Borough of Southwark. ANNUAL REPORT OF THE Medical Officer of Health FOR THE YEAR 1938. / William Stott, m b., b.s., d.p.h., Medical Officer of Health. Administrative Tuberculosis Officer. Administrative Officer for Maternity and Child Welfare. - Borough of Southwark ANNUAL REPORT OF THE Medical Officer of Health FOR THE YEAR 1938. 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 & San, Ltd., Tottenham, Enfield, Palmers Green and Woodi Green. Borough of Southwark. Health Services Department, Walworth Road, S.E.17. To His Worship the Mayor, Aldermen and Councillors, Sir, Ladies and Gentlemen, I beg to submit my Annual Report on the health of the Borough for the year 1938. Generally speaking, with the exception of a measles epidemic, the health statistics are good and in many respects show a satisfactory position, particularly those relating to infant mortality and maternal mortality. The work of the various departments has shown a marked increase and the staff are working under full pressure. Unfortunately in September this work was rudely interrupted by the international crisis and since this time much useful and constructive work has had to be delayed or submerged for the purposes of Air Raid Precautions. In presenting this report, I desire to place on record my appreciation of the continued good-will shown to me by the Chairmen and Members of the Committees of the Council, and also of the ever-willing advice and assistance rendered to me by the Chief Officers of the Council. To the members of my Staff I tender my sincere thanks for their unfailing loyalty throughout the year. I am, 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, 1938) 145,300 Number of inhabited houses (end of 1938) according to rate books 29,113 Rateable value £1,293,533 Sum represented by penny rate £5,212 SOCIAL CONDITIONS. The Metropolitan Borough of Southwark lies to the South of the River Thames and covers an area of 1,165 acres. The district is of two characters, namely, industrial and residential. The principal trades carried on in the industrial area comprise food manufacture, wharfage, engineering and printing. The population is principally of the artisan class, many of whom are engaged in local factories and workshops in Southwark, and the adjoining Boroughs of Bermondsey and Lambeth, also in the Cities of London and Westminster. Unfortunately, a considerable amount of unemployment exists in the Borough, and the official figures at the end of December were:— Men 5,892 Women 2,170 Juveniles 221 Total 8,283 In the residential area many of the small cottage properties which formerly existed have been demolished and in their place new blocks of modern dwellings have been erected. The Council, being a riparian authority, is responsible for the supervision of thousands of tons of foodstuffs imported into this country every year, both at the wharves and also at the main line railway depot in Gravel Lane, into which large quantities of continental foodstuffs are brought by train-ferry. 8 VITAL STATISTICS. Total. M. F. Live Births—Legitimate 1,924 974 950 Birth Rate, 14.0 Live Births—Illegitimate 106 58 48 Still Births, 67. (Registered). Rate per 1,000 total births, 32.0 Deaths 1,812. Death rate, 12.5 Deaths from Puerperal Causes:— . Rate per 1,000 Deaths. (Live and Still Births). From Puerperal fever 0 0.00 From other Puerperal causes 2 0.95 Death rate of infants under 1 year of age per 1,000 live births:— All Infants under 1 year of age 57 Legitimate 57 Illegitimate 66 Deaths from Cancer (all ages) 238 Do. Measles (all ages) 11 Do. Whooping Cough (all ages) 2 Do. Diarrhoea (under 2 years of age) 30 POPULATION. The population of the several divisions of the Borough at each Census since 1861, and also the estimated population for 1937 and 1938 are as follows:— Newington. St. George's. St. Saviour's and Christchurch. 1861 82,157 55,510 36,164 1871 88,691 56,083 31,299 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 1931 107,692 48,552 15,451 1937 92,365 41,773 13,262 1938 91,049 41,177 13,074 9 BIRTHS. The number of Births registered in the Borough during 1938 was 1,540, of which 799 were males, and 741 females. This represents a birth-rate of 10.6 per 1,000 inhabitants. The number of births registered in the individual parishes was as follows:—Newington, 419; St. George the Martyr, 202; Christchurch and St. Saviour's, 919. Of the 1,540 births registered in the Borough 604 were transferred away, the permanent residence of the parents being outside the Borough. 1,094 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 604 "outward" transfers are deducted and the 1,094 "inward" transfers are added to the 1,540 births actually registered in the Borough, the net amount of births belonging to Southwark for the year is found to be 2,030. This gives a corrected birth-rate of 14.0. TABLE 1. Birth-rate for the last Ten Years for the Three Divisions of the Borough as formerly existed. Newington. St. George's. St. Saviour's and Christchurch. Whole Borough. 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 1936 14.8 15.3 13.2 14.8 1937 14.9 14.9 12.8 14.7 1938 14.4 14.0 10.2 14.0 10 TABLE 2. Number of Births and Deaths belonging to each Ward, and the Infantile Mortality Rate, 1938. WARD Births. Infantile Mortality. Deaths. Males. Females. Total. Males. Females. Total. St. Mary 159 130 289 62 147 99 246 St. Paul 107 115 222 63 128 96 224 St. Peter 165 150 315 54 140 140 280 St. John 170 173 343 52 133 109 242 Trinity 70 77 147 68 71 69 140 St. Michael 112 115 227 35 121 94 215 St. Jude 82 86 168 42 85 72 157 St. George 92 93 185 59 76 64 140 Christchurch 37 20 57 158 50 38 88 St. Saviour 38 39 77 39 48 32 80 Borough 1032 998 2030 57 999 813 1812 11 DEATHS. 1,083 deaths were registered in the sub-districts of the Borough during 1938, the chief cause being Heart diseases, which accounted for 599, followed by Cancer with 238 deaths. 27 Southwark residents died in the street, or on the way to hospital, while 2 were drowned in the River Thames. 605 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 109 belonging to Southwark and 496 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 1,217. When the 487 deaths of those persons who were non-parishioners, but who died in our Borough, have been deducted, and the 1,216 "outlying" deaths added, the actual or "corrected" number of deaths belonging to the sanitary area is found to be 1,812, of which number 999 were males and 813 females. The death-rate, when calculated on this "corrected" number, is 12.5 per 1,000 inhabitants for the whole Borough for the year 1938, as against a rate of 14.1 for 1937. The percentage of persons dying away from Southwark in relation to the total number of deaths belonging to the Borough was 67.1. The principal localities in which the "outlying" deaths occurred are as follows:— Lambeth Hospital 432 St. Giles' Hospital 386 Rotherhithe Hospital 83 East Dulwich Hospital 13 St. Thomas's Hospital 23 King's College Hospital 9 Belgrave Hospital 3 Royal Waterloo Hospital 9 General Lying-in Hospital 2 Mental Hospitals 62 In the Street and other Institutions 194 1,216 12 TABLE 3. Deaths belonging to the Sanitary Area, with the Causes of Death at all Ages during 1938. Causes of Death. Nett Deaths at the subjoined ages of "Residents" whether occurring within or without the District. All Ages. 0. 1. 2. 5. 15. 25. 35. 45. 55. 65. 75. All causes 1812 116 18 17 27 47 51 88 180 316 -160 492 1. Typhoid and Paratyphoid Fevers – – – – – – – – – – – – 2. Measles 11 2 6 3 – – – – – – – – 3. Scarlet Fever 1 – 1 – – – – – – – – – 4. Whooping Cough 2 1 1 – – – – – – – – – 5. Diphtheria 9 – – 4 5 – – – – – – – 6. Influenza 11 – – – – – – – 4 2 4 1 7. Encephalitis Lethargica 4 – – – – 1 2 1 – – – – 8. Cerebro-Spinal Fever 3 – 1 – 1 – – – 1 – – – 9. Tuberculosis of Respiratory System 122 1 1 1 1 15 20 17 34 24 7 1 10. Other Tuberculous Diseases 12 – – – 4 4 2 – – 2 – – 11. Syphilis 11 2 – – – – – 2 3 – 4 – 12. Gen. Paralysis of Insane, Tabes Dorsalis 7 – – – – – – 2 1 3 1 – 13. Cancer, Malignant Disease 238 – – – – 2 2 10 37 69 82 36 14. Diabetes 25 – – – – – – – 2 8 9 6 15. Cerebral Haemorrhage etc. 66 – – – – – – 2 8 16 27 13 16. Heart Disease 599 – – 1 2 4 4 11 22 84 185 286 17. Aneurysm 10 – – – – – – 2 2 4 2 – 18. Other Circulatory Diseases 94 – – – – – – 1 8 17 34 34 19. Bronchitis 54 2 – – – – 1 1 3 17 14 16 20. Pneumonia (all forms) 129 23 5 1 – 1 4 12 17 14 27 25 21. Other Respiratory Diseases 7 – – – 1 1 – – – 2 – 3 22. Peptic Ulcer 21 – – – – – – 3 5 7 4 1 23. Diarrhoea, etc. 32 30 – – – – – – – 1 – 1 24. Appendicitis 6 – – – 1 2 – – – 1 2 – 25. Cirrhosis of Liver 7 – – – – – – 1 1 3 1 1 26. Other Diseases of Liver 7 – – – – – – 1 – 1 3 2 27. Other Digestive Diseases 30 5 – 1 – – – 2 6 6 7 3 28. Acute and Chronic Nephritis 58 – – 1 2 2 1 3 6 11 19 13 29. Puerperal Sepsis – – – – – – – – – – – – 30. Other Puerperal Causes 2 – – – – – – 2 – – – – 31. Congenital Debility and Malformation, including Premature Birth, etc 41 39 1 – – – 1 – – – – – 32. Senility 10 – – – – – – – – – 3 7 33. Suicide 24 – – – – 1 2 3 6 5 6 1 34. Other Violence 43 3 1 3 – 5 5 1 5 3 3 14 35. Other Defined Diseases 116 8 1 2 10 9 6 11 9 16 16 28 36. Causes (ill defined) – – – – – – – – – – – – Totals 1812 116 18 17 27 47 51 88 189 316 460 492 13 TABLE 4. BOROUGH OF SOUTHWARK. INFANT MORTALITY, 1938. Nett Deaths from stated causes at various ages under 1 Year of age. CAUSE OF DEATH. Under 1 week. J 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. Total Deaths under 1 Year. All causes 31 1 3 5 40 19 16 22 19 116 Measles – – – – – – 1 – 1 2 Diphtheria – – – – – – – – – – Whooping Cough – – – – – – – – 1 1 Diarrhoea – – 1 1 2 2 6 14 6 30 Enteritis – – – – – – 1 – 1 2 Influenza – – – – – – – – – – Cerebro-Spinal Fever – – – – – – – – – – Scarlet Fever – – – – – – – – – – Phthisis – – – – – 1 – – – 1 Other Tuberculosis – – – – – – – – – – Congenital Malformations 5 – 1 1 7 1 – – – 8 Premature Birth 14 – – – 14 – – – – 14 Atrophy, Debility and Marasmus 7 1 1 – 9 4 – 1 1 15 Atelectasis 2 – – – 2 – – – – 2 Erysipelas – – – – – – – 1 – 1 Syphilis – – – – – 1 – – 1 2 Rickets – – – – – – – – – – Meningitis – – – – – – – – – – Laryngitis – – – – – – – – – – Convulsions – – – – – – – – – – Gastritis – – – – – 2 – – 1 3 Intussusception – – – – – – 1 – 1 2 Dentition – – – – – – – – – – Dermatitis – – – – – – – – – – Bronchitis – – – 1 1 – – – 1 2 Pneumonia (All Forms) – – – 2 2 5 6 5 5 23 Suffocation (overlying) – – – – – – – – – – Accident (other) – – – – – 1 1 1 – 3 Nephritis, Acute – – – – – – – – – – Icterus Neonatorum – – – – – – – – – – Septic Pyaemia – – – – – – – – – – Otitis and Mastoiditis – – – – – – – – – – Other Causes 3 – – – 3 2 – – – 5 Not classified above – – – – – – – – – – 31 1 3 5 40 19 16 22 19 116 Nett Births in the year Legitimate 1924 Illegitimate 106 Legitimate Infants 109 Nett Deaths in the year Illegitimate Infants .. 7 14 TABLE 5. Death Rates for the last Ten Years for the Three Divisions of the Borough as formerly existed. Newington. St. George's. Christchurch and St. Saviour's. Whole Borough 1929 15.1 16.5 16.2 15.6 1930 12.6 12.8 11.2 15.2 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 1936 12.8 13.3 14.3 13.1 1937 14.2 10.9 15.5 14.1 1938 12.4 12.4 12.8 12.5 TABLE 6. DEATHS OF INFANTS UNDER ONE YEAR OF AGE. The deaths of Infants under one year of age to 1,000 births were 57 during the year 1938. The deaths under one year of age to 1,000 births for the last ten years were as follows:— 1929 81 1934 77 1930 57 1935 66 1931 61 1936 59 1932 72 1937 64 1933 63 1938 57 The average Infantile death rate for the last ten years is 65. 15 TABLE 7. Births and Deaths Registered in the Sub-Districts of the Borough in 1938. First Quarter. Second Quarter. Sub -Districts. Births. Deaths. Sub-Districts. Births. Deaths. Male. Female. Male. Female. Male. Female. Male. Female. Newington 59 53 43 69 Newington 60 55 37 36 St. George the Martyr, West 27 30 35 29 St. George the Martyr, West 25 28 29 25 Christchurch and St. Saviour 118 117 95 60 Christchurch and St. Saviour 123 97 80 48 Total 204 200 173 158 Total 208 180 146 109 Third Quarter. Fourth Quarter. Newington 51 54 21 45 Newington 45 42 43 48 St. George the Martyr, West 24 23 28 16 St. George the Martyr, West 21 24 26 30 Christchurch and St. Saviour 135 102 61 54 Christchurch and St. Saviour 111 116 79 46 Total 210 179 110 115 Total 177 182 148 124 Births. Deaths. M. f. M. f. In 1st Quarter 204 200 173 158 In 2nd Quarter 208 180 146 169 In 3rd Quarter 210 179 110 115 In 4th Quarter 177 182 148 124 Totals 799 741 577 506 16 TABLE 8. Showing the number of Deaths that occurred in Public Institutions in the Borough during the year 1938. Institution. In 1st Quarter. In 2nd Quarter. In 3rd Quarter. In 4th Quarter. During Year. Newington Institution 12 12 7 7 38 Christchurch do. – – – – – Evelina Hospital 15 9 10 10 44 Guy's Hospital 140 113 106 105 464 60, Lambeth Road (Catholic Nursing Home) 1 1 6 4 12 Royal Eye Hospital – 1 – – 1 All Saints' Hospital 11 10 10 9 40 Other Addresses 1 – 3 2 6 Total 180 116 142 137 605 17 TABLE 9. VITAL STATISTICS OF SEPARATE LOCALITIES (1934-38). Year. St. Mary's Ward. St. Paul's Ward. St. Peter's Ward. St. John's Ward. Trinity Ward. Births Registered. Deaths at all ages. Deaths under 1 year. Births Registered. Deaths at all ages. Deaths under 1 year. Births Registered. Deaths at all ages. Deaths under 1 year. Births Registered. Deaths at all ages. Deaths under 1 year. Births Registered. Deaths at all ages. Deaths under 1 year. 1934 317 280 23 236 224 14 321 312 21 367 317 20 210 161 12 1935 296 271 15 263 217 22 336 274 16 410 295 25 177 148 10 1936 328 290 21 241 209 6 328 291 14 336 299 23 153 133 3 1937 321 290 22 265 239 16 309 333 17 347 283 15 132 167 13 1938 289 246 18 222 224 14 315 280 17 343 242 18 147 140 10 St. Michael's Ward. St. Jude's Ward. St. George's Ward. Christchurch Ward. St. Saviour's Ward. 1934 251 273 28 199 189 24 257 199 26 107 108 8 126 97 8 1935 245 241 20 202 135 14 219 175 19 79 91 4 88 90 7 1936 259 233 24 168 173 13 231 169 17 96 102 5 85 94 8 1937 235 236 19 171 182 19 217 138 10 73 111 6 97 95 3 1938 227 215 8 168 157 8 185 140 11 57 88 9 77 80 3 18 TABLE 10. ZYMOTIC MORTALITY FOR THE SANITARY AREA, 1938. Showing the localities where the deaths occurred. Locality. Influenza. Measles. Scarlet Fever. Diphtheria. Whooping Cough. Enteric Fever. Diarrhoea. The Borough 8 1 – – – – 3 East Dulwich Hospital – – – – – – 1 Lambeth Hospital 2 1 – – – – 5 Newington Institution – – – – – – – Evelina Hospital – – – – – – 5 Guy's Hospital – – – – – – 2 St. Thomas's Hospital – – – – – – 1 Belgrave Hospital – – – – – – 1 Royal Waterloo – – – – – – – L.C.C. Hospitals, etc. – 9 1 9 2 – – St. Giles' Hospital 1 – – – – – 7 Rotherhithe Hospital – – – – – – 7 Total 11 11 1 9 2 – 32 TABLE 11. Deaths in the Sanitary Area from the principal Zymotic Diseases in the various Wards for 1938. WARD OR DISTRICT. Influenza. Measles. Scarlet Fever. Diphtheria. Whooping Cough. Enteric Fever. Diarrhoea. St. Mary 1 – – 1 – – 6 St. Paul 2 1 – 2 – – 2 St. Peter 4 1 – 2 – – 4 St. John 1 1 – – – – 4 Trinity – – – – – – 4 St. Michael 1 2 – 2 – – 3 St. Jude – 1 – – – – 4 St. George 1 2 1 1 – – 2 Christchurch – 2 – – 2 – 3 St. Saviour 1 1 – 1 – – – Borough 11 11 1 9 2 – 32 SECTION B. General Provisions of Health Services for the Area. 21 PUBLIC HEALTH OFFICERS. William Stott, M.B., B.S. (Hnrs.), D.P.H., Medical Officer of Health. Edward K. Pritchard, M.R.C.S., L.R.C.P., D.P.H., Tuberculosis Officer and Deputy Medical Officer of Health. Margaret Bergin, M.B., B.Ch., B.A.O. (N.U.I.), D.P.H., Assistant Medical Officer, Maternity and Child Welfare. Evelyn Ann Mower White, M.R.C.S., L.R.C.P., D.P.H., Assistant Medical Officer, Maternity and Child Welfare. Angel Valentine Brown Crawford, M.B., B.Ch., B.A., B.A.O., D.P.H., Assistant Medical Officer, Maternity and Child Welfare. Norman L. Rusby, B.A., M.A., M.R.C.S., M.R.C.P., M.B., B.Ch,, part-time Assistant Tuberculosis Officer (to 30.6.38). Thomas P. Evans, M.R.C.S., L.R.C.P., part-time Assistant Tuberculosis Officer (from 1.7.38). Sanitary Inspectors. a b G. Fisher, Senior Inspector (to 31.8.38). a b S. Bowers, Senior Inspector (from 1.9.38), Assistant Food Inspector (to 31.8.38). a b c J. C. Nicholson, Food and Drugs Inspector. a b W. H. Banham, Assistant to Food and Drugs Inspector. a b G. H. Duffield, Assistant Food Inspector. a b J. A. Syms, Sanitary Inspector. a b A. C. White, Sanitary Inspector (to 21.1.38). a b A. Ede, Sanitary Inspector. a b A. Groves, Sanitary Inspector. a b H. E. Hattersley, Sanitary Inspector. a J. R. Findley, Sanitary Inspector. a b H. S. Steele, Sanitary Inspector. a b F. J. Bryant, Sanitary Inspector. a b F. Mayhew, Sanitary Inspector. a b W. Richards, Sanitary Inspector. a b F. Dransfield, Sanitary Inspector. a b R. F. Stubbs, Sanitary Inspector. a b J. D. Walker, Sanitary Inspector (from 1.4.38). a J. Baillie, Temporary Sanitary Inspector (from 1.6.38). a d e Gladys Briggs, Women's Workshops and Child Life Protection. a Cert. Sanitary Inspector. c 1st Class Engineer (Board of Trade). b Meat and other Foods. d C.M.B. e S.R.N. 22 Other Officers. Cyril Dickinson, B.Sc., F.I.C., F.C.S., Public Analyst. F. Smith, F.I.C., Assistant Analyst. D. F. H. Button, A.R.C.S., F.I.C., Assistant Analyst. W. H. Goodger, Clerk and Laboratory Attendant. A. D. R. Harrisonl . D Pearson Laboratory Assistants. Tuberculosis Dispensary. Florence Nightingale (Certificate of Apothecaries Society of London), Secretary and Dispenser. Phyllis Angell, Junior Clerk. Nurses. M. E. Bennett, Certificate Sanitary Institute, S.R.N. E. Plummer, C. M.B., S.R.N., Cert. Health Visitor. L. Gordon, S.R.N., S.C.M. Day Nursery. M. Noel, Matron. E. George, Staff Nurse. 4 Probationers, 1 Cook. Health Visitors. d e Annie Rogers. dfg Clare Cottrill. d f Winifred Sayer. d ef Kathleen Hinde. dfg Florence Adair. dfg Mary Freeth. d f Mabel Howard Kave (from d g Mary George. [1.10.38). df g Annie Kingsmill. dfg Florence Mary Mason. dfg Evelyn M. Bevins. dfg Elizabeth M. Western. (1 Storekeeper. 1 Assistant Storekeeper part time.) d Cert. Health Visitor, e Cert. Sanitary Inspector. FC.M.B. g Nursing Part-time Officers. Dorothy Shepherd, M.B., Ch.B., Maternity and Child Welfare Clinic. Arabella C. Stevens, M.B., B.Ch., B.A.O., Maternity and Child Welfare Clinic. E. Fairfield Thomas, M.D., Ch.B., D.P.H., Schick Immunisation Officer. R. K. Bowes, M.D., M.B., Ch.B., F.R.C.S., Gynaecological Clinic. G. Phyllis Brocklesby, Sunlight Clinic, Villa Street. Public Vaccinators. P. O'Malley, M.B., B.Ch., B.A.O., N.U.I. M. M. Scott, M.R.C.S., L.R.C.P. D. M. Clune, M.B., B.Ch., B.A.O., N.U.T. A. M. Foxe, M.B., B.Ch., B.A.O., N.U.I. 23 Vaccination Officers. E. J. A. Holt. C. R. Fifer. Clerical Staff. A. C. White, Chief Clerk (from 22.1.38). G. H. Bell, Chief Clerk (to 21.1.38). R. A. Blaikie, Infectious Diseases Clerk. C. Savage, Maternity and Child Welfare Clerk. C. Duggan, Housing Clerk. F. Spearing. Housing Clerk. G. Stubbs, Registers Clerk. F. S. Bridges, Registers Clerk. J. Baillie, Registers Clerk (to 31.5.38). E. A. Clark, Shorthand-Typist. F. J. Goodman, General Clerk. H. Barling, Junior Clerk (from 17.1.38). J. W. Paine, Junior Clerk (from 19.7.38). 1 Temporary Clerk (to 21.1.38). 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. The new Laboratories, planned and designed by the Public Analyst, are equipped in the most up-to-date manner. They will enable the ever-increasing work of the department to be adequately dealt with and also make possible the conduct of investigations which could not be carried out in the old laboratories. Chemical analyses are undertaken of all samples submitted under the Food and Drugs Acts and Regulations, samples of imported foods taken from the wharves, together with any other analytical work or investigations required. Bacteriological examinations of Sputa, Swabs, Blood, etc., are made for Medical Practitioners in the Borough and for the Tuberculosis Dispensary. Routine examinations of the Swimming-bath waters are conducted. Other examinations of a varied character are carried out as required. (b) Ambulance Facilities.—The arrangements for the removal of (a) infectious cases and (b) maternity patients are satisfactory. No change has been made during the year. (c) Nursing in the Home.—General Nursing is carried out by the Benson Nursing Association, 96, Kennington Park Road, and the Catholic Nursing Home, 60, Lambeth Road. A few parishes also have their own private nurses. 24 MATERNITY AND CHILD WELFARE. The work of the Council's Maternity and Child Welfare Scheme has increased in every section during the twelve-month period. The new Clinics which were started at the Health Services Department have proved popular and are now very well attended. The Sunlight Clinic in particular has become extremely well attended, in fact the attendances are becoming so numerous that very shortly it will become necessary to commence evening clinics and to increase the staff in attendance. At the beginning of the year it was decided to re-arrange the duties of the Health Visitors and the Tuberculosis Visitors. In order to increase the number of visitors and to prevent duplicity of visits, the duties of the Health Visitors and the Tuberculosis Visitors were combined, each visitor being given a district for both Maternity and Child Welfare and Tuberculosis visiting. In August a Dental Clinic was commenced at the Health Services Department in connection with the Maternity and Child Welfare services. This has proved of extreme value and the number of attendances is increasing. The Maternity and Child Welfare Committee have noted this increase and have considered the possibility of adding another session in due course to meet the demands. A further responsibility for the Council was made on October 1st, by the taking over of the Maternity and Child Welfare sessions which had previously been held at St. John's Institute, Larcom Street, under the control of a voluntary committee. At the present time sessions for St. John's are being held at the Health Services Department until such time as the new Centre can be built at Hemp Row. The transference entailed the taking over of one Health Visitor, Miss Kaye, who has now been placed on the Council's official staff. The new Maternity and Child Welfare Centres will shortly be completed; the one at Pocock Street being in the course of erection and likely to be completed at the middle of 1939. The purchase of the site for the new Centre at Hemp Row is, I understand, completed, whilst information has also been received from the London County Council that the site for the new Centre in Rockingham Street will be available in the spring of the new year. The Council will note with great satisfaction that the infantile mortality rate for the year is 57, the lowest figure recorded, moreover, there were no deaths of mothers from puerperal fever and only 2 deaths as a result of disease and accident of pregnancy. 25 I should like to take this opportunity of expressing my warmest thanks to the National Society for the Prevention of Cruelty to Children and its officers for their co-operation in dealing with cases of neglect to children which have come to my notice from time to time. Thanks to their energetic work the lot of many children who were neglected, wilfully or otherwise, has now been improved. MATERNAL MORTALITY. Resulting from 2,097 live and still births, 2 mothers lost their lives —a mortality rate of 0.95 per 1,000 births. The same mortality rate for the Country as a whole is 2.97. Puerperal Fever and Pyrexia Regulations. There has been no change in the Council's scheme. During the year 0 cases of Puerperal Fever and 26 cases of Puerperal Pyrexia were notified. 18 of these cases were removed to hospital. Consultation with the Borough Specialist was sought in 1 instance. INFANT MORTALITY. The infant mortality rate is 57 per 1,000 births. HOME NURSING. The Council have made arrangements with the Benson Nursing Association, and the Catholic Nursing Home, for the home nursing of children under 5 years of age, suffering from pneumonia, bronchitis, whooping cough, measles, diarrhoea, etc. During the past year 349 sick children have been nursed under this arrangement. MATERNITY BEDS. Three beds are reserved at Lambeth Hospital for necessitous expectant mothers and during the year under review 1 mother was admitted for her confinement at a cost to the Council of £4 1s. Od. MATERNITY OUTFITS. One hundred and four maternity outfits were supplied to expectant mothers at cost price, or in necessitous cases free of charge, at the Ante-natal Clinics. 26 HOME HELPS. A panel of selected women to act as Home Helps is kept in the Health Services Department. 20 Home Helps were provided in necessitous cases. CONSULTANTS. The Council have a panel of two Obstetric Consultants who may be called in by any general practitioner in any midwifery case which presents difficulty or abnormality. One consultation took place during the year at a cost to the Council of £5 5s. Od. 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 4,176. 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 8,122. Crossways Mission, New Kent Road, has a Day Nursery accommodating 46 children. The number of attendances during the year was 8,306. TODDLERS' CLINICS. During the year 41 sessions were held at the Health Services Department with a total attendance of 569. In addition 12 sessions were conducted at the St. George's Infant Welfare Centre with an attendance of 463. WOMEN'S COUNTRY HOLIDAY FUND. Under the Council's approved scheme for convalescent treatment of nursing mothers and children recommended by the Medical Officers of the Welfare Centres, 109 mothers and 119 children were sent away at a cost of £400. 27 DRIED AND LIQUID MILKS. Milk is supplied to expectant and nursing mothers, and to children under the age of 3 years (in special circumstances 5 years). It is supplied in accordance with the Ministry of Health's Circular upon the recommendation of the Medical Officer in charge of the Welfare Centre in cases where she considers it to be a medical necessity. During the year 36,683 packets of dried milk and 67,547 pints of liquid milk were supplied free to necessitous cases at a cost to the Council of £3,554 2s. 9d. The amount charged to the Public Assistance Committee was £59 17s. 3d. The Scheme of co-operation with the Public Assistance Committee has worked smoothly. SUNLIGHT CLINIC, GUY'S HOSPITAL. The arrangement with Guy's Hospital for Sunlight Treatment for ailing and delicate children is still carried on in a few instances, and during the year 4 cases were sent for treatment. SUNLIGHT CLINIC, HEALTH SERVICES DEPARTMENT, WALWORTH ROAD. During the year 1,338 patients made 5,916 attendances. MUNICIPAL SUNLIGHT CLINIC, VILLA STREET. This year from the 4th January to 31st May and also from 2nd September to 31st December, the Sunlight Clinic had Sessions twice weekly. 98 patients made 1,105 attendances, 96 of whom were new patients. The usual results were a regular gain in weight, and a great improvement in appetite, sleeping, and general health. The following cases were treated:—Adenitis, Anaemia, Delayed Dentition, Asthma, Bronchitis, Debility, Delayed Walking, Pneumonia convalescents, Recurrent Colds, Rickets and Debility after Whooping Cough and Tonsillitis. 28 CONVALESCENT TREATMENT. The arrangement between the Borough Council and the Invalid Children's Aid Association is still being carried on, and 104 children under 5 years of age were sent away at a cost of £239 9s. 4d. 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 £59 18s. 2d. for the year. MUNICIPAL CENTRE—VILLA STREET. SEWING CLASSES. Classes were held weekly with a total attendance of 577. CHILD LIFE PROTECTION. A summary of the number of foster mothers and foster children in Southwark and other statistics in connection therewith is as follows:— Number of persons on the Register at the end of the year who were receiving children for reward 24 Number of children on the Register 35 Number of Child Life Protection Visitors at the end of the year:— Health Visitors Nil Female, other than Health Visitors 2 Male 2 Number of visits made by Visitors to the homes of foster mothers 711 Number of night visits made during the year 5 Number of foster children who died and upon whom inquests were held 1 Legal proceedings taken Nil 29 CHILD LIFE PROTECTION. PUBLIC HEALTH (LONDON) ACT, 1936. Sections 256-272. I have received the following report from Miss G. Briggs:— At the beginning of the year the names of 32 foster mothers and 42 foster children were on the register and at the end of the year there were 24 foster mothers and 35 foster children. The number of foster mothers has decreased owing to four having removed to other boroughs, eight names removed by request and three where foster children have reached the age of nine years. One foster mother died suddenly and immediate steps were taken to ensure the children were cared for and later arrangements were made to admit them to a home. Nine new applications were received from women who were desirous of taking a foster child and after the homes were inspected eight names were added to the register. On account of the number of foster mothers having decreased there are fewer foster children in the Borough. Many enquiries have been made by persons wishing to find a foster mother for their children, but owing to the lack of vacancies a number of them were referred to other districts. The number of new foster children is 37 and the number removed or reached the age of nine years is 44. Early in the year seven foster children were removed to hospital with measles, each made good recovery; later three other children had whooping cough and recovered satisfactorily. One foster child who had not been registered died and a coroner's inquest was held. This child was received for a few days as a day child and later slept at the house for several nights but was not registered. The foster mother has now ceased to have foster children. •Several foster mothers have children in their care for whom no payment has been made for a considerable time, but in each case the child is being well cared for. There are at present only three foster mothers who take in day children. The number received by each is usually one child. During the year 711 visits have been paid, 13 of which were special visits. Five homes were visited after 7 p.m.; the children were in bed and the cots were clean and satisfactory. Most of the foster mothers with children under five years of age attend the Welfare Centre for advice. 30 MATERNITY AND CHILD WELFARE CENTRES. Whole-time Assistant Medical Officers Dr. Margaret Bergin. (Municipal Centres) Dr. E. A. Mower White. Dr. A. V. B. Crawford. Part-time Assistant Medical Officers.. Dr. D. Shepherd. Dr. A. C. Stevens. Other Assistant Medical Officers .. Dr. E. M. Saxton. (Voluntary Centres) (To 1.10.38.) Dr. M. 0. Cruickshank. (To 1.10.38.) Dr. M. Fenwick. Dr. H. T. Sheehan. SESSIONS. Health Services Department, Walworth Road— Monday 2—4 p.m. Toddlers' Session and Milk Issues. Tuesday 10—12 a.m. Medical Session (St. John's). (From 1.10.38.) ,, 2—4 p.m. Gynaecological Clinic. (Fortnightly.) Milk Issues. Wednesday 10—12 a.m. Ante-natal Clinic. ,, 2—4 p.m. Medical Session (St. John's). (From 1.10.38.) Dental Clinic. Thursday 10 a.m.—4 p.m. Test-feeding Clinic. St. John's Institute, Larcom Street—(To 1-10-38) Sessions held every Wednesday and Thursday 2 p.m. to 4 p.m. Sutherland House, Sutherland Square— Monday 10—12 a.m. Medical Session. ,, 2—4 p.m. Sewing Class. Tuesday 10—12.45 p.m. Milk Issues only. ,, 2—4 p.m. Medical Session. Wednesday 10—12.45 p.m. Milk Issues only. ,, 2—4 p.m. Ante-natal Session. Thursday 10—12 a. m. Medical Session. ,, 2—4.30 p.m. Schick Clinic and Milk Issues. Friday 2—4 p.m. Medical Session. 31 New Maternity Centre, Villa Street— Monday 10—12.45 p.m. Milk Issues only. ,, 2—4 p.m. Medical Session. Tuesday 10—12 a.m. Medical Session. ,, 2—4.30 p. m. Sunlight Clinic. Wednesday 10—12 a.m. Medical Session. ,, 2—4 p.m. Sewing Class. Thursday 10—12.45 p.m. Milk Issues only. ,, 2—4 p.m. Medical Session. Friday 10—12 a.m. Ante-natal Session. ,, 2—4.30 p.m. Sunlight Clinic and Milk Issues. Lady Margaret Church Parish Room, Chatham Street— Sessions held every Thursday 10—12 a.m. and 2—4 p.m. Crossway Mission Hall, New Kent Road— Sessions held every Wednesday 10—12 a.m. and 2—4 p.m. Mission Hall, Lansdowne Place— Sessions held every Friday 10—12 a.m. and 2—4 p.m. St. Jude's Centre, 56, Lambeth Road — Sessions held every Monday and Thursday Monday, 2—4 p.m. Thursday, 10—12 a.m. Southwark Boys' Hostel, Pocock Street— Sessions held every Monday and Tuesday 10—12 a.m. and 2—4 p.m. St. George's Centre, 86, Borough Road— Sessions held every Monday 2—4 p.m. Roman Catholic Centre, 148, New Kent Road— Sessions held every Thursday 2.30—4 p.m. Salamon's Centre, 28, Newcomen Street— Sessions held every Monday and Thursday Monday, 2—4 p. m. Thursday, 10—12 noon and 2—4 p.m. 32 ANTE-NATAL CLINICS. Ante-natal Clinics are also held at the following Centres:— St. Jude's Centre, 56, Lambeth Road— Sessions held One monthly Salamon's Centre, 28, Newcomen Street— Sessions held—Monday, Wednesday and Friday 9.30—10.30 a.m. Tuesday 1.30—2 30 p.m. ANTE-NATAL CLINICS. Health Services Department, Walworth Road. Weekly sessions were held during the year at which 107 expectant mothers attended. They made 289 attendances. In addition 44 postnatal cases were seen by the doctor. Sutherland House, Sutherland Square. During the year, 161 expectant mothers were seen and given advice. They made 372 attendances. In addition, 58 post-natal cases were seen by the doctor. Municipal Centre, Villa Street. During the year, 117 expectant mothers were seen and given advice. They made 376 attendances. In addition, 9 post-natal cases were seen by the doctor. St. Jude's Centre, 56, Lambeth Road. One session is held monthly at this Clinic, and during the year 38 expectant mothers were seen and given advice. They made 222 attendances. Salamon's Centre, 28, Newcomen Street. During the year, 754 expectant mothers were seen and given advice. They made 5,151 attendances. 533 post-natal oases were also seen by the doctor. GYNAECOLOGICAL. CLINIC. Sessions have been conducted fortnightly during the year by the specialist, Mr. Kenneth Bowes. 146 patients were examined and given advice and treatment arranged where necessary. There were also 196 re-attendances of patients. 33 INFANT TEST FEEDING CLINIC. Weekly sessions were held during the year under the direction of Dr. Mower White. 224 attendances were made. DENTAL CLINIC. On August 10th, 1938, a dental session for Maternity and Child Welfare patients was commenced at the Health Services Department and weekly sessions were subsequently held. The number of patients who received dental examinations was 76 with a total re-attendance of 189. Patients in receipt of Public Assistance are referred to the London County Council Hospitals. The work of the clinic is carried out by a Dental Surgeon under an Agreement with the British Dental Hospital. 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. 34 35 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 12. m Street (to 1st Oct.) Health Services Dept. (from 1st Oct.) Sutherland House. Villa Street. Chatham Street. Cross way. Lansdowne Place. Lambeth Road. Pocock Street. Borough Road. Roman Catholic. Guy's. Total. Number of Births notified during the year 201 62 537 367 172 114 114 167 306 85 — 17 2142 Number of individual children attending the Centres during the year 416 836 593 267 268 226 319 558 241 112 119 3955 Number of Sessions held during the year 73 25 183 190 96 92 94 91 183 44 44 153 1268 Number of children in 1—5 age group attending during the year 253 508 367 157 186 150 209 335 181 54 104 2504 Number of new cases attending the Centres during the year— (1) Expectant Mothers (Ante-natal Clinics) — *107 161 117 — — — 38 — — — 754 1177 (2) Post-natal Cases (including Ante-natal Clinics) 237 90 331 238 137 89 18 117 164 55 — 449 1925 (3) Infants under 1 year 193 52 452 289 133 119 103 137 234 76 78 48 1914 (4) Seen by Doctor 193 52 452 289 133 119 103 137 234 76 78 48 1914 (5) Children 1 to 5 years 43 10 135 37 35 36 26 20 27 23 24 7 423 (6) Seen by Doctor 43 10 135 37 35 36 26 20 27 23 24 7 423 Method of Feeding—(a) Breast 184 46 350 241 102 89 101 92 193 63 46 35 1542 (b) Breast and bottle 2 3 61 24 21 23 2 23 30 8 26 4 227 (c) Bottle 8 1 24 16 9 5 — 16 12 3 10 9 113 (d) Ordinary diet 42 12 152 45 36 38 26 26 26 25 20 7 455 Total number of attendances during the year:— (1) Expectant Mothers (Ante-natal Clinics) seen by Doctor — *289 372 376 — — — 222 — — 5151 6410 (2) Post-natal Cases (including Ante-natal Clinics) 245 90 434 325 160 94 33 203 229 62 — 533 2408 (3) Infants under 1 year 4277 800 6043 4300 2379 1924 2034 2438 4573 1491 905 2080 33244 (4) Children 1 to 5 years 3007 362 3228 2564 2582 2447 1301 3883 3691 1280 875 855 26075 Average number of attendances (Infants under 1) 58.6 32.0 33.0 20.3 24.8 20.9 21.6 26.8 24.9 33.9 20.6 13.6 — Do. do. (Children 1—5) 41.2 14.5 17.6 13.5 26.9 26.6 13.6 42.6 20.2 29.1 19.9 5.6 — (5) Infants seen by Doctor during the year 1125 356 2976 2030 1033 1011 1137 1282 1912 768 455 624 14709 (6) Children 1 to 5 years seen by Doctor during the year 628 162 1540 1189 1083 936 587 1429 1257 574 258 403 10046 (7) Number of weighings recorded (Children) 4779 1161 9172 6822 4361 4094 3063 4674 7677 2766 1469 2342 52380 Total number of first visits paid by Health Visitors to homes of— (1) Expectant Mothers 197 60 602 276 150 43 50 226 238 41 21 326 2230 (2) Infants under 1 year 215 48 522 385 178 114 115 178 309 75 — 23 2162 Total number of revisits paid by Health Visitors to homes of— (1) Expectant Mothers 200 96 255 52 24 14 11 245 157 48 112 263 1477 (2) Infants under 1 year 994 465 3526 1552 1429 581 1418 1053 1896 692 333 240 14179 (3) Children 1 to 5 years 1292 757 4333 2612 1944 1186 1576 1984 2703 1274 559 921 21141 * For a period of 1 year. HEALTH WORK. The number of visits made by the Health Visitors and other Officers of the Health Services Department in connection with Births, and other Health Work during 1938. TABLE 13. Original Visits. Re-Visits under 1. Visits to Children 1—5 years. Ante-Natal Visits. Post-Natal Visits. Attendances at Welfare Centres. Measles. Ophthalmia Neonatorum. Puerperal Pyrexia. Visits to cases of Diarrhoea. Special Visits, etc. Tuberculosis Visits. Total. Mrs. Kingsmill 178 1304 1553 356 — 119 183 — 1 — 40 198 3932 Miss Western 149 1207 1089 292 49 88 152 2 — — 20 124 3172 Miss Sayer 195 1015 1691 211 3 94 140 — — — 27 151 3527 Mrs. George 201 667 1184 187 1 94 252 — 2 — 26 101 2715 Miss Rogers 184 885 1428 141 1 102 128 — 1 — 14 147 3031 Miss Adair 178 1429 1944 174 21 95 262 2 3 — 66 125 4299 Miss Cottrill 115 1418 1576 61 — 94 164 1 2 1 4 172 3608 Miss Hinde 114 581 1186 57 — 84 151 1 2 — 35 72 2283 Miss Bevins 177 1299 1547 253 40 118 161 4 2 — 73 191 3865 Miss Mason 132 597 1156 132 80 168 144 2 1 1 82 85 2580 Miss Kaye (from 1.10.38) 16 312 402 100 — 22 5 — — — 26 16 899 Miss Plummer (from 1.10.38) 32 153 355 56 1 25 23 4 — — 30 1020 1699 Miss Freeth — — — 10 — 188 34 — — — 10 5 247 Total 1671 10867 15111 2030 196 1291 1799 16 14 2 453 2407 35857 36 37 TABLE 14. NOTIFIED BIRTHS. 1938. Where Born and by Whom Attended. Mothers Continec Notifiec Births. StillBirths. Total Live Births. Born in— Guy's Hospital 299 304 18 286 1, Kennington Park Place — — — — General Lying-in Hospital 200 205 3 202 Lambeth Hospital 452 459 13 446 St. Thomas's Hospital 133 133 8 125 King's College Hospital 40 40 1 39 St. Giles's Hospital 148 154 6 148 St. Olave's Hospital 97 97 3 94 Westminster Hospital 11 11 — 11 Charing Cross Hospital 15 15 — 15 Clapham Maternity Hospital 11 12 1 11 Other Hospitals, etc. 68 68 1 67 1474 1498 54 1444 Born at Home and Attended by— Externa: Guy's Hospital 112 112 — 112 St. Thomas's Hospital 47 47 — 47 King's College Hospital 1 1 — 1 Midwives: L.C.C. 20 20 2 18 Guy's Hospital 107 107 — 107 St. Thomas's Hospital — — — — Lambeth Hospital 2 2 1 1 General Lying-in Hospital 8 8 — 8 Heygate Street 121 122 4 118 77, Southampton Street 6 6 — 6 Private 159 159 1 158 Doctors: Private 60 60 — 60 643 644 8 636 Totals *2117 2142 62 2080 *Of this number, 91, so far as our records show, did not receive ante-natal advice. TABLE 15. Vaccination Officers' Return respecting the Vaccination of Children whose Births were Registered in 1937. Number of theBe 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 (ha vaccination register, on account (as shown by report book), of Date . Registration subdistricts comprised in vaccination officers' district. Number of births returned in birth list sheets. 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 1938. 1937. 1st Jan. to 31st Dec. Northern Division 1099 443 3 393 46 1 113 56 44 647 Southern Division 475 217 1 195 16 — 9 11 26 622 Total 1574 660 4 588 62 1 122 67 70 1269 33 SECTION C. Sanitary Circumstances of the Area. 41 PUBLIC CLEANSING. The weekly collection of house refuse is still in operation in the Borough, with certain exceptions where the refuse is collected at more frequent intervals. The method of disposal of rubbish is as formerly, part being dealt with by pulverisation and the remainder by the controlled tipping process at the Council's country depots. SWIMMING BATHS WATER. There are five municipal swimming pools in the Borough, three being at Manor Place Baths and two at Lavington Street Baths. There are no privately owned swimming pools, with the exception of one at a London County Council school. The swimming bath water at Manor Place Baths is purified by filtration and ozonisation; the frequent samples of water taken for bacterial examination have been satisfactory. The purity of the water at the Lavington Street Baths is maintained by the frequent emptying and re-filling of the bath and by the addition of small quantities of Parazone. The condition at these baths is unsatisfactory and they have been condemned by the Borough Council. A site for new Public Baths to replace those at Lavington Street has now been acquired in the Borough High Street, and the erection of the new building will shortly be commenced. WOMEN'S COMMON LODGING HOUSES. I have received the following report from Miss G. Briggs:— During the year there has been no change in the number of Women's Common Lodging Houses which remains at five. The number of lodgers is getting gradually less. When the census was taken in February, only 182 beds were occupied out of 336. The reason for the decline is not apparent. Four of the houses were originally dwelling houses which had been converted for the purpose. These houses are visited and inspected regularly, 58 visits having been made during the year. Repairs have been carried out voluntarily or on verbal or written instructions being given. One of the houses has been repainted throughout and one partly repainted, and in the others the walls have been cleansed by washing. 42 A reasonable standard of cleanliness has been maintained throughout the year of the bedding, beds, floors, utensils, etc. Each house has a good supply of hot water and washing accommodation and a washhouse where personal clothing can be washed. Three of the houses are provided with baths which are appreciated by the lodgers. The deputy keepers have remained the same at four of the houses, but at one house there has been difficulty in getting a suitable person and several changes have been made. At present a temporary deputy is in charge. When changes are frequent the house suffers as routine work becomes disorganised. Night visits are paid periodically after 11 p.m., but all has been quiet and satisfactory at the time of visiting. MEN'S COMMON LODGING HOUSES. There are 8 Common Lodging Houses for men in the Borough, containing 1,573 beds. The premises are inspected regularly by the District Inspectors, 124 visits having been made during 1938. Many minor defects have been remedied following verbal instructions by the Inspectors, and the houses are generally clean, well-maintained, and conducted in an orderly manner. SMOKE ABATEMENT. During the year 161 observations were made by the several Inspectors for the purpose of determining the emission of smoke and grit from the chimneys of factories and similar buildings in the District. 5 nuisances were observed and 5 intimation notices were served accordingly. SHOPS ACT, 1934. During the year 1938, 25 premises have been inspected and recorded and 159 visits have been paid to premises already recorded. 18 notices have been served, 11 asking for the provision or maintenance of a reasonable temperature in the shops, in accordance with Section 10 (1) (b), and 7 asking for the provision of suitable sanitary conveniences, in accordance with Section 10 (2). Of these 18 notices, 13 have been complied with, 3 have been withdrawn, and 2 are still outstanding. 3 shops have been exempted from the provisions of Section 10 (2), in accordance with Section 10 (6). 43 TABLE 16. Summary of Sanitary Works completed under the Public Health Act during the year 1938. Intimation Notices complied with 3,832 Drains reconstructed 75 Drains repaired 180 Drains intercepted and ventilated 115 Drains unstopped 215 Gullies provided 147 Soil-pipes provided or repaired 198 Closets provided 566 Closet pans and traps 790 Water apparatus repaired 619 Sink, Lavatory and waste pipes 1,670 Rainwater pipes repaired, etc. 300 Water supply to upper floors 104 Draw taps on main 24 New water supplies 71 Roofs and gutters repaired 1,647 Paving repaired 354 Dampness abated 1,429 Rooms cleansed 4,769 Sub-floor ventilation 60 Staircase ventilated 60 Dust-bins provided 1,048 Miscellaneous nuisances abated 9,089 4,464 Intimation Notices were served during the year. 1,306 Statutory Notices were served during the year. PROCEEDINGS TAKEN UNDER THE PUBLIC HEALTH AND OTHER ACTS. Defendant. Cause of Proceedings. Result. S. E. Millborrow, 17, Wellesley Road, Ilford General nuisance existing at 30. Shorncliffe Road Order to carry out the work within 14 days. £1 1s. costs. F. Green & Sons, 35, Union Street, S.E.I Carrying out drainage work at 14, Nelson Square without giving notice Summons withdrawn on payment of £2 2s. costs. V. L. Baurer & Son, 57, Gold Street, E.l Selling Condensed Milk not properly labelled vide Condensed Milk Regulations Summons dismissed on payment of £1 1s. costs. W. Waine, 133-139, Newington Butts, S.E.17 Rag Flock containing excess soluble chlorine; 300 parts in 100,000 parts Case dismissed on payment of £3 3s. costs. Mrs. Davies, Wadhurst, Sussex Nuisances existing at 39, Tamerton Street Order to carry out the work in 14 days. Fined £1. Costs £1 1s. W. E. Roberts, 69, Park Hill, Clapham, S.W.4 Nuisances existing at 17, Frederick Road Order to carry out the work in 21 days. £1 1s. costs. W. E. Roberts. 69, Park Hill, Clapham, S.W.4 Nuisances existing at 18, Frederick Road Proceedings adjourned for 21 days (10th January, 1939). 44 45 RAG FLOCK. Under Section 136 of the Public Health (London) Act, 1936, provision is made for regulating the condition of rag flock fillings used in the manufacture of bedding, cushions and upholstered goods. Regulations have been issued by the Minister of Health. A standard of purity has been set up which is ascertained by estimating the free soluble chlorine present in any sample. An excess of more than 30 parts of free chlorine in 100,000 parts is an offence under the Act. In order to determine to what extent rag flock was used in the Borough, enquiries were made at all premises where upholstered goods and bedding were sold. Fifty visits were made, and it was found that to a large extent the goods sold are manufactured outside the Borough. Eleven firms were found to be actively engaged in work involving the use of rag flock, two of which supply rag flock to the trade. Rag flock is not manufactured in the Borough, supplies coming in from large wholesale firms. Twenty-two samples of fillings were submitted for analysis, two of which were found to contain an excess of free chlorine. As both samples were procured from the same firm, proceedings were taken in regard to the worst sample, particulars of which are appended hereto. Nine other samples, though containing an excess of free chlorine, were proved to be fillings which were outside the jurisdiction of the Act, although the material is used as a filling in the same manner as "rag flock'' as defined by the Act. A Departmental Committee has been set up by the Ministry of Health, the terms of reference being:— "To consider whether the Rag Flock Acts and the Regulations made thereunder are adequate to secure proper cleanliness in rag flock used in the manufacture of upholstery, bedding and other household furniture in Great Britain, or whether it is desirable that the provisions of those Acts and Regulations should be amended, and, if so, in what respects, and whether all or any provisions applicable to rag flock should be applied to materials other than rag flock which may be used in the said articles." 40 Rag flock is defined in the present Section of the Act as:— "Flock which has been produced wholly or partly by tearing up woven or knitted or felted materials, whether old or new, but does not include flock obtained wholly in the process of scouring and finishing newly woven or newly knitted or newly felted fabrics." In view of this definition it is particularly difficult to prove that any given sample is produced from the materials set out in the definition. To a very great extent the control of this material can only be enforced at the actual place of manufacture. PUBLIC HEALTH (LONDON) ACT, 1936. Section 224. The 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 physically 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. Age. Institution. Mrs. Edith Elizabeth Brattle 65 years Newington. Mrs. Catherine Boyce 84 years St. Olave's Hospital. 17 WATER SUPPLY. PUBLIC HEALTH (LONDON) ACT, 1936. Section 95. Certificates in regard to water supply have been granted in respect of the under-mentioned (new) houses during the year:— Premises. Certificates granted to. Edward Clifford House, Elsted Street (12 flats) A. V. Goad, 241, Camberwell Road, S.E.5. Lant House, Lant Street (25 flats) J. Knox, Ltd., Lant Street, S.E.I. Chilham House, Law Street (29 flats) Stewart & Partners, Ltd., 105, Baker Street, W. 1. Headbourne House, Law Street (29 flats) Shalford House (part), Law Street (20 flats) Westerham House, Law Street (25 flats) Wrotham House, Law Street (15 flats) Wesley Place Estate (part) (42 flats) "The Golden Fleece" P.H., Law Street (1 house) Farnham House, Union Street (10 flats) Holliday & Greenwood, Ltd., 11, Buckingham Palace Gardens, S.W.I. Hoadley House, Union Street (11 flats) Tomline House, Union Street (10 flats) Trelawney House, Union Street (20 flats) Waynflete House, Union Street (11 flats) Wykeham House, Union Street (10 flats) Comus Place Estate (part) (38 flats) Unit Construction Co., Ltd., 1, Robert Street, W.C.2. St. George's Court (part), Garden Row (15 flats) Wates, Ltd., 1258-60, London Road, S.W.16. "Flower of the Forest" P.H., 123, Blackfriars Road (1 house) Y. J. Lovell & Son, 6, Bathurst Street, W.2. "Royal Standard" B.H., Falmouth Road (1 house) Perry & Perry, 20, Woodstock Street, W.l. "The Rising Sun" P.H., Harper Road (1 house) Snelling & Rayment, 282, Mitcham Lane, S.W.16. "County Terrace Tavern," 93, New Kent Road (1 house) J. Dorey & Co., Ltd., Brentford, Middlesex. 48 "The Magnet" B.H., 64-68, Old Kent Road (1 house) H. V. Clogg, Ltd., 159-161, Hanbury Street, E.l. 54, Camberwell Road (part of house) G. E. Wallis & Sons, Ltd., 18-20, York Buildings, Adelphi, W.C.2. 221 -229, East Street (5 houses and shops) Davis (Contractors), Ltd., 312, Kilburn High Road, N.W.6. 177-187, Trafalgar Street (6 flats) L. & W. Whitehead, Ltd., 169, Clapham Road, S.W.9. WATER SUPPLY TO TENEMENT HOUSES. PUBLIC HEALTH (LONDON) ACT, 1936. Section 96. 175 additional water supplies were provided to houses during the year 1938. FACTORIES ACT, 1937. This amending and consolidating measure came into force on July 1st, 1938, and owing to the extension of the duties of Local Authorities under the new Act, I considered it necessary to abandon our old method of recording inspections and defects and action taken as the new requirements had rendered it obsolete. The new system now in use will be much more in keeping with present-day conditions and more adapted to our new responsibilities. 49 TABLE 18. Factories. 1.—Inspections. Premises. Number of Inspections. Written Notices. Occupiers Prosecuted. Factories with mechanical power 505 18 — Factories without mechanical power 387 28 — Other premises under the Act (including works of building and engineering construction but not including outworkers' premises) — — — Total 892 46 — 2.—Defects Found. Particulars. Number of Defects Found. Remedied. Referred to H.M. Inspector. In respect of which Prosecutions were instituted. Want of Cleanliness 79 80 — — Overcrowding — — — — Unreasonable temperature — — — — Inadequate ventilation 1 1 — — Ineffective drainage of floors — — — — Sanitary Conveniences: Insufficient 5 7 — — Unsuitable or defective 52 51 — — Not separate for sexes — 1 — — Other Offences 153 154 — — (Not including offences relating to Home Work, or offences under the Sections mentioned in the Schedule to the Ministry of Health (Factories and Workshops Transfer of Powers) Order. 1921, and re-enacted in the Third Schedule to the Factories Act, 1937.) Total 290 294 — — TABLE 19. 3.—Home Work. Nature of Work Outworkers' Lists, Section 110. Number of Inspections of Outworkers' Premises. Outwork in Unwholesome Premises, S. 111. 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. February List. August List. Failing to keep or permit inspection of lists. Failing to send lists. Lists. Outworkers Lists. Outworkers Wearing Apparel— (1) Making, &c. 45 42 40 30 248 301 — — 229 5 — — (2) Cleaning and washing — — — — — — — — — — — — Lace, lace curtains and nets — — — — — — — — — — — — Furniture and Upholstery 1 2 1 2 — 6 — — — — — — Fur pulling — — — — — — — — — — — — Umbrellas — — — — 2 — — — 6 — — — Paper Bags and Boxes 5 22 5 17 13 31 — — 50 — — — Brushmaking 4 12 5 13 — 3 — — 29 — — — Stuffed Toys — — — — — — — — — — — File making — — — — — — — — — — — — Electro Plate — — — — — — — — — — — — Cables and Chains — — — — — — — — — — — — Anchors and Grapnels — — — — — — — — — — — — Cart Gear — — — — — — — — — — — — Locks Latches and Keys — — — — — — — — — — — — Miscellaneous 14 26 17 30 80 90 — — 204 — — — Total 69 104 68 92 343 431 — — 518 5 — — 50 51 TABLE 20. 4.—Registered Factories. Factories, etc., on the Register at the end of the year. Number. Bakehouses 73 Eating houses and places where food is prepared for sale 558 Ice Cream Shops 233 Laundries 13 Dressmakers, Milliners, etc. 15 Tailoring 30 Brushmakers 8 Miscellaneous 2015 Total number of Factories etc., on Register 2945 5.—Other Matters. Class. Number. Matters notified to H. M. Inspectors of Factories:— Failure to affix Abstract of the Factory Act 2 Action taken in matters referred by H. M. Inspectors as remediable under the Public Health Acts, but not under the Factory Act:— Notified by H. M. Inspector 5 Reports (of action taken) sent to H.M. Inspectors 5 Other 1 Underground Bakehouses:— In use at end of the year 21 WOMEN'S FACTORIES. The supervision of the Women's Factories was carried out during the year by Miss G. Briggs. 679 inspections and 82 re-inspections were made. The following defects were discovered, and 16 intimations and 2 statutory notices were served in order to obtain the abatement of the nuisances complained of:— Water apparatus defective 14 Roofs defective 12 Rooms dirty 46 Closet Pans and Traps 24 Miscellaneous nuisances 75 Total 171 All the above-mentioned nuisances were remedied. 52 RATS AND MICE (DESTRUCTION) ACT, 1919. I have received the following report from Mr. A. Ede:— The work of rat repression in Southwark has received the constant attention of the staff throughout the year 1938. The main source of the brown rat continues to be weak points in drains at present in use, and old drains which have fallen into disuse through demolition and other causes. The tracing and remedying of these faults are the most important part of the work, as the brown rat is common to all parts of the Borough. Widespread damage is caused by the mining and gnawing of these pests. While they are happy in the use of the sewers for travel, and some sustenance, their working lives seem to be spent in delving nurseries at drier levels, where litters are reared without fear of flooding. I gather from the reports of the Council's sewermen that the periodic baiting of sewers has led to some reduction of the rodents inhabiting them. The work of tracing and eradicating rats has been carried out as efficiently as possible, while at the same time giving the occupiers a minimum of inconvenience and discomfort. It is often not possible to employ sufficiently drastic methods to bring about a rapid abatement of the infestation without serious dislocation of the household, and annoyance to the tenants. This particularly applies to the older parts of the Borough, where lath and plaster walls and decaying brickwork provide a catacomb of dwellings for rodents. The black rat is principally the problem of the occupiers of factories and warehouses in the northern half of the Borough. Some have sought advice at the Health Services Department and have willingly adopted measures advised. In the majority of cases, the larger infestations are dealt with by private enterprise under contract. There have been invasions of dwelling houses by black rats, the actual sources of which are often impossible to trace. In all probability they are generally due to involuntary passage in packages and goods. The wide use of rapid road transport increases the possibility of fresh colonies of the black rat being founded by this means. Given early notification, these newcomers may be exterminated before they are firmly established. Traps and bait (poison) are used to this end. 53 In most cases occupiers co-operate heartily in this work, but all too often people still dispose of waste food in the most convenient manner for the rat, and thus provide it with a safe alternative to the Council's poison. The increase by breeding of rats is in direct proportion to the amount of food available; a shortage of food soon leads to shortage in numbers. This is another very good reason for care in the disposal of waste, a point stressed in the new pamphlet issued by the Department. Excessive fear and horror of rats causes some people to give less assistance than they might. I try to overcome this by pointing out that traps with dead rats left therein are wasted, and show that it is possible to remove the dead bodies and reset the traps without actually touching the rat. In this way, the trap may be doing useful work all the time, and not lying dormant until your Rat Officer calls to reset it. This form of propaganda is, I am glad to say, not always useless. On occasions, I have instances of rats appearing to avoid the poison baits and traps. I think this is often due to them having taken less than a lethal dose, the consequent discomfort making them wary. I am hoping to overcome this by use of an alternative poison bait. In many cases, owners have co-operated in tracing the source of rats by taking up floors to expose the runs. The Council's powers under the Public Health Act, to uncover and examine drains, has been taken full advantage of in tracing the source of rats, and the willing co-operation of the Borough Engineer's staff has been most helpful. 54 TABLE 21. RATS AND MICE (DESTRUCTION) ACT, 1919. Summary showing investigations and inspections made during the year 1938. Inspections:— By Inspector 659 By Rat Officer 526 Re-inspections:— By Inspector 1,511 By Rat Officer 2,084 Premises where rats were found 263 Action taken:— By Council's Official:— Poison Baits laid by Rat Officer 10,268 Wire Traps set 211 Break-back Traps set 769 Premises freed of rats 242 Probable source:— Rat runs and holes 204 Defective Drains 151 Defective Sewers 19 Notices 12 55 ERADICATION OF BED BUGS. The methods adopted in Southwark for dealing with infestation of houses and tenants' belongings were fully described in my Annual Report for 1937. There has been no alteration in the system during the present year. Various insecticides are used according to the special circumstances of the property to be disinfested; they include the following :— Zaldecide, Deodex gassing solution, Vermicide and Vermicine. Gas generated from rock sulphur is frequently used, often in conjunction with one of the above insecticides. CLEANSING OF VERMINOUS ROOMS AND THEIR CONTENTS. During the year 1,683 verminous rooms and their contents were treated by the disinfecting staff. Council Houses found to be infested 3 Council Houses disinfested 3 Other premises found to be infested 1,680 Other premises disinfested 1,680 TABLE 22. Verminous Bedding, etc., Disinfested at the Council's Station during 1938. Articles. Disinfested. Destroyed. Beds 263 28 Palliasses 171 26 Bolsters and Pillows 681 33 Cushions 106 12 Blankets 1,494 8 Sheets 891 2 Quilts 553 5 Articles of Clothing, etc. 42,394 67 Total 46,553 181 In addition, 306 cwts. of bedding, household furniture, etc., were also destroyed. 56 VERMINOUS PERSONS. During the year there has been a total attendance of 8,277 at the Council's Cleansing Station, King James' Street. Of this number 5,885 were treatments given to verminous children in accordance with the Council's agreement with the London County Council. 2,392 baths were given to other verminous persons who had been sent from the Common Lodging Houses or other places in the Borough. In the Spring of the year under review, my attention was called to the increasing number of children suffering from Scabies and the recurrence of Scabies amongst children who had already been treated. Resulting from this, I made extensive enquiries into the process of disinfection and also of treatment. Lists of infected households and children were supplied to me by the London County Council School Medical Department and the homes of these people were visited. Many interesting points came to light, but briefly, the chief of these were:— (1) Many families had returned from the hop fields the previous Autumn, infected with Scabies. (2) Ineffective methods of disinfecting personal clothing of school-children at the Disinfecting Station. (3) Insufficient treatment of children by baths, etc. As a result of these findings I had several consultations with the Divisional School Medical Officer, and also reported to the Health Committee making certain recommendations regarding the methods by which clothing of children could be more readily and effectively disinfected. Accordingly, the Committee sanctioned the purchase of an electric oven, specially adapted for the disinfection of clothing infected with vermin and Scabies. This apparatus has now been installed and is in full working order. The various steps taken both by the School Medical Services and by the Borough seem to have been effectual in reducing the number of returned cases of Scabies, as I have since received no further reports of re-infection from the School Medical Department. It is to be hoped that at the end of the next twelve months period, I shall be able to report that this condition has been maintained, in fact, that there has been a general reduction of this skin infection. 57 COLLIER'S RENTS MORTUARY AND CORONER'S COURT. Number of post-mortems conducted at the Mortuary without Inquest 118 Number of post-mortems conducted at the Mortuary with Inquest 41 Number of Inquests held without a post-mortem — Number of Inquests with post-mortem conducted elsewhere 100 Number of bodies brought in for convenience and for which payments were made 2 Number of bodies brought in where death had occurred from Infectious Disease 6 Total 267 SECTION D. Housing. 61 OVERCROWDING. In administering the statutory provisions relating to overcrowding, which became operative in this Borough on the 1st January, 1938, due regard has been given to the view expressed by the Minister of Health, in Memorandum B issued in relation to the Housing Act, 1935, that local authorities will use their powers of prosecution with discretion and that even when overcrowding constitutes an ofience, the normal procedure will be to assist the overcrowded family to find other and more suitable accommodation. It is appreciated that families are, in most cases, overcrowded through no fault of their own and that lack of suitable accommodation, although perhaps not so acute as in former years, finance and the necessity for living in close proximity to the places of employment are the principal causes of overcrowding. Early in the year certain owners offered to transfer overcrowded families living in their premises to accommodation which, although larger, was not sufficiently large tp abate the overcrowding, until such time as suitable accommodation could be offered to them. In view of the present shortage of suitable alternative accommodation within the meaning of the Act, particularly for the larger families and the possibility that these families might have had to wait some considerable time before.they could be offered accommodation, this was deemed to be the " common sense " way of dealing with these cases, and the owners were informed that such transfers would be permitted subject to the Council being informed when they took place. In March, 1938, the Council appointed an Enquiry Officer to make all out-door enquiries in connection with overcrowding. This officer makes periodic visits to registered cases of overcrowding, and visits for the following purposes, viz.:— To ascertain whether overcrowded families offered accommodation have moved away, or the reason for the non-acceptance of the offers. To ascertain whether premises scheduled for review have become overcrowded. To make enquiries in connection with applications for housing accommodation. To carry out the enumeration of premises. 62 After the removal of a family, whether overcrowded or not, the landlord is warned against re-letting the premises in an overcrowded condition, and the premises are afterwards visited to ascertain the number of persons who have taken the vacated accommodation. From the small number of applications for permitted numbers of persons received from householders who, by virtue of sub-letting part or parts of their premises, are landlords within the meaning of the Act, it is apparent that the householder-landlord does not appreciate his responsibilities, and with a view to clarifying the position, the following leaflet setting out the duties of a landlord in a simple form has been prepared:— SOUTHWARK HEALTH SERVICES DEPARTMENT. Housing Act, 1936—Overcrowding Provisions. To On the 1st January, 1938, the overcrowding provisions of the Housing Act, 1936, became operative in this Borough, and from that date overcrowding, except in certain circumstances, became an oSence. Overcrowding falls within two categories; and a dwelling is overcrowded when (a) the number of persons sleeping therein is greater than the permitted number, or (b) the number of persons sleeping therein is such that two or more of those persons being ten years old or more, of opposite sexes and not being persons living together as husband and wife must sleep in the same room. ( (6) Can apply only to a one-roomed dwelling, as if the dwelling contains two or more rooms it is always possible to separate the sexes.) A dwelling means any premises occupied as a separate dwelling by members of the working classes or of a type suitable for such use. Therefore, any part or parts of a house occupied by separate families are regarded as separate dwellings. In calculating the number of persons sleeping in a dwelling, children over ten years of age are counted as persons, children between one and ten years as half-persons, and children under one year are not counted at all. 63 The Housing Act, in addition to setting up a standard for measuring overcrowding, places certain obligations upon landlords, who are defined aa being the immediate landlords of the tenants. (Thus, any person letting rooms is the landlord of the persons to whom the rooms are let.) The duties of a landlord are as follows :— (1) He must fix in his tenant's rent book, a summary of the overcrowding provisions of the Housing Act, set out in the following form, and also the permitted number of persons for the rooms occupied by his tenant. Summary of Sections 58, 59 and 61 of the Housing Act, 1936, to be inserted in a Rent Book or similar document. 1. After the First day of January, 1938, an occupier who causes or permits his dwelling to be overcrowded is liable to prosecution for an offence under the Housing Act, 1936, and, if convicted, to a fine not exceeding five pounds. Any part of a house which is occupied by a separate family is a dwelling." 2. A dwelling is overcrowded if the number of persons sleeping in it is more than the " permitted number," or is such that two or more of those persons, being ten years old or over, of opposite sexes (not being persons living together as husband and wife), must sleep in the same room. 3. The " permitted number " for the dwelling to which this [Rent Book] [ ] relates is persons. In counting the number of persons each child under ten years of age counts as half a person, and a child of less1 than one year is not counted at all. 4. The Act contains special provisions relating to overcrowding already existing on the above-mentioned date or which is due to a child attaining the age of either one or ten years after that date or which is due to exceptional circumstances. Full information about these special provisions and all provisions as to overcrowding can be obtained free on application to the Local Authority whose address is (see last paragraph). (Copies of this summary in the prescribed form, with gummed edge for fixing in rent books, may be obtained from most stationers and stores.) 64 (2) If after the appointed day (i.e., 1st January, 1938) he is informed in writing by the Council that his tenant is committing an overcrowding offence, he must take steps to put an end to the offence, even if it means his going to court to obtain possession. (3) He must when letting rooms after the appointed day enquire the number, sex and age of the intending occupiers, and must not let the rooms to a family in which the number of persons is greater than the permitted number. (4) He must within seven days inform the Council if any part of his premises becomes overcrowded after the appointed day. Failure on the part of the landlord to fulfil these requirements will render him liable to a penalty. The permitted number or numbers of persons in relation to your premises are forwarded with this notice, and you are warned that your premises may be visited from time to time in order to ascertain whether these requirements are being carried out. Any further information regarding overcrowding can be obtained free on application to me at the under-mentioned premises. W. STOTT, Medical Officer of Health. Southwakk Health Services Department, Walworth Road, S.E.17. This leaflet together with the permitted numbers of persons will, eventually, be in the hands of every landlord of this type in the Borough. The tenancies in this district change very rapidly and in older that the correct permitted numbers may be given, the Enquiry Officer is carrying out a re-enumeration of those premises occupied by more than one family, and the explanatory leaflet and the permitted numbers are sent to the landlord immediately after the Enquiry Officer's visit. So far, over 1,200 landlords have received this leaflet. During the year 208 new cases of overcrowding were registered; the causes of the overcrowding being as follows:— 169 due to children attaining the ages of one year or ten years; of which 152 were scheduled as review cases, 5 due to children born after the 1937 Survey to persons who were occupying the same 65 accommodation at the time of the survey, and 12 were in respect to families which had moved in after the survey had been made. 12 due to an agreement between the Medical Officer of Health and the Owners that rooms in certain properties should be regarded as sculleries. 2 families moved from overcrowded premises in the Borough before the appointed day and caused overcrowding in the premises to which they moved. 25 premises were found to be overcrowded in such circumstances as to render the occupier and/or landlord guilty of an offence. These 25 cases were discovered as follows:— 6 as a result of the Enquiry Officer visiting premises following the receipt of communications from the L.C.C's Housing Department asking if applicants for housing accommodation were living in overcrowded conditions. 5 by the occupiers applying to the Borough Council for assistance in obtaining more suitable accommodation. 2 were notified to the Council by the landlords of the premises concerned. 12 by the Enquiry Officer in the course of his duties. Of the 25 families concerned 10 moved into the district) from addresses outside the Borough of Southwark, 6 were previously living in overcrowded conditions in other parts of the Borough and 9 removed from addresses in the Borough in which they .were not overcrowded. All the cases were given careful consideration and no legal proceedings were instituted by the Council, but in five cases where it was considered that flagrant offences had been committed, notices requiring the abatement of the overcrowding were served on the landlords. Four of the families occupying premises in respect of which notices were served, moved privately, and with regard to the fifth family the owner of the premises is suing for possession. Of the remaining 20 cases 6 moved privately, 4 were transferred by owners to larger accommodation, 7 were re-housed—4 by the L.C.C. and 3 by the Church Army—and 3 remain on the register. 66 RE-OVERCROWDING OF DWELLINGS IN WHICH OVERCROWDING HAD BEEN ABATED. 10 instances of re-overcrowding of dwellings after overcrowding had been abated by re-housing the previous tenants, were discovered. 2 of these premises were re-let in an overcrowded condition, but before the appointed day, and 8 were not re-let in an overcrowded condition, but overcrowding was subsequently caused as follows :— 5 by children attaining the ages of one year or ten years. 2 by persons being brought into the premises after the commencement of the tenancy; in both cases the persons brought in were sisters of the occupiers. One of these occurred before the appointed day and after due consideration the family was recommended for re-housing. The other occurred after the appointed day, the owner was informed, who subsequently transferred the family to larger accommodation. In the remaining case there was an intervening tenancy during which period the premises were not overcrowded. The premises then became vacant and a family living in overcrowded conditions in another part of the Borough obtained possession by misrepresenting the number of persons in family. This re-overcrowding occurred after the appointed day and no action has, so far, been taken by the Council as it is understood that the owner is applying for a Court Order for Possession. ABATEMENT OF OVERCROWDING. Overcrowding has been abated as follows:— Re-housed by the London County Council 314 Re-housed by the Borough Council 35 Re-housed by the Church Army 15 Re-housed by the Ecclesiastical Commissioners 12 Re-housed or provided with additional accommodation by landlords 29 By domestic re-arrangement, marriages, deaths, etc. 33 Families moving away:— To known addresses 19 To unknown addresses 58 Total 515 120 of these families were living in premises which were dealt with by way of slum clearance, closing and demolition orders. Of the 515 cases abated, 34 were in dwellings owned by the London County Council and 17 in dwellings owned by the Borough Council. 67 SOME GENERAL OBSERVATIONS ON OVERCROWDING. Overcrowding is showing a steady decrease, although the number of abatements cannot be accurately ascertained in the absence |pf compulsory notifications by landlords of re-lettings. Accommodation appears to be slightly easier to obtain, but is not yet so easily obtainable that the overcrowding provisions can be rigidly enforced without inflicting hardship, and the principal need is for accommodation containing four or' more rooms. There appears to be a tendency on the part of some landlords, particularly the householder type, to let premises to the maximum number of persons, and during 1938, 8 instances of premises becoming overcrowded within six months of the commencement of the tenancy have been discovered. In one case the premises became overcrowded two days after the tenancy commenced. Overcrowding has in some cases been abated by the occupiers voluntarily making arrangements for members of their families to sleep or live away from home. Investigations into these cases reveal that this step has been taken because the present accommodation although overcrowded is suitable for the occupiers by reason of it being in close proximity to their work and at a rent within their means, or because of the possibility, if re-housed, of members of the family getting married and leaving the remaining members with accommodation in excess of their needs and/or at a rent higher than can be afforded. This is, undoubtedly, an unsatisfactory method of abating overcrowding as, apart from the dislocation of family life, it is difficult without paying night visits to be satisfied that these persons are not actually sleeping in the premises. The necessity for an out-door officer able to devote the whole of his time to overcrowding has been proved by the fact that a number of cases of overcrowding have been discovered which, without the services of such an officer, might have been missed, and experience has shown that the investigation and control of overcrowding could not be satisfactorily conducted solely from the office. It is believed that the existence of such an officer will deter landlords from letting their premises in an overcrowded condition for although the number of illegal cases is a high one, it will be observed that 50 per cent, of these cases were found by the Enquiry Officer in the normal course of his duties. 68 REVIEW OF HOUSING ACTIVITIES DURING 1938. I beg to give below a resume of housing activities in the Borough during the year under consideration. 1 am happy to say that re-housing from Slum Clearance Areas is going on apace, and 436 families have been allocated accommodation on L.C.C. Estates, as follows: — Southwark 208 Central London 196 Outer London 32 436 In addition to these, 99 families have been accommodated in the Borough Council's flats following action taken under the Slum Clearance, Demolition and Closing Order Sections of the Housing Act. Forty-six individual unfit houses have been the subject of Demolition Orders made by the Council, and twenty-four of these are now demolished. UNDERGROUND ROOMS. It has always been my opinion that these should be closed wherever possible, especially when they are inhabited by families of young children, or where the occupants are suffering in health, and the rooms cannot be made fit at a reasonable expense. As a result of my representations to the Committee, Closing Orders have been made in 56 instances. Moreover, a large number of basement rooms were found not to comply in all respects with the Council's Underground Room Regulations, and Notices were served on the Owners requiring them to carry out certain works. Following this action, 57 basements have been made fit for human habitation. TRINITY BUILDINGS. These buildings have been an "eyesore" to the Borough for several years, and were included in the L.C.C. Mermaid Court Clearance Scheme. The Minister of Health, however, decided to exclude them from the Clearance Order, and requested, the Borough Council to deal with each flat individually under Section 12, Housing Act, 1936. In accordance with his request, the 47 flats concerned were represented by me to the Housing Committee as unfit for human habitation, and Closing Orders were made. I have succeeded in securing alternative accommodation for 36 of the families, and hope to re-house the remainder early in the New Year. 69 APPLICATIONS FOR HOUSING ACCOMMODATION ON MEDICAL GROUNDS. Of the numerous applications received, special recommendations on medical grounds have been made by me in the majority of cases, and I give below a list of the numbers of families re-housed, and the L.C.C. Estates upon which they have been accommodated: — Southwark 55 Other Central London Estates 201 Becontree 41 Morden 42 Downham 79 Mottingham 56 Other Outer London Estates 9 Total 483 HOUSING ACT, I936-SECTION 25. The following areas were represented for Clearance and Re-Housing Schemes during the year under consideration:— (а) Comus Place Area. (27 Houses.) (Represented to Housing Committee, July, 1938.) (Now being dealt with by the London County Council.) (b) Bear Lane Area. (3 Houses.) (Represented to Housing Committee, November, 1938.) (c) Hurlbutt Place Area. (21 Houses.) ^Represented to Housing Committee, December, 1938.) HOUSING ACT, 1936—SECTION 11. The following properties were represented for demolition during the year under consideration :— 177, Trafalgar Street. (Demolished.) 179, Trafalgar Street. (Demolished.) 181, Trafalgar Street. (Demolished.) 183, Trafalgar Street. (Demolished.) 185, Trafalgar Street. (Demolished.) 187, Trafalgar Street. (Demolished.) 203, East Street. 205, East Street. 207, East Street. 9, Queen's Row. (Demolished.) 70 10, Queen's Row. (Demolished.) 11, Queen's Row. (Demolished.) 12, Queen's Row. (Demolished.) 13, Queen's Row. (Demolished.) 14, Queen's Row. (Demolished.) 15, Queen's Row. (Demolished.) 16, Queen's Row. (Demolished.) 18, Queen's Row. (Demolished.) 22, Queen's Row. (Demolished.) 24, Queen's Row. (Demolished.) 26, Queen's Row. (Demolished.) 28. Queen's Row. (Demolished.) 30, Queen's Row. (Demolished.) 31, Queen's Row. 32, Queen's Row. 33, Queen's Row. 7, Kingston Street. (Demolished.) 30a, Princess Place. 43, Flint Street. 45, Flint Street. 32, Park Street. 34, Park Street. 8, Speech Street. 9, Speech Street. 7, Layton's Buildings. 153, Southwark Bridge Road. 11, Crosby Row. 21, Crosby Row. 25, Crosby Row. 8, Carter Street. (Demolished.) 10, Carter Street. (Demolished.) 12, Carter Street. (Demolished.) 32, Dolben Street. 33, Dolben Street. 34, Dolben Street. 13, St. Agnes' Place. HOUSING ACT, 1936-SECTION 12. During 1938, 110 underground rooms or parts of premises were represented for Closing Orders, 53 of which have been closed, and 5 were made fit. 22, Faunce Street. (Made fit.) 15, Shorncliffe Road. (Closed.) 71 102, Penrose Street. (Made fit.) 31, Gladstone Street. 65, Deverell Street. (Closed.) 14, Gaywood Street. 88, Mann Street. (Made fit.) 14, Newington Crescent. (Made fit.) 89, Lancaster Street. (Closed.} 108, Lancaster Street. (Closed.) 8, Manor Place. (Made fit.) 166, Blackfriars Road (parts of premises). (Closed.) 167, Blackfriars Road (parts of premises). (Closed.) 168, Blackfriars Road (parts of premises). (Closed.) 121, Blackfriars Road (parts of premises). (Closed.) 175, Great Dover Street (parts of premises). (Undertaking not to be used.) 187, Great Dover Street. (Closed.) 110, Great Dover Street. 60, Camberwell Road. 62, Camberwell Road. (Closed.) 1, Trinity Buildings (parts of premises). (Closed.) 1b, Trinity/ Buildings (parts of premises). 2, Trinity Buildings (parts of premises). (Closed.) 3, Trinity! Buildings (parts of premises). 4, Trinityl Buildings (parts of premises). 5, Trinity; Buildings (parts of premises). 6, Trinity Buildings (parts of premises). (Closed.) 7, Trinity Buildings (parts of premises). (Closed.) 8, Trinity Buildings (parts of premises). (Closed.) 9, Trinity Buildings (parts of premises). (Closed.) 10, Trinity Buildings (parts of premises). (Closed.) 11, Trinity Buildings (parts of premises). (Closed.) 12, Trinity Buildings (parts of premises). 13, Trinity Buildings (parts of premises). (Closed.) 14, Trinity Buildings (parts of premises). 15, Trinity Buildings (parts of premises). 16, Trinity Buildings (parts of premises). (Closed.) 17, Trinity Buildings (parts of premises). (Closed.) 18, Trinity Buildings (parts of premises). (Closed.) 19, Trinity Buildings (parts of premises). (Closed.) 20, Trinity Buildings (parts of premises). (Closed.) 21, Trinity Buildings (parts of premises). (Closed.) 22, Trinity Buildings (parts of premises). (Closed.) 23, Trinity Buildings (parts of premises). (Closed.) 72 24, Trinity Buildings (parts of premises). (Closed.) 25, Trinity Buildings (parts of premises). (Closed.) 26, Trinity; Buildings (parts of premises). 27, Trinity Buildings (parts of premises). 28, Trinity Buildings (parts of premises). (Closed.) 28a, Trinity Buildings (parts of premises). (Closed.) 29, Trinity Buildings (parts of premises). (Closed.) 30, Trinity Buildings (parts of premises). (Closed.) 30a, Trinity Buildings (parts of premises). 31, Trinity Buildings (parts of premises). (Closed.) 31a, Trinity Buildings (parts of premises). (Closed.) 32, Trinity Buildings (parts of premises). 33, Trinity Buildings (parts of premises). 33a, Trinity Buildings (parts of premises). 34, Trinity Buildings (parts of premises). (Closed.) 35, Trinity Buildings (parts of premises). 36, Trinity Buildings (parts of premises). (Closed.) 37, Trinity Buildings (parts of premises). (Closed.) 38, Trinity Buildings (parts of premises). 39, Trinity Buildings (parts of premises). 40, Trinity Buildings (parts of premises). 41, Trinity Buildings (parts of premises). (Closed.) 42, Trinity Buildings (parts of premises). (Closed.) 195a, Borough High Street. 32, The Cut (parts of premises). 100, St. George's Road. (Premises demolished.) 3, Old Kent Road. (Closed.) 27, Queen's Buildings, C'ollinson Street. 2a, Queen's Buildings, Collinson Street. 41, Queen's Buildings, Collinson Street. 269, New Kent Road! (parts of premises). 1, St. George's House. 2, St. George's House. 11, Florence House. 12, Florence House. 21, Philemon House. 22, Philemon House. 59, Boyson Road. (Closed.) 65. Boyson Road. (Closed.) 107, Boyson Road. (Closed.) 109, Boyson Road. 29, Alberta Street. (Closed.) 10, Trinity Street. (Closed.) 73 187, Southwark Bridge Road. (Closed.) 183, Southwark Bridge Road. 151, Southwark Bridge Road. 20, Urlwin Street. 5, Blackwood Street. (Closed.) 25, Horsman Street. 27, Horsman Street. 29, Horsman Street. 106, Walworth Road. 21, Ralph Street. (Closed.) 55, Thurlow Street. 57, Thurlow Street. (Closed.) 59, Thurlow Street. 51, Nelson Square. 48, Lant Street. 27, Lorrimore Road. 29, Lorrimore Road. 33, Lorrimore Road. 39, Lorrimore Road. 69, Newcomen Street. 212, Union Street. (Closed.) 104, Westmoreland Road. (Closed.) 116, Westmoreland Road. (Closed.) HOUSING CONSOLIDATED REGULATIONS, 1925 and 1932. Houses in the following localities were inspected and recorded under the above mentioned Regulations during the year:— Albert House. Brigade House. Albion House. Burge Street. Alexandra House. Camberwell Road. Algar Buildings. Cambridge Street. Alpha Square. Carter Street. Alvey House. Clapton Buildings. Alvey Street. Clifton Buildings. Amelia Street. Clock Place. Ash Street. Collinson Street. Avon Place. Colworth Grove. Balfour Street. Comus Place. Beatrice House. Cooks Road. Bittern Street. Crampton Street. Boundary Lane. Dauncey Buildings. Boyson Road. Deacon Street. Brandon Street. Delarch Buildings. 74 De Laune Street. Otto Street. Delverton Road. Overy Buildings. Dolben Street. Peabody Buildings, Rodney Douglas Buildings. Road. Dover Buildings. Peabody Buildings, East Street. wark Street. Elgood House. Peacock Square. Elsted Street. Peacock Street. Faraday Street. Penrose Street. Finchley Road. Philemon House. Fleming Road. Pilgrim House. Florence House. Pollock Road. Gerridge Street. Prioress Street. Goschen Street. The Priory. Great Suffolk Street. Queen's Buildings. Guinness' Buildings, Queen's Row. Brandon Street. Rephidim Street. Gurney Street. Royal Road. Hampton House. St. David Street. Helena House. St. Gabriel Street. Hillingdon Street. St. George's Buildings. Hodson Street. St. George's House. Hopton's Almshouses. St. George's Road. Horsman Street. Salisbury Buildings. Huntsman Street. Salisbury Row. Hurlbutt Cottages. Sayer Street. Hurlbutt Place. Southwark Bridge Road. Inville Road. Steedman Street. John Ruskin Street. Sumption Buildings. Jubilee Buildings. Sutherland Square. King Edward Walk. Tarver Road. Lambeth Road. Thurlow Street. Larcom Street. Toulmin Street. Lorrimore Road. Townsend Street. Louise House. Trafalgar Street. Madron Street. Victoria House. Mann Street. Villa Street. Mawdlev Buildings. Walcorde Avenue. McLeod Street. Warren Buildings. Meadow Row. Waterloo Road. Mina Road. Webber Row. Montpelier Street. Westminster Bridge Road. Mowbray Buildings. Westmoreland Road. New Winchester Buildings. West Square. Old Kent Road. 75 TABLE 23. HOUSING. 1. Inspection of Dwelling Houses:— (1) (a) Total number of dwelling houses inspected for housing defects (under Public Health or Housing Acts) 5,084 (6) Number of inspections made for the purpose 42,147 (2) (a) Number of dwelling houses (included under sub-head (1) above) which were inspected and recorded under the Housing Consolidated Regulations, 1925 and 1932 3,109 (6) Number of inspections made for the purpose 3,109 (3) Number of dwelling houses found to be in a state so dangerous or injurious to health as to be unfit for human habitation 97 (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 4,131 2. Remedy of Defects without Service of formal Notices:— Number of defective dwelling houses rendered fit in consequence of informal action by the Local Authority or its officers 1,522 J. Action under Statutory Powers during the Year:— A. Proceedings under Sections 9, 10 and 16 of the Housing Act, 1936:— (1) Number of dwelling houses in respect of which notices were served requiring repairs 216 76 TABLE 23.—continued. 2) Number of dwelling houses which were rendered fit after service of formal notices:— (a) By owners 691 (b) By Local Authority in default of owners Nil. B. Proceedings under Public Health Acts:— (1) Number of dwelling houses in respect of which notices were served requiring defects to be remedied 3,915 (2) Number of dwelling houses in which defects were remedied after service of formal and informal notices:— (a) by owners 3,326 (b) by Local Authority in default of owners - C. Proceedings under Sections 11 and 13 of the Housing Act, 1936:— (1) Number of dwelling houses in respect of which Demolition Orders were made 46 (2) Number of dwelling houses demolished in pursuance of Demolition Orders 24 D. Proceedings under Section 12 of the Housing Act, 1936:— (1) Number of separate tenements or underground rooms in respect of which Closing Orders were made 110 (2) Number of separate tenements or underground rooms in respect of which Closing Orders were determined, the tenement or room having been rendered fit 5 (3) Number occupied but unfit 3,390 77 TABLE 23. —continual 4. Howiing Act, 1936—Overcrowding:— (a) (1) Number of dwellings overcrowded at the end of the year 2,461 (2) Number of families dwelling therein 2,461 (3) Number of persons dwelling therein 14,126 (6) Number of new cases of overcrowding reported during the year .. 208 (c) (1) Number of cases of overcrowding relieved during the year 515 (2) Number of persons concerned in such cases .. 3,033 (d) Particulars of any cases in which dwelling houses have again become overcrowded 10 Number of visits made by Overcrowding Enquiry Officer 9,537 78 TABLE 24. Sanitary Works completed under the Housing Acts, during the year 1938. Formal Notices complied with 691 Chimney flues repaired 83 Brickwork and pointing repaired 211 Window sashes repaired 567 New sash lines 179 Doors and woodwork repaired 585 Stair treads and risers repaired 75 Floors repaired 184 Provision of ventilated food storage 322 Plaster repaired 679 Stove and fireplace repaired 472 Copper repaired 49 Roofs repaired 93 Sinks provided 196 Walls and ceilings repaired 725 W.C.s amended 98 Dampness abated 317 Paving amended 67 Light and ventilation provided 488 Door and window sills repaired 79 SECTION E. \ Inspection and Supervision of Food. 81 INSPECTION AND SUPERVISION OF FOOD. The inspection of food premises has been maintained throughout the year and special attention has been given to butchers' shops, registered premises, and street stalls. The standard of cleanliness has been satisfactory. Considerable details are given later in this report on the matter of Imported food, but I should like to mention here a condition which was found to be present in English Poultry. Special attention has been given by my Inspectors to the examination of fowls, and it has been found that in hens which to all external appearances seemed to be perfect birds, when subjected to a detailed examination, the internal organs of many were found to be diseased. A percentage examination has been made and is still being continued, the average result shewing that 3J per cent, of the birds inspected are unsound. SLAUGHTER -HOUSES. There are 4 slaughter-houses in the Borough which are licensed annually. The following are the premises and licensees:— Situation of Premises. Name of Licensee. 129, Hillingdon Street Reuben Newbury. 70, Harper Road George Challis. 244, Walworth Road Messrs. Chalk & Cox. 283-5, Walworth Road Messrs. R. C. Hammett, Ltd. During the year, 170 oxen. 1,599 sheep and 124 pigs were slaughtered. The total weight found to be unsound was 3 cwts. 3 qrs. 4 lbs. all of which was destroyed. PUBLIC HEALTH (LONDON) ACT, 1936, SECTION 187. 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 233 480 Butchers' premises 84 493 Provision Dealers 69 110 82 I have received, the following report from Mr. J. A. Syms:— EATING HOUSES. Systematic inspection of all premises where meals are served has been carried out during the year under review and the required standard of cleanliness maintained. The following is a summary of the premises under inspection:— Restaurants in Licensed Premises 75 Restaurants in Unlicensed Premises 24 Coffee Houses 99 Cafes 95 Stalls 15 Other Premises 22 During 1938, 24 Eating Houses have been closed and 12 newly established or re-opened. The following facts are revealed by the record cards:— Reconstructed. Improved. Cleansed. Refrigerators. P.H. Restaurants 5 2 30 50 Restaurants - 5 6 22 Coffee Houses - 10 35 54 Cafes 4 6 20 43 Other Premises 3 4 8 12 FRIED FISH PREMISES. The number on the register at the end of 1937 was 54. 7 have been closed during 1938, the total now on the register being 47. Reconstruction of premises has been carried out in one instance, but all are equipped with satisfactory methods of holding prepared fish from the morning until the evening. Fish is invariably bought daily and no uncooked fish kept over for the following day. Electric potato peelers are used in most shops. FISH CURERS' PREMISES. 31 premises were on the register at the end of 1937, 3 have been closed and the total now registered is 28. The general standard of cleanliness has been maintained throughout the year. 83 ICE CREAM. Inspection of all makers' and sellers' premises has been carried out during the season, March to September. More up-to-date equipment has been installed in many shops and the condition of manufacture and storage has been satisfactorily maintained. Out of 233 makers and sellers only 30 now use salt and ice methods. 42 use Card Ice and 161 have electrical apparatus. The following facts are revealed by the record cards:— Manufacture and Sale: Number on Register, 1937 83 Number Registered, 1938 7 Number discontinued 8 Number on Register, 1938 82 Sale only: Number on Register, 1937 139 Number Registered, 1938 35 Number discontinued 23 Number on Register, 1938 151 CARCASES INSPECTED AND CONDEMNED. Cattle, excluding Cows Cows Calves Sheep and Lambs Pigs Number killed 181 55 - 2436 236 Number inspected 181 55 - 2436 236 All Diseases except Tuberculosis. Whole carcases condemned - - - - 2 Carcases of which some part or organ was condemned 6 - - 5 1 Percentage of the number inspected affected with disease other than T. B. 3.3 - - 0.2 1.2 Tuberculosis only. Whole carcases condemned - - - - - Carcases of which some part or organ was condemned 11 4 - - 4 Percentage of the number inspected affected with Tuberculosis 6.1 7.3 - - 1.7 84 FOOD FACTORIES. The places where food is manufactured have been under constant supervision throughout the year and a good standard of cleanliness has been maintained. BACON STOVES. There are five bacon stoves in the Borough and these are inspected periodically. MERCHANDISE MARKS ACT, 1926. This Act is administered by the Department and no difficulty has been experienced. AGRICULTURAL PRODUCE (GRADING AND MARKING) ACT, 1926. There are four cold stores registered in the Borough. An alteration in the "closed space" was made in one store with the approval of the Ministry of Agriculture and Fisheries. I have received the following report from Messrs. Bowers, Duffield and Groves:— PUBLIC HEALTH (IMPORTED FOOD) REGULATIONS, 1937. The above regulations became operative from 1st April, 1938, in the Riparian Area of Southwark. The principal amendments made in the new regulations relate to the requirement of Official Certificates of the country of origin with regard to meat and meat products. Under the Regulations of 1925 and 1933 the importation of certain classes of meat was prohibited and official certificates recognised by the Minister of Health were required with meat specified as "Conditionally Admissible Meat." The new Regulations remove the exemption thus given, and the effect of the Regulations is not only to prohibit the importation of kinds of meat specified in the First Schedule but also to prevent the importation of any meat or any meat product as defined in the Regulations. Instances of consignments having an incorrect certificate were dealt with, and on the Importer being informed, steps were taken to prevent a repetition. Close contact is maintained with the Port of London Health Authority and the Officers of H.M. Customs with a view to uniformity of action in difficulties that may or do arise. Without the co-operation of the Officers 85 of H.M. Customs and the wharfingers, the administration of these Regulations would be impossible and their help during the vcar is gratefully recognised. The following are brief notes of sundry parcels of food dealt with during the year and the action taken in regard thereto. Citrus Fruit. A feature during the year has been the large amount of Oranges and Grape Fruit that has been dealt with. Considerable quantities have had to be garbled resulting in 150 tons of Oranges and 230 tons of Grape Fruit having to be destroyed as unfit for human consumption. Mutton. A sample shipment of carcases of Mutton from India was received but was found upon examination to be unsound. Sultanas. Samples of Sultanas bleached by Sulphur Di-oxide were systematically taken, and where the analytical report shewed the quantity of S02 to be in excess of that allowed by the Preservatives in Food Regulations, the shippers were informed and the subsequent shipments shewed improvement. Sausage Casings. Sausage casings of unsatisfactory origin were rejected and the importers were discouraged from continuing importations from unreliable sources. Mandarin Oranges. A consignment of Tinned Mandarin Oranges arrived at a wharf in a bad condition owing to inferior tinning of the cans. A portion of the parcel was destroyed and the remainder released after examination. Frozen Egg. Tins of Chinese Frozen Egg in an unsound condition were stopped at a wharf and released for re-export to China. Bacon. Following the slight overflow of the River Thames on the night of February 12th-13th, some bales of bacon in a wharf were damaged, but were released after washing. Some lard damaged at the same time was released for technical purposes. Condensed Milk. Some unlabelled Condensed Milk was found being unloaded from a van into a warehouse, contrary to the Condensed Milk Regulations. Investigations disclosed the fact that a quantity of un labelled milk 86 was being sold and removed from a wharf which was situated in another Borough, for subsequent re-labelling and sale, under conditions which were prohibited by the Regulations. The quantity seized in this Borough was destroyed, being unsound, and suitable action was taken by the other Borough concerned to prevent a recurrence. Pears. A quantity of pears in boxes was removed for destruction from the Borough Market, being affected by low-temperature breakdown. Hog Fat. An experimental shipment of Hog Fat from Australia was not marked with the authorised Certificate, and was eventually released under guarantee for technical purposes. Hams. Early in the year Tinned Hams from Germany were allowed into the Borough under the old Certificate on the instructions of the Ministry of Health, but as no Certificate for these goods has been approved the trade has now ceased. Apples. 8,208 cases of Apples affected with brown heart were landed in August, and 1,083 cases were found to be unsound. Meat. Three cargoes of Meat were found on arrival to have been in contact with offensive fumes. The consignments were detained for ozonization and were then released. The routine examination of all imported carcases (5 per cent.) and joints of Mutton (100 per cent.), irrespective of the country of origin, is still being carried out to detect the presence of Caseous Lymphadenitis, and the improvement noted in past years has been maintained. Lettuce. During the year 1,616 crates of Lettuce from Spain and the South of France were found to be unfit and were destroyed. Apricots. In June and July, 77 tons of Apricots from Spain were destroyed by the Council as unfit for food. One consignment alone consisted of 63 tons. This parcel of unsound food was the largest that has been dealt with at one time, and its removal necessitated a special train of 12 trucks for conveyance to the Council's Depot. 87 Butter. A consignment of New Zealand Butter was damaged by brine from the refrigerating plant in the ship, and was released to approved firms for re-conditioning. A parcel of 16,238 boxes of Australian Butter was found to be contaminated with ships' oil. The whole of the consignment was released to an approved firm for the purpose of re-conditioning. PUBLIC HEALTH (PRESERVATIVES IN FOOD) REGULATIONS, 1925. A strict supervision over food imported into the Borough has been maintained during the year. Many samples have been taken under the Regulations and have been submitted to the Public Analyst. A detailed report on these samples is to be found on the following pages, such report containing the Public Analyst's findings in regard to each individual sample. 88 89 ANALYSIS OF PORT SANITARY SAMPLES, 1938. Sample of Condition of Can. Condition of Contents for Sample. Report. External. Internal. Tomato Puree Satisfactory No corrosion. Lacquered can Sound Lead not found, tin not found, copper 7 parts per million, zinc 10 parts per million. Tomato Puree Satisfactory No corrosion. Lacquered can Sound Lead 1.5 parts per million, tin not found, copper 8 parts per million, zinc 13 parts per million. Peeled Tomatoes Satisfactory No corrosion Sound Lead 1 part per million, tin not found, copper 2 parts per million, zinc less than 10 parts per million. Frozen Egg Yolk - - - Boracic compounds were not detected. Sardines Satisfactory. Seam soldered on outside No corrosion Sound Lead 6 parts per million, tin not found. Pilchards Satisfactory No corrosion Sound Lead 3 parts per million. Pilchards Satisfactory No corrosion Sound Lead less than 2 parts per million. Pilchards Satisfactory No corrosion Sound Lead less than 2 parts per million. Pilchards (contents of 6 cans well mixed together) Satisfactory No corrosion Sound Lead 2 parts per million. Sardines (contents of 6 cans well mixed together) Satisfactory No corrosion Sound Lead 5 parts per million. Glace Cherries - - - Copper 5 parts per million. Tomato Puree Satisfactory No corrosion. Lacquered can Sound Lead 1.5 parts per million, copper 4 parts per million, zinc 16 parts per million. Tomato Puree (contents of 3 cans well mixed together) Satisfactory Satisfactory Sound Copper 15 parts per million. Tomato Puree (contents of 3 cans well mixed together) Satisfactory Satisfactory Sound Copper 21 parts per million. Hog Fat - - Faintly brown in colour, offensive smell The sample was an emulsion of fat and water. It contained 10 per cent. of water and had become rancid. Frozen Egg - - - Boracic compounds were not detected. Frozen Egg - - The sample had an unpleasant smell Boracic compounds were not detected. The sample showed signs of decomposition. Frozen Egg - - The sample had an unpleasant smell Boracic compounds were not detected. The sample showed signs of decomposition. Butter - - - Genuine. Butter - - - Genuine. Butter - - - Genuine. Process Cheese and Smoked Ham - - Satisfactory Boracic compounds not found, sulphites not found, nitrites not found. Butter - - - Genuine. Butter - - - Genuine. Butter - - - Genuine. Butter - - - Genuine. 90 91 Sample of Condition of Can. Condition of Contents for Sample. Report. External. Internal. Butter - - - Genuine. Butter - - - Genuine. Frozen Egg - - - Boracic compounds were not detected. Butter - - - Genuine. Butter - - - Genuine. Butter - - - Genuine. Butter - - - Genuine. Butter - - - Genuine. Butter - - - Genuine. Frozen Egg - - - Boracic compounds were not detected. Skimmed Condensed Milk Satisfactory Satisfactory Sound Sample satisfied the requirements of the Public Health (Condensed Milk) Regulations, with regard to composition and labelling. Skimmed Condensed Milk Satisfactory Satisfactory Sound Sample satisfied the requirements of the Public Health (Condensed Milk) Regulations, with regard to composition and labelling. Skimmed Condensed Milk Satisfactory Satisfactory Sound Sample satisfied the requirements of the Public Health (Condensed Milk) Regulations, with regard to composition and labelling. Skimmed Condensed Milk Satisfactory Satisfactory Sound The sample satisfied the requirements of the Public Health (Condensed Milk) Regulations, with regard to composition and labelling. Skimmed Condensed Milk Satisfactory Satisfactory Sound The sample satisfied the requirements of the Public Health (Condensed Milk) Regulations, with regard to composition and labelling. Frozen Egg - - - Boracic compounds were not detected. Butter - - Sound Genuine. Butter - - Sound Genuine. Butter - - Sound Genuine. Butter - - Sound Genuine. Blackcurrants - - Sound Sulphur dioxide not found, benzoic acid not found, salicylic acid not found, lead, tin, copper not found. Hog Fat - - Faintly brown in colour disagreeable smell The sample contained 3 per cent. water, 4.4 per cent. free fatty acid (as oleic). Hog Fat - - Faintly brown in colour disagreeable smell The sample contained 0.8 per cent. water, 4.2 per cent. free fatty acid (as oleic). Butter - Sound Genuine. Butter - - Sound Genuine. Butter - - Sound Genuine. Butter - - Sound Genuine. Butter - - Sound Genuine. Butter -- - Sound Genuine. 93 93 Sample of Condition of Can. Condition of Contents for Sample. Report. External. Internal. Skimmed Condensed Milk Satisfactory Satisfactory Sound The sample satisfied the requirements of the Public Health (Condensed Milk) Regulations, with regard to composition and labelling. Skimmed Condensed Milk Satisfactory Satisfactory Sound The sample satisfied the requirements of the Public Health (Condensed Milk) Regulations, with regard to composition and labelling. Skimmed Condensed Milk Satisfactory Satisfactory Sound The sample satisfied the requirements of the Public Health (Condensed Milk) Regulations, with regard to composition and labelling. Skimmed Condensed Milk Satisfactory Satisfactory Sound The sample satisfied the requirements of the Public Health (Condensed Milk) Regulations, with regard to composition and labelling. Butter - - Sound Genuine. Butter - - Sound. Genuine. Butter - - Sound Genuine. Tamarind - - - Lead not found, copper not found, arsenic not found. Hog Fat - - Sound Genuine, containing 3 per cent. water. Butter - - Sound Genuine. Butter - - Sound Genuine. Butter - - Sound Genuine. Frozen Egg - - Sound Boracic compounds were not detected. Frozen Egg - - Sound Boracic compounds were not detected. Frozen Egg - - Sound Boracic compounds were not detected. Butter - - Sound Genuine. Butter - - Sound Genuine. Butter - - Sound Genuine. Frozen Egg Yolk - - Sound Boracic compounds were not detected. Frozen Whole Egg - - Sound Boracic compounds were not detected. Frozen Whole Egg - - Sound Boracic compounds were not detected. Frozen Whole Egg - - Sound Boracic compounds were not detected. Orange Juice - - Sound Sulphites not, found benzoic acid not found salicylic acid not found, tin not found, lead not found, copper Frozen Whole Egg - - Sound Boracic compounds were not detected. Skimmed Condensed Milk Satisfactory Satisfactory Sound The sample satisfied the requirements of the Public Health (Condensed Milk) Regulations, with regard to composition and labelling. Pilchards Satisfactory. Pressed can "Sulphur" stains Sound Lead 3 parts per million, tin not found. Frozen Eggs - - Sound Boracic compounds were not detected. Frozen Eggs - - Sound Boracic compounds were not detected. Frozen Eggs -- - Sound Boracic compounds were not detected. Sultanas - - Sound Sample containpd 650 parts of sulphur dioxide per million parts of sample. Sultanas - - Sound Sample contained 1,070 parts of sulphur dioxide per million parts of the sample. 94 95 Sample of Condition of Can. Condition of Contents for Sample. Report. External. Internal. Butter - - Sound Genuine. Butter - - Sound Genuine. Butter - - Sound Genuine. Sultanas - - Sound Sample contained 800 parts of sulphur dioxide per million parts of the sample. Sultanas - - Sound Sample contained 580 parts of sulphur dioxide per million parts of the sample. Sultanas - - Sound Sample contained 605 parts of sulphur dioxide per million parts of the sample. Sultanas - - Sound Sample contained 1,085 parts of sulphur dioxide per million parts of the sample. Sultanas - - Sound Sample contained 455 parts of sulphur dioxide per million parts of the sample. Sultanas - - Sound Sample contained 490 parts of sulphur dioxide per million parts of the sample. Sultanas - - Sound Sample contained 450 parts of sulphur dioxide per million parts of the sample. Sultanas - - Sound Sample contained 460 parts of sulphur dioxide per million parts of the sample. Sultanas - - Sound Sample contained 635 parts of sulphur dioxide per million parts of the sample. Sultanas - - Sound Sample contained 600 parts of sulphur dioxide per million parts of the sample. Sultanas - - Sound Sample contained 605 parts of sulphur dioxide per million parts of the sample. Sultanas - - Sound Sample contained 760 parts of sulphur dioxide per million parts of the sample. Sultanas - - Sound Sample contained 620 parts of sulphur dioxide per million parts of the sample. Sultanas - - Sound Sample contained 950 parts of sulphur dioxide per million parts of the sample. Sultanas - - Sound Sample contained 575 parts of sulphur dioxide per million parts of the sample. Sultanas - - Sound Sample contained 660 parts of sulphur dioxide per million parts of the sample. Tomato Juice - - Sound Tin not found, lead not found, copper not found. Frozen Eggs - - Sound Boracic compounds were not detected. Frozen Eggs - - Sound Boracic compounds were not detected. Frozen Eggs - - Sound Boracic compounds were not detected. Frozen Eggs - - Sound Boracic compounds were not detected. Frozen Eggs - - Sound Boracic compounds were not detected. Full Cream Condensed Milk, Sweetened Satisfactory Satisfactory Sound Composition of the sample satisfied the requirements of the Public Health (Condensed Milk) Regulations for "Full Cream Condensed Milk Sweetened." "Equivalent pints," 1¾ 96 97 Sample of Condition of Can. Condition of Contents for Sample. Report. Externa]. Internal. Grape Fruit Juice - - Sound Sample contained 620 parts of sulphur dioxide per million parts of the sample. Salicylic acid not found, benzoic acid not found. Grape Fruit Juice - - Sound Sample contained 660 parts of sulphur dioxide per million parts of the sample. Salicylic acid not found, benzoic acid not found. Grape Fruit Juice - - Sound Sample contained 655 parts of sulphur dioxide per million parts of the sample. Salicylic acid not found, benzoic acid not found. Frozen Eggs - - Sound Boracic compounds were not detected. Frozen Eggs - - Sound Boracic compounds were not detected. Frozen Eggs - - Sound Boracic compounds were not detected. Frozen Eggs - - Sound Boracic compounds were not detected. Pears Satisfactory Satisfactory Sound Lead not found, tin not found, copper 3.8 parts per million (equivalent to 21 parts per million on dried material). Lobster Satisfactory Satisfactory Lacquered can, soldered seam Sound, wrapped in paper Lead 6 parts per million. Lobster Satisfactory Satisfactory. Lacquered can, soldered seam Sound, wrapped in paper Lead 4 parts per million. Lobster Satisfactory Satisfactory. Lacquered can, soldered seam Sound, wrapped in paper Lead 2 parts per million. Lobster Satisfactory Satisfactory. Lacquered can, soldered seam Sound, wrapped in paper Lead 2 parts per million. Frozen Eggs - - Sound Boracic compounds were not detected. Frozen Eggs - - Sound Boracic compounds were not detected. Frozen Eggs - - Sound Boracic compounds were not detected. Frozen Eggs - - Sound Boracic compounds were not detected. Frozen Eggs - - Sound Boracic compounds were not detected. Frozen Eggs - - Sound Boracic compounds were not detected. Frozen Eggs - - Sound Boracic compounds were not detected. Frozen Eggs - - Sound Boracic compounds were not detected. Frozen Eggs - - Sound Boracic compounds were not detected. Frozen Eggs - - Sound Boracic compounds were not detected. Frozen Eggs - - Sound Sample contained boracic compounds. Frozen Eggs - - Sound Boracic compounds were not detected. Frozen Eggs - - Sound Boracic compounds were not detected. Frozen Eggs - - Sound Boracic compounds were not detected. Frozen Eggs - - Sound Boracic compounds were not detected. Frozen Eggs - - Sound Boracic compounds were not detected. Frozen Eggs - - Sound Boracic compounds were not detected. 98 99 Sample of Condition of Can. Condition of Contents for Sample. Report. External. Internal. Frozen Eggs - - Sound Boracic compounds were not detected. Ghi - - Rancid. Strong cheese-like smell Sample contained 18.8 per cent. of free fatty acid (as oleic). Duck Yolk - - Sound Sample contained boracic compounds. Hen Yolk - - Sound Sample contained boracic compounds. Hen Yolk - - Sound Boracic compounds were not detected. Hen Yolk - - Sound Boracic compounds were not detected. Hen Yolk(Glyeer.) - - Sound Boracic compounds were not detected. Frozen Eggs - - Sound Boracic compounds were not detected. Frozen Yolks - - Sound Boracic compounds were not detected. Frozen Eggs - - Sound Boracic compounds were not detected. Frozen Eggs - - Sound Boracic compounds were not detected. Frozen Eggs - - Sound Boracic compounds were not detected. Frozen Eggs - - Sound Boracic compounds were not detected. Cod Liver Oil - - Sound Genuine. Hen Yolk (Glycer.) - - Sound Boracic compounds were not detected. Sardines Satisfactory, soldered lid Slight stains Sound Lead 2 parts per million, tin not found. Sardines Satisfactory, soldered lid Slight stains Sound Lead 2 parts per million, tin not found. Egg Yolk - - Sound Sample contained boracic compounds. Egg Yolk - - Sound Sample contained boracic compounds. Egg Yolk - - Sound Sample contained boracic compounds. Lobster Satisfactory Satisfactory. Lacquered can Sound. Wrapped in paper Lead not found. Lobster Satisfactory Satisfactory. Lacquered can Sound. Wrapped in paper Lead not found. Pilchards Satisfactory Stained, no corro- sion Sound Lead not found, tin not found. Egg Yolk - - Sound Boracic compounds were not detected. Frozen Eggs - - Sound Boracic compounds were not detected. Whole Egg - - Sound Boracic compounds were not detected . Egg White - - Sound Boracic compounds were not detected. Egg Yolk - - Sound Boracic compounds were not detected. Frozen Eggs - - Sound Boracic compounds were not detected. Frozen Eggs - - Sound Boracic compounds were not detected. Black Currants - - Sound Sulphites not found, salicylic acid not found, benzoic acid not found, tin not found, lead not found, copper not found. Egg Yolks - - Sound Boracic compounds were not detected. Egg Yolks - - Sound Boracic compounds were not detected. Egg Yolks - - Sound Boracic compounds were not detected. Egg Yolks - - Sound Sample contained boracic compounds. Egg Yolks - - Sound Sample contained boracic compounds. Frozen Egg - - Sound Boracic compounds were not detected. 100 101 Sample of Condition of Can. Condition of Contents for Sample. Report. External. Internal. Frozen Egg - - Sound Boracic compounds were not detected. Frozen Whole Egg - - Sound Boracic compounds were not detected. Pilchards Satisfactory. Slight stains Sound Lead not found, tin not found. Egg Yolk Pressed lid - Sound Sample contained boracic compounds. Egg Yolk - - Sound Sample contained boracic compounds. Egg Yolk (Glycer.) - - Sound Boracic compounds were not detected. Frozen Eggs L. - - Sound Boracic compounds were not detected. Frozen Egg Liquid - - Sound Boracic compounds were not detected . Frozen Egg Liquid - - Sound Boracic compounds were not detected. Frozen Egg Liquid - - Sound Boracic compounds were not detected. Frozen Egg Liquid - - Sound Boracic compounds were not detected. Frozen Egg Liquid - - Sound Boracic compounds were not detected. Canned Crab Satisfactory. Pressed can Satisfactory. Lacquered Sound. Contents wrapped in paper Lead 2 parts per million, tin not found. Canned Cherries Satisfactory. Pressed can Satisfactory Sound Lead 2 parts per million, tin not found, copper not found. Sardines Satisfactory Slight stains, soldered seam Sound Lead 2 parts per million, tin not found. Sardines Satisfactory Slight stains, soldered seam Sound Lead 3 parts per million, tin not found. Corned Minced Beef Satisfactory Slight stains, pressed seam Sound Lead 3 parts per million, tin not found. Bacteriological examination showed that the sample was sterile. Frozen Egg - - Sound Boracic compounds were not detected. Frozen Egg - - Sound Boracic compounds were not detected. Frozen Egg - - Sound Boracic compounds were not detected. Frozen Egg - - Sound Boracic compounds were not detected. Frozen Egg - - Sound Boracic compounds were not detected. Frozen Egg - - Sound Boracic compounds were not detected. Frozen Egg - - Sound Boracic compounds were not detected. Canned Tomatoes Satisfactory Slight etching, pressed seam Sound Lead less than 0.5 part per million, tin not found, copper not found. Tomato Puree - - - Lead less than 1 part per million, tin 0.5 grain to the pound, copper 80 parts per million on dried material. Bleached Raisins - - - Sample contained 720 parts of sulphur dioxide per million parts of the sample. Bleached Raisins - - Sound Sample contained 560 parts of sulphur dioxide per million parts of the sample. Bleached Raisins - - Sound Sample contained 550 parts of sulphur dioxide per million parts of the sample. Bleached Raisins - - Sound Sample contained 800 parts of sulphur dioxide per million parts of the sample. 102 103 Sample of Condition of Can. Condition of Contents for Sample. Report. External. Internal. Bleached Raisins - - Sound Sample contained 535 parts of sulphur dioxide per million parts of the sample. Bleached Raisins - - Sound Sample contained 340 parts of sulphur dioxide per million parts of the sample. Bleached Raisins - - Sound Sample contained 285 parts of sulphur dioxide per million parts of the sample. Bleached Raisins - - Sound Sample contained 490 parts of sulphur dioxide per million parts of the sample. Bleached Raisins - - Sound Sample contained 355 parts of sulphur dioxide per million parts of the sample. Bleached Raisins - - Sound Sample contained 515 parts of sulphur dioxide per million parts of the sample. Bleached Raisins - - Sound Sample contained 505 parts of sulphur dioxide per million parts of the sample. Concentrated Tomato Paste Satisfactory Lacquered can, pressed seam Sound Lead 3 parts per million, copper 190 parts per million on dried material. Bleached Raisins - - Sound Sample contained 535 parts of sulphur dioxide per million parts of the sample. Bleached Raisins - - Sound Sample contained 415 parts of sulphur dioxide per million parts of the sample. Bleached Raisins - - Sound Sample contained 560 parts of sulphur dioxide per million parts of the sample. Bleached Raisins - - Sound Sample contained 450 parts of sulphur dioxide per million parts of the sample. Bleached Raisins - - Sound Sample contained 530 parts of sulphur dioxide per million parts of the sample. Bleached Raisins - - Sound Sample contained 890 parts of sulphur dioxide per million parts of the sample. Bleached Raisins - - Sound Sample contained 490 parts of sulphur dioxide per million parts of the sample. Lobster Tomali Satisfactory Lacquered can, pressed seam Sound Lead 2 parts per million. Lobster Satisfactory Lacquered can, Sound. Wrapped in paper Lead not found. Frozen Eggs - pressed seam Sound Boracic compounds were not detected. Tomato Puree - - Sound Copper 54 parts per million on dried material. Canned Cherries Satisfactory Pressed seam, soldered Sound Lead 2 parts per million, copper 0.5 part per million. Tinned Peeled Tomatoes Satisfactory Pressed seam, nn rnrrnmon Sound Lead less than 1 part per million, tin not found, copper 10 parts per million on dried material. Canned Peeled Tomatoes Satisfactory Pressed seam, no corrosion Sound Lead 1 part per million, tin not found, copper 7 parts per million on dried material. Canned Minced Mutton Satisfactory No seam, no corrosion Sound Lead less than 2 parts per million. Tomatoes Satisfactory Lapped seam, no corrosion Sound Lead less than 1 part per million, tin not found, copper 24 parts per million on dried material. 104 105 Sample of Condition of Can. Condition of Contents for Sample. Report. External. Internal. Frozen Eggs - - Sound Boracic compounds were not detected. Frozen Eggs - - Sound Boracic compounds were not detected. Pilchards Satisfactory. Pressed can Slight stains, no corrosion Sound Lead not found, tin not found. Salmon Satisfactory Stained, no corrosion Sound Lead not found, tin not found. Salmon Satisfactory Stained, no corrosion Sound Lead not found, tin not found. Salmon Satisfactory Stained, no corrosion Sound Lead not found, tin not found. Salmon Satisfactory Stained, no corrosion Sound Lead not found, tin not found. Salmon Satisfactory Stained, no corrosion Sound Lead not found, tin not found. Salmon Satisfactory No corrosion Sound Lead not found, tin not found. Machine Skimmed Sweetened Condensed Milk Satisfactory Satisfactory Sound The sample satisfied the requirements of the Public Health (Condensed Milk) Regulations, with regard to composition and labelling. Machine Skimmed Sweetened Condensed Milk Satisfactory Satisfactory Sound The sample satisfied the requirements of the Public Health (Condensed Milk) Regulations, with regard to composition and labelling. Machine Skimmed Sweetened Condensed Milk Satisfactory Satisfactory Sound The sample satisfied the requirements of the Public Health (Condensed Milk) Regulations, with regard to composition and labelling. Machine Skimmed Condensed Sweetened Milk Satisfactory Satisfactory Sound The sample satisfied the requirements of the Public Health (Condensed Milk) Regulations, with regard to composition and labelling. Frozen Egg - - Sound Boracic compounds were not detected. Tomato Puree - - Sound Lead not found, tin not found, copper 35 parts per million, zinc not found, arsenic not found. Tomato Puree - - Sound Lead not found, tin not found, copper 163 parts per million on dried material, zinc not found, arsenic not found. Tomato Puree - - Sound Lead not found, tin not found, copper 10 parts per million, zinc not found, arsenic not found. Tomato Puree - - Sound Lead not found, tin not found, copper 36 parts per million on dried material, zinc not found, arsenic not found. Frozen Eggs - - Sound Boracic compounds were not detected. Frozen Eggs - - Sound Boracic compounds were not detected. Grape Fruit Juice - - Sound Sample contained 575 parts of sulphur dioxide per million parts of the sample. Salicylic acid not found, benzoic acid not found. Grape Fruit Juice - - Sound Sample contained 660 parts of sulphur dioxide per million parts of the sample. Salicylic acid not found, benzoic acid not found. 106 107 Sample of Condition of Can. Condition of Contents for Sample. Report. External. Internal. Canned Tomatoes Satisfactory Pressed seam, no corrosion Sound Lead 1 part per million, tin not found, copper 13 parts per million on dried material. Fresh Tomatoes - - Sound Copper 16 parts per million on dried material. Fresh Tomatoes - - Sound Copper 17 parts per million on dried material. Tinned Peeled Tomatoes Satisfactory Pressed seam, no corrosion Sound Lead less than 1.5 part per million, tin not found, copper 11 parts per million on dried material. Tomato Puree Satisfactory Pressed seam, slight etching Sound Copper 12 parts per million on dried material. English Tomatoes (Fresh) - - Sound Copper 8 parts per million on dried material. Tinned Coneentrated Tomatoes Satisfactory Lacqured can, lapped seam, soldered. Slight corrosion Sound Copper 170 parts per million on dried material. Raisins - - Sound Sample contained 795 parts of sulphur dioxide per million parts of sample. Tomatoes Satisfactory Lapped seam, soldered, slight corrosion Sound Lead 1 part per million, tin not found, copper 19 parts per million on dried material. Raisins - - Sound Sample contained 440 parts of sulphur dioxide per million parts of the sample. Canned Tomatoes Satisfactory Pressed seam, soldered, no etching Sound Copper 19.5 parts per million on dried material. Frozen Eggs - - Sound Boracic compounds were not detected. Frozen Eggs - - Sound Boracic compounds were not detected. Frozen Eggs - - Sound Boracic compounds were not detected. Frozen Egg Whites - - Sound Boracic compounds were not detected. Frozen Eggs - - Sound Boracic compounds were not detected. Frozen Eggs - - Sound Boracic compounds were not detected. Frozen Eggs - - Sound Boracic compounds were not detected. Frozen Eggs - - Sound Boracic compounds were not detected. Tomatoes Satisfactory Lapped seam, soldered inside and outside, no etching Sound Copper 25.3 parts per million on dried material. 108 109 TABLE 25. Showing the quantity of foodstuffs examined at the wharves, the amount found 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. - - Apple Pulp 10 tins 3 16 - - - - - - Almonds 275 bags 27 10 0 0 - - - - - - Apples 1 barrel, 6120 boxes, 2108 cases 146 9 1 0 18 16 3 0 Yes - 5 5 1 ton 12 cwt. 3 qrs. released for technical purposes; 17 tons 4 cwt. barged to sea. Apricots 7933 crates 77 3 0 8 77 3 0 8 Yes - 3 3 1 cwt. 8 lbs. destroyed in truck; 77 tons 2 cwt. destroyed in Council's Depot. Apricot Kernels 109 bags 5 9 0 0 - - - - - - Apricot Pulp 1999 cases, 111 tins 100 11 2 0 12 2 0 Yes - - - Destroyed in Council's Depot. Artichokes 139 crates 1 4 2 8 1 4 2 8 Yes - - - Do. do. Bacon 152 boxes, 913 bales 180 0 1 7 1 0 7 Yes - - - Do. do. Beans, Vanilla 2 cases 1 2 12 - - - - - - Beef Quantity 95 2 0 15 5 10 3 4 Yes - 59 59 Released for technical purposes. Beans 6 baskets 3 0 0 - - - - - - Beef, tinned Quantity 754 6 2 0 2 15 3 20 Yes - 1 1 10 cwt. released for technical purposes; 2 tons 5 cwt. 3 qrs. 20 lbs. destroyed in Council s Depot. Beef Briskets, tinned 1206 cases 39 11 1 4 1 2 18 Yes - 2 2 Destroyed in Council's Depot. Blackberries, tinned 6 tins 1 20 - - - - - - Black Currants, tinned 556 cases 27 16 0 0 - - - - - - Butter 2425 boxes 60 12 2 0 - - - 1 1 - Casings Quantity 102 9 0 24 - - - - - - Cherries 39 crates 9 0 0 9 0 0 Yes - - - Destroyed in Council's Depot. Cherries, Glace 59 crates 5 18 0 0 - - - 1 1 - Chicken 2 cases 1 0 0 1 12 Yes - 1 1 Destroyed in Council's Depot. Cherries, tinned 440 cases 9 15 0 0 2 5 0 0 Yes - - - Destroyed in Council's Depot. Crab, canned 96 cases 2 1 0 0 - - - - - - Dripping 30 casks, 50 boxes 7 5 0 0 - - - - - - Ducks 10 cases 2 2 20 - - - - - - Eggs, frozen 100 tins, 30421 packings 1095 18 3 26 - - - - - - Egg Liquid 1390 cases, 33960 packings 660 1 2 20 106 12 3 12 Yes - 1 1 For export to China. Egg Yolk Liquid 1153 casks, 1639 packings 251 14 2 14 - - - 19 12 - Fat, Hog 28 drums 6 5 1 14 6 5 1 14 Yes - 6 6 Released for technical purposes. Fowls 40 cases 1 0 0 0 - - - - - - Carried forward 3659 3 2 12 221 18 3 19 99 92 110 111 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. Brought forward 3659 3 2 12 221 18 3 19 99 92 French Beans 5 bundles 1 0 14 1 0 14 Yes - - - Destroyed on premises. Flour 16 sacks 1 12 0 0 - - - - - - Fruits, Assorted 11 cases 5 2 4 5 2 4 Yes - 1 1 Destroyed in Council's Depot. Fruit, tinned 426 cases 10 0 2 22 5 13 3 22 Yes - 3 2 Do. do. Ghi 10 tins 6 0 0 6 0 0 Yes - 1 1 Do. do. Ginger 4 casks 4 0 0 4 0 0 Yes - - - Do. do. Greengages 121/2 sieves 2 3 4i 2 3 41/2 Yes - - - Destroyed on premises. Grapes 1573 boxes, 25 trays, 5 crates 17 3 2 8 16 2 2 8 Yes - 3 3 9 cwts. 2 qrs. 8 lbs. destroyed on premises; 15 tons 13 cwt. barged to sea. Grape Fruit Juice 75 cases, 1119 casks 231 6 0 0 1 12 0 0 Yes - 1 1 Destroyed on premises. Grape Fruit 48677 cases, 29819 boxes 6495 3 1 8 229 8 2 26 Yes - 51 51 Barged to sea. Hams 247 boxes, 14 bags, 30 hams, 10 cases 33 15 0 0 - - - 1 1 - Hams, canned 600 cases 23 6 0 0 - - - - - - Kawnie Nuts 15 bags 17 2 15 17 2 15 Yes - - - Destroyed on premises. Kidneys, Sheep's 19 crates 9 2 0 9 2 0 Yes - 1 1 7 cwt. 3 qrs. 2 1bs. released for technical purposes; 1 cwt. 2 qrs. 26 lbs. destroyed in Counical's Depot. Lard 10 drums, 2250 boxes 58 15 0 0 1 4 0 0 Yes - 2 2 Released for technical purposes. Lard Oil 174 barrels 34 16 0 0 - - - 1 1 - Lemons 14627 boxes, 1 case 549 4 0 4 4 3 3 12 Yes - 11 11 Barged to sea. Lettuce 1616 crates 11 14 1 26 11 14 1 26 Yes - - - 20 lbs. destroyed on premises; 11 tons 14 cwt. 1 qr. 6 lbs. destroyed in Council's Depot. Lobster, canned 250 cases 5 8 0 0 - - - - - Melons 370 boxes, 148 crates, 6 baskets, 383 melons 7 12 1 24 2 19 3 24 Yes - 1 1 19 cwt. barged to sea; 1 cwt. 3 qrs. 4 lbs. destroyed on premises; 1 ton 16 cwt. 20 lbs. destroyed in Council's Depot; 3 cwt. destroyed in truck. Milk, condensed 1686 cases 35 19 3 14 9 0 3 22 Yes - - - 3 tons 16 cwt. 1 qr. 20 lbs. released for technical purposes; 5 tons 4 cwt. 2 qrs. 2 lbs.destroyed in Council's Depot. Milk, evaporated 161 cases 3 0 0 9 1 12 2 17 Yes - - - 1 ton 10 cwt. destroyed in Council's Depot; 2 cwt. 2 qrs. 17 lbs. released for technical purposes. Mutton Quantity 1565 17 2 13 5 18 0 15 Yes - 593 593 Released for technical purposes. Mutton, boiled, tinned 6 cases 3 3 12 3 3 12 Yes - - - Destroyed in Council's Depot. Orange Juice 150 cases 6 12 2 0 - - - - - - Offal Quantity 10 14 3 20 1 15 3 4 Yes - 11 11 Released for technical purposes. Oil Seeds 18 bags 18 0 0 18 0 0 Yes - - - Destroyed in Council's Depot. Carried forward 12764 13 2 131/2 516 14 1 20* 780 772 112 113 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. - Brought forward 12764 13 2 131/2 516 14 1 201/2 - 780 772 Oleo Oil 60 tierces 12 0 0 0 - - - - - - Onions 12021 bags, 30 half-bags 275 6 0 0 12 10 2 0 Yes - 5 5 4 tons 1 cwt. destroyed in Council's Depot; 8 tons 9 cwt. 2 qrs. barged to sea. Oranges 51955 cases, 143 173 boxes 7218 12 0 12 149 14 0 2 Yes - 63 63 51 tons 1 cwt. 2 qrs. 8 lbs. destroyed in Council's Depot; 98 tons 12 cwt. 1 qr, 22 lbs. barged to sea. Oranges, tinned 2225 cases 39 14 2 16 2 10 2 12 Yes - 1 1 Destroyed in Council's Depot. Ox Bungs 25 casks 5 0 0 o - - - - - - Partridges 20 cases 7 2 0 - - - - - - Peaches 500 boxes, 2 crates 4 0 1 12 2 3 12 Yes - 1 1 1 qr. 12 lbs. destroyed in truck; 2 tons 2 cwt. barged to sea. Pears 58982 boxes, 11955 cases 1413 0 1 6 14 6 1 2 Yes - 16 16 Barged to sea. Peas 175 billots, 16 baskets 1 14 3 12 1 14 3 12 Yes - - - Destroyed in Council's Depot. Pilchards 1241 cases 28 10 1 12 10 1 12 Yes - 1 1 Do. do. Plums 3 boxes, 2 crates, 88 trays, 164 billots, 44 baskets 2 13 3 16 2 13 3 16 Yes - 1 1 1 ton 3 cwt. 2 qrs. 24 lbs. destroyed on premises; 9 cwt. 1 qr. 20 lbs. destroyed in truck; 1 ton destroyed in Council's Depot. Plums, canned 39 cases 16 3 2 16 3 2 Yes - 1 1 Destroyed in Council's Depot. Pineapple, canned 5 cases 2 2 0 2 2 0 Yes - 1 1 Do. do. Pork Quantity 8 14 0 7 14 3 16 Yes - 19 19 Released for technical purposes. Poultry Quantity 12 4 1 2 1 1 2 15 Yes - - - 3 cwt. 3 qrs. 4 lbs. released for technical purposes; 2 qrs. destroyed on premises; 17 cwt. 1 qr. 11 lbs. destroyed in Council's Depot. Prunes 3 boxes 1 0 9 1 0 9 Yes - - - Destroyed in Council's Depot. Rabbits 350 cases, 191 cretes 13 16 0 4 4 1 3 Yes - 4 4 Released for technical purposes. Rice 1 bag 1 0 0 - - - - - - Raisins 250 boxes 3 2 0 0 - - - - - - Salmon, tinned 1403 cases 28 0 1 26 1 7 0 26 Yes - 4 4 Destroyed in Council's Depot. Sardines 100 cases 1 0 0 0 - - - - - - Sausage, tinned 5 cases 9 2 22 - - - - - - Soups, tinned 10 cases 4 1 4 4 1 4 Yes - - - Destroyed in Council's Depot. Sugar 70 bags 8 10 0 0 - - - - - - Sultanas 40 boxes 8 3 20 - - - - - - Tamarinds 30 casks 7 10 0 0 - - - - - - Tomatoes 1000 cases, 19 billots 27 0 3 20 ) 5 3 20 Yes - 1 1 5 tons 3 cwt. destroyed in premises; 20 lbs. destroyed in Council's Depot. Tomato Puree 1500 cases, 2 tins 51 17 1 26 17 1 12 Yes - 5 5 Destroyed in Council's Depot. Tomatoes, tinned 4156 cases 113 0 2 0 2 18 3 4 Yes - 5 5 Do. do. Carried forward 22042 13 2 171/2 709 12 2 31/2 908 900 114 115 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. 908 900 Brought forward . . 22042 13 2 171/2 709 12 2 3 Yes - 1 1 Destroyed in Counicl's Depot Tongues, tinned 1238 cases.. 35 15 0 16 13 2 21/2 Yes - 1 1 Do. do. Tongues, Ox 849 cases 27 5 0 0 1 2 12 Yes - 7 7 Destroyed in Counicl's Depot(1 cwt. 14 lbs.): 2 tons 5 cwt. 2 qrs. 2 lbs. released for technical purposes. Veal 951 cases, 1 bag, 20 pieces, 3 carcases 30 15 1 25 2 6 2 16 Yes - 3 3 Destroyed in Counicl's Depot Veal, Jellied 1052 cases, 5402 tins 47 19 2 12 4 2 2 5 Yes - - - Destroyed on premises. Veal, tinned 9 tins 1 26 1 26 - - - - - Weasand's Beef 4 cases 1 2 0 - - - - - - Total 22184 10 3 121/2 716 17 1 81/2 - - 920 912 116 117 TABLE 26. Showing the quantity of Foodstuffs found unsound throughout the Borough during the year 1938 by the several Inspections. 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 5 boxes 1 3 4 5 boxes 1 3 4 - - Destroyed in Council's Depot. Bacon Quantity 4 10 1 0 Quantity 4 10 1 0 - - 1 cwt. 13 lbs. destroyed at Council's Depot.; 4 ton 9 cwt. 15 lbs. released for technical purposes. Bananas 1 crate 2 14 1 crate 2 14 - - Destroyed at Council's Depot. Beef Quantity 10 1 251/2 Quantity 10 1 251/2 - - 6 cwt. 51/2 lbs. released for technical purposes. 4 cwt. 1 qr. 20 lbs. destroyed on premises. Beef, tinned 23 tins 1 1 18 23 tins 1 1 18 - - Destroyed in Council's Depot. Biscuits 24 tins 1 2 0 24 tins 1 2 0 - - Do. do. Brisket Quantity 12 Quantity 12 - - Do. do. Cheese Quantity 3 11/2 Quantity 3 11/2 - - Do. do. Chicken 50 chickens 1 1 191/2 50 chickens 1 1 191/2 - - Do. do. Chicken, Boneless 321 jars 1 0 2 321 jars 1 0 2 - - Do. do. Chicken, tinned 78 tins 3 3 18 78 tins 3 3 18 - - Do. do. Confectionery 20 packages 1 0 0 20 packages 1 0 0 - - Do. do. Chocolate 3 cases 1 2 3 cases 1 2 - - Do. do. Crab, canned 50 cases 1 1 0 0 50 cases 1 1 0 0 - - Do. do. Fish 3 boxes 2 4 3 boxes 2 4 - - Destroyed on premises. Fish, canned 115 cases, 60 tins 2 11 2 0 115 cases, 60 tins 2 11 2 0 - - Destroyed in Council's Depot. Fowls Quantity 4 2 3 Quantity 4 2 3 - - Do. do. Fruit, dried 600 cases 6 0 0 0 600 cases 6 0 0 0 - - Do. do. Fruit, tinned ; 91 cases, 233 tins 1 15 1 16 91 cases, 233 tins 1 15 1 16 - - Do. do. Game Quantity 4 Quantity 4 - - Do. do. _ j Gelatine 1 bag, 19 kegs 1 0 0 0 1 bag, 19 kegs 1 0 0 0 - - Do. do. Grape Fruit 207 boxes 8 12 3 24 207 boxes 8 12 3 24 - - 1 cwt. destroyed in Council's Depot; 19 cwt. released for technical purposes. Hams, canned 39 tins 5 2 251/2 39 tins 5 2 251/2 - - Destroyed in Council's Depot. Heads, Pig's 16497 heads 89 3 0 4 16497 heads 89 3 0 4 - - 1 cwt. 21 lbs. destroyed on premises ; 4 cwt. 2 qrs. 41/2 lbs. destroyed in Councils Depot. Horse Radish 18 crates 7 2 0 18 crates 7 2 0 - - 2 tons 3 qrs. 26 lbs. destroyed in digester; 87 tons 2 cwt. 6 lbs. released for technical purposes. Herrings 12 boxes 1 0 8 12 boxes 1 0 8 - - Destroyed in Council's Depot. Jams 5 boxes 1 22 5 boxes 1 22 - - Do. do. Kippers 22 boxes 1 3 24 22 boxes 1 3 24 - - Do. do. Lemons 9 boxes, 185 cases 5 2 3 0 9 boxes, 185 cases 5 2 3 0 - - Do. do. Lettuce 194 crates 4 5 0 8 194 crates 4 5 0 8 j - - Do. do. Melons 47 crates, 45 cases 5 6 3 4 47 crates, 45 cases 5 6 3 4 - - Do. do. Milk, condensed 68 cases 1 9 0 16 68 cases 1 9 0 16 - - Do. do. Mutton Quantity 2 18 Quantity 2 18 - - 1 qr. 6 lbs. released for technical purposes; 1 qr. 12 lbs. destroyed on premises. Carried forward 133 4 2 17 133 4 2 17 - - 116 119 Foodstuffs. Quantity and Weight found Unsound Seized by Inspector. Surrendered by Owners. Remarks. Quantity. Weight. Quantity. Weight. Quantity. Weight. T. C. Q. T. T. C. Q. L. T. C. Q. T. Brought forward 133 4 2 17 133 4 2 17 - - 3 cwt. 15 lbs. destroyed in Council's Depot; 1 cwt 26 lbs. destroyed on premises. Offal - 4 1 13 - 4 1 13 - - Destroyed in Council's Depot. Oranges 38 cases, 286 boxes 14 1 1 0 38 cases, 286 boxes 14 1 1 0 - - Do. do. Pears 156 boxes 2 11 1 20 156 boxes 2 11 1 20 - - Do. do. Pickles 5 boxes 1 22 5 boxes 1 22 - - Do. do. Pears, tinned 31 boxes 1 0 0 0 31 boxes 1 0 0 0 - - 2cwt. 16 lbs. destroyed in digester ; 2 qrs. 12 lbs destroyed on premises; 1 cwt. 12 lbs. destroyec in Council's Depot; 33 tons 18 cwt. 2 qrs. 51/2 lbs released for technical purposes. Pork Quantity 34 2 1 171/2 Quantity 34 2 1 171/2 - - 2 qrs. 10 lbs. released for technical purposes; 2 tons 1 cwt. 1 qr. 16 lbs. destroyed in Council's Depot. Poultry Quantity 2 1 3 26 Quantity 2 1 3 26 - - Destroyed in Council's Depot. Rabbits Quantity 8 3 17 Quantity 8 3 17 - - Do. do. Sardines 38 cases 19 0 0 38 cases 19 0 0 - - Do. do. Sweets & Chocolate Quantity 1 1 20 Quantity 1 1 20 - - Do. do. Do. do. Tomato Paste 13 tins 1 0 13 tins 1 0 - - Destroyed on premises. Tomatoes, tinned 5 cases 4 0 0 5 cases 4 0 0 - - Do. do. Tongues, tinned 9 tins, 2 tongues 1 10 9 tins, 2 tongues 1 10 - - 1 cwt. 101/2 lbs. destroyed on premises; 1 cwt. 10 lbs destroyed in Council's Depot. Turkeys 1 case 1 2 0 1 case 1 2 0 - - Tongues, Ox 13 tongues, 26 tins 2 0 201/2 13 tongues, 26 tins 2 0 201/2 - - Released for technical purposes. Veal Quantity 2 3 Quantity 2 3 - - Destroyed in Council's Depot. Veal, tinned Quantity 1 15 0 0 Quantity 1 15 0 0 Do. do. Winkles 7 bags 6 1 17 7 bags 6 1 17 Total 191 6 0 7 191 6 0 7 - - 120 TABLE 27. Inspections of flood at Wharves, Markets and other places where food is stored, and the action taken by the officials during the year 1938. 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 Mouses. 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. Messrs. Bowers & Groves 581 — 590 45 422 35 33 177 — — — Mr. Duffield 1058 — 869 105 1090 885 879 766 — — — Market Inspections — 6371 — — — — — — — — — Total 1639 6371 1459 150 1512 920 912 943 — — — 121 MILK AND DAIRIES (AMENDMENT) ACT, 1922, AND ORDERS MADE THEREUNDER, ETC. Milksellers. Wholesalers. Retailers. In Borough. Outsiders. In Borough. Outsiders. Names on Register at end of 1937 36 49 396 83 Premises on Register at end of 1937 35 — 394 — Names Registered during 1938 1 4 42 6 Names Removed during 1938 — — 52 — Premises Registered during 1938 — — 10 — Premises Removed during 1938 — — 23 — Names on Register at end of 1938 36 53 386 89 Premises on Register at end of 1938 35 — 381 — The total number of retail Milksellers premises at the end of the year consisted of 6 depots, 53 dairies, 301 premises at which milk is sold in bottles or cartons only and 21 premises at which milk is sold for consumption on the premises only. MILK (SPECIAL DESIGNATIONS) ORDERS, 1936 AND 1938. The total number of licences issued for the sale of Graded Milks were as follows:— Tuberculin Tested Milk 21 (includes 1 bottling and 1 supplementary licence) Accredited Milk — Pasteurised Milk 95 (includes 9 bottling and 6 supplementary licences) Total 116 During the year the following samples of graded milks have been taken and submitted to the Public Analyst for bacteriological examination and chemical analysis. 122 Pasteurised milk.—39 samples were submitted for bacteriological examination, all of which complied with the requirements of the Order. In all cases the samples were also submitted for chemical analysis and were found to be genuine. Tuberculin-tested milk.—21 samples were submitted as follows:— 18th July. 25th July. 2nd Aug. 10th Aug. Total. 6 6 5 4 21 Of these samples 13 failed to satisfy both the Methylene Blue and the B. Coli tests, and 4 failed to satisfy the B. Coli test. In every case in which samples failed to satisfy the prescribed tests, the Medical Officers of Health for the districts in which the milk was bottled were notified and supplied with copies of the Public Analyst's reports. The samples which failed to satisfy these tests were the subject of a report which was considered at a special meeting of the Public Health Committee at which meeting the wholesalers and retailers of the milk concerned were present. In consequence of the investigation into the matter by the Committee, four licenses were suspended and the remainder of the license holders were cautioned. After bacteriological examination of these samples, informal samples were then taken and submitted for chemical examination. One of the samples was found to be 15 per cent. deficient in milk fat. Immediately formal samples were taken under the Food and Drugs Act, 1928. These formal samples were also found to be deficient, legal proceedings being taken in respect to one sample which showed a deficiency of 6.6 per cent. of milk fat. A conviction was obtained, a fine and costs being imposed. Further informal samples of this milk were purchased subsequently by an agent but were found to be in order. It is now the practice to purchase samples of "Tuberculin-tested" milk under the Food and Drugs (Adulteration) Act, 1928, for chemical analysis as well as the submission of samples for bacteriological examination under the Milk (Special Designations) Order, 1936-38. The following is a report by the Public Analyst to the Ministry of Health on the subject of deficiency of milk fat in "Tuberculin-tested " milk:— 123 Report on some Samples of "T.T." Milk. "On July 18th last, six samples of 'T.T.' Milk were submitted to me for bacteriological examination of which two did not satisfy the prescribed tests. Although the samples had only been submitted for bacteriological examination I considered it advisable, as Public Analyst, to examine them chemically to see if they satisfied the standards laid down by the Sale of Milk Regulations, 1901. One of the samples did not satisfy these Regulations, being deficient in milk-fat to the extent of 15 per cent. (318A). "I immediately asked the Inspector to procure another sample from the same source and to take the sample as 'Milk' under the Food Adulteration Act. This was done, and the portion submitted to me on July 21st (Sample 401) proved to be deficient in milk-fat to the extent of 2 per cent. "In consequence of the taking of this sample a letter was received on Saturday, July 23rd, from the vendors' Solicitor requiring my Council to take samples in course of delivery to his clients at the Dairy at Hatfield Peverel, Essex. "The Chief Inspector of the Essex County Council was accordingly informed of the facts by our Inspector and he agreed to take the required samples, which he delivered to our Inspector on July 27th, August 10th, and they were submitted to this laboratory for analysis on those dates. "The first lot of 17 samples were morning milks from separate farms taken after the milk from each farm had been bulked at the dairy. "The second series of 5 samples were afternoon milks taken in the same way. "Out of the first 17 samples, 10 proved to be deficient in milk-fat to the following extent:— 4.6, 5.3, 8.6, 9.3, 15.6, 7, 17, 9, 24.3 and 13.6 per cent. Out of the second 5 samples, 2 were deficient in milk-fat to the extent of 8 and 5.6 per cent. "A further sample (No. 439) was taken from the same retail source on August 5th. This sample was also below the standard, being 6.6 per cent. deficient in milk-fat. "No request for the taking of samples in the course of delivery was made in respect of this sample. 124 "The above results reveal a condition of affairs which I consider to be extremely serious. Milk, which in the ordinary course might only be examined bacteriologically, is being sold to the public at a high price (8d. per pint), with an utter disregard of its chemical composition. Apparently, no check of the fat content of these milks had been made— if it had, then the position is infinitely worse. "I am of the opinion that all wholesalers bottling this milk should be compelled to check the fat content of the milk before they allow it to be released for sale to the public. The results of these tests should be open for inspection by the local authority, and failure to take samples or to satisfy the required standards should mean a suspension or revocation of the licence. "(Signed) CYRIL DICKINSON, B.Sc., F.I.C. "Public Analyst. "6th October, 1938." A further 18 samples were submitted for bacteriological examination as follows:— 2nd Nov. 3rd Nov. 19th Dec. Total. 13 3 2 18 One of these samples failed to satisfy the B. Coli test. Of this latter 18 samples 11 were found to have been pasteurised, although the labels describing the milk were worded "TuberculinTested Milk "and not" Tuberculin-Tested Milk Pasteurised." The following is a report made by the Public Analyst in respect to these samples:— Milk (Special Designations) Order, 1936. 18 samples of "T.T." Milk (Raw) were examined, one of which failed to satisfy the prescribed tests. Of the above 18 samples, 11 proved to have been pasteurised and should have been labelled and sold as "T.T. Milk Pasteurised" and not as "T.T. Milk." The 11 samples were all supplied by the same wholesale firm which is situated outside the Borough of Southwark. (Signed) Cyril Dickinson, B.Sc., F.I.C., Public Analyst. 125 On the 1st November, 15 samples of Tuberculin-Tested Milk were submitted to the Public Analyst for chemical analysis and were all found to be genuine. Tuberculin-tested, milk pasteurised.—4 samples were submitted one of which failed to satisfy the prescribed test. Inoculation tests.--5 samples of "T.T. milk" and 2 samples of "T.T. pasteurised milk" were submitted to Dr. Guy Bousfield for inoculation tests, who reported as follows:— "Guinea pigs injected with some of the deposit obtained from these seven milks do not show evidence of tuberculous disease on post-mortem examination." Phosphatase test.—214 samples of milk were submitted for this test and all were found to be satisfactory. BACTERIOLOGICAL AND PHOSPHATASE EXAMINATIONS. 214 samples of Milk were submitted for Phosphatase test during the year, all of which were satisfactory. 39 samples of Pasteurised Milk were submitted to the Public Analyst for Bacteriological examination, all of which complied with the requirements of the Milk (Special Designations) Orders, 1936 and 1938. INSPECTIONS OF VARIOUS PREMISES. The following Inspections have been made during the year:— Milkshops, Dairies, etc. 1,048 Bakehouses, etc. 150 Soap Works 1 Tripe Boilers 2 Butter Factory 1 Fur Skin Dresser 14 Public Houses 107 Pharmacy and Poisons Act 110 Other premises 32 1,465 126 BAKEHOUSES. There are 21 underground bakehouses in Southwark which are still in use. In addition there are 32 bakehouses above ground in use, and 20 such bakehouses out of use. All underground bakehouses which had not been in use for twelve months have, in accordance with Section 54 of the Factories Act, 1937, been removed from the register. The following above-ground bakehouses have been closed during the year 1938:— 37, Bartholomew Street, 26, Friar Street, and 38, Law Street (demolished). NOXIOUS TRADES. Situation. Trade. Occupier. Inspections. Remarks. 24, Great Suffolk Street Tripe Boiler J. Martin 2 Periodical cleansing was duly carried out. do. Wansey Street Soap Works Holder's Soap Works, Ltd. 2 Sanctuary Street Skin Dresser Leeding & Co. 6 do. Little Lant Street Skin Dresser Dryden & Co. 1 do. BUTTER AND MARGARINE FACTORIES. 1 inspection was made at the Butter Factory and 4 samples of butter were procured for analysis. They were all certified genuine. There are 17 wholesale dealers in margarine in the Borough. PUBLIC HEALTH (CONDENSED MILK) REGULATIONS, 1923 and 1927. 4 samples of condensed milk were purchased under the above Regulations for analysis. They were certified by the Public Analyst to comply with the said Regulations, with one exception. 127 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 IN FOOD) REGULATIONS, 1927. FOOD AND DRUGS (ADULTERATION) ACT, 1928, Etc. Special attention has been given at the various premises visited in the carrying out of the above Act, Orders, etc., and where necessary the provisions relating thereto were explained and the shopkeepers advised. PUBLIC HOUSES. During the year 69 Public Houses have been inspected. Particulars of the defects found have been sent to the respective Brewers and Owners. Building of new premises, enlargement and reconditioning have been going on rapidly. There are now at least 40 premises in the Borough which are of entirely modern construction. Many more have teen remodelled and brought into line with modern requirements and a further inspection is to be made to check up progress. 128 POISONS AND PHARMACY ACT, 1933, AND ORDERS MADE THEREUNDER. During the year 110 visits were paid to the various premises listed by the Council for the sale of Part 2 Poisons under the above Act. There are 79 names of persons on the Council's List of Sellers of Part 2 Poisons. 6 names were newly entered upon the list and 6 names were removed. The following is a list of Poisons sold:— Kind of Poison Sold. No. of Premises. Remarks. Spirits of Salts 38 Conditions of sale have been complied with. Ammonia 56 Phenols 142 Caustic Soda 25 Caustic Potash 4 Sulphuric Acid 3 Nitric Acid 4 Salts of Lemon 5 Arsenical Poisons — Mercurial Poisons — Nicotine • Barium 3 Hair Dyes 6 129 SALE OF FOOD AND DRUGS AND OTHER ACTS. Name and Address of Defendant. Sample. Offence or Result of Analysis. Result of Proceedings. Elizabeth Bragg (Mrs.), 1, Lawson Street Milk 5 per cent. deficient in milk fat Dismissed; 12s. 6d. costs. Charles Evans, 13, Boundary Row Milk 26 per cent. deficient in milk fat Fined £3 and 10s. 6d. costs. Charles Evans, 13, Boundary Row — Unlawfully trading as purveyor of milk without being registered Fined 10s. Violet Chambers (Mrs.), 55, Peacock Street Butter Content—17 per cent. water Fined £1 and 12s. 6d. costs. Thomas Ives, la, Browning Street Milk 13 per cent. deficient in milk fat Dismissed P.O.A.; 12s. 6d. costs. George Henry Soton, 122, East Street Sausage Contained preservative—not labelled Fined £1 and 17s. 6d. costs. Lord Rayleigh's Dairies (Wholesale), Ltd. The Bury, Hatfield Peverel Milk 4.6 per cent. deficient in milk fat Withdrawn. Lord Rayleigh's Dairies (Wholesale), Ltd., The Bury, Hatfield Peverel Milk 15.6 per cent. deficient in milk fat Withdrawn. Lord Rayleigh's Dairies (Wholesale), Ltd., The Bury, Hatfield Peverel Milk 24.3 per cent. deficient in milk fat Withdrawn. Express Dairy Co., Ltd., 12, St. George's Road Milk 6.6 per cent. deficient in milk fat Fined £10 and £5 5s. 0d. costs. E.J. Chater and H. Bartholomew, "Red Lion" Public House, Walworth Road Whiskey 41.5 deg. under proof Fined £10 and £1 1s. 0d. costs each defendant. 130 FOOD AND DRUGS ACTS. TABLE 28. Return of Official Samples for the Year ending 31st December, 1938, showing the number taken, and the percentage of adulterated Samples for the year. FORMAL SAMPLES. Article. Number of Samples taken. Adulterated. Arrowroot 2 1 Barley 11 — Bicarbonate of Soda 1 — Blanc Mange Powder 2 — Borax 1 — Brawn 13 — Butter 75 2 Cakes and Biscuits 21 — Cake, Bun and Pudding Mixtures 15 — Canned Peas 3 — Cheese 20 — Chocolates and Sweets 15 — Cheese and Tomato 1 — Chocolate Flake 1 — Cocoa 25 — Coffee 6 — Coffee Mixtures 2 — Condensed Milk 1 1 Cornflour 5 — Crushed Linseed 2 — Curry Powder 1 — Custard Powder 12 — Danish Ham 1 — Dessicated Coconut 2 — Dried Fruit 3 — Dripping 14 — Egg Powder and Substitute 2 — Fish Paste 8 — French Coffee 4 — Gin 6 3 Gravy Thick 14 — Haricot Beans 1 — Herbs 6 — Carried forward 296 7 131 Article. Number of Samples taken. Adulterated . Brought forward 296 7 Jam and Marmalade 1 — Jellies and Jelly Crystals 19 — Lard 27 — Lemonade Powder and Crystals 6 — Margarine 67 — Meat Paste 5 — Milk 503 7 Meatox Cubes 2 — Mint 2 — Mustard Compound 8 — Mustard 7 — Oats and Oatmeal 5 — Pea Flour 4 — Pepper 9 — Prunes 1 — Rice 23 — Rum 1 1 Sago 3 — Salt 4 — Sausages 28 2 Self-raising Flour 20 — Soups 7 — Spices and Condiments 9 — Spirits 10 — Suet and Flour 2 — Suet and Rice Flour 7 — Sugar 9 — Tapioca 12 — Tea 31 — Tea Dust 1 — Whisky 9 3 Wheat Preparations 3 — Wine 2 — Total 1143 20 Percentage of adulterated samples for the year—1.75. 132 INFORMAL SAMPLES. In addition to the samples taken under the Food and Drugs Acts as shown in Table 28, 990 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 29. Article. Number of samples. Adulterated. Arrowroot 23 2 Banana Curd 1 — Barley 1 — Basilicon Ointment 10 — Blanc Mange Powder 1 — Boracic Ointment 3 — Boric Ointment 1 — Brawn 3 — Butter 96 — Cake, Bun and Pudding Powders 11 — Cakes and Biscuits 95 — Camphorated Oil 6 — Canned Fish 23 1 Canned Fruit 10 — Canned Meat 9 — Canned Milk Pudding 1 — Canned Plum Pudding 1 1 Canned Vegetables 22 — Castor Oil 11 — Chocolates and Sweets 22 — Christmas Pudding 1 — Cocoa 7 — Coconut 2 — Coffee 1 — Condensed Milk 3 — Cornflour 6 — Cream 4 — Crushed Linseed 9 1 Curry Powder 2 — Custard Powder 26 — Dried Fruit 8 — Dripping 51 1 Egg Powder and Substitute 1 — Eucalyptus Oil 9 — Fish Paste 7 — Flavouring Essences 4 — Flour 26 — French Mustard 2 — Carry forward 519 6 133 Article. Number of samples. erated Brought forward 519 6 Gin 14 6 Glycerine 6 — Golden Eye Ointment 3 — Golden Ointment 1 — Golden Syrup 3 — Ground Ginger 29 — Ground Nuts 1 — Honey 1 — Iodine Paint 4 1 Iodine Salve 1 — Jams 10 1 Junket Crystals 1 — Lard 45 — Liquid Paraffin 3 — Malt Extract of Cod Liver Oil and Parrish's Food 1 — Malt Vinegar 1 — Malted Milk 1 — Meat Paste 3 — Mercurial Ointment 1 — Milk 57 1 Mincemeat 1 — Nut Marzipan 1 — Oats and Oatmeal 32 — Olive Oil 18 — Pepper 15 — Phenolated Solution of Iodine 2 — Rice 14 — Rum 2 1 Sago 1 — Sauces 27 — Sausages 46 4 Self-raising Flour 2 — Semolina 1 — Soups 3 — Spices and Condiments 29 — Spirit of Iodine 2 — Sugar 1 — Sulphur Ointment 5 — Tapioca 14 — Tea 3 — Tincture of Iodine 11 1 Wheat Preparations 10 — Whisky 12 4 Wine 22 — Yellow Mercuric Oxide Ointment 1 — Zinc Ointment 10 — Total 990 25 Percentage of adulterated samples for the year—2.52. SECTION F. Prevalence of, and Control over, Infectious and other Diseases. 137 INFECTIOUS DISEASES. The year 1938 has been a Measles year in consequence of which 2,071 cases were notified with a mortality of 11. Since the institution of a Measles control system by the London County Council whereby there is close co-operation between this Council and the Borough Council, through the School Medical Service and the Borough's Maternity and Child Welfare Services, the number of deaths from Measles has been greatly reduced from the alarming proportion which formerly prevailed. Apart from Measles, the number of cases of other common infectious diseases as compared with previous years remained more or less of an average. During the year, owing to the successful results obtained by Measles control, similar control methods were decided upon for Whooping Cough. Accordingly, Whooping Cough became notifiable in this Borough on the 1st October, 1938. SMALLPOX. During the year under review no cases were notified. The number of cases notified during the last five years is as follows:— 1934 22 1937 — 1935 — 1938 — 1936 — SCARLET FEVER. Three hundred and forty 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. 1934 748 5 1935 513 2 1936 352 — 1937 308 — 1938 340 1 138 MEASLES. The number of cases of this disease notified during the year was 1,985. Of these, 1,301 were under five years of age, and 567 were removed to hospital. One hundred and twenty-seven 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:— 1934 65 1937 1 1935 1 1938 11 1936 23 ENTERIC FEVER. Three cases of Enteric Fever were notified during the year. The number of cases notified and the number of deaths during the last five years were as follows:— Notified. Deaths. 1934 — — 1935 3 — 1936 2 1 1937 5 — 1938 3 — DIPHTHERIA. Three hundred and sixty-one cases of this disease were notified, with 9 deaths. The annual death-rate per 1,000 population was 0.07 for England and Wales; 0.05 for London; and 0.06 for Southwark. Antitoxin is supplied free of charge and 68 phials and serules 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 live years were as follows:— Notified. Deaths. 1934 600 21 1935 362 14 1936 338 9 1937 364 8 1938 361 9 139 SCHICK TESTING AND DIPHTHERIA PREVENTION CLINIC. In the middle of the year the Borough Council decided to enlarge the scope of Diphtheria preventive inoculations by instituting a general practitioners' scheme whereby all general practitioners experienced in this work could undertake the inoculation of children applying to them for this form of treatment, at the cost of the Borough Council. Arrangements between general practitioners and the Council were that Schick testing should be performed by the Council's expert at the Schick Testing Clinic, and that a fee of half-crown per injection should be paid to the general practitioner. The scheme has been a great success, many more persons than was anticipated have taken advantage of this service. 140 SCHICK CLINIC, 1938. Primary Schick Test. Schick Test after 3 months. Age Group. Reading of Test. Inoculation. * Reading of Test. Number Tested. Immune. Susceptible. Miscellaneous. 1st without Primary S. Test. 1st. 2nd. 3rd. 4th. 5th. Number Tested. Immune. Susceptible. Miscellaneous. 0-5 8 — 3 2 171 5 165 165 4 1 148 124 1 — 5-14 128 14 105 2 3 84 93 96 11 3 81 68 2 8 Adults 9 3 5 1 — 5 5 3 2 1 2 2 — — 145 17 113 5 174 94 263 264 17 5 231 194 3 8 In addition to the above, 73 children received Primary Schick Tests in connection with the Council's Scheme for General Practitioners. 7 of these tests revealed natural immunity. 28 post-immunisation Schick Tests were performed, 1 indicating that the child was still susceptible after immunisation. * Toxoid antitoxin mixture. 141 INFLUENZA. The deaths from this disease during the last five years were as follows:— 1934 24 1937 73 1935 13 1938 11 1936 18 CEREBRO-SPINAL FEVER, ENCEPHALITIS LETHARGICA, AND POLIOMYELITIS. Seven cases of Cerebro-Spinal Fever were notified during the year, of which 3 died. Four cases of Poliomyelitis were also notified, which were sent to hospital. ACUTE PRIMARY AND INFLUENZAL PNEUMONIA. One hundred and forty-one cases were notified during the year, of which 70 were removed to hospital. There were 18 deaths of these notified cases. ANTHRAX. One case of Anthrax was notified, the source of infection being traced to Manchurian horse hair. This was the subject of a report to the Public Health Committee and the Ministry of Health, at the time of the investigation. DIARRHOEA. This disease is notifiable during the months of July, August and September in the Borough of Southwark. During this period no cases were notified. Deaths of infants under two years of age during the last five years were as follows:— 1934 39 1937 21 1935 25 1938 30 1936 19 142 WHOOPING COUGH. This disease became notifiable in the Borough on October 1st of this year, and during this period 145 cases were notified. 136 cases were removed to hospital during the year. The number of fatal cases during the last five years will be found hereunder:— 1934 13 1937 13 1935 15 1938 2 1936 16 OPHTHALMIA NEONATORUM. Twenty-seven cases occurred during the year, as against 29 in 1937. An analysis of the cases will be found hereunder:— Notified. Cases treated. Vision unimpaired. Vision impaired. Total Blindness. Deaths. At home. Hospital. 27 9 18 27 — — — 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. 143 TABLE 30. DEATHS FROM CANCER—1938. Site of Disease. Under 25 25— 35— 45— 55— 65— 75— Total. M. F. M. F. M. F. M. F. M. F. M. F. M. F. M. F. Buccal Cavity – – – – – – – – 1 1 — 1 1 Tongue – – – – – – – – 1 – – 1 – – 1 1 Larynx – – – – – – – – – – 2 – 1 – 3 – Pharynx 1 – – – 4 – – – 5 – Tonsil – – – – – – – – – – 1 – – – 1 – Antrum – – – – – – – – – – 1 – – – 1 – Neck Glands – – – – – – – – 1 – 2 1 1 1 4 2 Bronchus — — – — 1 — 5 — 1 1 2 — 1 — 10 1 Lung — — – — 1 — 1 2 7 2 1 1 1 4 2 Oesophagus – – – – – – – – 5 – 2 1 3 3 10 4 Stomach — 1 – — 1 — 3 2 2 8 11 8 — — 17 19 Pylorus — — — — — — — – 1 — – — — – 1 — Ventriculi — — – — — — 1 — 1 – 1 – – – 3 7 Large Intestines – – – – – – 3 – 2 4 8 3 4 – 17 7 Rectum — — 1 – – – – – – – – – – – 1 – Peritoneum — — – — 1 Liver – – – – – – – 1 2 5 1 1 3 2 6 9 Bile Duct – – – – – – – – 1 – – – – – 1 — Gall Bladder – – – – – – – – – – – – – 1 – 1 Pancreas – – – – – – 1 – 1 – 1 2 1– – 3 2 Kidney — — – — — — — 1 4 – – 1 – – 4 2 Bladder – – – – – – 1 – – – 1 2 – 1 2 3 Prostate — — – — — — — — 3 – 4 – 2 – 9 – Urethra – – – – – – – – – 1 – – – – – 1 Uteri – – – – – 1 — 1 — 2 – – – – – 4 Cervix — — – — — 2 2 – 3 – 4 – 1 – 12 Ovary – – – – – – – 1 – 1 – – – – – 2 Breast — — – 1 — 3 — 6 — 4 – 2 – 6 – 22 Other sites 1 – – – – – – 1 – – 1 1 2 – 4 2 Total 1 1 1 1 4 6 17 20 35 34 51 31 19 17 128 110 144 TABLE 31. NOTIFIABLE DISEASES (other than Tuberculosis) during the year 1938. Disease. 0– 1- 6- 10- 15- 20- 25- 35- 45- 55- 65- 75- 85- Males. Females. Total Cases admitted to Hospital Total Deaths Scarlet Fever 3 105 120 53 23 17 12 4 2 1 – – – 153 187 340 298 1 Smallpox – – – – – – – – – – – – – – – – – – Diphtheria 1 106 164 51 17 8 9 2 1 1 – – – 172 188 360 359 9 Memb. Croup – 1 – – – – – – – – – – – 1 – 1 1 – Enteric Fever — — — — — — 1 1 — — — — — 1 1 2 2 — Paratyphoid – – – – – – – 1 – – – – – – 1 1 1 — Puerperal Fever – – – – – – – – – – – – – – – – – – Puerperal Pyrexia — — — — — 11 11 4 — — — — — — 26 26 18 — Cerebro-Spinal Fever 1 3 1 – – 1 – – 1 – – – – 6 1 7 7 3 Measles 125 1175 711 34 6 8 10 2 — — — — — 1054 1017 2071 694 11 Whooping Cough 24 78 23 – – – – – – – – – – 58 67 125 136 2 Malaria — — — — — — 1 — 2 — — — — 3 — 3 3 — Dysentery — 11 3 1 4 1 2 1 2 1 — — — 17 9 26 20 — Epidemic Diarrhoea – – – – – – – – – – – – – – – – – – Encephalitis Lethargica — — — — — — — — — — — — — — — — — — Pneumonia 7 22 18 6 13 10 17 13 14 17 2 1 1 66 75 141 70 18 Ophthalmia Neonatorum 27 – – – – – – – – – – – – 13 14 27 18 — Erysipelas 2 1 2 1 3 4 8 13 10 13 7 5 3 30 42 72 49 1 Polio-Encephalitis – – – – – – – – – – – – – – – – – – Poliomyelitis — — 2 — 2 — — — — — — — — 4 — 4 4 — Anthrax – – – – – – – – – – – – – – – – – – Totals 190 1502 1044 146 68 60 71 41 32 33 9 6 4 1578 1628 3206 1680 45 145 DISINFECTION. The total number of disinfections of rooms during the year by the Council's disinfecting staff was 858. Of this number 764 rooms were disinfected after the occurrence of the ordinary notifiable infectious diseases, and 94 after cases of phthisis. 1,683 verminous rooms were sulphured and otherwise cleansed by the Council's staff during the year, as against 1,417 in 1937. TABLE 32. Bedding, etc., disinfected and destroyed after the occurrence of Infectious Disease during the year 1938. Articles. No. Disinfected. No. Destroyed. Beds 448 67 Palliasses 423 76 Bolsters 347 22 Pillows 1,406 90 Cushions 127 24 Blankets 1,621 13 Sheets 735 6 Quilts 746 11 Articles of Clothing, etc. 27,952 365 Books 384 — Total 34,189 674 In addition, 37¾ 1bs. of bristles were disinfected. 425 cwt. of household effects were destroyed. RECEPTION HOUSE, KING JAMES STREET. The Reception House is maintained by the Council for the temporary accommodation of persons displaced from their homes whilst disinfection and disinfestation is in progress. The total number of families housed was 4, consisting of 8 persons. 146 TABLE 33. PUBLIC HEALTH (TUBERCULOSIS) REGULATIONS, 1930. Summary of Notifications during the period from the 1st January, 1938, to the 31st December, 1938, in the Metropolitan Borough of Southwark. Age-periods Notifications on Form A. Number of Primary Notifications. Total Notifications on Form A. 0-1 1-5 5-10 10-15 15-20 20-25 25-35 35-45 45-55 55-65 65 and upw'rds Total Primary Notifications. Pulmonary Males — 1 4 2 14 13 25 25 34 30 9 157 184 ,, Females 1 3 5 3 11 19 24 7 8 5 1 87 106 Non-Pulmonary Males. — 5 4 2 4 4 6 3 — 1 2 31 38 ,, ,, Females — — 3 4 4 5 5 — 1 1 2 25 29 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. 147 TABLE 34. 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, 1938, to the 31st December, 1938, otherwise than by notification on Form A or Form B under the Public Health (Tuberculosis) Regulations, 1930. 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 — — — — — — 5 2 4 — — 11 ,, Females — — 1 — 2 3 3 1 1 — — 11 Non-pulmonary Males — — — — — — 2 — — — — 2 ,, ,, Females — — — 3 — — 1 — — — 4 148 DEATHS FROM PULMONARY TUBERCULOSIS. TABLE 35. Shewing the number of Patients who died in their own homes and the number who died away from home in Hospitals or other Institutions, 1938. 0- 1- 2- 5- 15- 25- 35- 45- 55- 65- 75- All Ages. Males. Females. Total. Number of patients who died at home — — — — 4 3 1 6 5 2 — 11 10 21 Number of patients who died in hospitals, etc. 1 1 1 1 11 17 16 28 19 5 1 69 32 101 1 1 1 1 15 20 17 34 24 7 1 80 42 122 Of the total number of deaths from Pulmonary Tuberculosis 80.1 per cent. occurred in hospitals or other institutions. 149 TABLE 36. TUBERCULOSIS. Age Periods. New Cases.* Deaths. Pulmonary. NonPulmonary. Pulmonary. NonPulmonary. 0 1 1 1 4 5 2 — 5 14 13 — 4 15 57 17 16 4 25 49 11 20 2 35 32 3 17 — 45 42 1 34 — 55 35 2 24 2 65 and upwards 10 4 8 — Total 244 56 122 12 (1) The ratio of non-notified tuberculosis deaths to total tuberculosis deaths is nil. 150 The number of notified cases and deaths for the last five years is as follows:— Notified. Deaths. 1934 339 142 1935 253 130 1936 217 126 1937 225 116 1938 244 122 The mortality rate was 0.84 per 1,000, as against 0.80 per 1,000 in 1937. 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 37. Notification Register. Pulmonabt. Non-Pulmonary. Total Cases. Males. Females. Total. Males. Females. Total. Number of cases of Tuberculosis remaining at the 31st December, 1938, on the Registers of Notifications kept by the Medical Officer of Health of the Metropolitan Borough 563 295 858 130 129 259 1117 Number of cases removed from the Register(s) during the year by reason inter alia of:— 203 120 323 50 36 86 409 (1) Withdrawal of notification 5 4 9 2 2 4 13 (2) Recovery from the disease 12 11 23 14 12 26 49 (3) Deaths 80 42 122 6 6 12 134 (4) Otherwise 106 63 169 28 16 44 213 151 Disinfection was carried out as follows:— TABLE 38. 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 13 18 10 8 9 12 7 8 9 94 WORK OF THE TUBERCULOSIS DISPENSARY. The following report has been received from Dr. E. K. Pritchard, your Clinical Tuberculosis Officer:— This report marks the end of the first complete year that the Dispensary has been working in the Health Services Department. An increase of work was noted in the last report and this was thought to be due to the improved conditions and equipment. In the year 1938 there has been a still further increase of work, in fact the number of cases sent up by General Practitioners for an opinion on chest conditions has increased almost 100 per cent. An extra session has been started on Thursday afternoons. This is intended primarily for female patients who find it inconvenient to attend during the mornings, and also to ease the pressure of work during the two evening sessions, which in the last year, have become very heavy. The times for seeing patients are now as follows:— Monday Tuesday Wednesday Thursday Saturday 9.30 a.m. to 12 noon. Tuesday 6 to 8 p.m. Thursday 3.30 to 5 p.m. and 6 to 8 p.m. Monday and Wednesday, 12 noon.—Artificial pneumothorax refills. Tuesday and Thursday, 6 to 8 p.m.—Artificial pneumothorax refills. These evening sessions are primarily intended for workers only. Saturday.—Children and contacts of school age. (Whenever possible children are seen on Saturdays for the convenience of the parents, but when necessary can be seen at any of the other sessions.) 152 In June, 1938, Dr. N. Lloyd Rusby resigned his appointment as Assistant Tuberculosis Officer and Dr. T. Penry Evans is now acting in this capacity. Home visiting of patients is carried out every Wednesday morning by Dr. Evans, but any additional cases are seen by Dr. Pritchard on other days during the week. Every effort is made to keep in close touch with the general practitioners in the Borough, and to give them every assistance in the diagnosis and treatment of their cases which are referred to the Dispensary. Dr. Pritchard continues to act as Honorary Consultant in Tuberculosis at St. Giles's Hospital, Camberwell, and attends there every Friday morning and is in this way enabled to keep in touch with the Southwark patients in the Hospital. DIAGNOSIS. In most cases new patients are referred to the Dispensary for an opinion by their own Doctors, but sometimes patients present themselves for examination on their own initiative. The examination of contacts is a further source of new patients and in every case the examination of contacts is as thorough as that of a new case. Early diagnosis of tubercular troubles is important if the results of treatment are to be successful. 522 patients were sent up by general practitioners for an opinion during the year. During this, the third year of its installation, the X-Ray plant has given even more useful service, and it is felt that the X-Ray plant has done a great deal towards the Dispensary now being recognised as the diagnostic centre for chest conditions in this Borough. The examination of sputum is carried out by the Public Analyst as it has been done in the past, and the number of examinations made have been 730. Of this total 176 were positive and 554 were negative. In addition to the usual physical examination which is carried out in every case, tuberculin skin tests are employed in the examination of children. The Mantoux Test is performed by an intradermal injection of a solution into the forearm which produces a mild local reaction in a case which has been infected with the tubercle bacillus. It must be emphasised that infection with the tubercle bacillus does not necessarily mean that the patient is suffering from tuberculosis as it has been proved 153 that nearly every town dweller has been infected with this bacillus by the time he attains adult age. It will be seen, however, that this test provides valuable information in the case of children who present symptoms which might be ascribed to tuberculosis. The younger a patient with a positive reaction the more importance can be attached to it. A Mantoux reaction can vary in degree and sometimes may give an indication of the efficiency or otherwise of the isolation of the infectious patient in the home. During the last year the Vollmer Patch Test has also been employed with very encouraging results. This has the advantage that a needle puncture is unnecessary and, probably for this reason, has proved quite popular with the children. During the year 16 Mantoux and Vollmer Patch Tests have been carried out. X-RAY DEPARTMENT. When the Dispensary moved to the Health Services Department in August, 1937, the X-Ray plant which was installed in February, 1936, was transferred to the new building. In the process of reassembling, the whole apparatus was inspected and was found to be in excellent condition, and there was no need for any repairs beyond the usual service. An X-Ray photograph is taken of every case, even if it has been referred to us already diagnosed and there is no doubt these photographic records of cases will be of great value in subsequent years when patients return for Dispensary supervision after sanatorium treatment. Every adult and adolescent contact is screened and if necessary a confirmatory photograph is taken. Younger children are always X-Rayed should there be any indication for it. The progress of patients who are having Artificial Pneumothorax refills (which will be explained later) is also checked by frequent screen examination. In fact it would be highly undesirable to carry out this treatment at the Dispensary without convenient access to an X-Ray plant. We have also acquired a small attachment for the existing X-Ray tube which makes it possible to do Dental X-Ray, and this proves of considerable help to the Dental Officer. 1,288 patients have been screened and 852 photographs taken during the year. 154 INSTITUTIONAL TREATMENT. The London County Council is responsible for all Institutional treatment of patients suffering from tuberculosis, and all patients so suffering spend some of their time in a Hospital or Sanatorium during the course of their disease. The Dispensary acts as a Clearing Station and is responsible for recommending patients to the L.C.C. at the appropriate time. In August, 1934, the L.C.C. decided that all Institutional treatment for tuberculous patients for whom they were responsible should not be subjected to any payment whatever on the part of the patient or his family. The object being that the financial strain of payment in some cases might hinder the patient's recovery by preventing adequate supplies of necessary nourishment. In certain cases it is necessary for the patients to undergo a period of observation in a Special Hospital for Diseases of the Chest before a final diagnosis can be made. Such patients are usually sent to Brompton Hospital. This Hospital also accepts early cases of tuberculosis, and cases requiring specialised surgical treatment. High Wood Hospital admits children for observation and diagnosis and definite casts cf Pulmonary Tuberculosis. The great majority of cases are sent to Sanatorium as soon as a diagnosis is completed. Sanatorium routine is the mainstay of all treatment of tuberculosis and of great educational value after the patient's discharge as he has then been taught the mode of life which gives him the best chance of maintaining the improvement in his health which he has gained while being away. General Hospital treatment is usually advised for those patients whose condition is so acute or advanced that removal to a sanatorium is inadvisable, but it must be remembered that many of these patients improve so much after a few months in a general hospital that they are subsequently transferred to a sanatorium. General Hospitals also accept chronic cases who are not expected to benefit from a further period of Sanatorium treatment. Another type of Institutional treatment is the Sanatorium Colony— Papworth near Cambridge, Preston Hall near Maidstone. Papworth takes both male and female adult patients, and Preston Hall takes male patients only. After a suitable period of Sanatorium routine the patients are trained in various spheres of useful work, e.g., Cabinet Making, Gardening, Poultry Farming, Leather Work of all kinds and Printing, etc., and the patients are paid for the work they do. 155 Suitable cases are allowed to "Colonise," that is to say, they make the Colony their home, and if married they are given adequate accommodation for their families. Burrow Hill Colony, near Frimley, trains male adolescents between the ages of 13 and 19. They specialise in two distinct courses of training— (1) Clerical; (2) Horticultural. These patients may be kept in the Colony for a period of up to two years and on their discharge, after a complete course of training, should be fitted both physically and economically to take their place in the outside world. The following cases were recommended to the London County Council for Institutional treatment during the year:— Adults. Under 15 years. Hospital for Observation 18 10 Sanatorium 177 21 Hospital 59 7 Convalescence 3 5 Open Air School — 18 SPECIAL TREATMENTS. For many years the treatment of tuberculosis consisted of rest, good food and fresh air. Some 35 years ago an additional principle of treatment was introduced, based on the theory of auto-inoculation. After an initial period of rest patients were put on gradually increasing amounts of exercise and work, the aim being for the patients progressively to immunise themselves against the increasing amounts of poisons liberated by the tuberculous lesion in the course of graduated exercise. In the last 20 years, further advances have been made by the application of surgical treatment of lung disease; and by this means to the principle of rest to the body as a whole, is added the method of rest to the diseased part. This process, collectively called collapse therapy, may be attained in several different ways. The most widely used of these operations is that known as Artificial Pneumothorax which consists of introducing a cushion of air between the lung and the chest wall. This operation has the merit of being simple and practically painless, but the air has to be replaced at intervals owing to its gradual absorption. Since the installation of the X-Ray plant in the Dispensary it has been possible to carry out these refills on the premises, thus saving the patient the inconvenience of attending both the Dispensary for supervision and a Hospital for refills. During 1938, 910 refills have been given to 57 patients. Treatment by the injection of Gold Salts in selected cases gives good results and usually reduces the amount and infectivity of the sputum. Injections are given once each week. 287 injections of Gold have been given to 10 selected patients at the Dispensary with most satisfactory and encouraging results. 156 NON-PULMONARY TUBERCULOSIS. All cases of Surgical Tuberculosis, such as Tuberculosis of Bones, Joints and Glands, are sent by the London County Council to special Sanatoria which deal only with this type of case. On the completion of the Sanatorium treatment, arrangements are made for patients to attend at an Orthopaedic Department of a General Hospital at frequent intervals, or at the After-Care Clinic held at the County Hall, by the Medical Superintendent of the Sanatorium at which their treatment was obtained. Cases requiring Actinotherapy are now referred for treatment in the Solarium of the Health Services Department, instead of being sent to General Hospitals as in the past. This scheme has the advantage that it is more convenient for the Tuberculosis Officer to maintain supervision over these patients. OCCUPATIONAL THERAPY. Occupational therapy may be included amongst special treatment for tuberculous patients who are not yet well enough to resume their ordinary work. The object is to give them some outside interest by training them in a useful hobby. For this purpose the Handicraft Class was commenced at the Dispensary a few years ago. The class is held each Tuesday afternoon and each Friday morning, under the tuition of an Instructress from the L.C.C. At the end of 1938, there were 18 patients on the Class Register, with an average weekly attendance of 16. The Woodwork Class, started in September, 1937, has made great strides during the past year and is held each Thursday evening. The voluntary instructor continues to give his services, and under his enthusiastic instruction the men are now turning out most excellent work and we are able to put on our sale market serviceable, decorative and useful pieces of furniture. The men themselves find the work extremely fascinating and the results from a psychological point of view are entirely satisfactory. In the latter part of the year another class was started for making Christmas crackers. The patients worked well and enjoyed this type of employment. Very creditable results were produced, the sales of which were most encouraging. 157 DENTAL TREATMENT. The arrangements with the British Dental Hospital continue to prove very satisfactory and Mr. G. E. King Turner, L.D.S., H.D.D., L.M.S.S. A., attends the Clinic every Monday afternoon. The Tuberculosis Officers recommend the patients for attendance at the Clinic. 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 and the remainder by the person concerned. If the patient is unable to afford anything towards dentures or does not belong to any Society under the National Health Insurance Act, the cost is met either in part or whole by some charitable organisation or by the Borough Council. The average attendance at each session is between 12 to 15 patients, and it has been found in many cases that patients who have steadfastly refused necessary dental treatment for years, now attend willingly at the Dispensary Dental Clinic. During the year there have been 567 attendances at the Clinic and the dental work done includes—Extractions, Gas Administrations, Fillings, Scalings and Dentures. Thursday evening sessions, once a month, have been started for working patients. EXTRA NOURISHMENT. Under the Ministry of Health Regulations, extra nourishment can be supplied at the expense of the Borough to patients attending the Dispensary who are unable to afford necessary nourishing food. This scheme is employed for patients who are waiting a Sanatorium vacancy and also to tide them over the difficult period between their discharge from Sanatorium and their return to work, but in the case of patients who are in receipt of Public Assistance no call is made upon the Borough funds, but recommendations are made to the Public Assistance Committee by the Tuberculosis Officers for the supply of extra food in necessitous cases, and there is no doubt that patients greatly benefit by this scheme. 119 patients have been granted extra nourishment at the expense of the Borough. 158 Both the Public Assistance Committee and the Unemployment Assistance Board have been most helpful in this respect and the Invalid Kitchens have also given much generous help to any patients who have been recommended to them from the Dispensary. 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. CONTACTS. A most essential part of the Dispensary work is aimed at the prevention of the spread of the disease. It is well known that tuberculosis is characterised by an extremely insidious onset and some patients have obviously suffered for a long period from the disease before they considered their symptoms serious enough to justify their consulting a Doctor. During this time these patients may have been unconsciously infecting their children and relatives. In the hopes of finding such cases, wherever possible the contacts of a known case of tuberculosis are examined both physically and radiologically at the Dispensary. Amongst the contacts examined last year we found 24 suffering from Tuberculosis and there is every reason to believe that some of these positive cases although examined as contacts were actually the primary infector in the family. 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. The L.C.C. also provides for the Boarding-out Scheme for child contacts of infectious tuberculous patients when it is considered that they are in danger of contracting the disease and also when the mother of the family is found to be suffering from tuberculosis and is having Sanatorium treatment and no other provision can be made for the care of the children. It is felt that this boarding-out of contacts is of great value in preventing the spread of tuberculosis amongst children and wherever possible the parents are encouraged to avail themselves of this scheme. As in the case of Institutional treatment for tuberculous patients the L.C.C. do not require any payment. The actual housing of the children while they are away from home is arranged through the Invalid Children's Aid Association. 159 This Association is also most helpful in arranging for Convalescent Treatment for children in a poor state of health, but not suffering from any form of tuberculosis, who come to the notice of the Dispensary. In certain cases the L.C.C. arranges for child contacts of infectious patients to be educated in one of the Open-Air Schools as it is felt that closer general supervision at such a school may help to prevent the child falling a victim to tuberculosis. This is an additional function of the Open-Air Schools which were primarily intended for cases of quiesccnt tuberculosis. During the year 16 children were recommended to the London County Council for Boarding-out under the "Contact Scheme." 7 contact children were recommended to the Invalid Children's Aid Association for Convalescence. SUPERVISION OF HOME CONDITIONS. At the beginning of the year the system of tuberculosis home visiting was re-organised. In the past the staff of the Dispensary included three tuberculosis nurses amongst whose duties was the home visiting of all notified cases of tuberculosis occurring in the Borough. Under the present system there is only one dispensary nurse who is in attendance at each Clinic. The home visiting is carried out by the Health Visitors and by this means reduplication of visiting at any one home is avoided. Reports of all home visits to tuberculosis patients are handed in to the Dispensary and records of all such visits are kept by the whole-time dispensary nurse. 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 are subjected as little as possible to infection. At the same time when the patient is 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. It is also the duty of the visiting nurses to encourage the other members of the family to present themselves at the Dispensary as "Contacts" and to a great extent the necessary attendances of contacts at the Dispensary is dependent on these tactful approaches by the Nurses. During the year 3,084 such visits were paid. 160 The Ranyard Nursing Association, the Benson Nursing Association and the Institute of Trained Nurses of Our Lady of Consolation, 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. In the case of patients whose homes have suitable 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. Owing to the district being thickly populated, however, the use of Shelters cannot very often be employed. 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. TUBERCULOSIS CARE COMMITTEE. The objects and aims of the Tuberculosis Care Committee were fully reported in my Annual Report for 1937. During the year a considerable amount of valuable work has been done for the benefit of Southwark tuberculous patients and their dependants, and I should again like to express my thanks to the following organisations for their very valuable assistance in providing help in this work:— The Charity Organisation Society, Soldiers' and Sailors' Help Society, British Legion and United Services Fund, Red Cross Emergency Committee, Friends of the Poor, Invalid Kitchens for London, Society of St. Patrick, Musicians' Benevolent Fund. Rockingham Estate Office, and the following Regimental Societies Royal Air Force, Royal Lancashire Regiment, Wiltshire Regiment Benevolent Fund, Shropshire Regiment, and several individuals. In addition my thanks are due to the Public Assistance Committee for the courteous attention which it has given to the cases referred to them. 161 TABLE 39. Return for the year 1938. (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):— (o) Definitely tuberculous 82 36 3 6 10 11 6 3 92 47 9 9 157 (ft) Diagnosis not completed 31 30 6 — 1 — 6 4 32 30 12 4 78 (e) Non-tuberculous 195 153 11 17 — — 1 2 195 153 12 19 379 B.—Contacts examined during the year:— (a) Definitely tuberculous 7 4 7 4 1 — 1 — 8 4 8 4 24 (6) Diagnosis not completed 4 11 4 8 — — — — 4 11 4 8 27 (<•) Non-tuberculous 62 79 70 57 — — — — 62 79 70 57 268 C.—Cases written of! the Dispensary Register as:— (a) Recovered 1 4 1 — 2 1 7 5 3 5 8 5 21 (6) Non-tuberoulous (including any such cases previously diagnosed and entered on the Dispensary Register as tuberculous) 258 232 82 74 — 2 1 3 258 234 83 77 652 D.—Number of Cases on Dispensary Register on December 31st:— (a) Definitely tuberculous .. 310 163 39 41 21 29 11 12 331 192 50 53 626 (6) Diagnosis not completed 35 41 10 8 1 — 6 4 36 41 16 12 105 1. Number of cases on Dispensary Register on January 1st 634 2. Number of cases transferred from other areas and cases returned after discharge under Head 3 in previous years 53 3. Number of oases transferred to other areas, cases not desiring further assistance under the scheme, and cases "lost sight of" 143 4. Cases written off during the year as Dead (all causes) .. 73 6. Number of attendances at the Dispensary (including Contacts) 5798 6. Number of Insured Persons under Domiciliary Treatment on the 31st December 30 7. Number of consultations with medical practitioners:— 8. Number of visits by Tuberculosis Officers to homes (including personal consultations) 118 (a) Personal 53 (ft) Other 522 9. Number of visits by Nurses or Health Visitors to homes for Dispensary purposes 2792 10. Number of:— (a) Specimens of sputum, etc., examined (ft) X-ray examinations made in connection with Dispensary work. 746 2140 11. Number of "Recovered" cases restored to Dispensary Register, and included in A (a) and A (ft) above 4 12. Number of "T.B. plus" cases on Dispensary Register on Decern ber 31st 324 (B) Number of Dispensaries for the treatment of Tuberculosis (exoluding centres used only for special forms of treatment). Provided by the Council—One. INDEX A. Abatement of Overcrowding 61-67, 77 Acute Influenzal Pneumonia 141 ,, Primary Pneumonia 141 Agricultural Produce (Grading and Marking) Act, 1926 84 Ambulance Services 23 Analysis of Port Sanitary Samples 87-107 Ante-Natal Clinics 32 Anthrax 141, 144 Area of Borough 7 Artificial Cream Act, 1929 127 B. Bacon Stoves 84 Bacteriological Specimens 23 Bakehouses 126 Bed Bugs, Eradication of 55 Birth Rates 8, 9 Births 9, 10 ,, Illegitimate 8 Blind Persons Act, 1920 142 Brushmakers 50 Butchers' Shops 81 C. Cancer 143 Carcases Inspected and Condemned 83 Census, 1931 8 Cerebro-spinal Fever 141, 144 Chemical and Bateriological Examinations 23 Child Life Protection 28, 29 Clinics 30-32 Common Lodging Houses 41, 42 Consultants 26 Convalescent Treatment 28 Coroners' Court 57 Country Holiday Fund 26 D. Dairies 121 Day Nurseries 26 Death Rates 8, 14 Deaths 11 Deaths, Causes of, Table 2 ,, Infants 13, 14 ii Deaths in Public Institutions 16 ,, in Wards 17 ,, Zymotic Mortality 18 Dental Clinic 33 Dental Treatment 156 Diarrhoea 141, 144 Dinners for Necessitous Mothers 28 Diphtheria 138, 144 ,, Prevention 139 ,, Schick Test 140 Disinfection 145 Disposal of Unsound Food 108-119 Dressmakers, Milliners, etc. 50 E. Eating Houses 82 Encephalitis Lethargica 141, 144 Enteric Fever 138, 144 Eradication of Bed Bugs 55 F. Factories Act, 1937 48-51 Fish Curers Premises 82 Food and Drugs, Tables of Samples 130-133 Food Inspection and Tables 81-133 Fried Fish Premises 82 c. General Hospitals 33 Gynaecological Clinic 32 H. Health Services Department 30 Health Services, Hospitals, Etc. 21-38 Health Visiting 34-35 Health Visitors, Summary 36 Home Helps 26 Home Nursing 25 Home Workers 50 Housing 61-78 I. Ice Cream 81, 83 Imported Food Regulations 84-87 Infant Mortality 10, 13, 14, 25 ,, ,, of Illegitimates 8 ,, Test Feeding Clinic 33 I iii Infectious Diseases, Control of 137-161 Influenza 141 Informal Samples 132 Inhabited Dwellings 7 Institutional Treatment of Tuberculosis 154 L. Laboratory Facilities 23 Legal Proceedings 44, 129 M. Maternal Mortality 8, 25 Maternity and Child Welfare 24-38 Measles 138-144 " Merchandise Marks " Act, 1926 84 Milk and Dairies (Amendment) Act, 1922 121 Milk (Special Designations) Order, 1936 121-125 Milksellers 121 Mortality Statistics 8, 10-18 Mortuary 57 Municipal Day Nursery 26 N. Notice Served 43 Notifiable Diseases 144 Notified Births 37 Nursing in the Home 23 0. Occupational Therapy 156 Offensive Trades 126 Ophthalmia Neonatorum 142, 144 Outlying Deaths 11 Overcrowding 61-67, 77 P. Part-time Officers 22 Phosphatase Examinations 125 Poisons and Pharmacy Act, 1933 128 Poliomyelitis 141, 144 Population 7, 8 Preservatives in Food Regulations 87-107 Puerperal Fever 25 ,, Pyrexia 25 ,, Sepsis, Deaths 12 Public Baths 41 iv Public Cleansing 41 Public Health (Imported Food) Regulations, 1937 84-87 ,, ,, (London) Act, 1936 Sec. 224 46 „ „ „ „ „ Sec. 187 81 „ „ „ „ „ Sec. 136 45-46 „ „ „ „ „Sec. 95 47-48 ,, ,, ,, „ „ Sec. 96 48 ,, ,, Officers 21 ,, ,, (Preservatives in Food) Regulations, 1925 87-107 „ Houses 127 ,, Vaccinators 22 R. Rag, Flock 45-46 Rateable Value 7 Rats and Mice (Destruction) Act 52-54 Reception House 145 Registered Births and Deaths 15 ,, Factories 49 Review of Housing Activities 68 S. Sale of Foods and Drugs Acts 129-133 Scabies 56 Scarlet Fever 137, 144 Schick Test and Inoculation against Diphtheria 139, 140 Sewing Classes 28 Shops Act 42 Slaughterhouses 81 Smallpox 137, 144 Smoke Abatement 42 Southwark Invalid Kitchens Society 28 Sputum, Examination of 23 Statistics and Social Conditions 7-18 Still Births 8 Sunlight Treatment 27 Swimming Bath Water 41 T. Tailoring 50 Toddlers' Clinic 26 Tuberculin Tested Milk, Report 122-124 Tuberculosis 146-161 ,, Care Committee 160 U. Underground Bakehouses 68 Unsound Food 108-119 ▼ V. Vaccination Officers 23 ,, Officers' Return 38 Verminous Persons and Children 55, 56 ,, Rooms and Bedding 55 Vital Statistics, Summary of 8 ,, „ Table 17 W. Water Supply 47-48 Whooping Cough 142, 144 Works Completed 43 X. X-ray Department 153 Z. Zymotic Mortality 18