localities where the deaths occurred. Locality. Smallpox. Measles. Scarlet Fever. Diphtheria. Whooping Cough. Enteric Fever. Diarrhoea. The Borough 1 3 2 East Dulwich Hospital - - - - - - - Lambeth Hospital - - - - - - 4 Newington Institution - - - - - - - Evelina Hospital - - - - - - 3 Guy's Hospital - - - 1 - - 2 St. Thomas's Hospital - - - - - - - Belgrave Hospital - - - - - - 3 Royal Waterloo - - - - 1 - 3 L.C.C. Hospitals, etc. - - 2 12 11 - 4 St. Giles' Hospital - - - 1 - - 1 Rotherithe Hospital - - - - - - 4 Total - 1 2 14 15 - 26 SECTION B. General Provisions of Health Services for the Area. 25 PUBLIC HEALTH OFFICERS TO WHOSE SALARY CONTRIBUTION IS MADE. William Stott, M.B., B.S. (Hnrs.). D.P.H., Medical Officer of Health. E. Fairfield Thomas, M.D., Ch.B., D.P.H., Deputy Medical Officer of Health. Margaret Bergin, M. B., B.Ch., B.A. 0. (N.U.I.). D.P.H., Assistant Medical Officer, Maternity and Child Welfare. John T. Crowe, L.S.A., L.M.S.S.A., Tuberculosis Officer. Edward K. Pritchard, M.R.C.S., L.R.C.P., D.P.H., Part-time Assistant Tuberculosis Officer. (Appointed July 24th, 1935.) Sanitary Inspectors. J || G. Fisher (Senior Inspector). J || H. S. Steele. * j || J. C. Nicholson (Food and J || F. J. Bryant. Drugs Inspector). J || F. Mayhew. I || J. A. Syms. j || S. Bowers (Food Inspector), j || A. C. White. J || G. H. Duffield (Food Inspector). + || W. H. Banham. J || W. Richards J || A. Ede. || Margaret Burrows (Women's J || H. E. Hattersley. Workshops). || J. R. Findley. t || F. Dransfield | || A. Groves. % || R. F. Stubbs. (Temporary Inspectors appointed September 1st, 1935.) || Cert. Sanitary Inspector. J Meat and other Foods. * 1st Class Engineer (Board of Trade). Health Visitors. || a Annie Rogers. |* a Mary Freeth. j* a Clare Cottrill. j a Mary George. * a Winifred Sayer. f* a Annie Kingsmill. ||* a Kathleen Hinde. j* a Florence Mary Mason * a Florence Adair. « Cert. Health Visitor. || Cert. Sanitary Inspector. * C.M.B. f Nursing (1 Storekeeper; 1 Home Help to October 11th, 1935.) (1 Assistant Storekeeper appointed October 11th, 1935.) Part Time Officers. Dorothy Shepherd, M.B., Ch.B., Maternity and Child Welfare Clinic. Arabella C. Stevens, M.B., B.Ch., B.A.0. do. do. Jredk. Porter-Smith. M.R.C.S., L.R.C.P., Schick Immunisation Clinic. 26 Public Vaccinators. P. O'Malley, M.B., B.Ch., B.A.O., N.U.I. G. G. Lawson, M.B., Ch.B., D.P. H. D. M. Clune, M.B., B.Ch., B.A.O., N.U.I. A. M. Foxe, M.B., B.Ch., B.A.O., N.U.I. Vaccination Officers. E. J. A. Holt. C. R. Fifer. Other Officers. Cyril Dickinson, B.Sc., F.I.C., F.C.S. (Public Analyst). Tuberculosis Dispensary. Secretary and Dispenser, Florence Nightingale (Certificate of Apothecaries Society, London). Nurses. M. E. Bennett, Cert, of Sanitary Institute, S.R.N. F. C. Rogers, C.M.B., S.R.N. " E. Plummer, C.M.B., S.R.N., Certified Health Visitor. GENERAL PROVISION OF HEALTH SERVICES. (a) Laboratory Facilities.—The Chemical and Bacteriological Laboratories are maintained by the Council under the direct control of the Public Analyst, who is a full-time officer. Chemical analyses are undertaken of all samples submitted under the Food and Drug Acts and Regulations, together with any other analytical work or investigations required. Bacteriological examinations of Sputa for Tubercle, Swabs for Diphtheria and Blood for the Widal reaction for Typhoid are made for Medical Practitioners in the Borough and for the Tuberculosis Dispensary. (b) Ambulance Facilities.—The arrangements for the removal of (a) infectious cases and (6) maternity patients are satisfactory. No change has been made during the year. (c) Nursing in the Home.—General Nursing is carried out by the Ranyard Nurses, the Benson Nursing Association (which is subsidised 27 by the Newington Charities to the extent of £400 per annum) and the Catholic Nursing Home, 60, Lambeth Road. A few parishes also have their own private nurses. TREATMENT CLINICS. diphtheria prevention clinic.— Sutherland House. Thursday, 2.0—4.0 p.m. (Dr. F. Porter-Smith.) (A detailed report will be found on pages 27-118.) VENEREAL DISEASE CLINIC ■>.— Guy's Hospital. Daily. 9.0 a.m.—8.0 p.m. St. Thomas's Hospital. Daily. 8.0a.m.—10.0 p.m. King's College Hospital. Monday to Friday. ULTRA-VIOLET RAY CLINIC.— Guy's Hospital. Daily. HOSPITALS. The Borough is fortunately situated as regards hospital accommodation of all descriptions. Hospitals for infectious diseases and tuberculosis cases are provided by the London County Council. No change in these services has been made since my last report. The following General Hospitals are within the area:— Guy's Hospital. Evelina Hospital for Children. Royal Eye Hospital. All Saints' Hospital. Hospital for Diseases of the Skin. The Hospitals available, but close to the borders of the Borough, are:— St. Thomas's Hospital. King's College Hospital. Royal Waterloo Hospital. General Lying-in Hospital, York Road. Belgrave Hospital for Children. 28 MATERNITY AND CHILD WELFARE. An outline of the Council's completed services has already been given in my opening remarks. The scheme as a whole has worked well, but we are still hampered with the inappropriate centres and our work limited thereby. There is no doubt that more sessions are required at several of the centres, but this increase will only be possible when the contemplated new centres are built. More ante-natal centres are needed, but the present rooms at which the child welfare work is carried out in the various districts of the Borough are totally unsuited for this important branch of the work. 0 During the year much discussion has been devoted to the proposed new Midwives Bill. The majority of the Metropolitan Boroughs are of the opinion, and quite rightly so, that they as the authorities for maternity and child welfare should be the authorities for the administration of the Midwives Act when it becomes operative. The working of the Act in Southwark would be a more or less simple matter, as we are fortunate in being well supplied with voluntary hospitals and bodies who already deal with the majority of the maternity work. From figures in this portion of the report it will be seen that out of a total of 2,407 confinements—306 were dealt with by private independent midwives and 111 by private doctors. According to the Midwives Bill a midwife should not attend more than 80 confinements per annum and therefore four whole-time midwives at the most would be ample provision to deal with the 300 odd confinements not dealt with by voluntary associations. Alternatively by an arrangement with the voluntary association interested this small deficiency might be made good. The London County Council on the other hand as Local Supervisor of midwives, has put forward strong claims to be the authority for the administration of the new Act, and at the present time the issue is somewhat doubtful. INFANT MORTALITY. The infant death rate of 66 is an improvement on the previous year, but, as already stated, one expects a lower rate in a non-measles year. Apart from this determining factor, however, the mortality of infants has slowly but surely decreased. This decrease is due to several causes, chief of which is the greater activity and improvements in the schemes of the maternity and child welfare authorities. 29 MATERNAL MORTALITY. The Maternal Mortality Rate, 2.9, is good, and compares favourably with that of the country as a whole, which is 3.9. An analysis of the maternal deaths, however, reveals the fact that even this low figure could at least be halved. Of the total 7 deaths which occurred in this Borough, 3 could certainly not have been avoided whatever the care and attention. The remaining 4, however, need not have happened. Two of these women owing to deformity on one hand, and severe heart disease on the other, should never have been allowed to have children. One was due to definitely bad treatment as a result of there being no qualified attendant, and the last case was the result of illegal interference. ARTIFICIAL LIGHT TREATMENT. The arrangement with Guy's Hospital whereby Ultra Violet Rays are applied to ailing and delicate children is still carried on, and during the year 89 cases were sent for treatment. Many of the children have derived benefit, and this service is of undoubted use, and worthy of continuance. CONVALESCENT TREATMENT. The arrangement between the Borough Council and the Invalid Children's Aid Association is still being carried on, and 55 children under five years of age were sent away in order to restore them to better health. DINNERS FOR NECESSITOUS MOTHERS. Dinner coupons were given to necessitous expectant and nursing mothers, who were referred to the Southwark Invalid Kitchen, at a cost to the Council of £10 13s. for the year. DAY NURSERIES. There are three Day Nurseries in the Borough. One is Municipal, and is situated at Sutherland House, Sutherland Square. The nursery accommodates 20 to 25 children and is supervised by a Committee of Nursery Managers. The number of attendances during the year was 3,729. 30 Guy's Hospital have in connection with their Maternity Scheme a Day Nursery which is used by children from Southwark and Bermondsey, and has accommodation for 40 children. The number of attendances during the year was 7,766. Crossways Mission, New Kent Road, has a Day Nursery accommodating 46 children. The number of attendances during the year was 8,169. INSTITUTIONAL PROVISION FOR MOTHERS AND CHILDREN. Cases coming to the knowledge of the Medical Officer of Health are referred to the Southwark Diocesan Society, to which the Council have this year made a grant of £55. INFANT LIFE PROTECTION. Hereunder will be found the number of foster mothers and foster children in the Borough, together with the work in connection therewith. Number of persons on the Register who were receiving children for reward at the end of the year 29 Number of children on the Register 47 Number of Infant Protection Visitors at the end of the year who were:— Health Visitors 9 Female, other than Health Visitors 1 Male 2 Number of visits made by Infant Protection Visitors to the homes of foster mothers during the year 950 No proceedings were taken during the year. ORTHOPAEDIC TREATMENT. This is undertaken by the London County Council and the General Hospitals in the Borough. Children attending the Welfare Centres needing attention are referred by the Medical Officer in charge to the various hospitals for treatment. 31 MATERNITY AND CHILD WELFARE CENTRES. Assistant Medical Officer of Health (Maternity and Child Welfare) Dr. Margaret Bergin. (14 Centres.) 1a CENTRE (Voluntary). St. John's Institute, Larcom Street. District served by Centre St. John's Ward. Sessions held every Wednesday and Thursday 2—4.0. Medical Officers Dr. E. M. Saxton and Dr. M. 0. Cruickshank. Superintendent Miss Kaye. 1b CENTRE (Municipal). Sutherland House, Sutherland Square. District served by Centre St. Mary's Ward. Sessions held every Tuesday 10.0—12. 2.0—4.0. Medical Officer Dr. Dorothy Shepherd. Health Visitor Mrs. Kingsmill. 2a CENTRE (Municipal). Sutherland House, Sutherland Square. District served by Centre St. Paul's Ward. Sessions held every Wednesday 10.0—12. 2.0—4.0. Medical Officer Dr. Dorothy Shepherd. Health Visitor Miss W. Sayer. 2b CENTRE (Municipal). Working Boys' Club, Villa Street. District served by Centre St. Peter's District. Sessions held every Wednesday.. 10.0—12. 2.0—4.0. Medical Officer Dr. Margaret Bergin. Health Visitors .. .. .. Mrs. M. E. George. 32 3a CENTRE (Municipal). All Saints' Parish Room, Surrey Square. District served by Centre The Southern portion of All Saints' District and the portion of St. George's Ward between East Street and Albany Road. Sessions held every Thursday 10.0—12. 2.0—4.0. Medical Officer Dr. A. C. Stevens. Health Visitor Miss A. Rogers. 3n CENTRE (Municipal). Lady Margaret Church Parish Room, Chatham Street. District served by Centre The Northern half of All Saints' District and the portion of St. George's Ward between East Street and New Kent Road. Sessions held every Thursday 10.0—12. 2.0—4.0. Medical Officer Dr. Margaret Bergin. Health Visitor Miss F. M. Adair. Miss A. C. Cottrill (to October 7th, 1935). 4a CENTRE (Partly Municipal and partly Voluntary). Crossways Mission Hall, New Kent Road. District served by Centre Trinity Ward. Sessions held every Wednesday 10.0—12. 2.0—4.0. Medical Officer Dr. A. C. Stevens. Health Visitor Miss K. L. M. Hinde. 4b CENTRE (Municipal). Mission Hall, Lansdowne Place. District served by Centre The Northern half of St. George's Ward and the streets between Trinity Street and Tabard Street. 3essions hold every Friday 10.0—12. 2.0—4.0. Medical Officer Dr. A. C. Stevens. Health Visitor Miss F. M. Adair (to October 7th, 1935). Miss A. C. Cottrill. 33 5 CENTRE (Partly Municipal and partly Voluntary) 56, Lambeth Road. District served by Centre A part of St Jude and St. Michael's Wards. Sessions held every Monday and Thursday 2—4.0. Medical Officer Dr. Dorothy Shepherd Health Visitor Miss Pearson. 6a CENTRE (Municipal). Southwark Boys' Hostel, Pocock Street. District served by Centre Christchurch Ward and a part of St. Michael and St. Jude's Wards. Sessions held eveiy Tuesday 10.0—12. 2.0—4.0. Medical Officer Dr. Margaret Bergin. Health Visitor Miss M. Freeth. 6b CENTRE (Municipal). Southwark Boys' Hostel, Pocock Street. District served by Centre St. Saviour's Ward. Sessions held every Monday 10.0—12. 2.0—4.0. Medical Officer Dr. Margaret Bergin. Health Visitor Miss F. M. Mason. 6c CENTRE (Voluntary). 86, Borough Road. District served by Centre A part of St. Michael's Ward. Sessions held every Monday 2.0—4.0. Medical Officer Dr. Vernon. Health Visitor Miss Oxley. In addition to the above, the Roman Catholic Centre, 148, New Kent Road (Voluntary), holds a session every Thursday from 2.30-—4, arid Salamon's Centre, 28, Newcomen Street (Voluntary), holds two sessions Monday, 2—5. and Thursday, 10—12. 34 ANTE-NATAL CLINICS. Sutherland House, Sutherland Square. District served by Clinic St. Mary and St. Paul Wards. Sessions held every Monday 10.0—12.0. Medical Officer Dr. Dorothy Shepherd. During the year 121 mothers were seen and given advice. They made 432 attendances. Sutherland House, Sutherland Square. Districts served by Clinic St. Peter, St. John Trinity, All Saints, St. Michael, St. George, Christchurch and St. Saviour's Wards. Sessions held every Friday 10.0—12.0. Medical Officer Dr. Margaret Bergin. During the year 181 mothers were seen and given advice. They made 503 attendances. 56, Lambeth Road. District served by Clinic St. Jude's Ward. Sessions held One monthly. Medical Officer Dr. Dorothy Shepherd. During the year 78 mothers were seen and given advice. They made 401 attendances. The local Midwives refer all cases needing advice and treatment to the above Clinics SALAMONS WELFARE CENTRE. Sessions held Monday, Wednesday and Friday, 9.30—10.30. Tuesday, 1.30—2.30. Medical Officer Assistant Obstetric Surgeon. During the year 730 mothers were seen and given advice. They made 4,136 attendances. MATERNITY AND CHILD WELFARE CENTRES. Showing the Attendances at the Several Centres and Visits paid to the homes of Mothers and Children by Health Visitors. TABLE 14 St. John 1a. St. Mary. 1b. St. Paul. 2a. St. Peter. 2b. All Saints. 3a. Lady Margaret 3b. Crossway. 4a . St. Stephens. 4b. St. Jude. 5. St. Michael. 6a. St. Saviour. 6b. St. George. 6c. Guy's. 7. Total. Number of Births notified during the year 301 235 334 223 161 191 142 135 216 213 158 92 31 2432 Number of individual children attending the Centres during the year 429 442 411 312 241 285 328 291 488 376 293 169 63 4128 Number of Sessions held during the year 94 96 94 94 94 94 92 92 90 96 88 44 101 1069 Number of children coming into (1-5) age group during the year 207 198 182 122 100 122 110 85 153 146 129 56 27 1637 Number of new cases attending the Centres during the year— (1) Expectant Mothers (Ante-natal Clinics) 121 181 — 78 — — — 730 1110 (2) Infants under 1 year 226 207 216 157 122 136 112 114 188 154 116 69 37 1854 (3) Seen by Doctor 226 207 216 157 122 136 112 114 188 154 116 69 37 1854 (4) Children 1 to 5 years 57 56 37 28 21 25 31 36 39 43 29 8 1 411 (5) Seen by Doctor.. 57 56 37 28 21 25 31 36 39 43 29 8 1 411 Method of Feeding—(a) Breast.. 210 149 170 118 88 124 86 93 133 123 99 55 25 1473 (6) Breast and bottle 2 23 14 11 10 10 13 8 11 13 7 4 3 129 (c) Bottle 14 29 30 24 18 10 13 17 42 19 9 6 7 238 (d) Ordinary diet 57 62 39 32 27 17 31 32 41 42 30 12 3 425 Total number of attendances during the year— (1) Expectant Mothers (Ante-natal Clinics) i O \ X C A i •« — 432 503 — — — — — 401 — — — 4136 5472 (2) Infants under 1 year 5853 3550 3676 2937 2186 2781 2074 2174 2518 3321 2134 1015 2446 36665 (3) Children 1 to 5 years 4122 2133 1904 1967 1534 1673 2456 1461 4559 1994 1720 1014 1087 27624 (1) Average number of attendances — 9-6 10-5 — — — — — 6-5 _ — — 41-0 — (2) do. do. 62-2 37-0 39-1 31-2 23-2 29-6 22-6 23-6 26-0 34-6 24-1 27-6 24-2 — (3) do. do. 44-0 22-2 20-2 20-9 16-3 17-8 26-7 16-0 50-6 20-7 19-7 27-6 10-8 — (4) Total number of attendances of Infants seen by Doctor during the year. 1482 1662 1797 846 761 1236 1001 1104 1166 1494 888 505 647 14589 (5) Total number of attendances of children 1 to 5 years seen by Doctor during the year 729 894 779 305 401 616 782 874 1115 583 771 520 450 8819 (6) Total number of Expectant Mothers seen by Doctor (Ante-natal Clinics) 432 503 - - - - - 401 - - - 4136 5472 (7) Children weighed 6321 5328 5055 4551 3657 3970 4573 3301 4718 5302 3604 1914 1977 54271 (8) Post-natal cases.. 233 - - 20 4 45 - 77 2225 346 4 224 343 3521 Total number of first visits paid by Health Visitors to homes of— Expectant Mothers 221 216 228 153 91 82 55 101 260 209 89 39 553 2297 Infants under 1 year 307 241 340 235 171 201 137 141 214 211 144 98 34 2474 Children 1 to 5 years 76 66 - - 56 - 198 Total number of revisits paid by Health Visitors to homes of— (1) Expectant Mothers 314 107 18 3 10 13 5 7 238 15 6 79 763 1578 (2) Infants under 1 year. 2218 1210 1356 827 1255 1155 1042 1406 1201 1370 695 888 449 15072 (3) Children 1 to 5 years 1979 1724 1281 786 1338 1355 1261 1466 2243 1403 995 2410 1149 19390 22 Sewing Classes were held during the year at Sutherland House with a total attendance of 170. 36 37 38 HEALTH WORK. The number of visits made by the Health Visitors and other officers of the Public Health Department to houses in connection with Births, and other Health Work during 1935. TABLE 15. Original Visits. Revisits . Visits to AnteNatal Cases. Visits to PostNatal Cases. Visits to Foster Children . 1 Visits to Cases of Diarrhoea and Sick Children. Attendances at Welfare Centres. Visits where Mothers were found to be out. Special Visits, etc. Puerperal Pyrexia. Total. Births. Measles. Ophthalmia Neonatorum. Births. Measles. Ophthalmia Neonatorum. Mrs. Kingsmill 241 15 5 1210 2 323 141 _ 114 28 5 2084 Miss Saver 340 15 1356 246 — 35 — 94 — 25 2111 Mrs. George 235 15 1 827 156 20 43 — 94 — 10 3 1404 Miss Rogers 171 10 2 1255 110 4 74 — 94 — 12 — 1732 Miss Cottrill 201 57 1 1115 9 95 45 65 — 94 — 22 — 1704 Miss Hinde 137 8 4 1042 60 — 174 3 96 — 51 3 1578 Miss Adair 141 16 1 1406 5 108 77 72 — 92 — 24 3 1945 Miss Freeth 211 7 8 1370 224 346 287 — 94 — 23 4 2574 Miss Mason 144 1 3 695 95 4 59 2 118 — 123 2 1246 Mrs. George (home help) (To Oct. 10th, 1935) 301 15 316 Total 1821 144 25 10276 16 1417 496 950 5 1191 — 333 20 16694 39 TABLE 16. NOTIFIED BIRTHS. 1935. Where Born and by Whom Attended. Mothers Confined Notified Births. StillBirths . Total Live Births. Born in— Guy's Hospital 165 169 10 159 1, Kennington Park Place 9 9 — 9 General Lying-in Hospital 255 259 10 249 Lambeth Hospital 346 352 17 335 St. Thomas's Hospital 161 161 8 153 King's College Hospital 58 58 3 55 St. Giles's Hospital 90 91 4 87 St. Olave's Hospital 69 69 3 66 Westminster Hospital 20 20 1 19 Charing Cross Hospital 22 22 1 21 Clapham Maternity Hospital 26 26 — 26 Other Hospitals, etc. 73 74 3 71 1294 1310 60 1250 Born at Home and Attended by— Externs: Guy's Hospital 199 200 2 198 St. Thomas's Hospital 60 61 1 60 King's College Hospital 2 2 — 2 Midwives: Guy's Hospital 210 212 4 208 St. Thomas's Hospital 33 34 2 32 Lambeth Hospital 1 1 — 1 General Lying-in Hospital 20 20 — 20 Heygate Street 149 149 3 146 77, Southampton Street 22 22 — 22 Private 306 307 3 304 Doctors: Private 111 114 3 111 1113 1122 18 1104 Totals *2407 2432 78 2354 *Of this number, 170, so far as our records show, did not receive ante-natal advice. 40 TABLE 17. Vaccination Officers' Return respecting the Vaccination of Children whose Births were Registered in 1934. Date . Registration subdistricts comprised in vaccination officers' district. Number of births returned in birth list sheets. Number of these births duly entered in Columns 1,2,4 and 5 of the vaccination register (birth list sheets), viz.:— Number of these births which are not entered in the vaccination register, on account (as shown by report book), of Column 1, successfully vaccinated. Column 2. Insusceptible of vaccination . Column 4. Certificate of conscientious objection. Column 5, dead, unvaccinated. Postponement by medical certificate. Removed to other districts and notified to vaccination officers of the districts. Removal to places unknown, or which cannot be reached, and cases not having been found. Cases remaining or temporarily unaccounted for. Total number of certificates of successful vaccination received during the calendar year 1935. 1934. 1 2 3 4 5 6 7 8 9 10 11 1st Jan. to 31st Dec. Northern Division 965 395 3 320 50 2 67 51 77 529 Southern Division 763 360 3 297 27 — 12 30 34 726 Total 1728 755 6 617 77 2 79 81 111 1255 SECTION C. Sanitary Circumstances of the Area. 43 PUBLIC CLEANSING. (a) Generally speaking, weekly collection is in operation, although more frequent collections are made from tenement buildings, eating houses and places where food is prepared. (b) The whole of the refuse is brought to the Council's Depot at Manor Place, Walworth, for transport by rail to the country depots at Longfield and Sevenoaks, Kent. Approximately 50 per cent. of the house refuse is passed through pulverising machines, the crushed material being disposed of partly by sale to Kent farmers as a dressing for heavy soil, and the remainder is used for covering the rough dust at the tips. At Longfield controlled tipping is operated satisfactorily. The Sevenoaks Depot will shortly be closed, the available space having been filled in. There are no cesspools, earth closets or privies in the Borough. COMMON LODGING HOUSES. The total number in the Borough is now 17, one less than in 1934, and are comprised as follows:—10 for men containing 1,711 beds, and 7 for women containing 460 beds. It was mentioned in last year's report that some of the houses, which are very old structures, converted for the purpose, were not all that could be desired, and I am able to report that another of this type, 112, Southwark Bridge Road, has been closed, making two since the Council has taken over the supervision. In the near future another will probably be dealt with in the same manner, thereby reducing the number to 16. The work of cleansing, repairing and painting has been going on steadily throughout the year, consequently raising the standard of cleanliness and making the conditions more amenable for the occupants. In a recent census taken, the men's houses, with a capacity for 1,711, had 1,259 lodgers, the women's, capable of accommodating 460, had 210. Comparing with last year the number of men lodgers increased by 16, although one house was closed, and the number of women decreased by 9. 44 TABLE 18. Summary of Sanitary Works completed under the Public Health Act during the year 1935. Intimation Notices complied with 3,972 Drains reconstructed 117 Drains repaired 186 Drains intercepted and ventilated 342 Drains unstopped 216 Gullies provided 364 Soil-pipes provided or repaired 217 Closets provided 425 Closet pans and traps 835 Water apparatus repaired 752 Sink, Lavatory and waste pipes 1,611 Rainwater pipes repaired, etc. 430 Water supply to upper floors 37 Draw taps on main 285 New water supplies 147 Roofs and gutters repaired 3,261 Paving repaired 634 Dampness abated 921 Rooms cleansed 4,531 Sub-floor ventilation 188 Staircase ventilated 56 Dust-bins provided 1,073 Overcrowding abated 17 Miscellaneous nuisances abated 4,025 3,425 Intimation Notices were served during the year. 1,429 Statutory Notices were served during the year. 45 PROCEEDINGS TAKEN UNDER THE PUBLIC HEALTH AND OTHER ACTS. 15 summonses were taken out during the year 1935, in respect to offences, particulars of which are set out below. The following table shows the number of summonses taken out in each of the several Districts:— TABLE 19. DISTRICT. Total. No. 1. No. 2. No. 3. No. 4. No. 5. No. 6. No. 7. No. 8. No. 9. Number of Summonses taken out 4 9 2 - - - - - - 15 The above summonses had reference to the following:— Ordinary Nuisances 14 Exposing for Sale (Unsound Food) 1 Total 15 TABLE 20. These proceedings resulted as follows:— Summonses withdrawn (with costs), the Council's requirements having been complied with 13 Penalties and costs 2 Total 15 46 TABLE 21. Proceedings taken under the Public Health and Other Acts. Defendant. Cause of Proceedings. Result. Messrs. A. King & Co. General nuisances existing at 55, Delverton Road Work done. Summons withdrawn on payment of 10s. 6d. costs. William Anthony Fisher (2) 6, Stirling Road, Stockwell, S.W.9 General nuisances existing at 3, Chapter Road and 25, Chapter Road Work done. Summons withdrawn on payment of 10s. 6d. in each case. Arthur Benabo 53, Commercial Road, E.l General nuisances existing at 40, Faraday Street Work done. Summons withdrawn on payment of 10s. 6d. costs. William Anthony Fisher 6, Stirling Road, Stockwell, S.W.9 General nuisances existing at 17, Chapter Road Work done. Summons withdrawn on payment of 10s. 6d. costs. William Anthony Fisher (8) 6, Stirling Road, Stockwell, S.W.9 General nuisances existing at 38, Aldred Road, 42, Aldred Road, 44, Aldred Road, 45, Aldred Road, 222, Hillingdon Street, 236, Hillingdon Street, 175, Lorrimore Road and 34, Royal Road Work done. Summons withdrawn on payment of 10s. 6d. costs in each case. Mrs. O. C. Francis.. 75, High Street, Cowes, Isle of Wight General nuisances existing at 30, Lorrimore Road Ordered to do the work within 14 days. £1 1s. costs. Messrs. Landway, Ltd. 122, East Street, S.E.17 Exposing for sale unsound meat Summons taken out in January, 1936. Fined £8 8s. and £7 7s. costs. 47 NEW LEGISLATION DURING THE YEAR. ACTS OF PARLIAMENT. The Housing Act, 1935. Pharmacy and Poisons Act. STATUTORY RULES AND ORDERS. Agricultural Produce (Grading and Marketing), Nos. 107, 462, 750, 796, 798, 799, 797, 910, 976, 1234, 1168, 1388, 20, 19. Anthrax (Fees for disinfection), No. 184. The Public Health (Meat) Amendment Regulations, 1935. The Public Health Treatment of Infectious Disease Regulations, 1934. The Sanitary Officers (London), Regulations, 1935, No. 1111. PROVISIONAL RULES AND ORDERS. Housing (England). Housing (Overcrowding). CIRCULARS. Treatment of Tuberculosis, No. 969, 1463. Treatment of Fractures, 1462. Public Health (Meat) Amendment Regulations, 1461. Public Health (Imported Food) Amendment Regulations, 1471, 1486, 1502. Infectious Disease, 1418. Prevention and Treatment of Venereal Diseases, 1474. Milk Pasteurising Plants, 1473. Pneumonia, 1499. Housing Act, 1935, 1500a, 1500b. Swimming Baths and Pools, 1503. Sanitary Officers (London Regulations), 1935, 1506. Housing Act, 1935, Sec. 1, 1507. SMOKE ABATEMENT. A considerable amount of the Inspectors' time has been taken up in carrying out observations under the above mentioned Act. Action has been taken by interviews with the Minister of Health and the several owners concerned, which has had the effect of reducing the number of complaints. Observation is still being kept. 48 TABLE 22. Showing the Number of Observations, etc., in regard to Smoke Nuisances made by the several District Inspectors during 1935. DISTRICT Total for Borough. No. 1. No. 2. No. 3. No. 4. No. 5. No. 6. No. 7. No. 8. No. 9. No. of observations made by the Inspectors - - 1 25 7 - 7 2 336 378 No. of Nuisances observed - - - 7 - - 1 - 6 14 No. of Intimation Notices served - - - 2 - - 1 - 3 6 No. of Statutory Notices served - - - 1 - - - - 1 2 No. of Summonses taken out - - - - - - - - - - HOUSES LET IN LODGINGS. The number on the Register at the end of the year was 1885. TABLE 23. No. 1. No. 2. No. 3. No. 4. No. 5. No. 6. No. 7. No. 8. No. 9. Total. Number on Register 408 \ 231 278 218 154 179 117 197 103 1885 49 L.C.C. GENERAL POWERS ACT, 1928-Sec. 28. This Act provides for the removal, upon an order from a petty sessional court, into a suitable hospital or institution, of any aged or infirm or physicallly incapacitated person residing in premises under insanitary conditions, or suffering from any grave chronic disease, who is unable to devote to himself (or herself) or receive from persons with whom he (or she) resides proper care and attention, and who may, therefore, suffer in health or become a serious nuisance to other persons. In this connection, the following persons have been removed during the year under review:— Name and Address. Age. Institution. Mr. Samuel Harrington, 22, Marsland 63 years Newington. Road. Mrs. Charlotte Bates, 2, Turquand 71 years Newington. Street. Mr. G. Wilkins, 92, Larcom Street 63 years Newington. Mrs. Clark-Quinton, 17, Sedan Street 83 years Newington. Mrs. Rosina Dibben, 159, Old Kent 76 years Newington. Road. RAG FLOCK ACTS. The Act requires that the amount of Chlorine found shall not exceed 30 parts in 100,000 parts of flock. Visits under this Act have been made to various premises, but rag flock is not being sold at any of them at the present time. 50 WATER SUPPLY. PUBLIC HEALTH (LONDON) ACT, 1891. Section 48. Certificates in regard to water supply have been granted in respect of the under-mentioned (new) houses during the year. Premises. Certificates granted to. Block "F," Doddington Grove (24 flats) Block "G," Doddington Grove (18 flats) Block "H," Doddington Grove (18 flats) The Mayor, Aldermen and Councillors of the Borough of Southwark 202/206, Borough High Street Messrs. H. V. Clogg, Ltd., 159, Hanbury Street, E.l. 176/178, Old Kent Road (2 flats) Messrs. Backhouse Estates, Ltd., 83, St. Paul's Churchyard, E.C.4. Harrison House, Hard Street (25 flats) Marnock House, Hard Street (24 flats) Messrs. Rowley Bros., Tottenham, N.17. Stopher Buildings, Friar Street (15 flats) Stopher Buildings, Silex Street (30 flats) V. Wilkins, Esq., Adelphi, W.C.2. Nicholson House, Hard Street (44 flats) Paxton House, Hard Street (25 flats) Messrs. Rowley Bros., Tottenham, N.17. WATER SUPPLY TO TENEMENT HOUSES. London County Council (General Powers) Act, 1907. 37 additional water supplies were provided to houses during the year 1935. 51 TABLE 24. Factories, Workshops, Laundries, Workplaces and Homework. 1.—Inspection (including Inspections made by Sanitary Inspectors). Premises. Number. Inspections. Written Notices. Prosecutions. Factories (including Factory Laundries) 267 25 .. Workshops (including Workshop Laundries) 224 11 .. Workplaces 90 18 .. Homeworkers' Premises (including Outworkers) 302 .. .. Total 883 54 .. 2.—Defects Found. Particulars. Number of Defects. Number of Prosecutions. Found. Remedied. Referred to H.M. Inspector. *Nuisances under the Public Health Acts:— Want of Cleanliness 57 50 Want of Ventilation 3 3 .. Overcrowding .. .. .. .. Want of drainage of floors .. .. .. .. Other nuisances 109 94 .. .. Sanitary accommodations: Insufficient 6 3 .. .. Unsuitable or defective 49 34 .. .. Not separate for sexes 4 .. .. .. Offences under the Factory and Workshop Act:— Illegal occupation of underground bakehouse (S. 101) .. .. .. .. Breach of special sanitary requirements for bakehouses (SS.97-100) .. .. Other offences 101 101 .. .. Total 329 285 .. .. *Including those specified in Sections 2,3,7 and 8 of the Factory Act as remediable under the Public Health Acts. 52 TABLE 25. 3.—Home Work. Nature or Work. Outworkers' Lists, Section 107. Number of Inspections of Outworkers' Premises. Outwork in Unwholesome Premises, S. 108. Outwork in Infected Premises, Sections 109-10 Lists received from Employers. Nos. of Addresses of Outworkers received from other Councils. Nos. of Addresses of Outworkers forwarded to other Councils. Prosecutions. Instances. Notices served. Prosecutions. Instances. Orders made (S. 110). Prosecutions. (Ss. 109-10). Twice in the year. Once in the year. Failing to keep or permit inspection of lists. Failing to send lists. Lists. Outworkers Lists. Outworkers Wearing Apparel— (1) Making, &c. 55 46 55 55 300 376 - - 141 3 - - - - - (2) Cleaning and washing - - - - - - - - - - - - - - - Lace, lace curtains and nets - - - - 1 - - - - - - - - - - Furniture and Upholstery- 1 5 1 4 2 2 - - 4 - - - - - - Fur pulling - - - - - - - - - - - - - - - Umbrellas - - - - 7 - - - 6 - - - - - - Paper Bags and Boxes 6 17 9 17 6 33 - - 41 - - - - - - Brushmaking 5 11 5 10 5 5 - - 16 - - - - - - Stuffed Toys 1 9 1 - - 9 - - 4 - - - - - - File making - - - - - - - - - - - - - - - Electro Plate - - - - - - - - - - - - - - - Cables and Chains - - - - - - - - - - - - - - - Anchors and Grapnels - - - - - - - - - - - - - - Cart Gear - - - - - - - - - - - - - - - Locks. Latches and Keys - - - - - - - - - - - - - - - Miscellaneous 10 14 9 14 90 34 - - 90 - - - - - - Total 78 102 80 100 411 459 - - 302 3 - - - - - 53 TABLE 26. 4.—Registered Workshops. Workshops, Workplaces, etc., on the Register (S. 131) at the end of the year. Number. Bakehouses (including Factory Bakehouses) 96 Eating houses and places whore food is prepared for sale 549 Ice Cream Shops 253 Laundries 15 Dressmakers, Milliners, etc. 20 Tailoring 43 Brushmakers 13 Miscellaneous 1811 Total number of Workshops, Workplaces, etc., on Register 2800 5.—Other Matters. Class. Number. Matters notified to H.M. Inspectors of Factories: — Failure to affix Abstract of the Factory and Workshop Act (S. 133) 1 Action taken in matters referred by H.M. Inspectors as remediable under the Public Health Acts, but not under the Factory Act (S. 5): Notified by H.M. Inspector 7 Reports (of action taken) sent to H.M. Inspectors 7 Other — Underground Bakehouses (S. 101):— In use at end of the year — WOMEN'S WORKSHOPS. The supervision of the Women's Workshops was carried out during the year by Miss Burrows. 338 inspections and 486 re-inspections were made. The following defects were discovered, and 5 intimations and 3 statutory notices were served in order to obtain the abatement of the nuisances complained of:— Water apparatus defective 8 Roofs defective 2 Rooms dirty 34 Closet Pans and Traps 7 Miscellaneous nuisances 32 Total 83 All the above-mentioned nuisances were remedied. Miss Burrows also made 1,568 inspections of the women's conveniences throughout the Borough. 54 TABLE 27. RATS AND MICE (DESTRUCTION) ACT, 1919. Summary showing investigations and inspections made during the year 1935. Inspections:— By Inspector 514 By Rat Officer 529 Re-inspections:— By Inspector 2,130 By Rat Officer 2,574 Premises where rats were found 319 Action taken:— By Council's Official:— Poison Baits laid by Rat Officer 10,139 Wire Traps set 494 Break-back Traps set 2,283 By Occupiers:— Cats or Dogs 49 Premises freed of rats 297 Probable source:— Rat runs and holes 255 Defective Drains 152 Defective Sewers 41 Notices 40 Number of rats destroyed 899 During "Rat Week" 3,013 additional baits were laid at the Council's Sewers. 55 CLEANSING OF VERMINOUS ROOMS AND THEIR CONTENTS. During the year 1,544 verminous rooms were treated by the disinfecting staff and 39,929 articles of bedding, clothing, etc., were dealt with at the Council's Disinfecting Station. 430 Intimations and 129 Statutory Notices were served on various owners, and 588 verminous rooms were stripped. TABLE 28. Verminous Rooms Cleansed. DISTRICT. No. of Intimation Notices served. No. of Statutory Notices served. Police Court proceedings taken. Verminous rooms treated by the Council's Disinfecting Staff. No. 1 69 25 — 189 No. 2 65 22 — 259 No. 3 39 9 — 103 No. 4 31 5 — 150 No. 5 57 23 — 217 No. 6 48 11 — 168 No. 7 41 12 — 100 No. 8 42 7 — 153 No. 9 38 15 — 205 Total 430 129 — *1,544 * 588 verminous rooms were stripped by owners. 56 TABLE 29. Verminous Bedding, etc., Disinfected at the Council's Station during 1935. Articles. Disinfected. Destroyed. Beds 322 38 Palliasses 278 44 Bolsters and Pillows 624 30 Cushions 52 5 Blankets 1,179 7 Sheets 523 3 Quilts 331 3 Articles of Clothing, etc. 36,613 319 Books 7 — Total 39,929 449 10 tons 10 cwt. of bedding, household furniture, etc., were also destroyed. VERMINOUS PERSONS CLEANSED DURING 1935. During the year 7,740 persons were cleansed at the station in King James Street. Of these, under our agreement with the London County Council, were 5,435 children. Many of the children treated were suffering from Scabies. In every case the treatment at our Station was thoroughly efficacious, and no recurrence of the trouble was experienced. 2.305 adults sent from the various common lodging houses and other places in our borough were cleansed during the year, as against 2,079 dealt with under the provisions of the Cleansing of Persons Act, in 1934. 57 COLLIER'S RENTS MORTUARY. (Coroners' Court.) TABLE 30. During the year 227 bodies were received into the Mortuary:— Reasons bodies were brought to Mortuary. Bodies brought in, upon which Inquests or Post Mortems were held 126 Bodies brought in, upon which Inquests were considered unnecessary 95 Bodies brought in for convenience for which payment was made — Bodies brought in where death had occurred from Infectious Disease 6 Total 227 SECTION D. Housing. 61 HOUSING. During the year the activities of the Housing Committee have continued, but unfortunately the clearance of the slum areas has been considerably slowed down owing to the lack of re-housing facilities. The chief obstacle to progress is the entire lack of suitable vacant sites for building purposes. Many suggestions have been made and many avenues explored without any solution to the problem having as yet been found, thus it comes about that of 11 small areas represented under Section 1 of the Housing Act for clearance, it has only been found possible to deal with one. House to House Inspections and Repair Work under Section 17 Housing Act. On the other hand, a great advance was made when the Council adopted my recommendation to expedite House to House Inspections under the Consolidated Regulations. Three additional temporary Sanitary Inspectors and two temporary Clerks were appointed in October to augment the permanent staff. Thus it was found possible to detail six Inspectors for these duties entirely. Already in so short a space of time much useful work and recording has been accomplished: 4,340 houses have been inspected and 3,872 houses rendered decently fit for occupation. Underground Rooms. The work of dealing with underground rooms had been so timed that the whole would have been dealt with under Section 20 of the Housing Act, 1930, by the end of 1935. The Housing Act, 1935, however, came into operation in August, and by Section 84 it was found that the powers given under Section 20 of the 1930 Act had been greatly extended. By this new Act, underground rooms which do not comply with the regulations or cannot be made to comply, now have to be closed for human occupation entirely. All the rooms dealt with under Section 20 during the last five years will have to be re-represented to the authority under the new Section 84 of the 1935 Act. This will of necessity take time as difficulties will arise, especially the re-housing of many persons who will thus be deprived of the use of basements for living purposes. In November the Council's new regulations dealing with underground rooms based principally on the model regulations were confirmed by the Minister of Health. 62 Houses Let in Lodgings and Tenement House Bye-laws. The tenement house bye-laws were instituted for the purpose of securing a reasonable standard of housing accommodation for the occupiers of thin class of dwelling. Unfortunately, however, there are certain difficulties in the application of the bye-laws, the chief of which are:— (1) The question of "Control" under the Kent Restriction Act. (2) The question of sub-letting ; and (3) A new dilliculty which has arisen since the overcrowding survey, i.e., the question of re-housing the families requiring six or more rooms. (1) The Question of Control.—The most important provisions of the above bye-laws are contained in Clauses Nos. 13, 17, 18 and 25. By virtue, however, of the amending Bye-laws made on the 24th February, 1931, these particular clauses only apply to a "decontrolled house." A "decontrolled house" is defined as a lodging house to which the principal Bye-laws apply, and which is not a dwelling house to any part of which the increase of Bent and Mortgage Interest Restrictions Act, 1920, applies. By virtue of the Rent and Mortgage Interest (Amendment) Act, 1933, dwelling houses not already decontrolled before the 18th July, 1933, of which the rateable value on the 6th April, 1931, did not exceed £20, remain subject to control until the expiration of the Acts, namely, 24th June, 1938. "Dwelling house" within the meaning of the Rent Restriction Acts is a house let as a separate dwelling or a part of a house, being a part so let. In this Borough there are many large houses which, if occupied by one family, would, by virtue of Section 1 (1) of the Rent and Mortgage Interest Restrictions (Amendment) Act, 1933, be automatically decontrolled as from the 29th September, 1933, having regard to the fact that the annual amount of the recoverable rent, and the rateable value, exceed £45. These houses, however, are let to several families in separate tenements and, as such, are lodging houses within the meaning of the Tenement House Bye-laws. Moreover, each tenement is a "dwelling house" within the meaning of the Rent Restriction Acts and if (as is often the case) any of such tenements remain controlled, Clauses 13, 17, 18 and 25, of the Bye-laws have no application to the house as a whole. 63 (2) The Question of Sub-letting.—The constant change of tenant and sub-tenant in this type of dwelling is a continual source of difficulty, and I am convinced that until there is some form of "controlled sub letting" there can be no satisfactory application of the Bye-laws, particularly of those sections requiring water, cooking, etc., for each family. It has happened in this Borough on several occasions, and it must have in others, where the Bye-laws have been enforced in all respects, that within a comparatively short space of time the letting of the house has completely changed and the entire sanitary and other arrangements upset. (3) The Question of re-housing large Families .—The overcrowding survey has disclosed the fact that there are many families who require six or more rooms in order to be decently housed. At the present time no authority is building flats or houses of more than six rooms and these are exceptional; moreover, it is not possible to provide this large accommodation in buildings now being erected at anything like the rental which the large family can afford. The question, therefore, is how and where can these people be housed ? It may be possible by some arrangement of exchange between the various housing authorities and the private owners of the larger type of houses, which are now being used as tenement houses, that these large families may be re-housed in these larger houses at reasonable rentals. Having regard to these suggestions it is very doubtful whether it is the right and proper thing to do to apply the Bye-laws, even where it is possible especially at this juncture, as the future usage of any particular house has yet to be determined. Overcrowding Survey. The survey commenced on 1st November. A temporary staff of enumerators, survey assistants, and clerks was engaged for the purpose— 60 in all. The preliminary work was finished by Christmas, but it will be several weeks before the results and figures will be published. The clerical staff are at present working on these. 64 HOUSING ACT, 1930, SEGTION 1. During the year 1933, the following Areas were represented for Clearance and Re-housing Schemes:— Townsend Yard Area. (6 Houses.) (Demolished.) Keyworth Street Area. (27 Houses.) Ministry of Health Inquiry to be held early in the new year. Surrey Place Area. (3 Houses.) Now included in L.C.C. Area. Surrey Row Area. (5 Houses.) Tenants re-housed and premises closed. Mander Place Area. (16 Houses.) Premises demolished. Avon Place Area. (10 Houses.) A Clearance Order has been made and confirmed by Minister. The houses will be demolished in due course. Bear Lane Area. (29 Houses.) Premises demolished. Prices Street Area. (16 Houses, 1 Store.) Doddington Grove (West) Area. (12 Houses.) Premises demolished. During the year 1934, the following areas were represented for Clearance and Re-housing Schemes:— Roy Place Area. (29 Houses.) Clearance Order confirmed by Minister of Health. Brune Place Area. (5 Houses.) Tenants re-housed and premises closed. Clock Place Area. Clearance Order confirmed by Minister of Health. Rodney Street Area. (5 Houses.) Now included in L.C.C. Scheme. Jane Street Area. (8 Houses.) Six houses closed, tenants re-housed. Aster Place Area. (17 Houses.) 65 Nelson Place Area. (8 Houses.) Subject to confirmation by the Minister, the Council propose to acquire these premises with others, by compulsory purchase, for the purpose of the Baths and Washhouses Acts. Holland Street Area. (5 Houses.) Demolished. Tupman Place Area. (46 Houses.) Approximately two-thirds of the area have been developed by the City Corporation and the work is still proceeding. Comus Place Area. (42 Houses.) Clearance Order made and confirmed by Minister of Health. Rehousing of tenants proceeding. Norfolk Street Area. (20 Houses.) Represented to Housing Committee on November 14th, 1934. The following areas were represented for Clearance and Re-housing Schemes during the year under consideration:— Worsdale Cottages. (5 Houses.) Represented to Housing Committee, 9th January, 1935. Gerridge Street No. 1. (4 Houses.) Represented to Housing Committee, 6th February, 1935. Gerridge Street No. 2. (6 Houses.) Represented to Housing Committee, 6th February, 1935. Wesley Place. (44 Houses.) Represented 6th March, 1935. (Clearance Order made on 8th January, 1936.) Ostend Place. (17 Houses.) Represented 3rd April, 1935. Ridler Place. (3 Houses.) Represented 3rd April, 1935. Farrell Court. (4 Houses.) Represented 3rd April, 1935. Dodson Street. (11 Houses.) Represented 3rd April, 1935. Lant Street. (15 Houses.) Represented 3rd April, 1935. 66 Gray Street. (14 Houses.) Represented 3rd July, 1935. Friar Street. (3 Houses.) Represented 3rd July, 1935. HOUSING ACT, 1930, SECTION 19. The following properties were represented during 1932, and have not yet been demolished:— 2, 3, 4, 5, 6, Cavan Terrace (closed). 8, 17, Baron's Place (to be included in Clearance Area). The following properties were represented during 1933, and have not yet been demolished:— 8, 9, Cavan Terrace (closed). 33, Beddome Street (closed). 24, Zoar Street (closed; to be included in L.C.C. Zoar Street Area). During 1934, 22 houses were represented for demolition and 16 have been demolished. The remainder are set out below:— 57, Kingston Street (closed). 12, Lawson Street (undertaking not to be occupied). 29, Deverell Street (undertaking to be made fit). 52, Holland Street (undertaking not to be occupied). 54, Holland Street (undertaking not to be occupied). 62, Brandon Street (made fit). HOUSING ACT, 1930, SECTION 19. The following properties were represented for demolition during the year under consideration:— 50, South Street (premises made fit). 14 and 16, Upper Bland Street (demolished). 32, Collingwood Street (premises empty). 49, Zoar Street (undertaking not to be used for human habitation), la, Mansfield Street (undertaking not to be used for human habitation). 277, Union Street (undertaking not to be used for human habitation). 203, Great Dover Street (undertaking not to be used for human habitation). 43, Great Bland Street (undertaking not to be used for human habitation). 67 85, Gurney Street. 2, Montague Street. 7 and 8, Dorrit Street. 199, Waterloo Road. 68, Orange Street. 22, 26, 32, 39, 43, Zoar Street. HOUSING ACT, 1930, SECTION 20. During 1934, 29 underground rooms or parts of premises were represented for Closing Orders, 28 of which were closed. The Order on 37, Newington Crescent was determined, the premises having been made fit. During 1935, 33 underground rooms or parts of premises were represented for Closing Orders, 16 of which were closed. 32, Marshall Street (closed). 75, Kennington Road (closed). 5, West Square (closed). 13, Ontario Street (closed), la, Deacon Street (closed). 1, Walworth Place (parts of premises; closed). 22, Ontario Street (closed). 19, Falmouth Road. 5, Princess Street. 129, Kennington Park Road (closed). 10, Ontario Street (closed). 2, Burrows Mews (parts of premises). 86, Blackfriars Road (rear of; parts of premises). 78, Blackfriars Road (rear of; parts of premises). 82, Penrose Street. 28, Gaywood Street. 12, Blackfriars Road. 2, Red Lion Row (parts of premises). 3, Red Lion Row (parts of premises). 67, Walworth Road (parts of premises). 67, Thurlow Street. 86, Lambeth Road. 17, Newington Crescent. 10, Cyril Street (parts of premises; premises made fit). 147, New Kent Road (parts of premises). 1, 3, 4, 9, 17, 18, 24, Ontario Street (closed). 202, Great Dover Street (parts of premises). 68 HOUSING ACT, 1935, SECTION 84. During 1935, 13 underground rooms or parts of premises were represented for Closing Orders, 2 of which have been closed. 1, Alberta Street (closed). 86, East Street (parts of premises; closed). 55, Nelson Square. 24, Union Square. 13, Great Suffolk Street. 26, Surrey Row. 12, Kennington Park Place. 79, Lancaster Street. 107, Southwark Bridge Road. 26, Cavour Street. 183, Beresford Street. 15, Surrey Row (parts of premises). 97, Collinson Street. 69 HOUSING CONSOLIDATED REGULATIONS, 1925. TABLE 31. The following localities were inspected and recorded under the above-mentioned Regulations, during the year:— Akers Street. Inville Road. Albany Road. Jubilee Buildings. Alberta Street. Kennington Park Gardens. Ambergate Street. Kennington Park Place. Beehive Cottages. Kingsbury House. Beresford Buildings. Mann Street. Beresford Street. Marshall's Buildings. Berryfield Road. Marsland Road. Brettell Street. Merrick Square. Burton Street. Minnow Street. Chatteris Square. New Kent Road. Cooks Road. Osborne Street. Darwin Street. Oswin Street. Delverton Road. Paragon Buildings. Deverell Street. Penton Place. Doddington Place. Prioress Street. Elsted Street. Pullen's Buildings. Eltham Street. St. Agnes Place. Exon Street. Sayer Street. Faraday Street. Short Street. Freemantle Street. Stanhope Buildings. Great Bland Street. Sturgeon Road. Grosvenor Terrace. Sumption's Buildings. Harper Street. Surrey Villa. Hayles Street. Theobald Street. Hearn's Buildings. Tisdale Place. Hemp Row. Valentine Row. Henshaw Street. Young's Buildings. 70 TABLE 32. HOUSING. 1. Inspection of Dwelling Houses:— (1) (a) Total number of dwelling houses inspected for housing defects (under Public Health or Housing Acts) 4,340 (b) Number of inspections made for the purpose 4,856 (2) (a) Number of dwelling houses (included under sub-head (1) above) which were inspected and recorded under the Housing Consolidated Regulations, 1925 2,386 (b) Number of inspections made for the purpose 2,386 (3) Number of dwelling houses found to be in a state so dangerous or injurious to health as to be unfit for human habitation 146 (4) Number of dwelling houses (exclusive of those referred to under the preceding sub-head) found not to be in all respects reasonably fit for human habitation 4,020 2. Remedy of Defects without Service of formal Notices :— Number of def<ctive dwelling houses rendered fit in consequence of informal action by the Local Authority or its officers 359 3. Action under Statutory Powers during the Year'.— A. Proceedings under Sections 17, 18 and 23 of the Housing Act, 1930:— (1) Number of dwelling houses in respect of which notices were served requiring repairs 485 (2) Number of dwelling houses which were rendered fit after service of formal notices:— (a) by owners 41 (b) By Local Authority in default of owners - 71 TABLE 33.—continued. B. Proceedings under Public Health Acts:— (1) Number of dwelling houses in respect of which notices were served requiring defects to be remedied 3,535 (2) Number of dwelling houses in which defects were remedied after service of formal and informal notices:— (a) by owners 3,472 (b) by Local Authority in default of owners - C. Proceedings under Sections 19 and 21 of the Housing Act, 1930:— (1) Number of dwelling houses in respect of which Demolition Orders were made 20 (2) Number of dwelling houses demolished in pursuance of Demolition Orders 18 (3) Number of dwelling houses rendered fit (Sub. Sec. 2) 1 D. Proceedings under Section 20 of the Housing Act, 1930 and Section 84 of the Housing Act, 1935:— (1) Number of separate tenements or underground rooms in respect of which Closing Orders were made 46 (2) Number of separate tenements or underground rooms in respect of which Closing Orders were determined, the tenement or room having been rendered fit 2 72 TABLE 34. Sanitary Works completed under the Housing Acts, during the year 1935. Formal Notices complied with 48 Chimney flues repaired 32 Brickwork and pointing repaired 137 Window reveals and sills 225 Window sash repaired 262 New sash lines 275 Doors and woodwork repaired 263 Stair treads and risers repaired 54 Handrail and balusters repaired 62 Floors repaired 189 Provision of ventilated food storage 6 Plaster repaired 172 Stove and fireplace repaired 296 Copper repaired 22 Stone steps repaired 30 Skylight repaired and new cords 3 SECTION E. Inspection and Supervision of Food. 75 INSPECTION AND SUPERVISION OF FOOD. Regular observation is kept of all food exposed or deposited for sale in slaughter-houses, butchers' shops, cooked meat shops, fishmongers' premises, stalls, market places, etc. SLAUGHTER -HOUSES. There are four in the Borough which are licensed annually. Notice is given to this department when animals are to be slaughtered, and all carcases and viscera are examined before being offered for sale. The following are the premises and the licensees:— Situation of Premises. Name of Licensee. 129, Hillingdon Street Messrs. Newbury & Manktelow. 70, Union Road George Challis. 244, Walworth Road Messrs. Chalk & Cox, Ltd. 283-5 Walworth Road Messrs. R. C. Hammett, Ltd. During the year 295 oxen, 2,597 sheep and 404 pigs were slaughtered. The total weight found to be unsound was 7 cwts. 1 qr. 3 lbs., of which 4 cwts. 18 lbs. were destroyed on premises where found, and 3 cwts. 13 lbs. were destroyed at the Council's Depot. LONDON COUNTY COUNCIL (GENERAL POWERS) ACT, 1932, SEC. 5. Registration of Premises for Sale, etc., of Ice Cream and Preserved Food. The following table shows the number of premises registered and the inspections made:— Premises. Registered. Inspections. Ice Cream 253 804 Butchers' premises 87 1,186 Provision Dealers 60 791 76 Registration of Premises for Sale of Ice Cream. I have received the following report from Mr. Syms on the premises used for the manufacture or sale of ice cream. The premises within the Borough used for the manufacture or sale of ice cream, during the year under review, are as follows:— Registered for sale and manufacture 142 Registered during 1935 7 Discontinued during 1935 49 Registered for sale 86 Registered during 1935 30 Discontinued during 1935 36 Itinerant Vendors 74 Discontinued 1 Systematic inspection of all premises used for the manufacture or sale of ice cream has been carried out during the season of sale, March to September. Registration of one maker had to be withdrawn owing to unsatisfactory conditions and the case was dealt with by the Health Committee in April. Considerable alteration and improvement was called for in 19 makers' premises and minor improvements carried out in most of the others. In regard to fresh applications for Registration the requirements of the memorandum were rigidly enforced. Considerable pressure was brought to bear on the efficient sterilization of all plant, and I am happy to say that this matter now receives the attention it warrants. One factory for the wholesale manufacture of ice cream has been extended by the erection of a new building which will be in occupation during 1936. Among the smaller traders concerned with the sale of ice cream on their own premises the policy of providing modern refrigerator equipment has been stressed with gratifying results. The Italian ice cream trade is on the whole well conducted and the conditions satisfactory. 77 In July I had occasion to deal with a quantity of drinking straws in a verminous condition. Finally 440 boxes containing 1,000 straws were surrendered by the wholesaler and destroyed at Manor Place Depot. Early in the year the following memorandum relative to the conditions of manufacture and sale of ice cream issued by the Department were left at all premises concerned and all applicants for Registration received a copy. Further visits were made and the requirements discussed with the proprietors and suggestions for the general improvement of the premises made. These improvements have been satisfactorily carried out. Manufacturers of Ice Cream. As a maker of ice cream, your attention is directed to the attached memorandum. Ice cream is rapidly increasing in popularity. Made under hygienic conditions and of suitable ingredients, its value as a food is unquestionable. Samples recently taken in the Borough for the purpose of bacteriological examination show that there is a need of a better and more thorough appreciation of the elementary factors which, when strictly adhered to, will ensure a pure cream, more or less free from bacteria or germs. It is necessary in the first place to point out that chemical purity is separate and distinct from bacteriological purity. Ice cream made from the finest ingredients and of excellent quality, may be found on examination to contain bacteria in enormous numbers, due largely to some faulty or careless method of handling, or to the exposure of the mix to dust contamination. It must be distinctly understood that ice cream is a milk product, and the same care and precautions necessary in handling milk must be observed. I am personally in favour of a boiled mix, or a mix held at a temperature of 150 degrees F. for 30 minutes, in order to ensure a sterile product. The Officers of my department will be only too pleased to give advice or assistance in connection with the hygienic layout and management of your cream making premises, should you so desire it. Premises: General.—The factory or ice cream premises should form a separate and distinct section, quite independent of any other business carried on. The floor, walls and ceiling shall be finished in impervious 78 material with a hard, smooth face, free from ledges where dust can accumulate. The floor should be even and have a suitable fall to a gullyoutside the premises. All surfaces must be washable and kept clean, free from dust, splashes of milk, or of the ice cream mix. Windows and ventilating grids should be screened with fine wire gauze or two thicknesses of butter muslin to exclude dust and flies. The water supplymust be direct from the main, and have a suitable sink with an efficiently trapped waste in connection with it. As an alternative to the above arrangement, the sink waste may discharge into an open channel running to a gully outside the building. The general surroundings should be kept clean, free from accumulations of refuse and disused containers or plant. Personal Cleanliness.—Strict personal cleanliness—hands, body and clothing—is essential. Overalls, preferably white, are recommended for those handling the mix, the same to be kept clean and washed at frequent intervals. A regular system as regards personal cleanliness is advocated. Before commencing work the hands should be thoroughly washed in hot water and soap, and the finger nails (which should be kept short) well scrubbed. Finally, the hands should be rinsed in cold water and dried on a clean towel. Care must be taken that before using the lavatory the overalls must be taken off. Before resuming work the procedure will be the same as before, this being of the utmost importance. Smoking, coughing or spitting must be avoided where the cream is exposed, and care taken that perspiration does not drop into the mix. Utensils.—All machinery and utensils should be sound and thoroughly cleansed before starting work. Damaged and rusty containers are quite unsuitable and must be replaced by new as often as may be necessary. Modern ice-cream plant is designed to avoid any possibility of contamination, and the best is invariably the cheapest in the end. Zinc freezers have been found to give rise to a certain amount of metallic contamination. The present method of removing with a swab the scum formed is very unsatisfactory and dangerous; where such freezers are still in use, small pieces of rag, thoroughly clean and sterile, should be kept in a properly stoppered bottle used only for this purpose. Zinc containers should be replaced by more suitable ones as soon as possible. Monel-metal, stainless steel and tinned steel, seamless or made in one piece, are more hygienic and safer. 79 All freezers, containers and saucepans, whisks, spoons, glasses, etc., must be sterilized each morning. Bacteria grows rapidly in remnants of milk or ice cream left in or on utensils. Ingredients.—All ingredients must be kept cool and protected from dust and flies at all times. Pasteurised milk is safer than the raw grades. Stale milk is dangerous, even when evidence of souring is not present. Use only the best quality of ingredients, and buy from those who handle the food hygienically. Boiling the mix destroys all germs except the spores, but it has the disadvantage of destroying the valuable vitamins. When an emulsifier is used the ingredients are heated to a temperature of 150 degrees F. for 30 minutes; this kills all germs without destroying the vitamins. Rapid cooling of the mix to 40 degrees F. is desirable, and running water or iced water from the previous mix may be used with advantage. There is no gain in keeping the prepared cream at a cold temperature for a period exceeding four hours before freezing. NEVER pour back into the freezer or container any ice cream that has melted or been returned unsold from the previous batch. Such ice cream is bound to contain bacteria. Memorandum for Manufacturers of Ice Cream. As far as possible the work should be kept in separate sections. (1) Storage for Ingredients and Utensils.—This should be in the form of a ventilated fly-proof cupboard of ample size to take the dry ingredients at the top, and the cleansed movable utensils in the lower part. (2) Mixing and Boiling Section.—This should be done in a dust and fly-proof room or building with walls, ceiling and floor of an impervious washable material. (3) Cooling of Mix.—Cooling should be done in a room similar to the above, or in a properly constructed fly-proof safe, the containers separately covered with two thicknesses of butter muslin. 80 (4) Freezing of Mix.—Freezing should be done in a room similar to the above, and all tools used in the process kept free from dirt or any contamination. (5) Cleansing of Utensils.—All utensils must be washed in cold water immediately after use, followed by a thorough cleansing in hot soda water, using a hard scrubbing brush to ensure the removal of all remnants of the mix. (6) Sterilization of Plant, and Utensils.—Sterilization can only be accomplished by the total immersion of each and every separate part of the apparatus used in the process, in boiling water for a period of not less than two minutes. Sterilization is best carried out immediately before the apparatus is used. PREMISES WHERE FOOD IS PREPARED. The maintenance of clean hygienic conditions in preparing, handling and cooking the food has been enforced. Considerable improvement has been made in many premises by re-arrangement and by the provision of up-to-date plant. The following is a summary of the premises inspected:— Restaurants in Licensed Premises 61 Restaurants in Unlicensed Premises 25 Coffee Houses 107 Cafes 92 Stalls 23 Stewed Eels and Pie Shops 14 During the period under review the following work has been carried out:— Reconstructed . Improved. Cleansed. Refrigerators. P .H. Restaurants 2 14 25 25 Restaurants — 6 6 13 Coffee Houses — 23 51 25 Cafes — 25 25 4 Coffee Stalls — 6 2 - Stewed Eels - 6 6 - 33 premises have been closed and 19 new ones have been established. 81 Fried Fish Premises. 55 premises are on this Register, of which 27 have the modern fish-frying furnaces with condensing, hooded pans, 21 have installed refrigerators and 39 have electric potato peelers. During the year the following work has been carried out:— Progress in the fish trade is slow owing to the big increase in the price of the raw materials used. Fish Curers. 33 Fish curers premises are on the Register. During the year work has been carried out as follows:— The above figures in regard to cleansing do not fairly represent the case, as the nature of the business necessitates frequent lime-washing and cleansing, and is invariably carried out by the proprietors. In October special enquiries were made at all Fish Shops relative to the removal of offal. The investigation proved that the amount of offal produced has been considerably reduced in quantity. Modern methods of fish marketing result in the fish being consigned headless and in many cases filletted. For many shops the amount of offal produced in two days is only half a bucketful, and the tank method of removal from the premises has become common in consequence. Occasionally a nuisance occurs by improper handling, only one complaint was received during the period under review. Other Foods. These include premises occupied by muffin makers, chip potato vendors, pie vendors and a sandwich shop. Three new ones have been added, 2 improved and 4 cleansed. Reconstructed 8 Improved 14 Cleansed 12 Reconstructed 1 Improved 9 Cleansed 4 82 FOOD FACTORIES. The food factories are constantly inspected, some of them daily. A large sausage and pie factory was completed during the year. This factory has been designed by Sir Owen Williams, and is one of the largest in the country. Its equipment is of the most modern design. BACON STOVES. There are five in the Borough, and they are inspected frequently. "MERCHANDISE MARKS" ACT, 1926. Section 9 of the above Act confers on Food and Drugs Authorities (in London, the Borough Councils) the power to execute all provisions of the Act (except those relating to importation) in respect of foodstuffs which are subject to an Order in Council made under the Act. The Sanitary Inspectors have been empowered by the Council to undertake the duties imposed by the above Act, in regard to food exposed for sale, and have in many instances called the attention of traders to the fact where they have discovered negligence in the marking of their goods, and have had the omission rectified. In addition, printed notices have been circulated from time to time calling attention to the Orders mentioned above. On the whole the Orders are being carried out satisfactorily throughout the Borough. AGRICULTURAL PRODUCE (GRADING AND MARKING) ACT, 1926. This Act provides for the grading and marking of agricultural produce and gives power to the Ministry of Agriculture and Fisheries by regulations to prescribe "designations" and "marks" to indicate the quality of such produce. Four cold stores in this district are registered under the 1930 Regulations, for the storage of English eggs. 83 PUBLIC HEALTH (IMPORTED FOOD) REGULATIONS, 1925. The Council is a Riparian Authority, and is responsible for the administration of the above Regulations. Our Northern Boundary extends from London Bridge on the East up to and including the premises of the Union Cold Storage Company, Nelson's Wharf, west of Blackfriars Bridge. Two Inspectors—Messrs. Bowers and Duffield— are engaged in this work, in addition to administering the Public Health (Meat) Regulations, 1924, throughout the Borough. A close liaison exists between the Officers of my Department and H.M. Customs' Officers on the river front. I would like to take this opportunity of expressing my appreciation of the cordial co-operation of the Customs Surveyor and Customs Officers in this district. The following are some of the items with which the food inspectors have had to deal with during the period under review Caseous Lymphadenitis. The instructions of the Ministry of Health regarding the 5 per cent, examination of all imported carcases of mutton, and 100 per cent, of all pieces, continues to take place. 1,576 loins of mutton were thus inspected, of which 19 tons were diseased and accordingly destroyed. The improvement noted in 1934 has been maintained. Asparagus. An experimental shipment of fresh asparagus was received from South America. This was not satisfactory on arrival, and had to be destroyed. Imported Lard. (a) A consignment of lard from the U.S.A. was found to be damaged, during transit, by Cobalt Oxide and Arsenic compounds, and was destroyed. (b) Lard from Hungary. Exception was taken by me to consignments from this country which were arriving in a very badly boxed condition. The boxes were too light, and very indifferently made, 84 in consequence of which much of the lard was damaged through repeated handling. As a result of my action, the Trade representative from the Hungarian Legation called to inspect a consignment, and immediately took steps to remedy the cause for complaint. The lard now arrives properly boxed. Fillets of Beef. In my report of last year I drew attention to the effect that this meat was difficult to identify as a definite part of a carcase. 471 bags were received during the period under review, and steps were taken by the importers to comply with the regulations in future. Pears. 1,078 boxes of pears from South America were found on arrival to be affected with the Mediterranean fruit-fly, Cerapitis Capitata, and were destroyed. Rabbits. (a) A large number of Australian rabbits were found to be in a rancid condition. They were packed in cardboard containers, which were unsatisfactory and were no doubt the cause of their condition. (b) 500 crates of New Zealand rabbits were found to be unsound, and considering their condition, it would appear that they were probably unsound before freezing. Fruit Juice. Considerable quantities of Orange and Grape Fruit Juice arrived from South America. Samples are taken from time to time, under the Preservatives in Food Regulations. Gas Storage of Apples. Chambers for the storage of apples in carbon dioxide have been installed at one wharf, and are working satisfactorily. 85 Nut-Megs. Parcels of nut-megs have arrived from China, affected by the beetle, Oryzaephilus Surinamensis. This is receiving the attention of the Ministry, and other Port Sanitary Officers, in conjunction with myself. General . (a) The large riverside premises with the "Oxo" tower, previously known as River Plate Wharf, and now changed to Stamford Wharf, have been acquired by the Union Cold Storage Company, whose premises, Nelson Wharves, are adjoining. Alterations are now in progress, and it is anticipated that these premises, together with Nelson's Wharf, will probably be one of the largest food concerns in the country. (b) The growing importance of this work will be realized when I state that 5,000 tons of food are handled weekly at this Wharf alone. Public Health (Preservatives in Food) Regulations, 1925. 60 samples were taken during the year on the Wharves and submitted to the Borough Analyst for examination. Tomato Puree Tin 0.7 grain per pound; Zinc 0.2 grain per pound. Canned Tomatoes Tin 0.3 grain per pound; Lead, Arsenic, Zinc and Copper were not found. Tomato Puree Tin 0.7 grain per pound. Sample of Lard and pieces of a wood packing case The wood was covered on the outside with a fine black powder, which had found its way to the inside of the case, blackening both the paper wrapper of the Lard and the Lard itself. The black powder consisted of Cobalt Oxide, contaminated with Arsenic compounds. Sultanas Sulphur dioxide 490 parts per million. Tomato Paste Tin 0.28 grain per pound; Copper 0.28 grain per pound; Zinc faint trace; Lead and Arsenic not found. 86 Canned Tunny Tin, Lead and Zinc were not found. Sardines Tin 6.7 grains per pound. Lemon Juice Sulphur dioxide 330 parts per million. Canned Peeled Tomatoes Can blown, 60-70 c.c. gas, 52 per cent, of which was carbon dioxide. Canned Tongue Contents fresh and sweet. Lead not found. Egg Liquid Boracic compounds not found. Pieces of Ox Tongues Cans in good condition, lined with paper. Pigs Tongues Contents quite fresh and sweet. Egg Yolk (2 samples) Boracic compounds not found. Oranges (2 cans) Contents of first can was sound and fresh; second can not so good and slightly greater acidity. Butter (S. African) (2 samples) Genuine. Meat Extract (2 samples).. Boracic compounds not found ; Lead not found; Arsenic less than 1 part per million. Sultanas Sulphur dioxide 680 parts per million. Sultanas Sulphur dioxide 380 parts per million. Egg Yolk Egg Yolk . Boracic compounds were not found. Lemon Juice Sulphur dioxide 740 parts per million. Lemon Juice Sulphur dioxide 570 parts per million. Egg Yolk Boracic compounds were not found. Egg Yolk Tinned Strawberries Cans in good condition. Tinned Strawberries Contents quite fresh and sweet. Raspberry Pulp Boracic preservatives not found ; Sulphite preservative not found; Lead not found. Egg Yolk Boracic compounds were not found. Egg Yolk Black Currant Pulp Sulphur dioxide 1,000 parts per million. Orange Juice Sulphur dioxide 384 parts per million. Orange Juice Sulphur dioxide 412 parts per million. Orange Juice Sulphur dioxide 405 parts per million. Orange Juice Sulphur dioxide 418 parts per million. Orange Juice Sulphur dioxide 556 parts per million. Orange Juice Sulphur dioxide 515 parts per million. Orange Juice Sulphur dioxide 563 parts per million. Orange Juice Sulphur dioxide 487 parts per million. 87 Egg Yolk Contained Boracic compounds. Egg Yolk Orange Juice Sulphur dioxide 954 parts per million. Orange Juice Sulphur dioxide 440 parts per million. Egg Yolk Contained Boracic compounds. Egg Yolk Boracic compounds were not found. Caviare Contained Boracic compounds. Soy Paraffin oil not found. Canned Crab Lead not found ; Tin not found. Canned Smoked Salmon . . Lead not found; Tin 0.3 grain to the pound. Frozen Whole Egg Boracic compounds were not found. Frozen Egg Yolk Boracic compounds were not found. Frozen Egg White Boracic compounds were not found. Frozen Egg Yolk (sugared) Boracic compounds were not found . Sultanas Sulphur dioxide 645 parts per million. Canned Tomatoes.. Lead not found; Tin not found; Copper not found. 88 89 TABLE 35. Showing the quantity of foodstuffs examined at the wharves, the amount of food to be unsound, the Notices served, and the method of disposal of the unsound portion. Foodstuffs. Quantity and Weight examined. Weight found to be unsound. Surrendered by Owner. Seized by Inspector. Notices served. How unsound portion disposed of. Quantity. Weight. (a) Detention (6) Release . T. c. Q L. T. c. q L. Apples 270 boxes, 100 barrels, 150 cases 17 13 3 14 7 0 16 Yes - — - Destroyed at Council's Depot. Apricot pulp 23 boxes, 1 tin .. '2 2 3 3 11 Yes - — - Do. do. Apricots 1471 crates, 600 cases, 200 packages 23 4 0 15 1 11 2 3 Yes - - - Destroyed on premises where found. Asparagus 1344 crates, 2 cases 14 7 2 26 11 1 2 4 Yes - 2 2 11 tons 3 qr. 18 lbs. destroyed on premises where found, and 2 qrs. 14 lbs. destroyed at Council's Depot. Bacon 660 bales, 58 boxes 125 11 0 2 - - - Beans 150 bags 12 2 0 — - - - - — Beef — 159 17 3 25 16 13 0 0 Yes - 74 74 Released for technical purposes. Beef powder — 6 2 8 6 2 8 Yes - - Do. do. Beef, salted 35 barrels 3 2 2 0 — - - - - Beef, tinned 1750 tins, 187 cases 8 8 0 6 5 16 1 26 Yes - - - Destroyed at Council s Depot. Blackcurrants 470 billots 5 0 2 17 5 3 4 Yes - - - Destroyed on premises where found. Blackcurrant pulp 50 barrels 10 0 0 0 — - - - - Butter 312 boxes, 58 casks 10 11 2 0 — - - Candied Peel 233 boxes 4 13 0 0 - - 1 1 Carrots 600 billots 6 8 0 0 3 0 0 Yes - - - Destroyed on premises where found. Casings 4 tierces, 96 casks 13 4 3 7 — - - - - Caviare 3 barrels .. 7 0 0 — Yes - 1 - Still under Stop Cereals — 2 8 2 8 1 4 2 8 yes - 1 1 10 cwt. destroyed at Council's Depot and 14 cwt. 2 qrs. 8 lbs. released for pig feeding. Cheese 75 bundles, 163 crates 10 9 0 25 15 1 27 Yes - - - Destroyed at Council's Depot. Chicken, tinned V A Uf v V U 977 tins, 2 cases .. 13 3 21 13 0 9 Yes - 2 2 Do. do. r\A J Condensed milk 2034 cases 37 14 2 26 9 11 2 10 Yes - - - UO . UO . Confectionery 14 cases 14 0 0 — Yes - - - I ipqIrnt^pn 0+ Pnnripi 1' a Crab, tinned 106 cases, 75 tins.. 2 5 1 10 1 10 - - - i/Cotlv yuu du vUUIltll 0 1/cUUh. Dates 90 cases 2 8 0 16 2 0 13 Yes - - - Destroyed on premises where found. Dripping 684 crates 21 0 0 0 — Yes - 1 1 I Rp pa qpH for tprhnip^ 1 nnmnapa Ducks 35 cases 15 0 20 20 - - - llClLdoCU Ivl uCLlililvui J U Ui U U 3Co • Egg Albumin 134 cases 12 1 0 8 - - 10 10 Egg Yolk, liquid 297 casks 59 8 0 0 - - - 1 1 Egg liquid 4185 tins .. 86 16 3 4 - - - - - Carried forward .. 642 7 0 9 48 12 0 1 - 93 92 90 91 Foodstuffs. Quantity and Weight examined. Weight found to be unsound. Surrendered by Owner. Seized by Inspector. Notices served. How unsound portion disposed of. Quantity. Weight. (a) Detention. (6) Release . T. c. Q- L. T. c. Q- L. 93 92 Brought forward .. 642 7 0 9 48 12 2 1 Figs 577 bags 8 0 0 0 1 1 22 Yes — 1 1 Destroyed at Council's Depot. Figs, tinned 28 cases, 22 tins .. 9 3 0 9 3 0 Yes — 3 3 Do. do. Fowls — 18 5 0 0 10 3 4 Yes — — — Do. do. Fruits, Crystallized 5 cases 5 0 0 — — — — — — Fruit, tinned 5189 cases, 674 tins 115 18 3 14 27 12 0 19 Yes 123 cases 5 5 24 tons 19 cwt. 1 qr. 19 lbs. destroyed at Council's Depot. 2 tons 12 cwt. 3 qrs. seized by Inspector, condemned by Magistrate and destroyed at Council's Depot. Fruit Salad 6 cases 2 2 8 — — — — Galantine 10 cases 2 0 0 — — — — Grape Fruit Juice 1 cask 2 0 0 — ■\r — — — 1 i i i i n I 1 i 1 c i Grape Fruit 2105 cases, 14306 boxes, 50 crates 490 8 0 3 7 11 3 7 Yes 9 9 1 ton 14 cwt. 1 qr. barged to sea and 5 tons 17 cwt. 2 qrs. 7 lbs. destroyed on premises where found. Greengages 51 billots, 102 crates, 14 boats 1 19 0 16 6 1 10 Yes 4 cwt. 1 qr. 10 lbs. destroyed on premises where found and 2 cwt. destroyed in Council's Depot. Hams 526 boxes, 369 bags and 3 cases 111 3 3 17 3 1 16 Yes 2 2 Released for technical purposes. Hams, tinned 1714 tins 9 9 0 14 9 9 0 14 Yes — — — Do. do. Hog Casings 4 casks 1 0 0 0 — Jam pulp 4 cases 4 2 0 4 2 0 Yes — — — Destroyed at Council's Depot. Lard 6674 boxes 133 16 2 0 4 0 2 21 Yes — 3 A 3 A Released for technical purposes. Lard Oil 285 barrels 58 8 0 0 4 4 Lemon Juice 50 casks and 10 15 0 0 0 — 1 1 Lettuce barrels 1032 crates 9 6 1 24 7 16 1 24 Yes 1 ton 9 cwt. 2 qrs. 14 lbs. destroyed on premises where found and 6 tons 6 cwt. 3 qrs. 10 lbs. destroyed at Council's Depot. Meat Extract 550 cases, 15 tins.. 27 10 1 2 1 2 Yes — — — Destroyed at Council's Depot. Mellamid 2 drums 2 0 0 — Yes 2 o Destroyed on premises where found. Melons 173 cases 8 2 0 8 2 0 Yes - 666 666 Released for technical purposes. Mutton Carcases and pieces 1576 7 0 19 19 2 2 26 Yes 1 1 Destroyed at council's depotr Mutton, tinned, boiled 510 cases 21 6 1 20 2 22 X 1 Nutmegs 40 bags 2 10 0 0 - - 1 1 - Offal 94 8 2 0 7 19 2 19 Yes — 40 40 Released for technical purposes. Onions 350 bags 22 10 0 0 — Carried forward 3361 10 3 6 134 10 3 11 831 830 92 Foodstuffs. Quantity and Weight examined. Weight found to be unsound. Surrendered by Owner. Seized by Inspector. Notices served. How unsound portion disposed of. Quantity. Weight. (a) Detention . (b) Release . T. c. Q L. T. c. Q. L. Brought forward.. 3361 10 3 6 134 10 3 11 831 830 Oranges 5398 cases, 22875 boxes, 100 crates 888 2 3 0 11 2 3 25 Yes — 11 11 9 tons 11 cwt. 13 lbs. destroyed on premises where found and 1 ton 11 cwt. 1 qr. 20 lbs. barged to sea and 1 qr. 20 lbs. destroyed in Council's Depot. Orange Juice 50 barrels 19 12 0 0 6 4 0 0 Yes — 5 5 Destroyed on premises where found. Partridges 1 case 1 0 1 0 Yes — 1 1 Released for technical purposes. Pears 8040 boxes, 1 tray 201 1 3 6 32 3 1 6 Yes 7 7 28 tons 2 cwt. 14 lbs. destroyed at Council's Depot, 3 tons 9 cwt. 2 qrs. 20 lbs. destroyed on premises where found, and 11 cwt. 1 qr. barged to sea. Peas 100 boats, 200 bags 1 19 2 0 — — — — — — Pheasants 11 cases 2 2 0 2 2 0 Yes - 1 1 Released for technical purposes. Pigeons 509 packages 4 10 0 0 5 0 0 Yes - 1 1 Do. do. Pilchards 16 cases 6 2 0 3 0 0 Yes - - - Destroyed at Council s Depot. Plums 225 packages, 453 billots, 649 crates, 75 sieves 15 10 1 18 1 17 3 26 Yes - - 1 ton 14 cwt. 1 qr. 26 lbs. destroyed on premises where found and 3 cwt. 2 qrs. destroyed at Council's Depot. Pork Carcases and pieces 41 11 0 7 1 3 2 10 Yes - 15 15 Released tor technical purposes. Pork, salt 2 barrels 2 0 0 2 0 0 Yes - - - Destroyed at Council s Depot. Pork, tinned 69 tins 4 1 7 4 1 7 Yes - - - Do. do. Potatoes 100 hi} O*Q fSO VinYPQ 10 o o o — 1 ulaiuc3 « • . . Prawns luv udtiij) tj\j uuauo 1 box lu v v 8 8 Yes — — — Released for technical purposes. Prunes 6 boxes, 15 cases .. 5 1 0 5 1 0 Yes 1 cwt. 2 qrs. destroyed on premises where found. 3 cwt. 3 qrs. destroyed at Council's Depot. Quail 5 cases 2 2 0 18 Yes — 1 1 Released for technical purposes. Rabbits 965 crates, 150 cases 254 boxes 26 13 2 22 6 2 3 26 Yes Yes - 4 4 Do. do. Raisins 2 cases, 44 cartons, 50 boxes 1 16 2 0 1 2 0 Yes - - - Destroyed on premises where found. Raspberry pulp 1 case 2 0 - Yes - 2 2 - Rice 60 bags 5 8 3 20 2 1 21 Yes Destroyed at Council's depot, Salmon, tinned 1271 cases, 2278 tins 29 1 1 12 12 3 1 4 Yes - 2 2 Do. D0 Shrimps, tinned 3 cases 1 0 23 1 0 23 Yes - - - Do. do. Soups, tinned 15 cases 6 1 20 r. 6 1 20 — — — — - Soy 50 drums 15 0 0 0 Yes Destroved at Council's Depot, Spinach 45 crates 4 0 0 4 0 0 Yes Do. do. Sturgeon, tinned 24 tins 16 16 — - Sultanas 958 boxes 11 19 0 0 - — - Carried forward 4635 13 1 25 207 7 0 25 881 880 93 94 ]Foodstuffs. Quantity and Weight examined. Weight found to be unsound. Surrendered by Owner. Seized by Inspector. Notices served. How unsound portion disposed of. Quantity. weight. (a) Detention. (b) Release. T c- Q L. T- c Q- L. Brought forward.. 4635 13 1 25 207 7 0 25 881 880 Tallow 20 tierces 8 0 0 0 - - 1 1 - Tomatoes 40 crates, 201 cases 4 14 0 12 8 1 12 Yes - 2 2 Destroyed on premises where found. Tomato paste 500 cases 22 6 0 0 - - - - - Tomatoes, tinned 6836 cases, 72 tins 191 1 1 0 15 2 3 Yes O O Destroyed at Council's Depot. Tomato puree, tinned.. 2 cases 1 3 4 1 3 4 Yes - - - Do. Do. Tongues, tinned 67 tins, 1664 cases 53 5 2 15 12 9 0 5 Yes - 1 1 Do. Do. Turkeys 130 boxes, 150 cases 8 10 0 0 — Veal 27 hinds 13 2 0 - - — — - - Veal, tinned 15 tins 3 21 3 21 Yes - - - Destroyed at council's Depot Walnuts, shelled 5 cases 2 1 23 2 1 23 Yes - - - Do. do. 4924 9 0 16 221 5 1 9 893 892 95 96 97 Table. 6. Showing the quantity of Foodstuffs found unsound throughout he Borough during the year 1934 by the several Inspectors. Foodstuffs. Quantity and Weight found Unsound Surrendered by Owners. Seized by Inspector. Remarks. Quantity. Weight. Quantity. Weight. Quantity. Weight. T. c. Q. L. T. c. Q. L. T. C. Q. L. Apples 6 barrels 5 1 12 6 barrels 5 1 12 - - Destroyed at the Council's Depot. Bacon 4 16 0 5 - 4 16 0 5 - - - 3 tons 5 cwt. 3 qtrs. 8 lbs. destroyed at the Council's Depot and 1 ton 10 cwt. 25 lbs. released for technical purposes. Bananas 2 crates 1 12 2 crates 1 12 - - Destroyed at the Council's Depot. Beef — 2 2 0 — 2 2 0 - - Do. do. Beef, tinned 39 tins 1 3 22 39 tins 1 3 22 - - Do. do. Blackberries 35 chips 1 1 0 35 chips- 1 1 0 - - Do. do. Bread 1 loaf 2 - - 1 loaf 2 Condemned by a magistrate and destroyed at the Council's Depot. Butter — 3 0 0 - 3 0 0 — — Destroyed at the Council's Depot. Cauliflowers 13 crates 3 0 0 13 crates.. 3 0 0 — — Do. do. Cheese 7 1 0 0 7 1 0 0 — - Do. do. Chestnuts 14 bags 5 0 0 14 bags 5 0 0 — - Do. do. Chocolate Biscuits 9 tins 1 8 9 tins 1 8 - - Do. do. Cod Roes 5 boxes 2 4 5 boxes 2 4 — - Do. do. Condensed Milk. . 2 cases 2 0 2 cases 2 0 — - Do. do. Dates 29 cases 14 2 0 29 cases 14 2 0 — - Released for technical purposes. Elderberries 7 casks 17 2 0 7 casks 17 2 0 — - Destroyed at the Council's Depot. Fowls — 1 4 2 18 — 1 4 2 18 — - 1 ton 4 cwt. 15 lbs. destroyed at the Council's Depot and 2 qtrs. 3 lbs. destroyed on premises where found. Fruits, tinned 11 cases, 106 tins 1 7 0 1 11 cases, 106 tins 1 7 0 1 — - 1 ton 6 cwt. 3 qtrs. 4 lbs. destroyed at the Council's Depot and 25 lbs. destroyed on premises where found. Haddocks 1 case 3 0 1 case 3 0 — - Destroyed at the Council's Depot. Hams, tinned 817 tins, 158 cases 6 18 3 14 817 tins, 158 cases 6 18 3 14 10 cwt. 1 qtr. 6 lbs. destroyed at the Council's Depot, 1 cwt. 2 qtrs. 9 lbs. destroyed on premises where found and 6 tons 6 cwt. 3 qtrs. 27 lbs. released for technical purposes. Heads, Pigs 13,449 heads 72 13 2 9 13,449 heads 72 13 2 9 — - Released for technical puropses. Leeks 9 crates 1 2 12 9 crates 1 2 12 — - Destroyed at the Council's Depot. Lettuce 44 crates 7 3 0 44 crates 7 3 0 — - Destroyed on the premises where found. Mutton 1 0 5 2 16 11 picees 1 17 2 qtrs. 16 lbs. destroyed on premises where found and 1 qtr. 17 lbs. condemned by a magistrate and destroyed at the Council's Depot. Offal 14 1 19 1 14 1 19 - 10 cwt. 1 qtr. 1 lb. destroyed at the Council's Depot and 4 cwt. 18 lbs. destroyed on the premises where found. Carried forward 91 2 2 3 91 2 0 12 — 1 19 98 Foodstuffs. Quantity and Weight found Unsound Surrendered by Owners. Seized by Inspector. Remarks. Quantity. Weight. Quantity. Weight. - Quantity. Weight. • T. c. Q- L. t. c. Q- L. T. C. Q- L. Brought forward 91 2 2 3 91 2 0 12 — 1 19 Oranges 120 crates 3 15 0 0 120 crates 3 15 0 0 Destroyed at the Council's Depot. Pears 64 boxes, 4 barrels 1 14 3 12 64 boxes, 4 barrels 1 14 3 12 — Do. do. 14 ½-barrels 14 ½-barrels Peas — 3 0 24 — 3 0 24 — Do. do. Plums 78 boats 17 1 18 78 boats 17 1 18 — Do. do. Pork Carcases and 44 17 3 26 Carcases and 44 17 3 26 — 44 tons 17 cwt. 1 qtr. 16 lbs. released for technical pieces pieces • purposes, 1 qtr. 6 lbs. destroyed at the Council's Depot and 1 qtr. 4 lbs. destroyed on the premises where found. Pork and Beans, tinned 1 tin 1 1 tin 1 — Destroyed on the premises where found. Potatoes 10 bags 10 0 0 10 bags 10 0 0 — Destroyed at the Council's Depot. Rabbits — 8 0 0 — 8 0 0 — Do. do. Salmon, tinned.. 2,304 tins 10 1 4 2,304 tins 10 1 4 — Do. do. Sardines — 4 0 0 — 4 0 0 — Do. do. Sausages, tinned 15 tins 1 17 15 tins 1 17 — Do. do. Skate 1 3 2 — 1 3 2 — 1 cwt. 26 lbs. destroyed at the Council's Depot and 2 qtrs. 4 lbs. destroyed on the premises where Soles 5 boxes 1 3 14 5 boxes 1 3 14 found. Destroyed at the Council's Depot. Tomatoes 187 boats, 4 bundles 1 2 1 4 187 boats, 4 bundles 1 2 1 4 — Do. do. Tomatoes, tinned 72 tins 1 3 20 72 tins 1 3 20 — Do. do. Tongues, tinned 19 tongues, 1 case 36 tins 3 0 10 19 tongues, 1 case, 36 tins 3 0 10 1 cwt. 2 qtrs. 12 lbs. destroyed at the Council's Depot and 1 cwt. 1 qtr. 26 lbs. destroyed on the premises where found. Turkeys 1 10 10 — Destroyed at the Council's Depot. 145 14 2 25 145 14 1 6 1 19 99 100 TABLE 37. Inspections of Food at Wharves, Markets and other places where food is stored, and the action taken by the officials during the year 1935. INSPECTION OF WHARVES, Etc. FOOD EXAMINED, Etc. WARD or DISTRICT. Inspections of Wharves and Warehouses. Inspections of Markets. Inspections of Shops or Street Stalls. Slaughter Houses. Parcels of Food Examined . Parcels of Food Stopped. Parcels of Food Released. Parcels of Food destroyed by consent of owner. Parcels of Food seized by Inspector. Parcels of Food condemned by Magistrate. Summonses taken out. Mr. Bowers 498 — 1211 174 1932 32 31 421 2 2 — Mr. Duffield 723 — 766 128 2329 861 861 1183 — — — Market Inspections 7218 — — 7218 — — — — — — Total 1221 7218 1977 302 11479 893 892 1604 2 2 — 101 MILK AND DAIRIES (AMENDMENT) ACT, 1922, AND ORDERS MADE THEREUNDER. I have received the following report from Mr. Nicholson of the work carried out under his supervision during the year:— At the end of 1934 there were on the Milksellers' Registers:— Retail 415 names 409 Premises. Wholesale 29 ,, 29 ,, Retail 72 ,, Outsiders. Wholesale 38 ,, ,, During the year 1935 :— *74 names and 73 premises were entered in the retail register. 76 names and 75 premises were removed from the retail register. Sale of milk newly started at 25 premises. Sale of milk discontinued at 27 premises. Total on register at end of 1935:— 413 names; 407 premises.* *Of these 407 premises:— 63 are Dairies. 4 Depots for bottled milk for rounds. Of these 46 sell milk on round. 324 Sell milk in containers only (as received). 16 Sell milk for consumption on premises only. 407 Total. Wholesale:— 6 names and 5 premises were entered in wholesale register. 3 names and 3 premises were removed from wholesale register. Discontinued at 1 premises. Newly started at 3 premises. Total at end of 1935 :— 32 names; 31 premises. Outsiders:— 5 names were entered in retail register. 5 names were entered in wholesale register. Total at end of 1935:— Retail, 77 names; Whol sale, 43. *Of these 73 premises:— 6 are Dairies, 5 for consumption on the premises, and 62 for bottled milk only. 102 MILK (SPECIAL DESIGNATIONS) ORDER, 1923, ETC. 1 Dairy is licensed to pasteurise milk. 2 Dairies are licensed to bottle and sell Grade A (T.T.) milk. The total number of persons and premises licensed to sell graded milk is as follows:— Certified .. .. 5 Includes 1 Supplementary Licence Grade A (T.T.) .. 17 Includes 1 Supplementary and 2 Bottling Licences. Grade A 1 Grade A Pasteurised 5 Pasteurised 38 Includes 2 Supplementary and 1 Pasteurising Licence. Total .. 66 CHEMICAL, BACTERIOLOGICAL AND PHOSPHATASE EXAMINATIONS. 39 samples of pasteurised milk submitted for bacteriological examination. 5 samples of Grade A (T.T.) milk submitted for bacteriological examination and inoculation test. 1 sample of pasteurised milk and 1 sample of Grade A (T.T.) milk were not in order, but further samples were satisfactory. 43 samples of pasteurised milk submitted for phosphatase test. Of these 16 were certified as underheated. The dairymen concerned were informed, and the Medical Officer of Health of the districts in which the milk was pasteurised was notified. The 5 Grade A (T.T.) samples were found to be free from tubercle bacilli. There are 50 L.C.C. schools with 115 departments supplied with pasteurised milk by 13 dairy firms. The children drink this milk through a straw. 51 boxes containing 500 straws each were found to be mouldy and unfit for use and were thereupon destroyed in furnace. 8 samples of frozen eggs were procured by Dr. Latham, Ministry of Health, from several of our bakehouses, for bacteriological examination. 103 INSPECTIONS OF VARIOUS PREMISES, The following inspections have been made during the year:—• Milkshops, Dairies, etc. 1,630 4 Notices served. Bakehouses, etc. 293 15 ,, ,, Soap works 4 Tripe boilers 4 Butter factory 4 Fur skin dresser 4 Artificial cream 1 Wholesale margarine dealer 1 Other proposed offensive trades 2 Totals 1,943 19 Verbal instructions and suggestions as required. NUISANCES ABATED IN CONSEQUENCE OF NOTICES. Dirty walls 25 The periodical cleansing was duly carried out in the various premises, 12 of the premises being repainted. ,, ceilings 26 ,, floors 6 Defective walls 4 ,, ceilings.. 2 ,, floors 7 paving.. 1 ,, utensils 3 ,, roofs 2 Miscellaneous 32 Total 108 In addition to the foregoing, the following is a brief account of some of the works carried out and utensils provided at the various premises, viz. :— 1, 2, 3, Great Suffolk Street.—A bottle washing and sterilizing machine comprising—(1) Soaking tank (hot soda water); (2) Brush machine (6 brushes), the insides, outsides and ends of bottles being brushed; (3) Hot water (rotary) rinser and final steam jets (inside and out); also a rotary bottle filling and capping machine. 84, Villa Street.—A new dairy provided, consists of 3 compartments— (1) For washing up and steam boiler room; (2) Sterilizing room (containing 2 metal chests); (3) Store and bottling and capping room. (1) This room has been newly concreted, walls rendered, asbestos ceiling, all woodwork 104 painted; ventilation—windows, airbricks and bottom of door to yard; contains 2 metal washing troughs, fitted with steam pipes and main water supply; steam boiler (30 lbs. per sq. in. working pressure). Rooms 2 and 3—Wooden floors taken up and concrete floors laid; walls rendered, woodwork painted; ventilation—airbricks, fanlight and windows. Room 2 contains 2 sterilizing chests (metal), 4ft. by 3ft. by 6ft. high. Room 3—A 6-syphon bottle filler, bench and capping appliance, etc. 62, Beckway Street.—Provided a new cold store (Thompson, Houston, Ltd.), electric. 16, Pilgrimage Street.—Provided a new cold store. 105, Kennington Road.—A new dairy constructed in yard, 2 compartments; walls, concrete blocks rendered both sides, concrete floor; roof, asbestos; ceiling matchlined; all woodwork painted; well lighted and ventilated. Contains in one compartment, steam generator, metal washing trough and racks; in the other compartment—metal sterilizing chest and bottle capper; bottles are left in chest till required, etc. 29, Southwark Street.—A new cold store provided (Frigidaire). Rear 92, Thurlow Street.—A bottle capping appliance provided. 128-132, New Kent Road.—These premises have been converted into a bakery, bakehouses on the ground and 1st floor. 1st and ground floor— Bakehouses, walls and asbestos ceiling painted, floor concreted. 1st and 2nd floor—Storerooms, asbestos ceilings provided. Contains: Ground floor—Men, 2 W.C.'s, 2 urinals, 2 lavatory basins; Women, 3 W.C.'s, 2 lavatory basins; a cleansing room for wooden crates and cake tins, a large metal tank with hot and cold water supply for the purpose; middle of floor used for stacking cakes, etc., ready for vans. In bakehouse— 3 cake mixers, 2 dough presses, 1 hot plate, 1 metal tank for washing utensils (hot and cold water supply), 3 double-deck ovens and 2 peel ovens, coke fuel, furnace fed at rear; numerous benches. 1st floor, around stacking room, a gallery on which cakes are packed into boxes, some icing done and 1 cake mixer. Off this gallery is the 1st floor bakehouse. Contains: 2 ovens (gas-heated), travelling bed plates, 2 doughnut frying pans, 2 meat cooking coppers, 1 dough roller and 1 dough divider, 2 marble top benches and several wooden top benches, 3 dough presses, 3 cake mixers, 1 lavatory basin, 1 cold plate table, etc. Also on this floor is a cake storeroom (asbestos ceiling). On 2nd floor—Fruit and flour store (asbestos ceiling), etc. 151, Borough High Street.—This underground bakehouse is being overhauled. The walls of bakehouse scraped and faced with cement and sand and rendered impervious. Floor concreted and tiled; other works proceeding. 105 63, Finchley Road.— This bakehouse has been rebuilt; the bakehouse floor and walls tiled and a sheet metal ceiling (painted) provided. Flour store above also rebuilt, ceiling provided and a new covered storage tank (accessible for cleansing) which supplies the water to the hot water-system. 7, East Street.—A new bakehouse has been built at this address and is without doubt the best constructed bakehouse in the Borough. The inside walls and floor are tiled, and the ceiling is of sheets of opalite; is well lighted and ventilated. Contains: 1 double-decker steam-heated oven (gas guel), 2 (gas) water heaters, 3 dough troughs, 1 dough mixer, 1 roll divider, sink with hot and cold water supply, etc. Dressing-room alongside oven. Flour loft above, access by stairs in bakehouse, concrete roof and floor, etc. 272, Old Kent Road.—Bakehouse floor tiled. Bennett Street and Paris Gardens (J. Sainsbury, Ltd.).— New premises. Bakehouse is situated on the 3rd floor. Walls, floors and ceilings reinforced concrete; floors covered with impervious bricks, glazed tops; walls and ceiling painted; well-lighted and ventilated (Electric fans); Partitions of steel and glass. The bread baked is used in making sausages and meat pies. Appliances in bakehouse: 4 double-decker ovens (Electrically heated), 1 flour sifter, 1 dough mixer with 10 pans, 5 improvers, 1 dough divider, 1 bread disintegrator. Pies: 1 roller machine, 2 dough mixers and pans, 8 stainless steel benches, 25 steel racks, etc. All the machines are electrically driven. NOXIOUS TRADES. Situation. Trade. Occupier. Inspections. Remarks. 24. Gt. Suffolk Street Tripe Boiler J. Martin 4 - Wansey Street Soap Works Holden's Soap Works, Ltd. 4 Harrow Street Skin Dresser Leeding & Co. .. 4 - Cleansing, etc., duly carried out. There are no cowsheds in the Borough. BAKEHOUSES. Particulars at end of year 1935 :— Position. In use. Not in use. Totals. Remarks. Above ground 37 25 62 3 newly started. Under ground 25 9 34 Totals 62 34 96 106 BUTTER AND MARGARINE FACTORIES. 5 inspections made. 6 samples of butter procured for analysis. They were certified genuine. There are 19 wholesale dealers in Margarine in the Borough. PUBLIC HEALTH (CONDENSED MILK) REGULATIONS, 1923-7. ARTIFICIAL CREAM ACT, 1929. PUBLIC HEALTH (DRIED MILK) REGULATIONS, 1923-7. MILK AND DAIRIES ORDER, 1926. MERCHANDISE MARKS ACT, 1926, AND ORDERS. PUBLIC HEALTH (PRESERVATIVES, ETC., IN FOOD) REGULATIONS. FOOD AND DRUGS (ADULTERATION) ACT, 1928, ETC. Special attention has been given to the various premises visited, in the carrying out of the above Orders, etc. Where necessary, these were explained and 13 shopkeepers cautioned. This has had the desired effect. 1 Bample of Cleansing Powder was procured for analysis and certified in order. 107 SALE OF FOOD AND DRUGS AND OTHER ACTS. Proceedings taken, with the result. Name and Address of Vendor. Sample. Result of Analysis. Result of Proceedings. T. Harwood, 81, Sumner Street Milk 7.5 per cent, added water Fined £5. F. L. Bowman, 9, Redcross Street Vinegar.. 44 per cent, deficient in acetic acid Dismissed on payment of 10s. 6d. costs. A.. Hogg, 30, Manor Place Milk 10 per cent, deficient in milk fat .. Ordered to pay £1 Is. costs. C. Davis, 15, Cornbury Street Milk 10 per cent, deficient in milk fat .. Fined £2 and £2 2s. costs. J. Taaffe, 104, Union Street V inegar 23 per cent, deficient in acetic acid Fined £1. R. Skelton, 1, Charles Street Vinegar.. 45 per cent, deficient in acetic acid Fined £1. J. H. Lavell, 8, Harper Street Rum 50 degrees under proof Ordered to pay £5 5s. costs. Do. do. Gin 39 degrees under proof Ordered to pay £4 4s. costs. T. J. Peaceful, 71, Campbell Buildings, Lambeth Milk Filling and capping a bottle of milk on the public highway Fined £1. 108 POLICE COURT PROCEEDINGS TAKEN UNDER THE FOOD AND DRUGS ACT. 9 summonses were taken out during the year 1935. TABLE 38. Showing the Districts in which proceedings were taken under the Food and Drugs Act. No. 1. No. 2 No. 3 No. 4. No. 5. No. 6. No. 7. No. 8. No. 9. Total. Number of Summonses taken out 1 - — — 2 1 1 4 9 The offences for which the above-mentioned summonses were taken out are tabulated hereunder:— Milk deficient in fat 2 cases Milk (added water) 1 case Vinegar deficient in acetic acid 3 cases Filling bottles in public highway 1 case Rum. 50 degrees under proof 1 case Gin. 39 degrees under proof 1 case Total 9 cases 109 SALE OF FOOD AND DRUGS ACT. During the year ended 28th December, 1,196 "official" samples were taken by the Inspector. The following Table shows the localities in which these samples were taken:— TABLE 39. Showing the number of samples taken in each District of the Borough during the year. No. 1. No. 2. No. 3. No. 4. No. 5. No. 6. No. 7. No. 8. No. 9. Total. Number of samples taken 127 133 155 186 118 124 86 166 101 1196 22 of these samples were certified as adulterated, a percentage of 1.8, as compared with 0.99 in 1934. Particulars of the samples taken, together with the results of the analyses are given in Tables 40 and 41 110 FOOD AND DRUGS ACTS. TABLE 40. Return of Official Samples for the Year ending 29th December, 1935, showing the number taken, and the percentage of adulterated Samples for the year. FORMAL SAMPLES. Article. Number of Samples taken. Adulterated. Milk 473 9 Butter 81 — Cheese 4 — Margarine 69 - Lard 32 - Tea 31 — Coffee 5 — Cocoa 22 — Sugar 34 - Mustard 10 - Port Wine 14 - Whisky 29 2 Gin 14 6 Brandy 13 — Rum 14 3 Jellied Veal 1 — Cake 9 — Krusto 1 — Sponge Mixture 5 — Table Jelly 13 — Self-raising Flour 26 - Cornflour 11 — Luncheon Sausage 2 — Breakfast Sausage 9 — Meatox 1 — Bisto 8 — Ox-Tail Soup.. 3 — Oatmeal 4 - Semolina 2 — Custard Powder 8 — Rice 13 — Pearl Barley 8 — Carraway Seeds 1 — Milk Chocolate 2 — Tea Siftings 1 — Curry Powder 6 — Ground Mace 1 — Carried forward 980 20 111 Article. Number of Samples taken. Adulterated. Brought forward 980 20 Cayenne Pepper 1 — Ground Carraways 1 — Arrowroot 3 — Tapioca 14 — Saxa Salt 7 — Jam Sandwich 2 — Lemonade Powder 4 — Raspberryade Powder 1 — Ham and Tongue Paste 2 — Sifta Salt 1 — Pea Soup Flour 11 — Blanc-Mange 7 — Dripping 19 — Gravy Thick 6 — Brawn 6 — Corned Beef 1 — Swiss Roll 2 — Preserved Sausage 5 — Cake Flour 1 — Rolled Oats 2 — French Cream Slices 1 — Flaked Rice 1 — Flaked Tapioca 1 — Quick Oats 1 — French Coffee 8 — Mustard Compound 5 — Sage 1 — Water Oats 1 — Bospur 1 — Fish Paste 8 — Groats 1 — Sherbet 1 — Sue Flakes of Beef 1 — Cakeoma 2 — Vinegar 3 2 Cookeen 1 — Macaroni 4 —-- Ginger Pudding 1 — Gravy Salt 6 — Swiss Jam Roll 1 — Crushed Linseed 1 - Bicarbonate of Soda 3 - Ground Rice 3 - Tomato Soup 1 - Milk Jelly Crystals 1 - Carried forward 1134 22 112 Article. Number of Samples taken. Adulterated . Brought forward 1134 22 Desiccated Soup 1 - Chicken and Ham Roll 1 — Suet and Rice Flour 2 — Mixed Spice 2 — Chocolate 1 - Sweets 13 — Soup Mixture 2 — Gravo Thick 1 — Pear Drops 1 — Table Salt 1 — Lardex 1 — Lentils 1 — Pea Flour 1 — Bentex 1 — Straw erry Crystals 1 — Grape Fruit Crystals 1 — Bun Flour 2 — Baking Powder 1 — Boracic Crystals 1 — Powdered Borax 1 — Epsom Salts 2 — Glauber Salts 1 — Citrate of Magnesia 1 — Sandwich 1 — Jelly Crystals 1 — Pickling Spice 1 — Chocolate Roll 1 — Pudding Flour Mixture 1 — Barley 1 — Pork Sausages 1 — Tomato Soup 1 — Flaked Oats 1 — Dates 1 — Yorkshire Pudding Powder 1 — German Sausage 1 — Viota Mixture 1 — Lard Substitute 1 — Liquid Paraffin 1 — Eucalyptus Oil 1 — Concentrated Cinnamon and Quinine 1 — Tartaric Acid 1 — Cod Liver Oil 1 — Camphorated Oil 1 — Cream of Tartar 1 — Boracic Powder 1 — Total 1196 22 Percentage of adulterated samples for the year—1.8. 113 INFORMAL SAMPLES. In addition to the samples taken under the Food and Drugs Acts as shown in Table 40, 799 samples were purchased informally by the Inspector through his several agents. The whole of these samples were submitted to the Public Analyst for analysis, with the following result:— TABLE 41. Article. Number of samples. Adulterated. Milk 49 - Butter 304 — Lard 37 3 Lard Substitute 1 — Vinegar 209 45 Linseed Meal 1 — Crushed Linseed 37 — Cheese 1 — Cocoa 55 — Self-raising Flour 1 — Dripping 20 — White Pepper 52 — Pepper Compound 4 — Mixed Spice 10 — Mincemeat 7 — Mayonnaise 3 - Salad Cream 2 — Lemon Cheese 2 — Marzipan 1 — Sandwich Spread 1 — Sweets 1 — Cream 1 ~ Total 799 48 SECTION F. Prevalence of, and Control over, Infectious and other Diseases. 117 INFECTIOUS DISEASES. During the year the incidence of Infectious Diseases was lower than it has been for several years, Whooping Cough being the exception. Measles, Whooping Cough, Diarrhoea, and Diphtheria still remain the chief "killing" diseases of young life. Mortality from Diphtheria can now be wiped out entirely, as and when the people desire it, by the simple method of immunisation. The prevention of Measles, and to a somewhat less degree of certainty, of Whooping Cough, is now being practised. Whilst it cannot be said that these two diseases can be prevented to the same degree as Diphtheria, the serious complications which cause death can be, and have been, in a very large number of cases, prevented. Deaths from Diarrhoea have shown a slight decrease from 39 in 1934, to 25 in 1935. One will expect to find a still greater decrease, as and when the home conditions of the people are bettered. SMALLPOX. During the year under review no cases were notified. The number of cases notified during the last five years is as follows:— 1931 31 1934 22 1932 161 1935 — 1933 63 SCARLET FEVER. Five hundred and thirteen cases of this disease were notified during the year. The annual death-rate per 1,000 population for England and Wales was 0.01; for London, 0.01; and for Southwark, 0.01. The number of cases notified and the number of deaths during the last five years were as follows:— Notified. Deaths. 1931 514 3 1932 623 4 1933 1,268 3 1934 748 5 1935 513 2 118 ENTERIC FEVER. No case of Enteric Fever was notified during the year. The number of cases notified and the number of deaths during the last five years were as follows:— Notified. Deaths. 1931 5 1 1932 2 — 1933 6 3 1934 — — 1935 3 - DIPHTHERIA. Three hundred and sixty-two cases of this disease were notified, with 14 deaths. The annual death-rate per 1,000 population was 0.08 for England and Wales; 0.06 for London; and 0.09 for Southwark Antitoxin is supplied free of charge and 24 phials of 8,000 units have been supplied to Medical Practitioners in the Borough during the year. The number of cases notified and the number of deaths during the last five years were as follows— Notified. Deaths. 1931 426 8 1932 448 14 1933 486 12 1934 600 21 1935 362 14 SCHICK TESTING AND DIPHTHERIA PREVENTION CLINIC. This Clinic is held every Thursday afternoon at Sutherland House. Dr. Porter Smith is the Medical Officer in charge of the session. The attendances are gradually increasing, 394 persons having attended during the year. The number of patients tested and immunised during the last six years is set out in the following table:— 119 SCHICK CLINIC 1929-1935. Number tested, 0—5. Inoculation without test. Immunised. Number tested, 5—14. Inoculation without test. Immunised. Number tested, Adults. Immunised. Total. 1929 (9 months) 23 (4 immune) 20 18 142 (60 immune) — 46 9 (2 immune) 2 66 1930 27 (4 immune) 16 33 78 (29 immune) 1 86 1 (1 immune) — 119 1931 34 (3 immune) 23 48 75 (9 immune) 1 67 3 (2 immune) 1 116 1932 67 (11 immune) 66 88 83 (39 immune) 1 45 — — 133 1933 71 (8 immune) 74 112 171 8 (67 immune) 82 — — 194 1934 60 (11 immune) 113 147 119 (52 immune) 3 130 7 (5 immune) - 277 1935 34 (9 immune) 154 178 183 (76 immune) 14 152 9 (8 immune) 1 331 120 MEASLES. The number of cases of this disease notified during the year was 210. Of these, 144 were under five years of age, and 45 were removed to hospital. Fourteen of those over five were also removed to hospital. All cases treated in their homes were visited by the Health Visitors, who gave advice and instruction where necessary. The number of deaths from Measles during the last five years will be found hereunder:— 1931 3 1934 65 1932 53 1935 1 1933 6 DIARRHOEA. This disease is notifiable during the months of July, August and September in the Borough of Southwark. During this period 1 case was notified, which was kept at home. Deaths of infants under two years of age during the last five years were as follows:— 1931 16 1934 39 1932 34 1935 25 1933 32 WHOOPING COUGH. This disease is not notifiable in the Borough, but cases come to the knowledge of the Public Health Department through the medium of the various local hospitals, or the general practitioners; 95 cases were removed to hospital during the year. The number of fatal cases during the last five years will be found hereunder:— 1931 18 1934 13 1932 20 1935 15 1933 23 121 INFLUENZA. The deaths from this disease during the last five years were as follows:— 1931 35 1934 24 1932 43 1935 13 1933 98 CEREBRO-SPINAL FEVER, ENCEPHALITIS LETHARGICA, AND POLIOMYELITIS. Nine cases of Cerebro-Spinal Fever were notified during the year, of which 5 died. Two cases of Poliomyelitis were also notified, which were sent to hospital. ACUTE PRIMARY AND INFLUENZAL PNEUMONIA. One hundred and one cases were notified during the year, of which 45 were removed to hospital. There were 22 deaths of these notified cases. CANCER. The number of deaths during the last five years, together with a table showing the site of disease, for the period 1935 will be found hereunder:— 1931 290 1934 269 1932 263 1935 284 1933 288 TABLE 42. Deaths from Cancer (1935). Site of Disease. Under 15. 15-25 25-35 35-45 45-55 55-65 65-75 75 and over. Total. M. F. M. F. M. F. M. F. M. F. M. F. M. F. M. F M. F. Buccal Cavity, Pharynx, Œsophagus, Stomach, Liver and Annexa — — — - 2 - 3 2 19 7 29 9 35 9 13 8 101 35 Peritoneum, Intestines, Rectum, Bladder — 1 — — 2 1 1 3 4 5 9 7 14 10 7 10 37 37 Genital Organs - - - - - - - 2 - 6 3 6 — 9 — 3 3 26 Breast - - - - - - - 3 - 11 — 5 — 4 — 6 — 29 Other and unspecified organs - — — 1 — — — — 3 — 3 3 3 2 — 1 9 7 — 1 — 1 4 1 4 10 26 29 44 30 52 34 20 28 150 134 122 OPHTHALMIA NEONATORUM. Twenty-nine cases occurred during the year, as against 14 in 1934. An analysis of the cases will be found hereunder:— Notified. Cases treated. Vision unimpaired. Vision impaired. Total Blindness. Deaths. At home. Hospital. 29 13 16 16 — - — PREVENTION OF BLINDNESS. A record is kept under the Blind Persons Act, 1920, of all cases under 5 years of age reported from the Welfare Centres. These are referred to the Metropolitan Society for the Blind. 123 TABLE 43. NOTIFIABLE DISEASES (other than Tuberculosis) during the year 1935. Disease. 0- 1- 5- 10- 15- 20- 25- 35- 45- 55- 65- 75- 85- Males. Females. Total Cases admitted to Hospital Total Deaths Scarlet Fever 5 164 180 96 21 22 17 5 2 1 - - - 226 287 513 475 2 Smallpox - - - - - - - - - - - - - - - - - — Diphtheria 5 135 152 35 16 13 2 3 1 — — — — 151 211 362 362 14 Memb. Croup - - - - - - - - - - - - - - - - - - Enteric Fever - - - - - - - - - - - - - - - - - - Paratyphoid — — — — 2 — — — — 1 — — — 1 2 3 3 - Puerperal Fever - - - - - 2 5 3 - - - - - - 10 10 10 - Puerperal Pyrexia — — — — 2 11 16 5 - - - - - - 34 34 30 2 Cerebro-Spinal Fever 3 2 — 1 2 — 1 — — — — — — 6 3 9 9 5 Measles 14 129 58 6 1 2 - - - - - - - 97 113 210 59 1 Malaria - - - - - - - - - - - - - - - - - Dysentery - - - - - - - - - - - - - - - - - - Epidemic Diarrhoea - 1 - - - - - - - - - - — 1 - 1 - - Encephalitis Lethargica - - - - - - - - - - - - - - - - - - Pneumonia 2 8 5 6 8 10 13 15 23 10 1 - - 65 36 101 45 22 Ophthalmia Neonatorum 29 — — — — — — — — — — - — 9 20 29 16 - Erysipelas 1 2 2 2 4 4 10 20 19 18 12 - - 48 46 94 62 - Polio-Encephalitis - - - - - - - - - - - - - - - - - - Polio-Myelitis Chickenpox - 2 - - - - - - - - - - - 1 1 2 2 — Anthrax - - - - - - - - - - - - - - - - - - Totals 59 443 397 146 56 64 64 51 45 30 13 - - 605 763 1368 1073 46 124 TABLE 44. Return of Families Admitted into tha Council's Reception House during the year 1935. 1935. Scarlet Fever. Diphtheria. Smallpox. Other Diseases, etc. Verminous Persons. Week ending No. of Families No. of Persons No. of Days No. of Families No. of Persons No. of Days No. of Families No. of Persons No. of Days No. of Families No. of Persons No. of Days No. of Families No. of Persons No. of Days Jan. 5 „ 12 - - — — — — — — — — — — — — — „ 19 1 2 4 2 5 10 — — — — — — — — — „ 26 — — — 1 2 4 - - - - - - 1 1 2 Feb. 2 — — — 1 3 6 - - - - - — 1 1 3 „ 9 1 2 4 - - - - - - - - - - - - „ 16 - - - - - - - - - - - - - - - „ 23 - - - - - - - - - - - - - - - March 2 - - - - - - - - - - - - - - - „ 9 - - - - - - - - - - - - - - - „ 16 - - - - - - - - - - - - - - - „ 23 - - - - - - - - - - - - - - - „ 30 - - - - - - - - - - - - - - - April 6 2 8 16 - - - - - - - - - - - - „ 13 - - - - - - - - - - - - - - - „ 20 - - - - - - - - - - - - - - - „ 27 — — - - - - - - - - - - - - - May 4 — — — — - - - - - - - - 1 2 4 „ 11 - - - - - - - - - - - - - - - „ 18 1 3 6 - - - - - - - - - - - - „ 25 — — — - - - - - - - - - - - - June 1 — — - - - - - - - - - - - - - „ 8 - - - - - - - - - - - - - - - „ 15 — — - - - - - - - - - - - - - „ 22 — - - - - - - - - - - - - - - „ 29 — — - - - - - - - - - - - - - 125 Brght. forwd. 5 15 30 4 10 20 - - - - - - 3 4 9 July 6 - - - - - - - - - - - - 2 2 4 „ 13 - - - - - - - - - - - - 1 1 2 „ 20 - - - - - - - - - - - - - - - „ 27 - - - - - - - - - - - - - - - Aug 3 - - - - - - - - - - - - - - - „ 10 - - - - - - - - - - - - - - - „ 17 - - - - - - - - - 1 1 2 - - - „ 24 - - - - - - - - - - - - - - - „ 31 - - - - - - - - - 2 8 320 - - - Sept.7 - - - - - - - - - - - - - - - „ 14 - - - - - - - - - - - - - - - „ 21 - - - - - - - - - - - - - - - „ 28 - - - - - - - - - - - - - - - Oct. 5 - - - - - - - - - - - - - - - „ 12 - - - - - - - - - - - - 1 1 2 ,, 19 - - - - - - - - - - - - 1 1 8 „ 26 - - - - - - - - - - - - - - - Nov. 2 - - - - - - - - - - - - - - — ,, 9 - - - - - - - - - - - - 1 2 4 ,, 16 - - - - - - - - - - - - - - - ,, 23 - - - - - - - - - - - - - - - ,, 30 - - - - - - - - - - - - - - - Dec. 7 - - - - - - - - - - - - - - - ,, 14 - - - - - - - - - - - - - - - ,, 21 - - - - - - - - - - - - - - - ,, 28 - - - - - - - - - - - - - - - Total 5 15 30 4 10 20 — — — 3 9 322 9 11 29 126 DISINFECTION. The total number of disinfections of rooms during the year by the Council's disinfecting staff was 1,223. Of this number 993 rooms were disinfected after the occurrence of the ordinary notifiable infectious diseases, and 230 after cases of phthisis. 1,483 verminous rooms were sulphured and otherwise cleansed by the Council's staff during the year, as against 1,627 in 1934. Among the total number of disinfections (1,223) it was found un necessary to strip any rooms. TABLE 45. Bedding, etc., disinfected and destroyed after the occurrence of Infectious Disease during the year 1935. Articles. No. Disinfected. No. Destroyed. Beds 571 56 Palliasses 534 47 Bolsters 416 13 Pillows 1,607 65 Cushions 164 25 Blankets 1,922 9 Sheets 950 7 Quilts 899 21 Articles of Clothing, etc. 24,105 154 Books 325 2 Total 31,493 399 127 TABLE 46. PUBLIC HEALTH (TUBERCULOSIS) REGULATIONS, 1912. Summary of Notifications during the period from the 1st January, 1935, to the 31st December, 1935, in the Metropolitan Borough of Southwark. Notifications on Form A. Number of Primary Notifications. Total Notifications on Form A. Age-periods 0-1 1-5 5-10 10-15 15-20 20-25 25-35 35-45 45-55 55-65 65 and upwrds Total Primary Notifications. Pulmonary Males 1 3 1 6 11 17 31 24 27 25 6 152 189 ,, Females — 1 3 4 11 22 28 17 8 5 2 101 125 Non-Pulmonary Males 2 5 3 5 2 5 2 1 — 1 — 26 30 ,, ,, Females 1 2 6 2 3 1 3 3 — — 1 22 26 Primary Notifications relate to patients who have not previously been formally notified in the area to which the return relates. Any additional notification of a case which has been previously notified in the area is to be regarded as duplicate. 128 TABLE 47. SUPPLEMENTAL RETURN. New cases of Tuberculosis coming to the knowledge of the Medical Officer of Health or Chief (Administrative) Tuberculosis Officer during the period from the 1st January, 1935, to the 31st December, 1935, otherwise than by notification on Form A or Form B under the Public Health (Tuberculosis) Regulations, 1912. Age Periods 0-1 1-5 5-10 10-15 15-20 20-25 25-35 35-45 45-55 55-65 65 & upwards Total Cases Pulmonary Males — — - 1 - 2 4 5 2 - 1 15 ,, Females — — - 1 2 2 — 1 1 - 1 8 Non-pulmonary Males 1 1 - 1 1 — - - - — — 4 ,, ,, Females — 1 — - — 1 — - — — 1 3 129 DEATHS FROM PULMONARY TUBERCULOSIS. TABLE 48. Shewing the number of Patients who died in their own homes and the number who died away from home in Hospitals or other Institutions, 1935. 0- 1- 2- 5- 15- 25- 35- 45- 55- 65- 75- All Ages. Males. Females. Total. Number of patients who died at home — — — — 5 6 3 11 — 2 1 15 13 28 Number of patients who died in hospitals, etc. 1 — 1 1 14 13 18 11 34 9 — 72 30 102 1 — 1 1 19 19 21 22 34 11 1 87 43 130 Of the total number of deaths from Pulmonary Tuberculosis 78.5 per cent, occurred in hospitals or other institutions. 130 TABLE 49. TUBERCULOSIS. Age Periods. New Cases.* Deaths. Pulmonary. NonPulmonary. Pulmonary. NonPulmonary. 0 1 3 1 3 1 4 7 1 3 5 14 16 1 2 15 61 11 19 3 25 59 5 19 1 35 41 4 21 2 45 35 — 22 — 55 30 1 34 2 65 and upwards 8 1 12 Total. 253 48 130 • 16 (1) The ratio of non-notified tuberculosis deaths to total tuberculosis deaths is 1 in 43. This figure is represented in 3 deaths; and as a result of post-mortem examination these were all found to be suffering from tuberculosis. There is no evidence of wilful neglect on the part of the private practitioner to notify, neither is there evidence of excessive incidence of or mortality from tuberculosis, in any particular occupation in the Borough. 131 The number of notified cases and deaths for the last five years is as follows:— Notified. Deaths. 1931 312 208 1932 329 171 1933 285 172 1934 339 142 1935 253 130 The mortality rate was 0.83 per 1,000, as against 0.89 per 1,000 in 1934. The following tables give, in tabular form, the number of cases of Tuberculosis on the Medical Officer's Register; the number of new cases coming to the knowledge of the Medical Officer of Health, and the number of deaths from Tuberculosis for the period under review. TABLE 50. Notification Register. Pulmonary. Non-Polmonary. Total Cases. Males. Females. Total. Males. Females. Total. Number of cases of Tuberculosis remaining at the 31st December, 1935, on the Registers of Notifications kept by the Medical Officer of Health of the Metropolitan Borough 765 425 1190 210 186 396 1586 Number of cases removed from the Register(s) during the year by reason inter alia of:— 191 126 317 53 32 85 402 (1) Withdrawal of notification 91 67 158 24 21 45 203 (2) Recovery from the disease 15 12 27 18 6 24 51 (3) Deaths 85 45 130 10 6 16 146 132 Disinfection was carried out as follows:— TABLE 51. The Locality of the Rooms Disinfected after the occurrence of Phthisis. No. 1. No. 2. No. 3. No. 4. No. 5. No. 6. No. 7. No. 8. No. 9. Total. Disinfected 38 23 23 47 20 22 24 21 12 230 PUBLIC HEALTH (PREVENTION OF TUBERCULOSIS) REGULATIONS 1925. It was unnecessary to take action under these Regulations during the year. WORK OF THE TUBERCULOSIS DISPENSARY. The following report has been received from Dr. Crowe, your Clinical Tuberculosis Officer:— Since August 1935 Dr. Pritchard has also been working as part-time Assistant Tuberculosis Officer, and since the commencement of his duties the sessions for patients held at the Dispensary have been as follows:— Monday Tuesday Wednesday Thursday Saturday 9.30—12. Tuesday Thursday 6—8 p.m. The number of new cases examined and the total number of attendances, etc., at the Dispensary, will be found in Table No. 52. The home visiting of patients has been carried out each Wednesday morning by Dr. Crowe, and each Friday morning, by Dr. Pritchard. The total number of such visits paid was 368 for the year. Recommendations for preferential housing accommodation for families in which there are one or more notified cases of Tuberculosis, 133 have been sent to the Medical Officer of Health in the form of special medical reports. Such reports numbered 44. The Handicraft Centre is held once a week at the Dispensary, as it has done since its commencement in 1932. The class proves popular amongst the patients, who look forward to their weekly two hours of instruction in handicraft. We can now honestly say that the work is improving steadily, showing that the patients are keen and interested. We feel that a word of thanks and appreciation should be given to the Hon. Organiser and to the L.C.C. teacher who have, by their unwearied efforts and their infective enthusiasm, kept alive the interest of the patients and have so brought the work to its present standard of efficiency. The work done by the pupils includes the making of gloves and small leather articles, embroidery of all kinds, wool rug mats, coloured trays, baskets, fire-side stools, small fire-side chairs and parchment lamp shades. In November a Sale of Work was held in conjunction with the Westminster Tuberculosis Dispensary, the Sale taking place in the Westminster Health Centre, Ebury Bridge Road. The Sale was a complete success, the proceeds totalling £24. This amount was divided between the General Fund and the patients whose work was sold. DENTAL CLINIC. A Dental Clinic was inaugurated in the Dispensary for treatment of Tuberculous persons in October 1935. The Clinic opened on the 28th October and since that date a fortnightly session has been held on a Monday afternoon. The apparatus was supplied by the British Dental Hospitals, and a highly qualified Dental Surgeon is in attendance. The Tuberculosis Officers recommend the patients for attendance at the Clinic and all extractions, fillings and scalings are done free of charge. The cost of dentures is, in the case of insured persons, paid in part by the society of which the patient is a member, the remainder being paid, if it is possible, by the person concerned, or, if this is not feasible, then some charitable society is approached. For those cases who are unable to pay anything, the Council pays; a sum of money being included in the yearly estimates for this purpose. The number of attendances at the Clinic is rapidly increasing; the patients are glad to attend at the Dispensary for their treatment, and it is hoped that in the near future all Tuberculous persons will be dentally fit. DIAGNOSIS OF TUBERCULOSIS. During the year 113 patients were sent to Guy's Hospital for X-ray examination for the purposes of investigation and diagnosis. 134 The Public Analyst examined 420 specimens of sputum from Dispensary patients. PROVISION OF EXTRA NOURISHMENT. Under the Ministry of Health Regulations, extra nourishment is allowed to be given to patients attending the Dispensary who are requiring nourishing food and who are unable to afford such extras. The nourishment cannot be granted to persons who are in receipt of Public Assistance Relief. Allowances of such foods as milk, butter and eggs have been granted to 65 patients during the year. In the case of patients who are in receipt of Public Assistance, recommendations for extra nourishment have been made to the appropriate Committee of that Authority. In all cases such recommendations from the Tuberculosis Officer have received careful attention and consideration. Patients requiring clothing have also, in many cases, been sent to the Public Assistance Committee, and these cases also have received every consideration. The Charity Organisation Society, the British Red Cross, the United Services Fund and the National Association for the Prevention of Tuberculosis have all given most valuable help to cases sent for assistance. SUPERVISION OF HOME CONDITIONS. There are three Tuberculosis Nurses on the Staff of the Dispensary and their duties include the home visiting of all notified cases of Tuberculosis occurring in the Borough. The Nurses report to the Tuberculosis Officer details relating to the home conditions of all patients. As the greatest aim of the Tuberculosis Service is to prevent the spread of the disease, the homes are visited at frequent intervals and the Nurses endeavour to obtain the confidence of the patients and their families, and to help them to so arrange their homes that other members of the family may remain free from infection. At the same time, should the patient be at home they offer suggestions of a simple and commonsense nature, as to how the patient can obtain the maximum amount of benefit to his health while living a more or less normal life. 135 When each newly notified case of Tuberculosis is visited, the Nurses urge all "contacts" to attend at the Dispensary for an early examination by the Tuberculosis Officer. Such examinations can be made as frequently as the contacts themselves desire, and in the case of delicate members of a family it is always stressed that such members should attend the Dispensary at frequent intervals so that they may be under constant medical supervision. During the year 5,080 such visits were paid by the three Nurses. ISSUE OF SHELTERS, ETC. In the case of patients to whose homes are attached either yards or gardens, shelters can be lent if the patient so desires. Under this arrangement the patient is able to live and sleep in the open air, and at the same time, if there is overcrowding in the home, the use of a shelter is a very useful means of alleviating such overcrowding. Patients requiring an extra bedstead, but who are unable to afford this added expense, can be loaned a bedstead from the Dispensary. In many cases this allows the patient to sleep alone even though the room may, under difficult housing accommodation, have to be shared with another member of the family. HOME NURSING. The Ranyard Nursing Association and the Benson Nursing Association have very willingly carried out home nursing to bedridden patients who were either unwilling to enter an Institution, or who were too ill to be removed to a Hospital. CO-ORDINATION OF DISPENSARY WITH OTHER HEALTH SERVICES. During the year under review the complete co-ordination between the L.C.C., the School Medical Services and the Maternity and Child Welfare Services of the Borough has as ever been well maintained. Most satisfactory relations between the L.C.C., the Ministry of Pensions, the Medical Practitioners in the district and the Dispensary, have existed during 1935. 136 Each Saturday morning session at the Dispensary is entirely given over to the examination of children of, and under, school age. In specially urgent cases children are of course seen at other times and by special appointment. Children of school age, who are examined as contacts of notified cases of Pulmonary Tuberculosis, are referred to the School Medical Service for constant supervision. Should the School Medical Officer at any time consider that the health of these children is not entirely satisfactory, they are again referred to the Dispensary for further examination and, if necessary, observation by the Tuberculosis Officer. INSTITUTIONAL TREATMENT. During the year 219 patients were recommended to the London County Council for sanatorium treatment. 27 recommendations were made to the same authority for patients to be admitted to Hospital for the purposes of observation and diagnosis. Recommendations for children to attend an Open Air School after the completion of sanatorium treatment numbered 13. 65 patients were recommended to the London County Council for admission to one of their General Hospitals as they were considered unsuitable for sanatorium treatment on account of their chest condition and the extent of the disease found to be present. Convalescent treatment through the L.C.C. was recommended in 11 cases. The total number of recommendations to the L.C.C. for all forms of Institutional treatment was 335. NON-PULMONARY TUBERCULOSIS. All cases of Surgical Tuberculosis, such as Tuberculosis of Bones, Joints and Glands, are sent by the L.C.C. to special Sanatoria which deal only with this type of case. On the completion of the sanatorium treatment, arrangements are made for these patients to attend at either the Orthopaedic Department of a General Hospital, or at the After-Care Clinic, held at the County Hall, at frequent intervals of the Medical Superintendent of the sanatorium at which their treatment was obtained. 137 One long-standing case of Lupus of the Palate has been attending Guy's Hospital on the recommendation of the Tuberculosis Officer, for Artificial Sunlight treatment. ARTIFICIAL PNEUMO-THORAX TREATMENT. Most satisfactory results are, generally speaking, obtained from this form of treatment which is now, very frequently carried out in cases of Pulmonary Tuberculosis. Very frequently this treatment is induced while the patient is in Sanatorium and, as in most cases the refills have to be continued from two to three years, and at regular intervals, the refills are continued after the patients' return home and in many cases after they have resumed work. The length of the treatment required varies and is determined according to the condition of the patient's chest. During the year 32 patients received such treatment in the OutPatients Departments of St. Thomas's, Brompton, Guy's and other Hospitals. Each refill given to Dispensary patients was paid for at the rate of 10s. 6d., and the total amount paid by the Borough Council during the year to the Hospitals concerned was £224 17s. COLONY TRAINING. During the year, two ex-service men, both suffering from Pulmonary Tuberculosis, were colonised at Preston Hall, after having received Sanatorium treatment there through the L.C.C INVALID CHILDREN'S AID ASSOCIATION. Children who attend the Dispensary, and who after examination are considered to be not suffering from any form of Tuberculosis, but who are delicate and suffering from debility after some illness, are referred, when necessary, to the Invalid Children's Aid Association for a period of Convalescence, at either sea-side or country homes. Children who are living at home in contact with an infectious case of Pulmonary Tuberculosis are also boarded-out, with the approval of the L.C.C., by this Association. The boarding-out scheme, which is 138 frequently made use of in this Borough, is also eligible and very often taken advantage of, when the mother of a family of young children is admitted to a Hospital or Sanatorium for treatment, and when no satisfactory arrangements can be made with relatives for the care of her family during her absence. During the year 26 children were dealt with under this scheme. LONDON COUNTY COUNCIL HOSPITAL. Dr. Crowe has, during the year, continued to pay weekly visits, in the capacity of Consultant, to St. Giles' Hospital, Camberwell, where special attention has been paid to all Southwark patients in that Institution. MEMBERS OF THE COMMITTEE FOR 1935. Name. Representative of Ashe, Miss L. Soldiers and Sailors Help Society. Bennett, Mrs. Tuberculosis Dispensary. Carey, Miss Charity Organisation Society and British Red Cross Society. Cosens, Miss London County Council. Coats, Dr. Panel Practitioners of the Borough. Collins, Rev. C. H. L.C.C. School After-Care Committee. Crowe, Dr. J. T. Tuberculosis Dispensary. Deed, Miss D. M. Invalid Children's Aid Association. Drenham, Mrs. F. Local Public Assistance Committee. Hirst, S. T. London Insurance Committee. Howell, Miss P. Invalid Children's Aid Association. Martin, Miss M. .. United Services Fund. Plummer, Miss Tuberculosis Dispensary. Gordon, Miss Tuberculosis Dispensary. Greenwell, Mrs. C. Local Public Assistance Committee. Saunders, Mrs. E. Borough Council. Stott, Dr. Medical Officer of Health. Thomas, R. Southwark No. 1 Branch, British Legion. Zimmerman, Mrs. F. Borough Council. Chairman Dr. J. T. Crowe. Honorary Organiser Miss L. Ashe. 139 REPORT FOR THE YEAR 1935. The following is an extract from the report sent to me by Miss Ashe, the Hon. Organiser:— The extinction of tuberculosis is a great national ideal, and great efforts are made towards this goal by the London County Council, who provide treatment in sanatoria and hospitals, and by the Metropolitan Borough Councils who provide dispensaries, where home treatment is given, and the cases are attended and watched, and where necessary, recommended for hospital and sanatoria treatment. The Southwark Care Committee, which meets weekly, works as a supplement to the services above referred to. They see that anyone under their care is not suffering privations, and when the patient is away, they do everything possible to ensure that his family is cared for so as not to cause the patient anxiety. The funds available for use by the Committee are too small to carry out schemes of help, so that their chief work consists of interesting various charitable societies and individuals in such work, and getting them to render substantial assistance. During 1935, 291 appeals were made, either personally or by letter. 16 societies were approached, in addition to the London County Council Public Assistance and Public Health Departments, for the provision of clothes, when it was not found possible to get them elsewhere. A small fund was raised during the year, amounting to £33 10s. Of this amount, £15 was obtained as the result of a very successful dance arranged by members of the Committee, and the remainder was raised by the sale of sketches, painted by the Honorary Organiser. This fund was used mainly to provide pocket money for patients in hospitals or sanatoria, who had nothing of their own, and no relations or friends in a position to assist them. It is found that this little help makes a great difference to the happiness and contentment of the patients. One Matron writes "the psychological effect of receiving a small sum weekly to call their own is very great." Railway fares are also paid to enable relatives to visit patients. In some cases, money is not required, but only care and attention, as, for example, taking the place of responsible relations for people who have none, and receiving and administering their National Health Insurance for them. In fact, any service which comes our way. 140 The Committee work in close co-operation with the Invalid Children's Aid Society, and the Secretaries of both Southwark Branches are members of the Committee. This Society takes entire charge of the children's cases, and also co-operates with the Tuberculosis Officer in aranging for the removal of children of patients suffering from tuberculosis, to homes under the London County Council Contact Scheme, for the purpose of keeping them from infection, or to be cared for in their mother's absence. The following societies helped and co-operated with the Committee during the year, viz. :— Soldiers and Sailors Help Society. Charity Organisation Society. United Service Fund and British Legion. Invalid Kitchens for London. National Society for the Prevention of Tuberculosis. Society for Relief of Distress. Friends of the Poor. Red Cross Emergency Committee. Queen Mary's Needlework Guild. Southwark Diocesan Society for Social Welfare. Royal Naval Benevolent Trust. Various Regimental Societies obtained through Soldiers and Sailors Help Society. The housing problem is still acute in Southwark, but as the Borough Council and the London County Council are both active in building flats to let at moderate rents, some of our overcrowded families have been enabled to move to better surroundings. The cost of moving the furniture has on some occasions been met by help from Soldiers and Sailors Help Society and the United Services Fund and British Legion. Visits are paid to patients returning from hospital or sanatorium to see if they require help and how they have got on, but we find it very difficult to get them work if they cannot go back to their old employment. A member of the Committee was recently able to help a boy with spinal trouble, to get a good light job, and a rather troublesome girl was placed in service through the Charity Organisation Society, and money advanced for her clothes. The work problem, however, does remain a very serious one. W. STOTT, Medical Officer of Health. 141 TABLE 52. Return for the year 1935. (A) Return showing the work of the Dispensary (or Dispensaries). Diagnosis. Pulmonary. Non-Pulmonary Total. Grand Total. Adults Children Adults Children Adults Children M. F. M. F. M. F. M. F. M. F. M. F. A.—New Cases examined during the year (excluding contacts):— (a) Definitely tuberculous 73 62 7 6 11 9 8 5 84 71 15 11 181 (b) Diagnosis not completed 19 8 4 3 1 — 5 1 20 8 9 4 41 (c) Non-tuberculous 34 36 1 2 2 1 1 — 36 37 2 2 77 B.—Contacts examined during the year:— (a) Definitely tuberculous .. 4 5 3 1 — — 1 1 4 5 4 2 15 (b) Diagnosis not completed — — 2 2 — — — — — — 2 2 4 (c) Non-tuberculous 56 86 64 77 — — — — 56 86 64 77 283 C.—Cases written off the Dispensary Register as:— (a) Recovered 12 9 2 1 6 1 12 5 18 10 14 6 48 (b) Non-tuberculous (including any such cases previously diagnosed and entered on the Dispensary Register as tuberculous) 90 122 65 79 2 1 1 - 92 123 66 79 360 D.—Number of Cases on Dispensary Register on December 31st:— (a) Definitely tuberculous 283 174 19 21 21 31 29 30 304 205 48 51 608 (b) Diagnosis not completed 19 8 6 6 1 — 5 1 20 8 11 6 45 1. Number of cases on Dispensary Register on January 1st 687 2. Number of cases transferred from other areas and cases returned after discharge under Head 3 in previous years 47 3. Number of cases transferred to other areas, cases not desiring further assistance under the scheme, and cases "lost sight of" 180 4. Cases written off during the year as Dead (all causes) 94 5. Number of attendances at the Dispensary (including Contacts) 3125 6. Number of Insured Persons under Domiciliary Treatment on the 31st December 68 7. Number of consultations with medical practitioners:— 8. Number of visits by Tuberculosis Officers to homes (including personal consultations) 368 (a) Personal 28 (b) Other 202 9. Number of visits by Nnrses or Health Visitors to homes for Dispensary purposes 4199 10. Number of:— (a) Specimens of sputum, etc., examined 439 (b) X-ray examinations made in connection with Dispensary work. 113 11. Number of "Recovered" cases restored to Dispensary Register, and included in A (a) and A (b) above Nil 12. Number of "T.B. plus" cases on Dispensary Register on December 31st 364 (B) Number of Dispensaries for the treatment of Tuberculosis (excluding centres used only for special forms of treatment). Provided by the Council—One.