Ac 4353 Public Health Dept. REPORTS COLLECTION COPY STMARY 55 BOROUGH OF ST. MARYLEBONE REPORT of the MEDICAL OFFICER OF HEALTH FOR THE YEAR 1950 H. A. BULMAN, M.R.C.S., D.P.H. London: Vail & Co., Ltd. 170 Farringdon Road, E.C.1 2 CONTENTS page Members of the Public Health Committee 4 Section A—Statistics and Social Conditions:— General Statistics Extracts from Vital Statistics 4 Maternal Mortality 4 Marriages 4 Deaths 4 Infantile Mortality 6 Mortuary 6 Crematorium 6 Section B—General Provision of Health Services:— Staff 6 Staff Medical Examinations 6 Laboratory Facilities 6 Representation upon other Bodies 6 Financial Contributions to Voluntary Organisations 7 Conferences 7 Care of Old People 7 Special Laundry Service 7 St. Marylebone Old People's Welfare Association 8 Section C —Sanitary Circumstances:— Sanitary Inspection 8 Nuisances Detected and Remedied 9 Sanitary Accommodation at Public Houses 9 Water 9 Drainage 10 Combined Drainage 10 Building Licences 10 Public Conveniences 10 Public Cleansing and Salvage 10 Shops 10 Diseased or Infirm Persons 10 Burial or Cremation of the Dead 10 Disinfestation 11 Verminous Persons 11 Shelter 11 Rodent Control 11 Dog Nuisance 11 Pigeons 11 Mosquitoes 11 Noise 11 Atmospheric Pollution 12 Poisons 12 Factories 12 Inspections and Defects Found 12 Out-workers 13 Outwork in Unwholesome Premises 13 Industrial Health Service 13 Methylated Spirit Drinking 13 PAGE Section D—Housing:— Permanent Schemes 14 Fisherton Street Housing Estate 15 Requisitioned Premises and Factory-made Bungalows 15 "Half-Way" Houses 15 St. Marylebone Housing Trust 15 Inspection of Dwelling-houses 15 Underground Rooms 15 Re-housing 15 Slum Clearance 15 Common Lodging Houses 15 Rent Restrictions Acts 16 Section E—Food:— Clean Food Campaign 16 Food and Drugs Analysis 16 Milk 18 Butter and Margarine Premises 18 Ice-Cream 18 Preserved Food 19 Fried Fish Vendors and Fish Curers 19 Bakehouses 19 Restaurants, etc. 19 Horseflesh 19 Slaughter of Animals 19 Unsound Food 20 Section F—Infectious and other Diseases:— Notifications 20 International Certificates of Vaccination and Inoculation 20 Smallpox 20 Undulant Fever 21 Food Poisoning Outbreaks 21 Tuberculosis:— New Cases and Mortality 21 Notifications 21 Mass Miniature Radiography 22 Venereal Diseases 22 Scabies 22 Impetigo 22 Disinfection 22 Bacteriological Examinations 22 Appendix — St. Marylebone Clean Food Association:— Articles of Association 23 Code of Practice 24 3 Public Health Department, Town Hall, St. Marylebone, W.l. To the Mayor, Aldermen and Councillors of the Metropolitan Borough of St. Marylebone. Mr. Mayor, my Lord, Ladies and Gentlemen, Health conditions generally in the Borough continued to be satisfactory throughout the year 1950, and there are no untoward happenings to record in this respect. The home population of 78,260, as estimated by the Registrar-General, was fewer by 1,550 than the estimate (79,810) for 1949. (Page 4) The birth-rate dropped still further from 11.44 (1949) to 10.99, and the infantile mortality rate of 22.09 reached a new record low level. The death-rate of 11.64 also was lower than the 1949 figure (12.00). (Page 4) The revised mortality table, based upon the new international classification of death causes, is used in this report for the first time. (Page 4) Notifications of infectious and other diseases declined from 851 (1949) to 749, of which measles accounted for 323 and whooping cough 170. Seven cases of poliomyelitis were reported, but again there was no case of diphtheria. (Page 20) Methylated spirit drinking was suspected to be on the increase, more particularly in a common lodging house for men, and an investigation into the practice and its effects formed the subject of a report to the Public Health Committee. (Page 13) In anticipation of future slum clearance and housing development programmes, a further survey of the Borough was completed in the early part of the year. (Page 15) With its numerous restaurants and other eating-places, one of the Borough's largest industries is catering. Food hygiene, therefore, received special attention and the formation of the St. Marylebone Clean Food Association, upon which the Borough Council is represented, proved a valuable aid in the campaign to secure improved conditions in the preparation and handling of food. (Page 16) The majority of the 1,700 factories in St. Marylebone are engaged in the making of wearing apparel. A survey of all such premises, commenced towards the end of 1949, was practically completed during the year and resulted in the service of over 400 notices calling for the remedy of defective conditions. (Page 12) Rodent control measures were extended, more especially in an endeavour to combat the menace of the black rat, and "block control" in the eastern part of the Borough was continued on a larger scale. In the majority of infestations the owners or occupiers of the premises involved took advantage of the rodent destruction service provided by the Council. In this connection the charge previously made for treatment at residential properties was abolished and a free service provided as from the 1st June, 1950. A charge continues to be payable in respect of business premises. (Page 11) Much useful work in the care of old people was again carried out by the Department, while the local Old People's Welfare Association also reported a year of great activity in various directions with new services planned for 1951. (Page 7) My grateful thanks are due to the Chairman (Councillor Captain Robert Whitney, M.B.E., J.P.) and members of the Public Health Committee for the consideration and encouragement they gave me throughout the year. To the staff my obligations are too numerous to mention individually, but to all members I acknowledge my great indebtedness for their continued loyalty and support in the public health work of the Borough. I am, Mr. Mayor, my Lord, Ladies and Gentlemen, Your obedient Servant, H. A. BULMAN, Medical Officer of Health. 4 PUBLIC HEALTH COMMITTEE. 1950. HIS WORSHIP THE MAYOR: Councillor Charles Henry Press, J.P. COUNCILLORS: T. K. Creamer. Stafford Lorie. Frederick Frame. The Hon. Mildred Lowther, O.B.E. Herbert C. Garrard. The Rt. Hon. Lord Mancroft, M.B.E., T.D. (Vice-Chairman). R. T. Glenny. Mrs. Angus Maude. B. Hawley. B. J. Owen (until May). Mrs. Henderson-Begg. Miss L. West Russell. J. P. Honour. Capt. Robert Whitney, M.B.E., J.P. (Chairman). Dr. Elizabeth Jacobs. Elliott Levy (from October). SECTION A.—STATISTICS AND SOCIAL CONDITIONS. GENERAL STATISTICS. Area of Borough: (a) excluding area covered by water, 1,427.8 acres; (b) including area covered by water, 1,473 acres. Rateable value of the Borough: £3,418,690. Sum represented by a penny rate: £13,549. Number of residential units (separate assessments): 22,579. Resident population: 1921 census—104,173; 1931 census—97,627. Registrar-General's estimate of the home population (which includes members of the armed forces stationed in the area and is used in calculating various rates in this report): 1950—78,260. EXTRACTS FROM VITAL STATISTICS. Total M. F. Live Births- Legitimate 743 392 351 Birth Rate per 1,000 estimated civilian population 10.99 Illegitimate 117 58 59 Stillbirths— Legitimate 14 4 10 Rate per 1,000 total (live and still) births 19.39 Illegitimate 3 3 - Deaths (all ages) 911 453 458 Death Rate per 1,000 estimated civilian population 11.64 Deaths. Rate per 1,000 total (live and still) births. Maternal Mortality—Deaths from "Pregnancy, Childbirth, Abortion" (Registrar-General's Code No. 30) 1 1.13 Total M. F. Deaths of Infants under one year of age— Legitimate 16 7 9 Illegitimate 3 1 2 Death Rate of Infants under one year of age—All infants per 1,000 live births, 22.09; legitimate infants per 1,000 legitimate live births, 21.53; illegitimate infants per 1,000 illegitimate live births, 25.64. Marriages.—The total number of marriages was 1,439, being 22 below the number for 1949 and 55 above the average for the previous 10 years. The rate for persons married in 1950 was 37 per 1,000 of the estimated civilian population. Deaths.—The deaths given in Table I are classified under the 36 headings based on the Abbreviated List of the International Statistical Classification of Diseases, Injuries and Causes of Death, 1948, which came into use for this purpose as from the 1st January, 1950. The new classification differs in many respects from that previously employed, which was based upon the International Classification of 1938, and it is to be noted, for example, that "typhoid and paratyphoid fevers," "scarlet fever," "polioencephalitis" and "acute infective encephalitis" have been removed from the Table. These diseases are now included under the group "other infective and parasitic diseases" (No. 9 in the Table). Amongst other diseases and conditions which no longer appear in the Table are "diarrhoea (under 2 years of age)" and "other digestive diseases," now included under "gastritis, enteritis 5 and diarrhoea" (No. 27); "appendicitis," and "premature birth," now included under "other defined and ill-defined diseases" (No. 32) or, in the case of "premature birth," in certain instances under "congenital malformations" (No. 31). Causes of death now specially listed which were not previously mentioned separately are "malignant neoplasm, lung, bronchus" (No. 11); "leukaemia, aleukaemia" (No. 15); "coronary disease, angina" (No. 18); "hypertension with heart disease" (No. 19); "hyperplasia of prostate" (No. 29); and "homicide and operations of war" (No. 36). It may be explained that the total number of deaths (911) shown in the Table is inclusive of persons who, though normally resident in the Borough, died elsewhere in England and Wales, but exclusive of persons who, though they died in St. Marylebone, were ordinarily resident in other parts of England or Wales. Deaths of persons ordinarily resident outside the borders of England and Wales are included in the St. Marylebone figures if they occur in the Borough as also are those of members of the armed forces who were stationed in the area. TABLE 1.—Deaths—According to Age-Group and Sex. Code No. CAUSE OF DEATH Net Deaths at the Sub-joined Ages of Residents (Male and Female) whether occurring within or without the Borough. All Ages Under 1 year 1 and under 5 5 and under 15 15 and under 45 45 and under 65 65 and upwards M. F. M. F. M. F. M. F. M. F. M. F. M. F. 1 Tuberculosis, respiratory 18 2 - - - - - - 4 - 6 1 8 1 2 Tuberculosis, other 1 - - - - - - - - - 1 - - - 3- Syphilitic disease 3 2 - - - - - - - - - - 3 2 4 Diphtheria - - - - - - - - - - - - - - 5 Whooping cough — 1 — 1 - — — — - — - — — — 6 Meningococcal infections - - - - - - - - - - - - - - 7 Acute poliomyelitis - - - - - - - - - - - - - - 8 Measles - - - - - - - - - - - - - - 9 Other infective and parasitic diseases 1 2 — 1 — — — — — 1 1 — — — 10 Malignant neoplasm, stomach 12 9 - - - - - - 1 — 5 1 6 8 11 Malignant neoplasm, lung, bronchus 36 9 - - - - - - 3 — 24 5 9 4 12 Malignant neoplasm, breast — 15 — — — — — — — 1 — 5 — 9 13 Malignant neoplasm, uterus — 10 — — — — — — — 1 — 4 — 5 14 Other malignant and lymphatic neoplasms 54 30 - - - 1 - - 4 1 18 12 32 16 15 Leukaemia, aleukaemia 3 1 - - — — — — 1 — 1 — 1 1 16 Diabetes — 2 - - - - - - - - - 1 - 1 17 Vascular lesions of nervous system 31 66 - - - - - - 1 2 10 10 20 54 18 Coronary disease, angina 85 65 - - - - - - 3 1 29 14 53 50 19 Hypertension with heart disease 17 27 - - - - - - - - 4 8 13 19 20 Other heart disease 47 79 - - - - - - 2 2 4 7 41 70 21 Other circulatory disease 18 24 - - - - - - - - 3 2 15 22 22 Influenza — 1 - — — — — - - 1 — — — — 23 Pneumonia 13 19 2 2 1 — — — 1 1 2 2 7 14 24 Bronchitis 26 12 - - - - - - - - 13 3 13 9 25 Other diseases of respiratory system 1 5 — 1 - - - - - - - - 1 4 26 Ulcer of stomach and duodenum 10 4 - - - - - - 1 — 2 — 7 4 27 Gastritis, enteritis and diarrhoea 3 4 1 1 - - - - - 1 1 1 1 1 28 Nephritis and nephrosis 4 6 - - - - - - - 1 1 — 3 5 29 Hyperplasia of prostate 4 — — — - — — — — — 1 — 3 — 30 Pregnancy, childbirth, abortion — 1 - - - - - - - 1 - - - - 31 Congenital malformations 6 1 — — — — 1 — 3 — 1 1 1 — 32 Other defined and ill-defined diseases 38 32 5 5 — — — — 4 4 6 10 23 13 33 Motor vehicle accidents 7 4 - - - - - - 2 1 2 1 3 2 34 All other accidents 11 15 - - - - - 2 3 1 3 3 5 9 35 Suicide 4 9 - - - - - - - 4 2 3 2 2 36 Homicide and operations of war — 1 - - - - - - - - - 1 - - Totals 453 458 8 11 1 1 1 2 33 24 140 95 270 325 911 19 2 3 57 235 595 6 TABLE 2.—Infantile Mortality—According to Age-Group and Sex. CAUSE OF DEATH Under 1 week 1 and under 2 weeks 2 and under 4 weeks 1 and under 3 months 3 and under 6 months 6 and under 9 months 9 and under 12 months Total M. F. M. F. M. F. M. F. M. F. M. F. M. F. M. F. Whooping cough - - - - - - - - - - - 1 - - - 1 Diarrhoea and enteritis - - - - - - - - - - - 1 1 — 1 1 Premature birth 3 2 - - - - - - - - - - - - 3 2 Atelectasis 2 2 - - - - - - - - - - - - 2 2 Meningitis - - - - - - - 1 — - - - - - - 1 Pneumonia - - - - - - 1 1 1 1 - — - — 2 2 Other causes — 1 - - - - - - - 1 - - - - - 2 Totals 5 5 - - — — 1 2 1 2 — 2 1 - 8 11 10 - — 3 3 2 1 19 No infantile death occurred from the following causes not shown in the table: Small-pox, chicken-pox, measles, scarlet fever, diphtheria and membranous croup, tuberculous meningitis, abdominal tuberculosis, other tuberculous diseases, congenital malformation, atrophy, debility and marasmus, injury at birth, erysipelas, syphilis, rickets, convulsions, gastritis, laryngitis, bronchitis, suffocation, overlying. Mortuary.—Three bodies (all male) were received at the Public Mortuary, Chiltern Street. No postmortem examinations were carried out. Crematorium.—The Medical Officer of Health is Medical Referee in connection with the Council's Crematorium, situated in the St. Marylebone Cemetery at East Finchley. During 1950, 759 certificates authorising cremation were issued, as compared with 669 certificates in 1949, and 360 in 1948. There is every indication that the number of cremations will continue to increase. SECTION B.—GENERAL PROVISION OF HEALTH SERVICES. Staff.—Several changes in the sanitary inspectorial and clerical staffs took place during the year. Mr. R. H. W. Howard filled a vacancy for a district sanitary inspector and commenced duty in the Department on the 13th February, 1950. Mr. V. A. Bignell, a district sanitary inspector, was transferred on the 1st June, 1950, to a vacancy in the position of drainage inspector caused by the untimely death, on the 17th May, 1950, of Mr. H. E. P. Corline, who had rendered devoted service to the Council for 19 years. The consequent vacancy in the staff of district sanitary inspectors was filled by Mr. R. C. Lillis, who commenced duty on the 18th September, 1950. Miss E. L. Turbayne and Miss J. M. Evans resigned their appointments as shorthand-typists on the 2nd April, 1950, and 4th June, 1950, respectively, and they were succeeded by Miss M. L. Shaul and Miss C. A. Cruickshank, who both commenced duty on the 17th July, 1950. Mr. P. C. Bedward, a general division officer, returned to duty in the Department on the 20th March, 1950, on completion of military service. Staff Medical Examinations.—The Medical Officer of Health is the Council's medical adviser for the purposes of the superannuation scheme. During 1950, 96 examinations of members of the staff and new entrants were carried out. Laboratory Facilities.—Dr. C. J. C. Britton is the Council's Bacteriologist and the work is carried out at No. 35, Harley Street, W.l. Mr. Thomas McLachlan, A.C.G.F.C., F.R.I.C., whose laboratory is situated at No. 4, Hanway Place, W.l, is the Public Analyst for the Borough. Representation upon other Bodies.—The Council were represented upon the under-mentioned statutory and voluntary bodies as indicated:— Body. London County Council Divisional Health Committee (Division 2). London County Council Divisional Tuberculosis Care Committee (Division 2). St. Marylebone Chest Clinic. Representatives. The Chairman of the Public Health Committee (until February). Councillor H. C. Garrard (from March). Councillor Dr. Elizabeth Jacobs. Councillor Miss L. West Russell. The Medical Officer of Health. Councillor F. Frame. 7 Body. West End Hospital for Nervous Diseases. Samaritan Hospital—House Committee. National Smoke Abatement Society. London and Home Counties Smoke Abatement Advisory Council. Paddington & St. Marylebone District Nursing Association (Executive Committee). St. Marylebone Youth Centre Committee (Management Committee). St. Marylebone Clean Food Association. Representatives. Councillor Mrs. M. E. Henderson-Begg. Councillor the Hon. Mildred Lowther, O.B.E. The Chairman of the Public Health Committee. The Medical Officer of Health. The Chairman of the Public Health Committee. The Medical Officer of Health. Councillor the Hon. Mildred Lowther, O.B.E. Alderman Mrs. V. A. L. Freeman, J.P. Councillor F. Frame. Councillor H. C. Garrard. Councillor Miss L. West Russell. Financial Contributions to Voluntary Organisations.—Payments to the funds of voluntary bodies were, on the recommendation of the Public Health Committee, made by the Council during 1950 as indicated below:— Organisation. Amount. Statutory Authority. £ s. d. Central Council for Health Education. 10 10 0 Public Health (London) Act, 1936, section 298. Family Welfare Association (Area 2). 100 0 0 Local Government Act, 1948, section 136. National Smoke Abatement Society. 5 5 0 Public Health (London) Act, 1936, section 298. London and Home Counties Smoke Abatement Advisory Council. 2 2 0 Local Government Act, 1948, section 136. Local Government Act, 1948, section 136. St. Marylebone Youth Centre, Paddington Street. 1,414 0 0 Physical Training and Recreation Act, 1937, section 4 (4). St. Marylebone Old People's Welfare Association:— "Meals on Wheels" Service. 258 18 2 National Assistance Act, 1948, section 31. "Hard of Hearing" Club. 6 10 0 National Assistance Act, 1948, section 31. Conferences.—The Council were officially represented at the under-mentioned conferences dealing with matters within the purview of the Public Health Department:— Conference. Delegates. Royal Sanitary Institute. Eastbourne, 24th to 28th April. The Chairman of the Public Health Committee and the Medical Officer of Health. Central Council for Health Education—"Food and Drink Infections." London, 31st August. Mr. H. E. Scoble, Food Inspector and Sampling Officer. Sanitary Inspectors' Association. Bridlington, 11th to 15th September. Mr. E. E. Willis, Senior Sanitary Inspector. National Old People's Welfare Committee-"Care of Old People." Brighton, 18th to 20th October. Councillor The Hon. Mildred Lowther, O.B.E., and Miss M. M. Sharp, Sanitary Inspector. Care of Old People.—Three hundred and fifty-six old people (including 33 married couples) were visited by one of the women sanitary inspectors. The great majority were living alone and some required constant observation, particularly where they were awaiting admission to hospital. The domestic help service continued to render valuable assistance to a large number of the aged inhabitants of the Borough. Special Laundry Service.—From time to time difficulty and distress are caused by the inability of old people who are acutely ill and suffering from incontinence to get their bed linen and night-wear washed. These cases generally arise because of the lack of sufficient hospital accommodation, the fact that many old people who are living alone have no reserve of bed linen, and to the unwillingness of laundries to deal with badly soiled sheets and clothing. Wherever it is possible, efforts are made to tide over the emergency by borrowing sheets from the District Nursing Association, but the laundry problem still remains. The Council therefore decided to take advantage of section 122 of the Public Health (London) Act, 1936, which states, inter alia, that on a report from the Medical Officer of Health that any article in a house is in such a filthy, dangerous or unwholesome condition that health is affected or endangered thereby, the Sanitary Authority may cause the article to be cleansed and removed for that purpose. Special arrangements were accordingly made at the Council's Cleansing 8 Station to deal in appropriate cases with the bed linen, etc. of old people, and during 1950 twenty-two aged persons were assisted in this way. The service has functioned satisfactorily, it meets a definite need, and is greatly appreciated by all who are concerned with the care of incontinent old people who have to be nursed at home. Some cases require to be dealt with for short periods only, while others need the service for a considerable time. There has not been a break without a case since the scheme started, and the largest number in hand at any one time has been seven. St. Marylebone Old People's Welfare Association.—This voluntary body, established in May, 1947, and supported by representatives of various organisations, religious bodies and statutory authorities, continued its beneficent work. The pooling of knowledge and experience at the monthly meetings of the Executive Committee has led to further developments in its existing activities and to the launching of new services. The Association is affiliated to the London Council of Social Service, and representatives attend the quarterly meetings of its Standing Conference of Old People's Welfare Committees in the Greater London area. The Association was also represented at a special conference at County Hall convened by the Chairman of the Welfare Committee, London County Council, to consider the setting up, under the aegis of the County Council, of a Central Consultative Committee for Old People's Welfare in the London area. The National Conference on Old People's Welfare, held at Brighton in October, was attended by the Hon. Secretary and Miss Margaret Sharp (Sanitary Inspector) whose account of the special laundry service for the aged sick, initiated by the St. Marylebone Borough Council in 1949, aroused great interest. The Association's work in 1950 fell, as before, into three main categories: (1) clubs and parties; (2) "meals on wheels," and (3) visiting. All six "Darby and Joan" clubs continued their weekly meetings and had successful summer outings and Christmas parties. As its own social function the Association held a party for the home helps serving in St. Marylebone. This was attended by the Mayor and Mayoress and by the Council's representatives on the London County Council, and afforded an opportunity of voicing appreciation of the valuable work carried out by the home helps for old people in the Borough. The "meals on wheels" service continued to be operated by the Women's Voluntary Services on five days a week, an average of 30 dinners being served each day. Meals are obtained from the London County Council Restaurant in Bryanston Square, and although invalid diets cannot be provided there is a choice of dishes as far as resources allow. The charge to the old people is still 8d., as the Welfare Committee of the County Council pay to their Restaurants Committee the difference between this charge and the actual cost price. The Borough Council renewed their grant in respect of the running costs of the van provided for the transport of the meals, and the Association expressed thanks to the Public Health Department for lending a van while their vehicle was off the road on several occasions. Two lunch clubs continue to flourish, the Cookshop of the St. Marylebone Housing Association and the W.V.S. Luncheon Club providing their popular 8d. meals. The number of visitors was 24, with an additional 15 attached to a local church and reporting to the Association through their liaison officer. The visitors' meeting, held monthly, proved a valuable link between the visitors, the Hon. Secretary, and Miss Sharp of the Public Health Department, to whose knowledge and ever-ready help the Association is deeply indebted. Of the many services available to old people through the Association, mention may be made of an arrangement made with a local dental surgeon whereby those who cannot attend a surgery may have treatment in their own homes. Five members of the Association's Executive Committee, including the Chairman and Hon. Secretary, were appointed to the Committee of the specially formed Housing Society which is engaged in establishing in St. John's Wood a "care and attention" home for St. Marylebone's old people. New services for the aged, concerned with (a) emergency fuel supplies and (b) chiropody, were planned late in 1950 but did not come into operation until 1951. An account of them will be given in next year's report. SECTION C.—SANITARY CIRCUMSTANCES. Sanitary Inspection.—Complaints were received in respect of 1,521 premises. Details of the various nuisances detected and remedied, to the total number of 4,714, are set out in Table 3. In 1,327 cases a preliminary (intimation) notice was issued, and in 227 instances this was followed by the service of a statutory notice to secure abatement of nuisances. In addition, 99 notices were served under London County Council Bye-laws made under the Housing, Metropolis Management or Public Health Acts. 9 Legal proceedings were instituted in 10 cases under the Public Health (London) Act, 193(5, in respect of failure to comply with statutory notices. In 5 instances penalties amounting to £8 5s. 0d. were imposed, costs being awarded to the Council in four of these. Costs without the imposition of a fine were allowed in one other instance. In the remaining cases the summonses were withdrawn, the necessary work having in the meantime been completed. Legal proceedings under the County Council Bye-laws were taken in two instances, in one of which a conviction was obtained and a fine of £1 0s. 0d. imposed. The other case was adjourned sine die. TABLE 3.—Nuisances Detected and Remedied. Nature of Nuisance Districts The Borough No. 1 No. 2 No. 3 No. 4 No. 5 No. 6 Houses damp, dirty or dilapidated remedied 70 83 380 153 143 218 1,047 Doors, windows, floors, ceilings, sash cords, grates and flues, etc., repaired 34 63 123 56 58 82 416 Verminous dwellings disinfested 66 41 115 143 87 65 517 Verminous furniture and bedding disinfested 58 29 44 31 12 77 251 Overcrowding abated 41 18 34 26 17 19 155 Water closet defects remedied 10 14 36 25 58 21 164 Insufficient and unsuitable water closet accommodation remedied - - - 1 3 2 6 Urinal defects remedied 2 1 — 1 - — 4 Drain and water closet stoppages cleared 4 10 51 14 11 22 112 Drains relaid or amended 2 - 10 7 2 4 25 Soilpipes and ventilating shafts repaired or renewed 3 1 6 2 4 1 17 Waste pipe defects remedied 2 6 10 7 13 17 55 Yard defects remedied 3 — 3 — 2 6 14 Wash-house defects remedied — — 3 6 2 2 13 Area defects remedied — — — 1 2 — 3 Roofs and gutters repaired 15 27 63 51 44 32 232 Water supply to houses reinstated 3 3 — 6 3 — 15 Water supply laid on to upper storeys 1 2 9 6 2 5 25 Water cistern defects remedied 4 8 3 6 3 3 27 Dung or dust receptacles repaired or renewed 4 1 15 3 5 — 28 Rubbish, manure, etc., accumulations removed 7 3 12 10 18 16 66 Animal nuisances abated — — 12 — — — 12 Rat and mouse infestations dealt with 139 170 270 251 295 316 1,441 Bakehouses cleansed 1 — 3 3 4 2 13 Smoke nuisances abated - — 3 9 — 1 13 Shops—sanitary defects remedied 1 — — — 2 — 3 Miscellaneous 5 2 4 5 8 16 40 Totals 475 482 1,209 823 798 927 4,714 Sanitary Accommodation at Public Houses.—In the report for the year 1949 reference was made to a special survey of the sanitary accommodation at licensed premises in the Borough which had revealed the general standard of accommodation to be satisfactory in 77 instances and unsatisfactory in 51. The Council have no power to compel publicans to provide sanitary accommodation at their premises for the use of the public, but the attention of the licensing justices was drawn to those public houses where conditions were unsatisfactory. It is gratifying to report that, as a result of representations which the justices subsequently made to the licensees concerned, the sanitary accommodation at 14 premises had been reconditioned or reconstructed by the end of 1950 and work at a further 8 premises was in hand. In addition, schemes were in course of preparation for dealing with 6 more public houses. It is probable that even greater progress would have been made in this direction but for the increasingly difficult position in relation to the granting of the necessary building licences. Water.—Although water for domestic purposes is obtained from private wells at a small number of blocks of flats and offices, the chief source of a constant supply throughout the Borough is from the mains of the Metropolitan Water Board. Two complaints as to quality were received during the year and referred to the Board. In accordance with the provisions of the Public Health (London) Act, 1936, the Board notified eight instances where water had been cut off in occupied premises for non-payment of rates or for waste. In all cases the supply was reinstated, in four instances after service of a notice. New byelaws, to replace those issued in 1934, were made by the Metropolitan Water Board on the 21st July, 1950, under section 16 of the Metropolitan Water Board Act, 1932, for preventing waste, undue consumption, misuse or contamination of water. 10 Further examinations of the private well waters from the ten borings still in use were made by the Public Analyst and the Council's Bacteriologist, and these indicated that since the last survey was carried out in 1947 at the request of the Ministry of Health there has been no appreciable change. The reports generally for 1950 were satisfactory and no pathogenic contamination was found. Nine certificates relating to the provision of a proper and sufficient supply of water in dwellinghouses were granted under section 95 (2) of the Public Health (London) Act, 1936, in respect of newly erected or rebuilt blocks of flats. Drainage.—The number of plans approved was 308, of which 20 related to new buildings, including three Borough Council housing schemes, with a total of 145 flats. The drainage inspectors made a total of 3,182 visits. Combined Drainage.—Five orders under seal for combined drainage were issued. Building Licences.—During the year 272 applications for building licences were referred to the Department by the Borough Engineer for observations in relation to proposals concerning drainage, ventilation and underground rooms, and also in cases where work had been called for by sanitary notices. Public Conveniences.—The usual supervision was exercised over the 15 public sanitary conveniences (11 for men, 4 for women). The only major work carried out during the year was the laying of a new tiled floor in the women's convenience at Oxford Circus. The free washing facilities, with paper towels and liquid soap, brought into operation in all public conveniences in the Borough in May, 1949, to encourage personal hygiene and prevent the spread of disease, have proved extremely popular and the public continue to take full advantage of them. The need for further public conveniences in St. Marylebone was again reviewed by the Public Health Committee who, although approving in principle the provision of additional accommodation in various parts of the Borough, realised that while the present building restrictions are in force it will be some considerable time before existing facilities can be improved and extended. Public Cleansing and Salvage.—The Director of Public Cleansing has kindly provided the following information on these services. The materials dealt with during 1950 were: house and trade refuse, 35,728 tons; street sweepings and gully slop, 2,753 tons; salvaged materials, 4,125 tons, including 1,428 tons of kitchen waste for pig and poultry feeding collected from 550 bins placed at intervals in the streets for the reception of this material. A sum of £9,737 was obtained from the sale of salvaged materials. In addition, £833 was received for the removal of trade refuse, green offal and the cleansing of petrol interceptors. As from the 1st August, 1950, the Council ceased disposing of refuse at Yeading, Middlesex, and arrangements were made for house and trade refuse to be delivered to the Westminster City Council Disposal Depot, Grosvenor Dock, S.W.I, and street sweepings to Mr. F. W. Surridge's Wharf at Nine Elms Lane. Twenty 'Paragon' and four 'Paladin' refuse collection vehicles and 290 galvanised refuse containers were purchased and put into commission during the year. Orders were also placed for two gully-emptying machines fitted with power-operated street washing apparatus, four low loading vehicles, 50 orderly barrows and 60 sand and ballast bins. Shops.—Inspections under the Shops Acts numbered 441. In three instances service of notice was necessary. The Shops Act, 1950, a consolidating measure, came into operation on the 1st October, 1950. Diseased or Infirm Persons.—On two separate occasions it was necessary to resort to action under section 47 of the National Assistance Act, 1948. Spinsters, aged 74 and 87 years, living alone in insanitary conditions, were found to be infirm, physically incapacitated and unable to look after themselves. The respective relatives and friends were approached but stated they could not render any assistance. It therefore became imperative in the interests of these women and for preventing injury to the health of, or serious nuisance to, other persons, that removal to hospital should be arranged. As they refused to leave their room voluntarily, application to Court was made and the period named in the orders issued was three months. Both, however, died within a month of admission to Paddington Hospital. Burial or Cremation of the Dead.—Under the provisions of section 50 of the National Assistance Act, 1948, it is a duty of the Council to cause to be buried or cremated the body of any person who has died or been found dead in the Borough where no other suitable arrangements for disposal of the body have been or are being made. The arrangements set up when the section became operative 11 on the 5th July, 1948, continued to work satisfactorily and during 1950 the burial of seven bodies was undertaken by the Council. The total expenditure incurred in dealing with these cases was £35 4s. 0d., of which £25 14s. Id. had been recovered by the end of the year. Disinfestation.—The campaign against the bed-bug was continued on the lines described in detail in the 1948 report, 517 dwellings, involving 1,033 rooms, being treated with D.D.T. by means of the special van containing a petrol-driven compressor unit and the necessary hosing and spraying apparatus. Included in the 517 dwellings were 80 requisitioned premises and 17 municipal flats where bugs were found. Treatment of verminous furniture by hydrocyanic acid gas, which has been carried out, in specially constructed vans, under contract by the Council for many years, has been continued, more particularly in the case of removals to fresh housing accommodation. In 1950 the furniture of 251 families (of whom 239 were being rehoused) was dealt with by this method. In addition 6,652 verminous articles of bedding were disinfected by steam. Verminous Persons.—The Council's Cleansing Station in Lisson Grove dealt with 1,362 vermininfested persons: adults 506 (men 474, women 32); children 856 (boys 272, girls 584). Shelter.—It was not found necessary during the year to make use of the shelter accommodation provided at 217, Lisson Grove, under section 195 (4) of the Public Health (London) Act, 1936, for families temporarily dispossessed of their homes. The room set aside for this purpose was, however, utilised for other public health work. Rodent Control.—Complaints received numbered 1,602, and 1,441 premises were found to be infested by rodents. Of this number, 1,278 premises were treated by the Council's staff and in the remaining 163 cases the owners or occupiers employed a commercial firm or carried out treatment themselves. The black or ship rat continued to be the predominant rodent within the Borough, infestations being discovered at 884 premises. The brown rat was located at 223 premises, and mice infestations were found in 334 instances. Under the "block control" scheme instituted in November, 1949, twenty-nine blocks, comprising 1,634 premises, were inspected and test-baited during the year. As a result, 243 infestations were discovered. In 160 cases the owners or occupiers requested treatment by the Council's staff; in the remaining 83 premises commercial firms were engaged or action was taken by the occupiers. Treatment of rodent infestations was carried out in accordance with the recommendations of the Ministry of Agriculture and Fisheries. A minimum charge of 10s. per treatment continued to be made in respect of work carried out by the Council's Rodent Control Service at premises other than dwellings, but as from the 1st June, 1950, the charge of 5s. per treatment for residential properties was abolished and a free service provided except in cases where the infestation appeared to be the result of gross negligence. The Prevention of Damage by Pests Act, 1949, which came into operation on the 31st March, 1950, provides, among other things, that it shall be the duty of every local authority to take steps to secure, as far as practicable, that their district is kept free from rats and mice. It is also the duty of occupiers of land (which includes buildings) to notify the local authority of the presence of rats or mice in substantial numbers on such land. The Act, which supersedes the Infestation Order, 1943, and the Rats and Mice (Destruction) Act, 1919, authorises the Minister of Agriculture and Fisheries to make grants of one-half of the non-recoverable expenditure incurred by local authorities. The degree of co-operation by owners and occupiers has been such that it was not necessary to serve notices under the Act requiring specific treatment or structural alterations. Routine sewer baiting was carried out by the Council's staff in January and July. Dog Nuisance.—Contraventions of the bye-law relating to the fouling of footways by dogs reported by the streets nuisance inspector resulted in summonses in 25 cases. In all of these convictions were secured and penalties imposed, costs being awarded to the Council in one case. The total number of prosecutions taken by the Council since the bye-law came into operation in 1928 is 456. Pigeons.—Nuisance from these birds was reported in relation to a church, a public building and a block of flats, and the complaints were referred to an approved pigeon catcher. Mosquitoes.—Two complaints of mosquitoes were received and satisfactorily dealt with. Noise.—Complaints of 22 noise nuisances were received. They were concerned with such diverse matters as radio, street musicians, dogs, machinery, demolition operations, night baking, refrigerators in shops, and social gatherings of various kinds. The majority of these nuisances were abated after action by the sanitary inspector and streets nuisance inspector. In other cases, where upon 12 investigation it appeared that the Department had no power to take direct action, the complaints were referred to the Town and Country Planning Authority and to the Police. In no case was legal action necessary by the Council. Atmospheric Pollution.—Observations were made regularly throughout the year, and 24 complaints were received in respect of smoke nuisances arising from 19 premises, relating to commercial undertakings, blocks of flats, private houses, a public institution, and to the two electricity generating stations. With the exception of those arising from the last named, the nuisances, although recurrent in some instances, were abated after informal action. Apparatus to record the amount of atmospheric pollution, more especially from grit emissions, in the vicinity of the electricity generating stations in Aberdeen Place and Lodge Road was installed on the roof of Welfare Centre No. 2, Lisson Grove, close to the generating stations, and on the roof of the Town Hall to act as a "control." These sites were chosen upon the advice of the Atmospheric Pollution Branch of the Department of Scientific and Industrial Research. The apparatus came into operation on the 1st April, 1950, and monthly readings are to be taken for a year. The findings will be reported and discussed in next year's report. Fuel Technology courses, arranged by the Ministry of Fuel and Power, were held during the autumn at technical colleges in the Greater London area. The object of these courses, which were primarily intended for firemen, boiler attendants and engineers, was to raise the standards of boilerhouse operation, thus ensuring the economical and efficient burning of fuel with a consequent reduction of the nuisance caused by smoke and grit emission. The names and addresses of 13 establishments in the Borough where boiler installations of any considerable size are in operation were forwarded to the Ministry, with a suggestion that copies of the syllabus might be sent to the managements of these concerns. Poisons.—The names of 78 traders were on the Council's list of persons entitled to sell poisons included in Part II of the Poisons List (Pharmacy and Poisons Acts, 1852 to 1941), the premises concerned numbering 90. Factories.—The great majority of factories in the Borough were surveyed during the year by the sanitary inspector who specialises in this work, with the part-time assistance of one of the women sanitary inspectors. The remaining factories will be dealt with in 1951. As required by section 128 of the Factories Act, 1937, a report on the administration by the Borough Council of the matters under Parts I and VIII of the Act is given in Tables 4 and 5. TABLE 4.—Factories: Inspections for Purposes of Provisions as to Health. Premises Registered Inspections Written notices Occupiers prosecuted Factories without mechanical power 314 460 81 - Factories with mechanical power 1,302 1,840 326 - Other premises* (excludingout-workers' premises) 165 321 — — Total 1,781 2,621 407 — *Electrical stations, institutions, sites of building operations and works of engineering construction. TABLE 5.—Factories: Defects Found. Particulars Defects Found Remedied Referred In respect of which prosecutions were instituted To H.M. Inspector By H.M. Inspector Want of cleanliness 406 270 - 8 - Overcrowding — — — — — Unreasonable temperature — — — — — Inadequate ventilation 74 50 — 1 — Ineffective drainage of floors — — — — — Sanitary conveniences:— (a) insufficient 13 8 — 3 — (b) unsuitable or defective 208 138 — 23 — (c) not separate for sexes 37 24 — 2 — Other offences (excluding offences relating to outwork) 392 130 2 — — Total 1,130 620 2 37 - 13 Out-workers.—Seventy-nine employers submitted lists in respect of a total of 870 out-workers (227 contractors and 643 workpeople). Of these, 135 contractors and 211 workpeople carried out the work in the Borough. The nature of the work upon which the out-workers were engaged is indicated below:— Wearing apparel—making, etc. 841 Electro-plate 1 Artificial flowers 2 Carding of buttons, etc. 6 Textile weaving 18 Lampshades 2 Total 870 There was no case of default in sending lists to the Council. Outwork in Unwholesome Premises.—A firm of confectionery makers with a factory in an adjoining area was found to be employing out-workers at three separate addresses in the eastern end of the Borough. These workers were engaged in making wrappings for an effervescing lemonade powder. All three premises were totally unsuitable for the purpose and the firm was ordered to discontinue forthwith the employment of these out-workers. This request was complied with. The work was afterwards carried out at the factory itself, and the manufacturers stated that they had no intention of employing out-workers in future in connection with any of their products. Industrial Health Service.—The Prime Minister appointed a committee to investigate the question of providing a comprehensive industrial health service which, it was understood, would include such matters as the routine inspection of factory workers, the supervision of factory hygiene and the conditions under which work is carried out. Metropolitan borough councils already have certain functions and responsibilities in regard to working conditions in factories, in the exercise of which they have acquired much local knowledge and experience which, it was felt, could be used with advantage in any new organisation concerned with health in industry. The St. Marylebone Borough Council accordingly requested the Metropolitan Boroughs' Standing Joint Committee to make representations to the Industrial Health Service Committee set up by the Prime Minister to the effect that, in London, the metropolitan borough councils should be the authorities mainly responsible for the administration of the proposed service. Methylated Spirit Drinking.—From reports by officers of the Department it was evident that drunkenness due to the consumption of methylated spirit was increasing in certain parts of the Borough. As this was considered a matter of some concern from the public health point of view, the following report was submitted by the Medical Officer of Health to the Public Health Committee in October, 1950:— "During the last twelve months serious disturbances have been caused at the Salvation Army Hostel, a common lodging house for men at No. 31, Lisson Street, N.W.1, by men suffering from this form of intoxication. Two or three times a week it has been necessary to call the police to deal with parties of methylated spirit drinkers whose violence and irresponsibility is a recurring source of danger to other lodgers and to the hostel staff. An average of fifty men were ejected during each of the months of May, June, July and August this year—frequently not before there had been a minor pitched battle. And this takes no account of the many who were refused admission. "The drinking is usually done in groups in the parks and in the lodging house, and appears to be confined to those without money for the more usual forms of alcoholic drink. Sometimes cold black tea is "laced" with methylated spirit to make a concoction known as "Blow Hard." Most of the men are natives of Eire, are under forty years of age, and are either out of work or else follow no regular employment. It is not by coincidence if the night following pay day at the Public Assistance Office and the Employment Exchange proves troublesome at the lodging house. "Addicts create special problems not only within the hostel itself but also in the surrounding neighbourhood. When refused admission they cause nuisance by their noise and eagerness to fight all comers. Footways are defiled by their vomiting and sanitary accommodation is befouled by their attacks of diarrhoea. Methylated drinkers contaminate cups and glasses by merely drinking from them. Even bed linen becomes saturated with the persistent and characteristic smell of the spirit. "Mineralised methylated spirit, which is the cheapest form of concentrated alcohol available in this country, can be readily obtained by anyone, without a prescription or a signed order, from any chemist or oil shop. It is a mixture of ethyl alcohol—the active ingredient of most conventional intoxicating drinks—with 9.5 per cent. wood naptha and about 1 per cent. pyridine, petroleum and 14 violet colouring matter. These substances are added to make spirit, which is sold duty-free for purely domestic and manufacturing purposes, unpalatable and distinctive in appearance. "Industrial methylated spirit is colourless and consists of ethyl alcohol with only 5 per cent. wood naptha, but it cannot be obtained by the general public without certain formalities which put it beyond the reach of the usual addicts. With the addition of 2½ per cent. castor oil and 1 per cent. boric acid, however, it can be freely bought from chemists under the name of Surgical spirit. This costs little more than the violet-coloured variety and is less noxious. During a three-week period in August, stewards at the Salvation Army Hostel collected from the dormitories, day-room and lavatories no fewer than thirty-four bottles which had contained methylated spirit. Of these, twenty-five were labelled "Surgical Spirit B.P.C. No. 3—Boots, Chemists." "It is not intended to suggest that there is anything new in the conditions outlined, nor that a menace of alarming proportions exists. Nevertheless, reports from the lodging house and observations at the public conveniences in the Borough—more especially Barrett Street and, to a lesser extent, Salisbury Street where frequently urinal stalls are stained violet and the odour of methylated spirit is encountered—provide sufficient evidence to justify the conclusion that the practice of drinking this form of spirit may be widespread in this country and is on the increase. "Mineralised methylated spirit is so very nauseous that it may be that only the more hardened habitues resort to it. On the other hand, the ease with which the less unpalatable surgical spirit can be obtained would seem to foster addiction and may provide the greater potential danger. To remedy these conditions it is suggested that legislation should be sought to restrict the sale of surgical spirit, possibly by making it available only upon a prescription. Because of its extensive use for legitimate domestic and other purposes, tighter control of the sale of common methylated spirit would probably be difficult to achieve. Deliberate drinking of it might, however, be discouraged if, without impairing its necessary qualities, further additions could be introduced during manufacture to render it even more noxious to the taste than it is at present." After consideration of this report, the Public Health Committee agreed that a further attempt should be made to discourage the practice of methylated spirit drinking, and on their recommendation the Council requested the Metropolitan Boroughs' Standing Joint Committee to make representations (i) to the Home Office to the effect that surgical spirit be designated a Part I poison, and (ii) to H.M. Commissioners of Customs and Excise asking that further unpalatable additions be made to "mineralised" methylated spirit. The Standing Joint Committee subsequently supported the views of the Council and decided that such representations should be made. SECTION D.—HOUSING. Permanent Schemes.—A further 51 flats on the Church Street Estate were completed by the end of the year, making a total of 140 flats. A further 98 of the 172 flats on the Barrow Hill Estate were also completed during 1950, bringing the total number of occupied flats to 156. A maternity and child welfare centre was opened in premises on the latter Estate on the 14th April, 1950. Both at the Barrow Hill and Church Street Estates the Council have provided and equipped social rooms which are managed by associations formed by the tenants themselves. The communal laundries are being used by 70 per cent. of the tenants at the Church Street Estate and 33 per cent. at the Barrow Hill Estate. The first section of the Townshend Estate, comprising 70 flats in three blocks, is nearing completion. A tender has been accepted, in the sum of £76,029, for building 40 flats on the second section of the Estate. At the request of the London County Council, a site has been allocated for a nursery school on this Estate with an area of about one-third of an acre, and this will be included in the last stage of the scheme. The Estate, when completed, will provide 221 dwellings at an estimated cost of £580,000. The development of the St. John's Wood Road site (Winchilsea House—23 flats) was completed during the year at a cost of approximately £49,000. The Council decided to proceed with a scheme for the extension of the newly-completed Church Street Estate, and to this end purchased the Aenon Baptist Church site and a number of freeholds formerly held by the Portman Estate. Negotiations are proceeding for the acquisition of the outstanding interests and it is hoped to provide a further 65 flats and 10 shops on the extension site. Steps have been taken for the acquisition of sites at Hamilton Terrace, Carlton Hill, Wellington Road, Abercorn Place, Boundary Road, Springfield Road, Queen's Terrace and Pembroke Terrace for the erection of further flats. Plans for development were prepared and tenders invited. At the request of the Commissioner of Police, the Council allocated 10 dwellings in new estates for the accommodation of police officers. 15 Fisherton Street Housing Estate.—The Council decided to replace gradually all the tire-places, which are now obsolete in design, and as a first instalment 30 new fire-places were fitted during the year. Requisitioned Premises and Factory-made Bungalows.—Re-decoration and maintenance works to requisitioned premises were carried out during the year at an expenditure of £22,589, and similar works to factory-made bungalows cost £980. The total number of residential units held by the Council in requisitioned premises at 31st December, 1950, was 1,038. "Half-way" Houses.—Two "half-way" houses, at Beaumont Street and Nottingham Place, were completed during the year. Their purpose is to assist families in sudden and urgent need of accommodation pending the allocation of more permanent homes. St. Marylebone Housing Trust.—The Council agreed to co-operate with, and financially assist, the St. Marylebone Housing Trust in the erection of 24 flats on a site adjacent to the existing Cochrane Street Estate. Inspection of Dwelling Houses.—The total number of houses and flats (separately assessed residential units) in the Borough at the end of 1950 was 22,579. Details of inspections made and resultant action are given in the following statement:— Number of houses inspected for defects under the Public Health or Housing Acts 2,938 Number of inspections made 11,102 Number of houses found not to be in all respects reasonably fit for human habitation 921 Number of defective houses rendered fit in consequence of informal action 557 Number of houses in which defects were remedied by owners after service of formal notices under the Public Health (London) Act, 1936 306 Underground Rooms.—Closing orders under section 12 of the Housing Act, 1936, were made in respect of 16 rooms, and variations in the user of six rooms already subject to closing orders were approved by the Public Health Committee. Four undertakings from owners not to use or permit to be used ten underground rooms for human habitation were accepted by the Committee during the year. Re-housing.—During the year 595 enquiries were received from the Borough Council's Housing Director, the London County Council and other local authorities, regarding the circumstances of persons applying for re-housing. Each case necessitated investigation by a sanitary inspector before the enquirer could be provided with a report to assist him in assessing the degree of priority to be given to the various applicants. In November, 1950, a form of certificate was adopted for use by medical practitioners desiring to support applications by their patients for re-housing on health grounds. As these certificates are considered by the Medical Officer of Health personally, the medical practitioner is invited to give fuller and more precise information than he would ordinarily provide. This detailed medical evidence, along with environmental reports by the sanitary inspectors, places the Medical Officer of Health in a better position to express an opinion on the number of "points" to be awarded in these cases. Medical practitioners generally have been quick to take advantage of the new arrangement, and their co-operation has been most helpful in this further endeavour to improve methods of assessment as to need for re-housing. During the remainder of the year 37 certificates from local doctors were reported upon. Slum Clearance.—A further survey of the Borough was undertaken by the Department to ascertain the housing development needs and potentialities for the next 10- and 20-year periods and to form the basis of a new slum clearance programme for consideration and discussion with the London County Council. Thirty areas, involving a total of 961 houses and 2,710 families, were inspected and graded for representation in order of priority. The Ministry of Local Government and Planning had not indicated by the end of the year the extent to which they were prepared to authorise clearance operations or the degree of priority to be afforded to the Council's claims. Common Lodging Houses.—There are two lodging houses in the Borough: one, accommodating 436 men, owned by the Salvation Army and situated at No. 2, Burne Street and premises in Lisson Street; the other, registered for 100 women, conducted by the Church Army at Portman House, No. 10, Daventry Street. The extensive alterations at the men's lodging house were completed during the year and effected a marked improvement in the condition and amenities of the building. Dilapidated and out-of-date sanitary accommodation has been abolished and replaced by water-closet, urinal and washing facilities which are now readily accessible from each dormitory. The preparation and serving of food, previously 16 carried out on the ground floor, have been re-arranged in a position adjacent to the dining room, which is situated in the basement of the building. The re-siting of the kitchen and the installation of new equipment have brought the catering arrangements into line with modern hygienic conceptions. Works still to be done include the replacement of the defective basement wooden floor'by quarry tiles on concrete in order to facilitate cleansing. Difficulty has been experienced in regulating the admission of lodgers, and to overcome this the main entrance lobby in Lisson Street is to be re-designed. At the women's lodging house, the dormitories are being slightly reduced in size to permit of the introduction of sanitary accommodation, baths and washing facilities on each of the four floors where sleeping quarters are situated. Work to bring about this much-needed improvement was still in hand at the end of the year. The sanitary inspectors made 51 visits to the common lodging houses during 1950. Rent Restrictions Acts.—During the year one disrepair certificate and one certificate of revocation were issued. SECTION E.—INSPECTION AND SUPERVISION OF FOOD. Clean Food Campaign.—In the report for the year 1949 mention was made of a proposal to form a Clean Food Association in St. Marylebone. Letters were later sent to all persons known to be holding food licences in the Borough, inviting them to attend a meeting to consider the matter. This meeting was held at the Town Hall on the 4th April, 1950, under the chairmanship of His Worship the Mayor, and was attended by over 100 food traders and other interested persons. The Chairman of the Public Health Committee summarised the various factors which had led to the calling of the meeting and after a spirited discussion it was formally resolved that a St. Marylebone Clean Food Association should be formed, and a Working Committee, consisting of 14 traders and 2 members of the Borough Council, was appointed to draft Articles of Association and a Code of Practice to be observed by members of the Association. In due course these drafts were prepared and at a further general meeting of traders held on the 31st May, 1950, the Articles and Code of Practice (which are reproduced as an Appendix to this report) were adopted. At the same time, their task having been completed, the Working Committee was dissolved and an Executive Committee and honorary officers appointed. This Committee met at monthly intervals throughout the remainder of the year and, in addition to the ordinary business of the Association, adopted designs for a badge and a certificate of membership which were subsequently made available to members. By the end of the year 89 members had been admitted to the Association and 19 applications were deferred or awaiting investigation. As part of a programme for educating food handlers in hygiene, arrangements were made for the showing of Central Office of Information propaganda films at the Town Hall followed by commentaries by the Council's food inspector, and for talks, illustrated by film strips, to be given to food traders and members of their staffs, both centrally and at the premises of the firms concerned. From the outset the Association was received with enthusiasm by the more progressive members of the various trades, and there have been many signs of a growing interest in its work and general recognition and approval by the public. The Association is essentially a body of food traders whose premises and methods reach an approved standard of hygiene and who undertake to comply with the Code of Practice which aims at securing better food handling. Although it has the full support of the Council the Association is run by members of the trade and not by the Council. Apart from a registration fee of ten shillings and sixpence, due from members upon admission to the Association and devoted to reimbursing the Council for their expenditure upon the initial cost of badges and certificates, no subscription or other fee is payable. Food and Drugs Analysis.—Samples of 76 different kinds of foodstuffs and 29 varieties of drugs were taken and analysed under the Food and Drugs Act, 1938. The total number of samples submitted during the year was 721 (51 formal, 670 informal) and these included: milk 66, butter 79, margarine 75, cheese 68, cooking fat 72, sausages 72. The sum paid in respect of each analysis was £1 1s. 0d. The 23 samples reported as adulterated or otherwise irregular are referred to by the Public Analyst (Mr. Thomas McLachlan) in the following report: "The percentage of adulterated samples is lower this year than it has been for the past few years in St. Marylebone, only 3.2 per cent. of the samples submitted being reported as adulterated. "No samples of milk submitted as routine samples were reported as adulterated during the year, but a member of the public complained that a bottle of milk had turned tea a peculiar colour. The milk was found to have a high iron content and contained foreign matter consisting of dry flakes of milk. The matter was taken up with the suppliers. "A sample of butter received as a complaint sample appeared to have been kept by the purchaser for some time and was found to contain 10.9 per cent. of water instead of 14 per cent., and the fat 17 was rancid. It was unfit for consumption in the ordinary way but could have been used for cooking purposes. Another sample of butter had a definite tang, probably picked up during storage in the refrigerator. It was suggested that the refrigerator should be overhauled. "A sample of cheese was examined and found to be 27 per cent. deficient in fat. A sample of Camembert cheese received as a complaint sample was considered to be over-ripe, but was still edible and was, therefore, reported as inferior. "An opened bag of self-raising flour was received with the complaint that it contained dirt. It was found to contain mouse dirt and similar matter, but it was impossible to express an opinion as to how the sample had become contaminated. As there was no sign of entry through the paper, the mouse might have gained access in the larder of the complainant. "A sample of bread was received contaminated with gear oil, probably from overhead shafting. "Some ginger cake received with a complaint that it possessed a soapy flavour had been prepared with rancid fat and was, therefore, unsuitable for food. "Pieces of foreign fruit related to the cucumber species were found in a hot cross bun. The fruit was carefully sliced so that the manufacturers must have known of its presence, and the sample was reported as inferior. "Some packets of milk chocolate contaminated with traces of gilt from the wrappers were received, but the chocolate was considered safe for eating as the copper amounted only to 5 parts per million. A further sample of chocolates was received with the complaint that they had caused sickness when eaten, but this complaint could not be confirmed and the sample was reported as genuine. "A purchaser had complained of dirt in a table jelly tablet, and when examined this was found to contain fragments of porcelain and other dirt, and had probably been manufactured in a dirty mould. "A sample of currant sugar sweet spread contained invert sugar and was reported adulterated as currant sugar must consist of dextrose obtained from grapes. "Some drinking straws were submitted because of a complaint that their colouring contaminated liquids drunk through them, but when examined the colours were found to be harmless and only slowly extracted from the straws. "Your analyst received a sample of cooked meat and gravy which was found to be decomposing badly. Decomposition was due to the fact that the meat and water, in which it had been heated, had never been raised to a sufficiently high temperature, and attention was drawn to the fact that partially cooked food and cooked food which may be contaminated during cooling are the commonest causes of food poisoning. Another sample of meat was received with the complaint that it had made two people sick. The meat was found to be a normal sample of genuine beef and your analyst ate some without any ill effects. A meat pie was received containing a piece of hide with hairs, the meat not having been properly cleansed. The matter was taken up with the manufacturers. A can of potted meat contained excessive quantities of tin due to the corrosion of the tinned metal surface. "Complaint was made that a sample of crawfish appeared to contain glass, but this was found to be crystals of magnesium ammonium phosphate. Some tinned oysters were found to be extremely soft and of an unusual colour. This condition was probably due to the pressure required to sterilise the fish breaking down the structure, and the sample was reported as genuine. "A sample of salad cream examined was found to contain gram-positive cocci and the emulsion had broken down and caused the oil to separate. It was suggested that the whole stock should be returned to the manufacturers or condemned. "Boracic ointment was found to contain 840 per cent. excess of boric acid. Some mercury ointment failed to comply with the requirements of the British Pharmacopoeia as it contained only 6 per cent. of mercury instead of 9.5-10.5 per cent. "A sample of tincture of quinine contained an excess of both ammonia and quinine. The label of a sample of Friar's balsam tablets was considered to be misleading, as the amount of menthol was greater than the active constituents of the Friar's balsam and the amount recommended as a dose was too small to be significant. The matter was taken up with the manufacturers. "So-called fruit laxative tablets owed their laxative properties to phenolphtalein and not to fruit. The manufacturers were warned of our objection. A sample of liquid paraffin failed to comply with the test for readily carbonisable substances as required by the British Pharmacopoeia. "A sample of sweet spirits of nitre was deficient in ethyl nitrite, but this deficiency was probably due to the rapid deterioration which occurs when a bottle of this medicament has been opened. "The label of some vitamin tablets contravened the Labelling of Food Order, as the quantity of vitamin B2, equal to 2.5 grains of fresh brewer's yeast, would not constitute one-sixth of the vitamin B2 requirements for the day. 18 "During the year several consignments of tinned cherries were received from Italy containing an excessive amount of sulphur dioxide for ordinary use, and owing to the attack of this acid on the tinplate the odour was sometimes objectionable. Unfortunately, the Preservatives in Food Order allows 350 parts of sulphur dioxide per million of fruit or fruit pulp and does not exclude its presence in canned fruit, where its use is unnecessary. The cherries were passable for use in cocktails but not as a sweet. Their importation appears to have stopped owing to their unpopularity. A sample of such cherries was submitted by the St. Marylebone sampling officer on account of the odour when attempts were made to eat the cherries as a dessert. "A sample of luncheon meat, imported from abroad, was submitted owing to the can appearing to be bulged and to the fact that some of the meat was of poor colour on the outer surface in contact with the tinplate. The swelling was due to the fact that the can had been filled and sealed when containing cold meat, and when placed in a fairly warm room the air had expanded. Many continental packers fill cold and without a vacuum, whereas British and American packers employ a vacuum, which is much more satisfactory. The poor colour of the meat was caused by insufficient time being allowed, after adding potassium nitrate to the meat, for bacteria to reduce it to nitrite. In contact with the tinplate the small amount of nitrite formed was reduced, leaving an unpleasant appearance, but this did not make the meat unsatisfactory for actual consumption. "A sample of processed cheese was received with a complaint about its odour and taste. Some of this was submitted to Professor Crossley, of Reading University, who kindly pointed out that the cheese was a processed "blue vein cheese." As such it should not have been sold on the ration, and it was suggested that the matter be referred to the Ministry of Food. "A patient, who was in the habit of taking dried parsley for rheumatism, complained that a particular sample he had purchased caused diarrhoea and sickness, but your analyst could find no cause for complaint. It is surprising how frequently some particular item of food is blamed for sickness due to entirely different causes, and it is often difficult to know whether to suspect the food or to look for other symptoms. In cases of this type greater collaboration between the family doctor, the public health department and the public analyst would be of considerable assistance." Legal proceedings were not advised in respect of any of the samples adversely reported upon by the Public Analyst, and the matters were taken up, with satisfactory results, with the manufacturers, wholesalers or retailers concerned. The Labelling of Food Order, 1950, which substantially re-enacts in a consolidated form the Order of 1946 and subsequent amending Orders, came into operation on the 1st November, 1950. Milk.—There are 160 premises from which milk is sold. Inspections made numbered 189. Legal proceedings were taken in respect of one case where there was failure to ensure that a bottle used for containing milk for sale was, immediately before use, in a state of thorough cleanliness. The defendants pleaded guilty and a fine of £20 was imposed, costs being awarded to the Council. During the year 222 applications under The Milk (Special Designations) (Raw Milk) Regulations, 1949, and The Milk (Special Designations) (Pasteurised and Sterilised Milk) Regulations, 1949, were received from 72 milk purveyors, and licences were granted as follow:— Accredited milk 8 dealers'. Tuberculin tested milk 46 dealers' and 13 supplementary. Pasteurised milk 1 pasteuriser's, 59 dealers' and 16 supplementary. Sterilised milk 1 steriliser's, 65 dealers' and 13 supplementary. The average composition of the 67 genuine samples of milk analysed was: total solids, 12.28 per cent.; fat, 3.53 per cent.; solids not fat, 8.75 per cent., as compared with the legal minima, namely, 11.50 per cent., 3.00 per cent. and 8.50 per cent. respectively. Thirty-six samples of milk taken at the premises of two authorised wholesale firms operating heat treatment plants were submitted to the test prescribed for the various designations. All were reported to be satisfactory. Of 44 other samples of milk examined by the Council's Bacteriologist, all were found to comply with the requisite standards. Butter and Margarine Premises.—At the end of the year there were on the register 15 dealers in margarine and 2 butter manufacturers. Fifty-five inspections of the premises were made. Ice Cream.—The number of premises on the register was 148, which includes three where ice cream is manufactured: 192 inspections were made. Four applications for registration were refused as the premises in each case were considered to be unsuitable for the sale of ice cream. Fifteen samples of ice cream were examined bacteriologically. Of these, ten were found to be satisfactory and five were below standard. The question of the unsatisfactory samples was in each case taken up with the manufacturers either direct or through the medical officer of health of the 19 district in which the factory was situated. In addition, 16 samples were submitted to the Public Analyst and all were returned as genuine. The Council continued to co-operate with the Ministry of Food in securing the observance of undertakings given by manufacturers of ice cream under a scheme made by the Ministry whereby an increased allocation of sugar with a corresponding allocation of fat would be made available to such manufacturers on the understanding that the fat content of their products would not fall below 2½ per cent. In this connection the Ministry were subsequently supplied with particulars of the under-mentioned ice cream analyses which showed that the fat content of none of these samples fell below the percentage required by the Ministry. TABLE 6.—Ice Cream Analyses. Sample No. Fat (%) Solids not fat (%) 1 10.8 24.1 2 9.2 21.8 3 9.2 18.8 4 17.2 23.4 5 12.4 20.1 6 9.4 24.0 7 7.8 22.5 8 10.0 25.7 9 9.6 25.1 10 10.8 25.2 11 10.0 24.5 12 8.8 26.8 13 9.2 25.1 14 10.8 26.1 15 11.6 27.7 16 11.6 20.9 Preserved Food.—There were 111 shops, etc., on the register of premises approved for the preparation or manufacture of preserved foods (sausages mainly) intended for sale, and 228 inspections were made. Fried Fish Vendors and Fish Curers.—The number of premises used by vendors of fried fish is 11 and by fish curers 2. Thirty-five inspections of fried fish shops and 20 inspections of fish curers' premises were carried out. One notice was served in respect of a fried fish shop. Bakehouses.—There are 18 basement bakehouses on the register; 86 inspections were made. Legal proceedings were instituted under the Food and Drugs Act, 1938, and the Factories Act, 1937, against one firm of bakers in respect of the dirty condition of their bakehouse, food storage rooms, shop and staff accommodation. After hearing the evidence, the Magistrate imposed a fine of £40 and awarded £25 4s. 0d. costs to the Council. Proceedings were also taken against a firm of retail provision merchants for selling a loaf of bread in a mouldy condition. In this case a fine of £2 0s. 0d. was imposed and £3 3s. 0d. costs awarded to the Council. Restaurants, etc.—Premises in which meals are provided or food is sold already cooked or is prepared for sale numbered 852, including 309 restaurants, snack bars and railway refreshment rooms, 52 hotels, 330 staff and club canteens, 133 public houses, 23 school and nursery canteens, and 5 coffee stalls: 1,109 inspections were made and 29 notices served. During the year the kitchens of 4 restaurants, 3 snack bars, 1 hotel, 1 canteen, 1 fish restaurant and 1 licensed premises were completely reconstructed. Legal proceedings were taken under section 13 of the Food and Drugs Act, 1938, against three caterers in respect of the dirty condition of premises used for the preparation and cooking of food for sale to the public. Fines respectively of £48, £14 and £7 were imposed and costs awarded to the Council. In his summing up of one of these cases the magistrate stated that he was very glad indeed to see prosecutions of this kind and considered that the Council were performing an extremely valuable service to the general public in bringing them. Horseflesh.—Twenty-seven visits were paid to the only shop in the Borough selling horseflesh for human food. Slaughter of Animals.—The only licensed slaughterhouse in the Borough is that at the Zoological Society's premises in Regent's Park, where slaughtering is done occasionally to augment the food supply for the animals in the menagerie. Humane killers are used, and the licence granted to the Society's skilled slaughterman was renewed. Fourteen inspections were made during the year. 20 Unsound Food.—Some 23 tons of food condemned as unfit for human consumption included the following: meat, 5 tons, 12 cwts., 2 qtrs., 11 lbs.; bacon, 8 tons, 1 cwt., 6 lbs.; poultry and rabbits, 13 cwts., 7 lbs.; sausages, 2 cwts., 1 qtr., 4 lbs.; fish, 2 cwts., 1 qtr., 5 lbs.; fruit, 17 cwts., 1 qtr., 6 lbs.; cereals, 17 cwts.; tea, 4 cwts., 1 qtr., 2 lbs.; confectionery, 2 cwts., 1 qtr., 18 lbs.; canned goods, 15,043 tins. A large proportion of this unsound food was salvaged and used for animal feeding. SECTION F.—PREVALENCE OF, AND CONTROL OVER, INFECTIOUS AND OTHER DISEASES. Infectious and other diseases notifiable in St. Marylebone are listed in Table 7, which gives also information regarding notifications received during 1950. Enquiries relating to cases of infectious disease were carried out by one of the women sanitary inspectors who paid 1,093 visits in this connection during the year. TABLE 7.—Notifiable Diseases and Notifications. *Notifiable Disease Cases notified in whole Borough Cases removed to hospital Cases isolated at home At all ages At ages—years -1 1— 2— 3— 4- 5— 10— 15— 20— 35— 45— 65- Ophthalmia neonatorum 1 1 - - - - - - - - - - - - 1 Erysipelas 10 - - — — — — — 1 1 2 3 3 3 7 Scarlet fever 65 1 2 3 5 4 40 4 3 3 — — — 30 35 Puerperal pyrexia 3 - - — — — — - — 2 1 — 3 — Poliomyelitis— Paralytic 4 - — — — — 1 — — 3 — — — 4 — Non-paralytic 3 - — — — — — — — 3 — — — 3 — Pneumonia 41 2 2 1 — 1 3 2 — 6 5 13 6 11 30 Dysentery 12 1 — 2 1 — 2 — 1 2 2 — 1 6 6 Measles 323 14 26 45 42 43 134 8 2 8 1 - — 26 297 Whooping cough 170 10 18 22 27 22 66 3 — 1 — 1 — 19 151 Scabies 16 — — — — - 2 - 1 8 - 4 1 - 16 Meningococcal infection 1 - - - - - 1 - - - - - - 1 — Paratyphoid fever 1 - - - - - 1 - - - - - - 1 — Tuberculosis— Pulmonary 82 - - 1 — — 2 — 11 33 19 12 4 28 54 Non-pulmonary 6 — — — — — — — 1 3 — 2 - 5 1 Food poisoning 11 — 2 — — — 2 1 — 1 3 - 2 2 9 Totals 749 29 50 74 75 70 254 18 20 74 33 35 17 142 607 * There were no cases of the following diseases, which are also notifiable in the Borough: Smallpox, diphtheria, cholera, typhus fever, relapsing fever, continued fever, plague, glanders, farcy, anthrax, induced malaria, malaria, acute encephalitis (infective or post-infectious), typhoid fever, enteric fever, membranous croup. International Certificates of Vaccination and Inoculation.—In accordance with the request of the Ministry of Health, arrangements were made for the authentication by the Medical Officer of Health of certificates of vaccination and inoculation issued by medical practitioners in St. Marylebone in respect of persons proceeding abroad. Smallpox.—St. Marylebone, fortunately, was not actually affected by the Glasgow outbreak, which was started by a seaman from the R.M.S. "Chitral" on the 5th March, 1950, and led to 21 cases of smallpox of a severe type. It was reported by the Medical Officer of Health of Rugby that he had examined, at a reception centre, two men who were tramping from the Glasgow area to London. These men were found to be quite fit, but had refused vaccination. They were said to be proceeding to a common lodging house in the Borough, and although a close check was maintained on the premises for the necessary period the men failed to arrive. Numerous requests for vaccination were received in the Department from persons proceeding to Glasgow on business or holiday, and they were referred to the Vaccination Clinic in the Town Hall Extension. At Aden on the 19th June, 1950, the S.S. "Strathnaver" landed a Goanese seaman who was diagnosed as suffering from chicken-pox but was subsequently considered by the port health authorities at Aden to be a mild case of smallpox. The ship arrived at Tilbury on the 2nd July, 1950, and of the passengers who disembarked, 64 proceeded to addresses in this Borough. All these contacts had been vaccinated, and the usual surveillance was maintained during the incubation period but no further cases were reported. 21 In the Brighton outbreak, the first case (a Royal Air Force officer from abroad) was diagnosed on the 28th December, 1950, as suffering from the disease. Altogether, there were 38 cases with 9 deaths. The patients included 5 nurses of whom 3 had never been vaccinated. There were a number of St. Marylebone contacts from Brighton and these were kept under strict observation. Moreover, local medical practitioners were on the alert for possible cases and a number of suspects were reported from various parts of the Borough. In each instance the Medical Officer of Health was called in consultation. Fortunately, no case was found to be smallpox. During the outbreak, 201 vaccinations were carried out in municipal clinics in the Borough. This number included the whole staff at a bank where a clerk was the first St. Marylebone contact to be notified by the Brighton Health Department. In addition, apart from vaccinations by general practitioners, 1,700 persons were vaccinated at the Middlesex Hospital. Undulant Fever.—Though not a notifiable disease, a case of this rather uncommon fever, usually acquired through infected milk, was reported early in August, 1950. The patient, an American tourist, aged 72 years, first felt unwell on the 7th July at his home in Kansas. On the following day he set sail in the "Queen Mary" for a visit to England and arrived at a Bloomsbury hotel on the 15th July. Feeling generally ill, feverish and exhausted and running a swinging temperature, he called in a doctor who arranged his removal first to a nursing home in the Borough on the 19th July, and subsequently to hospital. Various bacteriological examinations were made, and these finally showed a positive reaction to undulant fever. The Ministry of Health were provided with a full report of the case, together with detailed information as to where the patient obtained his milk supply and dairy produce in Kansas, where the infection undoubtedly originated. Food Poisoning Outbreaks.—Details of cases of food poisoning notified during the year are given below:— (a) Number of outbreaks.—One of five cases and also six single cases. (b) Total number of cases.—Eleven. (c) Deaths.—None. (d) Organisms or other agents responsible, with number of outbreaks attributable to each. Salmonella enteritidis, type Jena—One case 'B' Emteritidis gaertner-Four cases Relates to one outbreak. Salmonella typhi-murium—One case. 'B' aertrycke—Two single cases. Not ascertainable—Three single cases. (e) Foods involved, with number of outbreaks associated with each food—In no case was it possible definitely to identify a particular foodstuff as being the source of infection. Tuberculosis—New Cases and Mortality.—Table 8 contains information with regard to age and sex distribution of, and mortality from, all forms of tuberculosis. TABLE 8.—Tuberculosis: New Cases and Deaths. At ages— years ‡ NEW CASES DEATHS Pulmonary Non-Pulmonary Pulmonary Non-Pulmonary M. F. M. F. M. F. M. F. 0—1 - - - - - - - - 1—5 - 1 - - - - - - 5—15 2 1 - - - - - - 15—25 15 27 4 2 - - - - 25—35 19 19 — 1 1 — - — 35—45 16 10 — — 2 — - — 45—55 10 1 1 1 1 - - - 55—65 9 4 - - 6 1 1 - 65 and upwards 12 2 — — 8 1 - — Totals 83 65 5 4 18 2 1 — ‡ Including all primary notifications and also any other new cases of tuberculosis which came to the knowledge of the Medical Officer of Health during the year. Notifications.—Table 7 (p. 20) gives information regarding notifications of pulmonary and nonpulmonary tuberculosis received during the year. One hundred and fifty-six visits from the housing and sanitary viewpoints were paid by one of the women sanitary inspectors to new cases and those 22 moving into the Borough from other areas. The total number of cases of tuberculosis remaining on the register at the 31st December, 1950, was 933. This was 59 more than at the end of the previous year. Mass Miniature Radiography.—During February, 1950, one of the miniature radiography units of the North-West Metropolitan Regional Hospital Board was installed on premises of the London Zoological Society, Regent's Park, for the examination of workers in the surrounding districts. The findings are detailed in Tables 9 and 10. TABLE 9.—Miniature Film Analysis. Male Female Total Number of persons X-rayed 2,130 2,559 4,689 Number recalled for large films 32 28 60 Recall percentage 1.5 1.09 1.27 TABLE 10.—Large Film Recall Analysis. Male Female Total Further medical advice recommended 9 9 18 To return later to unit for re-check 6 3 9 No further action 15 16 31 Failed to attend for large film 2 — 2 Totals 32 28 60 It will be noted from Table 10 that of the 4,689 persons X-rayed, 18 (0.38 per cent.) were referred for further medical advice, and 9 (0.19 per cent.) were invited to attend later for re-examination. Separate figures for persons actually living in St. Marylebone are, unfortunately, not available in respect of this investigation. Venereal Diseases.—Continued assistance was given to the propaganda campaign for drawing public attention to the dangers of tRese conditions, and to the adequate facilities which exist for those in need of treatment. Scabies.—The Council's Cleansing Station in Lisson Grove dealt with 198 cases of scabies: adults 45 (men 30, women 15); children 153 (boys 102, girls 51). Domiciliary visits paid in connection with St. Marylebone cases numbered 18. Impetigo.—Five boys and four girls received treatment for this condition at the Cleansing Station. Disinfection.—During the year, 364 rooms and 3,059 articles of bedding (mattresses, blankets, sheets, bolsters, pillows, etc.), together with 1,083 books, were disinfected after infectious diseases generally. In addition, 381 dressing drums from a local hospital were sterilised. Bacteriological Examinations.—Table 11 shows the number of specimens examined for the purposes of diagnosis and indicates also the organisms in relation to which the examinations were made. 23 TABLE 11.—Work of the Bacteriological Laboratory. Nature of Specimen and Examination Positive Negative Total Throat and nasal swabs for— B. diphtheriae - 104 104 Haemolytic streptococci 22 57 79 Vincent's organisms 7 12 19 Vaginal swab—for N. gonorrhoeae — 1 1 Swabs—for Staphylococcus aureus 2 — 2 Cough plates—for H. pertussis 1 3 4 Sputa—for tubercle bacilli 3 50 53 Faeces—for parasites 1 1 2 Faeces—for dysentery, food poisoning organisms and typhoid 16 94 110 Blood—for typhoid, paratyphoid and Brucella abortus . . 2 3 5 Blood—for blood sugar estimation — 1 1 Blood—-for malarial parasites — 1 1 Foods—for food poisoning organisms — 11 11 Totals 54 338 392 APPENDIX. ST. MARYLEBONE CLEAN FOOD ASSOCIATION. Articles of Association. 1. Name: The Association shall be known as the St. Marylebone Clean Food Association. 2. Objects: The objects for which the Association is established are as follow:— (a) To promote clean methods of handling food amongst persons engaged in the food trades in St. Marylebone. (b) To encourage the observance of all statutory standards of hygiene regarding food. 3. Membership: Membership of the Association shall be accorded to:— (a) Food traders or their representatives, carrying on business within the Borough of St. Marylebone, who have undertaken to comply with these Articles of Association. (b) Members of the St. Marylebone Borough Council elected to serve on the Executive Committee to represent consumers. 4. Officers of the Association: The Honorary Officers of the Association, all of whom shall be elected annually, shall be a Chairman, Vice-Chairman, and a Secretary and Treasurer, all of whom shall be ex-officio members of the Executive Committee. The Association may appoint such other officers as may from time to time be deemed necessary. 5. Meetings: An Annual Meeting of the Association shall be held in April or May in each year. Other meetings of the Association shall be held at such times as may be determined by the Executive Committee, who, except in emergency, shall give not less than 14 days notice of any General Meeting. Meetings of the Executive Committee shall be held at such times as may be determined by the Executive Committee. 6. Annual Meeting: The business of the Annual Meeting shall include the election of the Honorary Officers of the Association for the ensuing year; the appointment of members of the Executive Committee; and the reception, approval, and adoption of the Annual Report of the Association for the past year. 7. Quorum: The Quorum at a meeting of the Association shall be 15, and the quorum at a meeting of the Executive Committee shall be 7. 8. Executive Committee: An Executive Committee of the Association shall be formed of 15 members of the Association as follow:— 13 representatives composed, so far as possible, of one member from each food trade or group of food traders, and 2 members of the St. Marylebone Borough Council nominated by the Borough Council to represent consumers. 24 The Executive Committee shall have power to co-opt additional members up to a total not exceeding one-third of the non-co-opted members. Members of the Executive Committee shall retire annually but shall be eligible for re-election. The Medical Officer of Health will act as adviser to the Executive Committee. The duties of the Executive Committee shall include:— (a) Consideration of applications for membership of the Association. (b) Authorisation of the issue, refusal to issue, or withdrawal of Clean Food Certificates and Badges of Membership. (c) The keeping of a Register of Members. (d) The arranging of talks, discussions and similar educational activities on various aspects of hygiene as applied to the food trades. (e) Reporting to the Association at the Annual and other Meetings on matters concerning the Association. (f) Dealing with any matters concerning the Association arising at, or referred to the Executive Committee from, any Annual or other Meeting of the Association. 9. Application for Membership: Each application for membership of the Association shall be:— (а) Made to the Honorary Secretary, in writing, on the prescribed form. (b) The subject of a report by the Medical Officer of Health. (c) Submitted together with the report of the Medical Officer of Health to a Meeting of the Executive Committee who shall, if the conditions of membership are complied with, forthwith cause the name of the applicant and the address of the premises to which the application refers to be entered in the Register of Members and issue to such applicant a Clean Food Certificate and Badge of Membership. 10. Conditions of Membership: It shall be a condition of membership of any food trader that:— (a) An application for membership shall be accompanied by an undertaking, on the prescribed form, by the applicant to comply with these Articles of Association including the Code of Practice which is set out hereunder. (A copy of the Code of Practice shall be handed to each employee and a copy shall be exhibited on the premises in some prominent position for the information of all concerned with the handling or distribution of food). (b) The premises to which the application relates shall comply with the requirements of the Food & Drugs Act, 1938, and any relevant statutory requirements in force in the district. 11. Clean Food Certificate and Badge of Membership: The Clean Food Certificate and Badge of Membership shall remain the property of the Association and shall not be displayed on premises other than those in respect of which they have been granted. 12. Breaches of Articles of Association: On receipt of a complaint alleging that there has been a breach of the Articles of Association by a member, the Executive Committee shall cause an investigation to be made by the Medical Officer of Health and, if as a result they are of opinion that any membership should be terminated, and the Clean Food Certificate and Badge of Membership withdrawn, such member shall be invited to attend a meeting of the Executive Committee at which the matter will be discussed. If the member concerned does not show cause to the satisfaction of the Executive Committee why the membership shall not be terminated and the Clean Food Certificate and Badge of Membership withdrawn, then the Committee shall cause the member's name to be deleted from the Register of Members and the Clean Food Certificate and Badge of Membership which were issued to him to be withdrawn. 13. Alteration to the Articles of Association: Alteration to the Articles of Association must receive the assent of not less than two-thirds of the members of the Association present and voting at a General Meeting. A notice of motion for the alteration of the Articles of Association must be received by the Honorary Secretary of the Association in writing at least 7 clear days before the meeting at which such notice of motion is to be brought forward. Code of Practice. The Management shall provide all reasonable facilities for the personal cleanliness of their staff, whilst at work, and shall encourage and as far as possible ensure that all persons engaged in the preparation, distribution and handling of food stuffs on their premises shall do so in a hygienic manner and comply with the under-mentioned rules:— 25 (a) Foodstuffs shall be treated with care and not handled unnecessarily. (b) All utensils and equipment used for the preparation, distribution, etc., of food shall be kept clean. (c) Hands and finger nails shall be scrubbed clean before commencing work, and after every visit to a sanitary convenience, and as often as necessary to ensure that the hands are kept clean. (d) Water-closets shall be maintained in a clean condition and an adequate supply of toilet paper provided. (e) Any cut or sore on the hands shall be properly covered with a plastic or other waterproof dressing. (f) Overalls shall be changed as frequently as necessary to maintain cleanliness. (g) Head-coverings should be worn and maintained in a clean condition in kitchens and other premises where food is in course of preparation. (h) Smoking shall be forbidden during the preparation of foodstuffs and during the handling or distribution of unprotected foodstuffs. (i) Employees shall immediately notify the management if they suspect that they are in an infectious condition or have been in contact with any infectious or contagious disease. (j) Employees shall be required to do everything possible to support the efforts of the management to ensure that the preparation, handling, and distribution of food are carried out in a thoroughly hygienic manner. (k) Personal clothing shall not be hung or stored in food preparation rooms, but shall be kept in lockers or similar accommodation which shall be provided by the management for the outdoor clothing of members of the staff. (l) All food shall be stored off the floors and clear of the walls, thus facilitating cleansing. (m) Where cooked foods, or articles of food requiring no further preparation before eating, are displayed the quantity displayed shall be limited to the barest minimum, and this shall be protected from contamination by flies, dirt, dust, etc., by means of glass, cellophane, or other adequate covering. (n) Foods such as butcher's meat, fish, game, poultry, etc., shall be stored in a refrigerator or cold store in bulk, and only a minimum displayed which shall be adequately protected from contamination by flies, dirt, dust, etc. (o) All opened sacked-goods shall be transferred to galvanised bins with close-fitting covers when in store to prevent contamination by rats, mice, insects, pests, etc.