Ac.4353 Ach 2/12/52 bg. STMARY 56 BOROUGH OF ST. MARYLEBONE REPORT of the MEDICAL OFFICER OF HEALTH FOR THE YEAR 1951 H. A. BULMAN, M.R.C.S., D.P.H. London: Vail & Co., Ltd., 170 Farringdon Road, E.C.I 2 CONTENTS page Members of the Public Health Committee 4 Sec tion A -Statistics and Social Conditions:— General Statistics 4 Extracts from Vital Statistics 4 Maternal Mortality 4 Marriages 4 Deaths 4 Infantile Mortality 5 Mortuary 6 Crematorium 6 Section B—General Provision of Health Services:— Staff 6 Staff Medical Examinations 6 Laboratory Facilities B Representation upon other Bodies B Financial Contributions to Voluntary Organisations 7 Conferences 7 Care of Old People 7 Special Laundry Service 7 St. Marylebone Old People's Welfare Association 7 Section C —Sanitary Circumstances - Sanitary Inspection 8 Nuisances Detected and Remedied 9 Sanitary Accommodation at Public Houses 10 Water 10 Drainage 10 Combined Drainage 10 Building Licences 10 Public Conveniences 10 Public Cleansing and Salvage 10 Food Bins 11 Shops 11 Diseased or Infirm Persons 11 Burial or Cremation of the Dead 11 Disinfestation 11 Verminous Persons 12 Shelter 12 Rodent Control 13 Dog Nuisance 13 Pigeons 13 Noise 13 Atmospheric Pollution 13 Poisons 15 Factories 16 Inspections and Defects Found 16 Out-workers 17 Rag Flock and other Filling Materials 17 Rivers : Prevention of Pollution 17 Methylated Spirit Drinking 18 page Section D- Housing:— Permanent Schemes 18 County of London Development Plan 18 Barrow Hill Primary School 18 St. Marylebone Housing Association and Trust 19 Inspection of Dwelling-houses 19 Underground Rooms 19 Re-housing 19 Common Lodging Houses 19 Rent Restrictions Acts 20 Section e—Food:— Food and Drugs Analysis 20 Milk 22 Cream 22 Butter and Margarine Premises 22 Ice-Cream 22 Preserved Food 23 Fried Fish Vendors and Fish Curers 23 Bakehouses 23 Restaurants, etc 23 Canteens at Government Premises 23 Retail Food Shops 24 Horseflesh 24 Slaughter of Animals 24 Unsound Food 24 Clean Food Campaign 24 St. Marylebone Clean Food Association 24 Dogs in Food Shops 25 Glass-washing in Public Houses 25 Section f—Infectious and other Diseases:— Notifiable Diseases 25 Notifications 26 International Certificates of Vaccination and Inoculation 27 Smallpox 27 Leprosy 27 Food Poisoning Outbreaks 27 Tuberculosis:— New Cases and Mortality 27 Notifications 27 Mass Miniature Radiography 28 Venereal Diseases 28 Scabies 28 Impetigo 28 Disinfection 28 Bacteriological Examinations 28 Illustration:— Festival of Britain: Civic Exhibition facing 3 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 1951. The population, according to the census taken during the year, numbered 75,764 (males 31,663; females 44,101) as compared with 97,627 at the previous census (1931) and 104,173 at the 1921 census. Both the birth-rate (12.18) and the death-rate (13.77) showed an increase over the figures for 1950 (10.99 and 11.64 respectively). The infantile mortality rate of 19.39 again reached a new record low level, and is now about one-seventh of the average rate recorded some 50 years ago. Maternal mortality during 1951 was nil. Notifications of infectious and other diseases increased from 749 (1950) to 1,108, nearly three-quarters of this number being accounted for by measles (678) and whooping cough (135). There were two deaths from measles but none from whooping cough. No case of diphtheria was reported. A perusal of the report will show that, apart from routine matters, there was special activity in the environmental field, more particularly in connection with the widening of the scope of the clean food campaign, which included a survey of retail food shops; factory registration and inspection; rodent control, and more especially "block treatment"; atmospheric pollution; and disinfestation of verminous premises. The commencement of legal action for a variety of offences and contraventions was called for in a greater number of instances than usual, and although in many it was ultimately found unnecessary to proceed, it will be noted that 58 cases were actually brought before the Court. The care of old people continued to receive special attention, and grateful acknowledgement is made of the invaluable assistance rendered by the St. Marylebone Old People's Welfare Association, which not only carried out a full year's work on well-tried lines but embarked on several new services for the benefit of the Borough's aged inhabitants. As one of the Council's contributions to the Festival of Britain, a civic exhibition was held at the Town Hall from the 13th August to the 8th September, and attracted a total attendance of nearly 5,000. Owing to the restricted space available it was impossible to present on the public health stand a comprehensive picture of all the major activities of the Department. It was therefore decided to concentrate on one aspect only, and the choice fell upon a subject very much in the public mind at the time—food poisoning: its cause and prevention. The exhibit endeavoured to convey its story mainly by specially-taken photographs, simple charts and bacteriological specimens, supported by various leaflets which visitors were invited to take away. The Central Office of Information considered the display of sufficient merit to warrant the ordering of prints from negatives produced under the direction of the Department. Representatives of several other local authorities who were contemplating the holding of similar exhibitions also evinced interest in the content and lay-out of the stand, a photograph of which faces this page. The weather of 1951 had many disappointing features, including the absence of any really hot days and the large number of thunderstorms from June to August. Rainfall was the heaviest for five years, and had been exceeded only five times in the past 72 years. The relatively dry months were June, July and also October when drought conditions developed. Councillor Captain Robert Whitney, M.B.E., J.P., Chairman of the Public Health Committee until May, was succeeded in this position by Councillor The Rt. Hon. Lord Mancroft, M.B.E., T.D. To both and to the members of the Committee and, indeed, to members of the Council generally, I desire to offer my thanks for the support and sympathetic consideration always extended to me, and for their attention to the problems which it has been my duty to place before them. To the staff of the Public Health Department, and to my colleagues in other departments of the Council, I again express my appreciation of their assistance and co-operation 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. 1951. HIS WORSHIP THE MAYOR: *Councillor Charles Henry Press, J.P. †Alderman Frederick William Dean, J.P., D.L., F.I.A.S. COUNCILLORS: †Dr. H. K. Ashworth, T.D. †Mrs. E. M. Brown *T. K. Creamer Frederick Frame Herbert C. Garrard (†Vice-Chairman) *R. T. Glenny B. Hawley Mrs. M. Henderson-Begg J. P. Honour Dr. Elizabeth Jacobs *Until May. Elliott Levy Stafford Lorie The Hon. Mildred Lowther, O.B.E. †Mrs. L. Lyons The Rt. Hon. Lord Mancroft, M.B.E., T.D. (*Vice-Chairman; †Chairman) *Mrs. Angus Maude Miss L. West Russell Capt. R. G. Whitney, M.B.E., J.P. (*Chairman) †From June. 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: £3,431,530. Sum represented by a penny rate: £13,702. Number of residential units (separate assessments): 22,772. Population : 1951 census—75,764. 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): 1951—76,160. EXTRACTS FROM VITAL STATISTICS. Total M. F. Live Births—Legitimate 842 426 416 \ Bi Illegitimate 86 44 42/ Stillbirths—Legitimate 12 10 2\ Rc Illegitimate 10 5 5J Deaths (all ages) 1,049 540 509 De Maternal Mortality—Deaths from "Pregnancy, Childbirth, Abortion" (Registrar-General's Code No. 30) Birth Rate per 1,000 estimated home population 12.18 Rate per 1,000 total (live and still) births 13.16 Death Rate per 1,000 estimated home population 13.77 Nil. Deaths of Infants under one year of age- Legitimate Illegitimate Total 12 6 M. 6 3 F. 6 3 Death Rate of Infants under one year of age—All infants per 1,000 live births, 19.39; legitimate infants per 1,000 legitimate live births, 14.25; illegitimate infants per 1,000 illegitimate live births, 69.77. Marriages.—The total number of marriages was 1,415, being 24 below the number for 1950 and 37 above the average for the previous 10 years. The rate for persons married in 1951 was 37 per 1,000 of the estimated home population. Deaths.—The total number of deaths (1,049) shown in Table 1 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 stntioned in the area. 5 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 23 7 — — 1 - — — 2 5 15 1 5 1 2 Tuberculosis, other - - - - - - - - - - - - - — 3 Syphilitic disease 6 1 - - - - - - - - 2 — 4 1 4 Diphtheria - - - - - - - - - - - - - - 5 Whooping cough - - - - - — - - - - - - - - 6 Meningococcal infections - - - - - - - - - - - - - - 7 Acute poliomyelitis 1 - - - - - - - 1 - - - - - 8 Measles 2 1 - - 2 - - - - - - - - 1 9 Other infective and parasitic diseases 2 1 - — — - — — 1 — 1 — — 1 10 Malignant neoplasm, stomach 11 9 - - - - - - - 1 4 4 7 4 11 Malignant neoplasm, lung, bronchus 21 8 - - - - - - 2 — 11 2 8 6 12 Malignant neoplasm, breast — 21 - - — - — — — 2 — 9 — 10 13 Malignant neoplasm, uterus — 8 - - - - - - - - - 5 — 3 14 Other malignant and lymphatic neoplasms 56 47 - - - - - - 4 4 20 14 32 29 15 Leukaemia, aleukaemia 1 5 - - - 1 - - 1 - - 2 — 2 16 Diabetes 5 10 - - - - - - - 1 3 1 2 8 17 Vascular lesions of nervous system 55 76 - - - - - - - - 11 19 44 57 18 Coronary disease, angina 90 47 - - - - - - 1 — 37 6 52 41 19 Hypertension with heart disease 21 24 - - - - - - 1 — 5 6 15 18 20 Other heart disease 76 73 - - - - - - - 1 14 5 62 67 21 Other circulatory disease 13 16 - — — - - - - - 4 2 9 14 22 Influenza 5 12 — — — - — — 1 — 2 1 2 11 23 Pneumonia 25 20 — — - - — — — — 7 4 18 16 24 Bronchitis 44 28 — 2 - - — — — — 8 1 36 25 25 Other diseases of respiratory system 6 8 - - - - - - - - 1 2 5 6 26 Ulcer of stomach and duodenum 16 5 1 - - - - - - - 6 2 9 3 27 Gastritis, enteritis and diarrhoea 3 4 1 - - - - - — - 1 1 1 3 28 Nephritis and nephrosis 3 6 - — - - - - - 2 1 1 5 29 Hyperplasia of prostate 8 - - - - - - - - - 1 - 7 — 30 Pregnancy, childbirth, abortion - - - - - - - - - - - - - - 31 Congenital malformations 2 1 2 - - - - - - - - - - 1 32 Other defined and ill-defined diseases 26 37 5 6 — - — — 4 4 9 10 8 17 33 Motor vehicle accidents 6 6 — — 1 - 1 — 1 2 — 2 3 2 34 All other accidents 9 18 — — — - 9 —. 2 2 1 3 4 13 35 Suicide 4 8 - - - - - - - - 3 6 1 2 36 Homicide and operations of war 2 — 1 — 1 - — — — — — — — Totals 540 509 9 9 4 2 3 — 21 22 168 109 335 367 1,049 18 6 3 43 277 702 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. Congenital malformation 1 - 1 - - - - - - - - - - - 2 - Enteritis — - — - — — 1 — — — — — — — 1 — Premature birth 1 2 — 1 - - - - - - - - - - 1 3 Atelectasis — 2 — - — - - — — — — — — — — 2 Bronchitis - — - 2 - - - - - - - - - - - 2 Pneumonia — — 1 1 - - - - - - - - - - 1 1 Ulcer of duodenum 1 - - - - - - - - - - - - - 1 - Homicide — 1 - — — - - - - - - - - - - 1 Other causes 2 - 1 - - - - - - - - - - - 3 - Totals 5 5 3 4 - — 1 - - - - - - - 9 9 10 7 — 1 - - - - 18 No infantile death occurred from the following causes not shown in the table: Small-pox, chicken-pox, measles, whooping cough, scarlet fever, diphtheria and membranous croup, tuberculous meningitis, abdominal tuberculosis, other tuberculous diseases, atrophy, debility and marasmus, injury at birth, erysipelas, syphilis, rickets, convulsions, gastritis, laryngitis, meningitis, suffocation, overlying. 6 Mortuary.—Six bodies (2 male, 4 female) were received at the Public Mortuary, Chiltern Street. No post-mortem examinations were carried out. Crematorium.—The Medical Officer of Health is Medical Referee for the Council's Crematorium, situated in the St. Marylebone Cemetery at East Finchley. During 1951, 1,284 certificates authorising cremation were issued, as compared with 759 certificates in 1950, 669 in 1949, and 360 in 1948. Since the Crematorium was opened in December, 1937, 4,882 cremations have been carried out. SECTION B.—GENERAL PROVISION OF HEALTH SERVICES. Staff.—There were no changes in the staff of the Department during the year. The Minister of Health accepted the recommendations of the Local Government Manpower Committee for simplifying the control which his Department was required to exercise over the appointment of medical officers of health and sanitary inspectors, and in order to implement those recommendations issued the Sanitary Officers' (London) Regulations, 1951. These Regulations came into operation on the 1st July, 1951, and they amend the Sanitary Officers' Order, 1926, which, with the Sanitary Officers' (London) Regulations, 1935, were in force in London only. The amendments are designed to relax central controls but to retain the measure of security of tenure which these officers have enjoyed. The main changes in procedure are, briefly, that (i) the Minister's approval is no longer required to the actual appointment of any medical officer of health or sanitary inspector, but consent will still be required before steps are taken to fill a vacancy in the position of medical officer of health; (ii) the Minister's approval is no longer required to individual salaries, which are now governed by negotiating machinery; (iii) an officer who objects to a proposed variation in the terms of his appointment has a right of appeal to the Minister. In order to enable the County Council to make its contribution to the salaries of medical officers of health and sanitary inspectors, local authorities have now to inform the County Council of all new appointments in these positions and furnish particulars of the persons appointed. Staff Medical Examinations.—The Medical Officer of Health is medical adviser for the purposes of the Council's superannuation scheme. During 1951, 77 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. St. Marylebone Tuberculosis Care Committee. Western Ophthalmic Hospital—House Committee. West End Hospital for Nervous Diseases. Samaritan Hospital—House Committee. National Smoke Abatement Society. London and Home Counties Smoke Abatement Advisory Council. Paddington and St. Marylebone District Nursing Association (Executive Committee). St. Marylebone Youth Centre Committee (Management Committee). Representatives Councillor H. C. Garrard. Councillor Dr. Elizabeth Jacobs. Councillor Miss L. West Russell. The Medical Officer of Health. Councillor F. Frame. Councillor Miss L. West Russell (from February). The Medical Officer of Health (from February). Councillor F. Frame (from February). 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. (until February). Councillor F. Frame (until February). Councillor R. T. Glenny (from March). Councillor The Hon. Mildred Lowther, O.B.E. (from March). 7 Body St. Marylebone Clean Food Association. Department of Scientific and Industrial Research— Standing Conference of Co-operating Bodies dealing with Atmospheric Pollution. Representatives Councillor H. C. Garrard. Councillor Miss L. West Russell (until May). Councillor Mrs. M. E. Henderson-Begg (from June). The Chairman of the Public Health Committee. The Medical Officer of Health. With the concurrence of the Council the Medical Officer of Health continued to serve on the Health Committee of the Association of Municipal Corporations during the year. 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 1951 as indicated below:— Organisation Central Council for Health Education. Family Welfare Association (Area 2). National Smoke Abatement Society. London and Home Counties Smoke Abatement Advisory Council. St. Marylebone Old People's Welfare Association:— "Meals on Wheels" Service. "Hard of Hearing" Club. Amount £ s. d. 10 10 0 100 0 0 5 5 0 2 2 0 324 10 3 19 10 0 Statutory Authority Public Health (London) Act, 1936, section 298. Local Government Act, 1948, section 136. Public Health (London) Act, 1936, section 298. Local Government Act, 1948, section 136. Local Government Act, 1948, section 136. National Assistance Act, 1948, section 31. 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 Royal Sanitary Institute. Southport, 23rd to 27th April. Sanitary Inspectors' Association. Margate, 11th to 14th September. Central Consultative Committee on the Welfare of Old People. London, 29th November. Delegates The Chairman of the Public Health Committee and the Medical Officer of Health. Mr. H. E. Scoble, Food Inspector and Sampling Officer. The Vice-Chairman of the Public Health Committee and Miss M. M. Sharp, Sanitary Inspector. Care of Old People.—Four hundred and seventy-one old people (including 46 married couples) were visited by one of the women sanitary inspectors. The great majority were living alone and some required constant observation. The domestic help service continued to render valuable assistance to a large number of the aged inhabitants of the Borough. Special Laundry Service.—Under the scheme for dealing with the bed linen and night-wear of acutely ill and incontinent old people, 32 cases were dealt with during 1951, each individual case being the subject of a certificate by the Medical Officer of Health under section 122 of the Public Health (London) Act, 1936. The work is carried out directly by the Council at the Public Health Department laundry, No. 217, Lisson Grove, N.W.8. The service has now been in operation for a second year and continues to be greatly appreciated by all who are concerned with the nursing of the aged in their own homes. Some of the cases assisted were awaiting admission to hospital but others, with the help of the service, were able to continue to be cared for at home. Certain of the cases require to be dealt with for short periods only, while others need assistance for a long time. There has not been a break without a case, and the largest number in hand at any one time during the year has been eight. During the greater part of June it was necessary, on account of electrical failure, to close the laundry dealing with this service, but with the co-operation of the Baths Superintendent it was possible to maintain it uninterruptedly by having the work done at the Public Baths. St. Marylebone Old People's Welfare Association.—The Association held no public meetings during the year but the monthly meetings of the Executive Committee were well supported. Representatives attended various conferences on the welfare of old people at which the pooling of experience and interchange of ideas proved most helpful features. 8 The Women's Voluntary Services continued to deliver meals to the housebound on five days a week, and over 5,000 meals, obtained from the London County Council restaurant in Bryanston Square, were distributed during the year. The Association expressed thanks to the Public Health Department for arranging an overhaul of the delivery van and for lending a vehicle while their own was out of commission on several occasions. The "meals on wheels" and home helps services together make, perhaps, the most important contribution to domiciliary welfare work for old people, the ultimate aim of which is to enable them to live in their own homes as long as possible. The W.V.S. Luncheon Club and the Cookshop of the St. Marylebone Housing Association and Trust continued to function, the food for the former being delivered to the club premises from the London County Council restaurant by the Association's van, thus bringing the total number of meals transported annually to 10,000. The seven "Darby and Joan" Clubs held weekly meetings and arranged summer outings and Christmas parties. Three of the clubs are organised by the W.V.S., one by the Women's Committee of the Liberal Jewish Synagogue, one by the Inner Wheel of St. Marylebone Rotary, one by the Fourth Feathers Club, and one by a member of the League for the Hard of Hearing. The friendly unofficial visiting of lonely old people, which was the first work undertaken by the Association, remains the most important. Though visiting is carried out by officers of many official bodies, notably the National Assistance Board, the Borough Public Health and Housing Departments, and by district nurses, home helps, the clergy and church workers of all denominations, as well as by club organisers when their members are ill or in hospital, there are still many old people with no "official" needs, and it is they whom the Association's small band of fifteen visitors try to help. All the various visiting organisations were represented on the Association's Executive Committee, where their combined knowledge and experience is available for the benefit of all. There is also a monthly visitors' meeting, which is attended by a member of the Executive Committee who is the Association's liaison officer with the parish visitors of a group of churches in the Borough. Through its visiting service the Association kept in touch with nearly a thousand old age pensioners, and it has issued an earnest appeal to anyone who can spare a few hours a month to help in this work, upon which all other activities are based. Turning to new services inaugurated by the Association during 1951, arrangements were made to deliver small quantities of coal and wood blocks to old people in their homes to tide them over an emergency or until their priority permits for fuel were honoured. In the early part of 1951 there were many calls on the service but with milder weather prevailing at the close of the year only a small number of deliveries were necessary. A foot clinic for old people, started in June, 1951, proved to be an outstanding success. The equipment was purchased out of a grant from the Sunday Cinematograph Entertainments Fund of the London County Council, and the clinic is administered by the local branch of the British Red Cross Society and staffed by a qualified chiropodist and two students from the School of Chiropody at Chelsea Polytechnic. Sessions were held weekly in the Town Hall Extension, and 240 patients received treatment during the first six months. A home chiropody service, closely associated with the clinic, provided treatment for 61 patients, visits at the outset being made once a month by the chiropodist and later fortnightly owing to the increased demand. The Association renders incidental help in many ways. It has a small relief fund for emergencies; it assisted a few old people with holidays; obtained the loan of wireless sets for the housebound; and through a local press appeal secured a stock of sheets for the use of the aged. Certain members of the Association's Executive Committee, including the Chairman and Hon. Secretary, continued to serve on the Committee of the specially-formed housing society (St. Marylebone Old People's Homes, Ltd.) which is engaged in establishing in St. John's Wood a "care and attention" home for St. Marylebone's old people. With the concurrence of the Council, the Medical Officer of Health accepted an invitation by this organisation to become Honorary Medical Officer of the home, which, despite difficulties and delays, it is hoped to open early in 1952. The Hon. Secretary of the St. Marylebone Old People's Welfare Association is Miss M. K. C. Macintosh, Room 103, Town Hall, St. Marylebone, W.l. SECTION C.—SANITARY CIRCUMSTANCES. Sanitary Inspection.—The number of complaints received (excluding those relating to rat and mouse infestations) was 1,428. Details of the various nuisances detected and remedied, to the total number of 2,275, are set out in Table 3. In 802 cases a preliminary (intimation) notice was issued, and in 9 298 instances this was followed by the service of a statutory notice to secure abatement of nuisances. In addition, 163 notices were served under London County Council Bye-laws made under the Housing, Metropolis Management or Public Health Acts. Legal proceedings were instituted in 11 cases under the Public Health (London) Act, 1936, in respect of failure to comply with statutory notices. In three instances penalties amounting to a total of £9 0s. 0d., were imposed, costs being awarded to the Council. Costs without the imposition of a fine were allowed in two other instances. In the remaining cases the summonses were withdrawn, the works having in the meantime been completed. Legal proceedings under the County Council Bye-laws were taken in two instances. One resulted in a fine of £2 0s. 0d. with two guineas costs, and the other was withdrawn upon completion of the necessary work. Amongst the various provisions of the London County Council (General Powers) Act, 1951, are certain amendments of the Public Health (London) Act, 1936, including the right of appeal of an aggrieved person to a court of summary jurisdiction (instead of the London County Council as formerly) against certain acts and decisions of a borough council; and power to make a charge on premises where a sanitary authority has incurred expenses (for example, on the remedying of nuisances) for the repayment of which the owner of the premises is liable. 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 37 46 372 174 183 193 1,005 Doors, windows, floors, ceilings, sash cords, grates and flues, etc., repaired 35 37 129 74 74 72 421 Water closet defects remedied 7 9 40 44 51 17 168 Insufficient and unsuitable water closet accommodation remedied - - - 1 1 1 3 Urinal defects remedied — 1 — 1 — — 2 Drain and water closet stoppages cleared 4 4 53 10 23 31 125 Drains relaid or amended 2 2 — 1 — — 5 Soilpipes and ventilating shafts repaired or renewed 2 - — 2 2 2 8 Waste pipe defects remedied 5 2 12 13 10 9 51 Yard defects remedied — — 4 — 8 2 14 Wash-house defects remedied — —- 3 2 1 — 6 Area defects remedied — — — — 2 — 2 Roofs and gutters repaired 23 30 71 64 79 36 303 Water supply to houses reinstated 2 1 — 8 — — 11 Water supply laid on to upper storeys 3 1 6 4 7 3 24 Water cistern defects remedied — 2 — 5 — — 7 Dung or dust receptacles repaired or renewed 2 1 . 30 5 4 - 46 Rubbish, manure, etc., accumulations removed 2 1 6 — — 14 17 39 Animal nuisances abated - 1 — — 1 — 2 Shops—sanitary defects remedied — - — — 1 2 3 Miscellaneous 6 2 8 4 7 3 30 Totals 130 145 728 412 468 392 2,275 Sanitary Accommodation at Public Houses.—In the last two annual reports reference has been made to the special survey of the sanitary accommodation at licensed premises carried out in 1949, which revealed the standard to be unsatisfactory in 51 of the 128 premises. The position at the end of the year 1951 is summarised below:— Satisfactory standard: Previously reported as satisfactory 81 Brought up to standard since 1949 survey 17 98 Schemes in hand: Work proceeding 3 Plans approved and building licences granted 2 5 Building licences refused: After approval of plans by Council 3 Without submission of plans to Council 4 7 Cleansed but not brought up to standard 5 Still unsatisfactory (including 2 on Crown Estate) 13 Total 128 10 As previously stated, it is probable that 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. The matter continues to receive the close attention of the Department. 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. One complaint as to quality was received during the year and referred to the Board. In accordance with the provisions of the Public Health (London) Act, 1936, the Board notified three instances where water had been cut off in occupied premises for non-payment of rates. In all cases the supply was reinstated without the need for service of a notice. 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 for 1951 were generally satisfactory and no pathogenic contamination was found. There were, however, indications that, as a sole source of supply of drinking water to any particular premises, an artesian well cannot always be relied upon, as such water is liable to earthy contamination and there is always the possibility of trouble arising from the breakdown of pumping and other equipment. Because of this it is the practice of the Department to keep these wells under observation and sample their waters every six months. Six certificates relating to the provision of a proper and sufficient supply of water in dwelling-houses were granted under section 95 (2) of the Public Health (London) Act, 1936, in respect of newly-erected and rebuilt premises, including three Borough Council blocks of flats. Drainage.—The number of plans approved was 325, of which 24 related to new buildings. The drainage inspectors made a total of 3,421 visits. Legal proceedings under the London County Council Drainage and Water-Closet Bye-laws were taken in respect of six cases where work had been done improperly and without notice to the Council. All defendants were found guilty: fines totalling £48 0s. 0d. were imposed and £38 17s. 0d. costs awarded to the Council. Combined Drainage.—Eight orders under seal for combined drainage were issued. Building Licences.—During the year 138 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 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, still proved to be extremely popular and the public took full advantage of them. During the Festival of Britain period the three main conveniences were kept open beyond the usual closing times for the benefit of the large number of visitors to the West End, and as a result of observations it was subsequently arranged for the conveniences at Oxford Circus to continue to close later as a normal practice. On the 26th November, 1951, the Consistorial and Episcopal Court of London issued a Faculty authorising the Council to erect a public convenience in the St. John's Wood Burial Ground, Wellington Place. Planning permission having already been obtained, arrangements were proceeding at the end of the year for the construction of the convenience, which will have accommodation for men and women, with access from the burial ground and the highway. Public Cleansing and Salvage.—The Director of Public Cleansing has kindly provided the following information on these services. The materials dealt with during 1951 were: house and trade refuse, 35,537 tons; street sweepings and gully slop, 2,876 tons; salvaged materials (including kitchen waste) 1,964 tons. A sum of £15,406 was obtained from the sale of salvaged materials. In addition, £718 was received for the removal of trade refuse, green offal and the cleansing of petrol interceptors. During the year delivery was taken of four "Karrier" low-loading vehicles for general cartage purposes, and two "Karrier" mechanical vacuum gully machines with power-operated street washing attachments. Orders were also placed for twelve new mechanically-driven 4-wheeled tractors, complete with barrier loading articulated trailers, for the collection of salvage and refuse, and for two additional "Paladin" portable refuse container collection vehicles. 11 Food Bins.—Complaints were received of nuisance from communal bins placed at intervals in the streets for the reception of kitchen waste for pig and poultry feeding. To ascertain the position throughout the Borough, the sanitary inspectors made 150 pig bin inspections over a period of two weeks. These revealed that almost without exception the lids were on the bins and no bins were overflowing, but in some cases there was decaying vegetable matter in the bottom of the bins which might give rise to nuisance from smells. The obvious remedy is to ensure that the bins are flushed and cleansed at each emptying, but it is appreciated that the cost of introducing this ideal arrangement or, alternatively, of removing every bin every time and replacing it by an empty bin previously cleansed at the wharves, would be excessive. The Director of Public Cleansing, as the officer responsible for the operation of this salvage service, is equally aware of the potential source of nuisance which these bins create, and while he is endeavouring to meet this problem as far as practicable, it is inevitable that some nuisance will arise. The bins (279 in all) are emptied thrice weekly, and are taken to the wharves at the rate of six a day for thorough cleansing, repair and, where necessary, repainting. Bins little used or regularly misused are withdrawn and the remainder sited where they are found to be most needed. Kitchen waste collected from all sources in the Borough, it may be added, has shown a marked decrease: about 1,700 tons in 1949; 1,400 tons in 1950; 900 tons in 1951. The Public Health Committee, of course, are particularly concerned with the nuisance aspect of the scheme, but while the separate collection of pig food remains a direction by the Government it would seem that the Council have no option but to collect the material. Shops.—Inspections under the Shops Acts numbered 153. In two instances service of notice for the provision of adequate sanitary accommodation was necessary. Diseased or Infirm Persons.—In the case of five infirm and physically incapacitated old people who were living alone under insanitary conditions and whose relatives or friends were unable to render assistance, it became necessary to resort to action under section 47 of the National Assistance Act, 1948. Three old ladies were removed to Paddington Hospital on Court Orders issued for a period of three months, but two (aged 70 and 82 years) died within six weeks of admission. In the third case the Order was subsequently revoked by the Court as the health of the patient (aged 80) showed improvement and arrangements had been made for her future welfare. In two other cases (a man of 81 and a woman of 79) arrangements were made to apply to the Court for an Order for removal to hospital but before the applications could be heard both old people had died, in one instance at home and in the other after admission to hospital in an unconscious state. The unavoidable delay in dealing with these last cases and others of a similar nature, caused by the obligation to give to the persons concerned seven clear days' notice of the intention to apply for a Court Order for removal to hospital, led the Council to request the Metropolitan Boroughs' Standing Joint Committee to take steps to secure amendment of the provisions of the Act of 1948 so as to reduce from seven days to not less than 48 hours the period of notice necessary. This point was met by the National Assistance (Amendment) Act, 1951, which came into force on the 1st September, 1951, and gives local authorities further powers to enable them to deal expeditiously with cases of persons urgently in need of care and attention which they are unable to provide for themselves and are not receiving from other people. The new Act authorises a special procedure whereby a removal order may be made, without giving the seven days' notice required under the 1948 Act, in a case where the medical officer of health and another registered medical practitioner certify that in their opinion the person should be removed without delay. This method provides for a person's detention for a period not exceeding three weeks. Any application for an extension of this time has to be made under the provisions of the 1948 Act. 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 on the 5th July, 1948, continued to work satisfactorily and during 1951 the burial of 16 bodies was undertaken by the Council. The total expenditure incurred in dealing with these cases was £123 2s. 2d., of which £76 18s. 6d. had been recovered by the end of the year. Disinfestation.—In 1948 a campaign against the bed-bug was launched on a scale greater than any hitherto attempted. This was made possible by increased knowledge in the field of disinfestation brought about mainly by wartime conditions and centred more particularly round the use of D.D.T. (dichlorodiphenyltrichloroethane) and improved methods of application to verminous premises. Unlike many other disinfestants, D.D.T. is a stable substance and possesses distinct advantages in the eradication of the bed-bug and other insect pests. Used in a 5 per cent. solution in kerosene, D.D.T. has been found not only to possess an immediate killing effect on bugs but to leave on walls and other surfaces a lethal deposit which remains effective for many weeks. The best known method of application of the solution is by means of a fine whirling spray under constant pressure from a compressor unit 12 driven by a petrol engine. This method is utilised in the Council's disinfestation scheme, and a van has been equipped to carry the apparatus to and from premises to be disinfested. During 1951, 509 dwellings, involving 857 rooms, were disinfested. Included in the number of dwellings treated were 81 requisitioned premises and 13 municipal flats where bugs were found. Altogether 170 requisitioned dwellings were, on becoming vacant, inspected to ascertain if they were vermin infested. It is also appropriate to include in this report a note on the working of the scheme since its inception, together with an indication of the results obtained. Operations were commenced on the 1st July, 1948, and figures for that month and the three following months have been extracted and tabulated, together with those for the corresponding months in the three years 1949-1951. These months have been chosen as representative of the time of year when bugs are in their most active state. TABLE 4.—Disinfestation. Month No. of Infestations No. of Rooms Involved Insecticide used (gallons) 1948 1949 1950 1951 1948 1949 1950 1951 1948 1949 1950 1951 July 44 60 57 58 123 137 111 133 76 124 83 86 August 56 66 74 72 211 149 147 106 117 124 107 71 September 56 94 51 47 138 190 83 64 96 164 63 53 October 51 73 26 45 121 178 43 86 91 146 33 61 Totals 207 293 208 222 593 654 384 389 380 558 286 271 It will be seen from Table 4 that the number of rooms affected in 1948 was comparatively high for the number of infestations. A peak was reached in 1949, when the number of infestations reported was large compared with the other three periods under review and when the greatest quantity of insecticide was used. This was due to the publicity campaign at the time. In 1950 there was a marked decline in the number of rooms infested, with a 50 per cent. reduction in the consumption of insecticide, and it will be noted that the 1951 figures were remarkably similar. It is evident from the reduced number of rooms per infestation that the degree of incidence is lessening generally. It would appear that already a substantial reduction in the number and extent of verminous infestations has been effected, and there are indications that a continuation of the scheme will bring even better results. 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 1951 the furniture of 196 families (of whom 179 were being rehoused) was dealt with by this method. In addition, 5,018 verminous articles of bedding were disinfected by steam. In June an article of clothing handed in at the receiving depot of a firm of dry cleaners was subsequently found to be infested with lice. This led to a heavy infestation not only among the articles in the receiving depot but among those already sent for cleaning to two factories outside the Borough. In all some 850 garments were affected. Thorough disinfestation of the factories and all clothing was carried out under the supervision of the medical officers of health of the areas concerned, and the receiving depot was closed for two days and similarly treated. Verminous Persons.—The Council's Cleansing Station in Lisson Grove dealt with 1,079 vermin-infested persons: adults 535 (men 493, women 42); children 544 (boys 109, girls 435). Following an arrangement which has been in force for many years, the free issue of 2 oz. bottles of medicated (lethane) hair oil for the control of head lice was continued, more particularly to meet the needs of adults where it is considered that treatment could usefully be undertaken at home. Though the demand for the preparation has never been great, stocks are still kept at the Welfare Centres of the London County Council and at the Borough Council's Cleansing Station, where they are available to the women sanitary inspectors, health visitors and school nurses for distribution in suitable cases. Shelter.—It was not found necessary during the year to make use of the shelter accommodation provided at No. 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. 13 Rodent Control.—The smaller number of ship rat infestations discovered indicates a trend towards a greater measure of control of the rodent menace within the Borough. This improvement was offset to some extent by increases in the numbers of common rat and mouse infestations. As the presence of the common rat is usually associated with drainage defects, the rodent operatives were trained to include a superficial inspection of drains in their routine treatments. The increase in the number of complaints of mice may be attributed to the publicity given to the free treatment available to the occupiers of dwelling accommodation. A minimum charge of 10s. for dealing with each infestation at business premises continued to be made. It is gratifying to be able to report that owners, occupiers and commercial rat-catching firms co-operated closely with the Council's staff. Two additional rodent operatives were appointed in April and thereafter the scheme of "block treatment" was intensified, as shown in Table 5. It was not necessary to take formal action under the Prevention of Damage by Pests Act, 1949, but 193 informal notices were served. Twenty-five notices were served under the London County Council bye-laws in respect of drainage defects. Sewer baiting was carried out in January at 158 baiting points and again in June when the number of baiting points was increased to 234. TABLE 5.—Work of the Rodent Control Service. Year Complaints Blocks Treated Infestations Discovered Premises Treated by Council's Staff Number Premises involved Number Premises involved Ship rat Common rat Mice Total 1950 1,602 1,547 29 1,634 884 223 334 1,441 1,278 1951 1,562 1,548 117 7,488 592 312 399 1,303 1,130 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 30 cases. In 27 of these convictions were secured and penalties imposed, costs being awarded to the Council in two cases. The remaining three cases were dismissed, one on the payment of costs. The total number of prosecutions taken by the Council since the bye-law came into operation in 1928 is 486. Pigeons.—Nuisance from these birds was reported in four instances, relating mainly to residential properties, and in three cases the complaints were referred to an approved pigeon catcher. In the remaining case, the nuisance, which was caused by the feeding of pigeons, was abated after informal action. Noise.—Complaints of 33 noise nuisances were received. They were concerned with such diverse matters as radio, musical instruments, dogs, fowls, machinery, building operations, refrigerator in a shop, chimney cowl, dustbin trolley, social gatherings of various kinds, and a coach park. The majority of these nuisances were abated after action by the sanitary inspector and streets nuisance inspector. In other cases, where upon 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 continued to be made regularly throughout the year, and 8 complaints were received in respect of smoke nuisances arising from 7 premises, relating to a commercial undertaking, a block of flats, private houses, 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," i.e., to record the amount of deposit which occurs in a locality which may be taken to represent average conditions in the Borough. Welfare Centre No. 2 is approximately E.N.E. of the Aberdeen Place generating station and would thus tend to be "down wind" from this station. It may therefore reasonably be supposed to be affected more by this station than by the Lodge Road Generating Station which is N.N.E. of the Welfare Centre, i.e., "up wind." 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 the monthly readings for the year ended 31st March, 1951, are shown in Table 6. 14 TABLE 6.—Atmospheric Pollution. Summary of readings from deposit gauge apparatus installed to record the amount of deposit from the atmosphere, solids being expressed in tons per square mile. Month Welfare Centre No. 2 Town Hall Rainfall (mm.) Insoluble Deposit Soluble Deposit Total Solids Rainfall (mm.) Insoluble Deposit Soluble Deposit Total Solids 1950 April 36 13.74 11.13 24.87 36 12.50 8.88 21.38 May 29 28.95 10.31 39.26 36 10.82 7.29 18.11 June 37 17.02 8.50 25.52 23 7.43 4.01 11.44 July 60 11.10 5.01 16.11 70 5.40 4.95 10.35 August 31 11.33 3.06 14.39 45 8.65 5.75 14.40 September 51 16.00 9.57 25.57 63 8.65 6.40 15.05 October 8 11.98 6.54 18.52 9 6.14 4.44 10.58 November 111 19.50 14.06 33.56 111 12.28 12.94 25.22 December 26 19.83 10.26 30.09 37 12.91 7.29 20.20 1951 January 57 15.61 9.08 24.69 63 9.66 11.63 21.29 February 115 19.58 11.72 31.30 123 13.42 9.80 23.22 March 70 20.78 13.36 34.14 68 11.11 5.90 17.01 Average (12 months) 53 17.12 9.38 26.50 57 9.91 7.44 17.35 Generally, it may be said that the deposit at the Welfare Centre indicates a much greater degree of atmospheric pollution there than at the Town Hall. The figures, however, show a few remarkable inconsistencies, notably in August when the readings for the Welfare Centre and the Town Hall were 14.39 and 14.40 tons per square mile, respectively; and in April and January when the figures in respect of the Welfare Centre were only slightly higher than those for the Town Hall. On the other hand, during May, June and March there was approximately double the amount of deposit at the Welfare Centre as compared with the control. At the time it was not known whether these differences were in any way associated with output at the generating stations. It is important that readings of this kind should be considered in conjunction with similar readings taken in other parts of London and of the country, as in many respects atmospheric pollution is relative and what might be regarded as a serious case in a rural district might appear to be very moderate as compared with the degree of pollution prevalent in an industrial town. The readings shown in the table were submitted to the Superintendent of Observations, Atmospheric Pollution Research, Department of Scientific and Industrial Research, who kindly gave his views upon the results of the year's observations in the following report:— "The results obtained in this investigation are quite positive in that they show clearly that the rate of deposition of solids in the Lisson Grove area is consistently much higher than that at the Town Hall. The largest differences lie in the insoluble matter and particularly in the ash content of the insoluble matter—a result which suggests that the greater rate of deposition at Lisson Grove has been most likely due to emission from industrial installations in the near vicinity. Thus it is seen that the average value for insoluble matter at Lisson Grove is almost twice that for the Town Hall. "The largest individual consumers of fuel in the Lisson Grove area are the electricity generating stations at Lodge Road and Aberdeen Place and there are, in addition, railway marshalling yards between Lisson Grove and Park Road. These possible sources of atmospheric pollution lie respectively to the north-east, west and south-east of the observing station at Welfare Centre No. 2 and, therefore, the deposit gauge at this station will not be collecting the pollution from all three sources at any one time. The prevailing wind over the area is south-west and thus it is probable that of the three possible sources, the gauge will be exposed most frequently to the pollution from the generating station at Aberdeen Place. This does not, however, necessarily mean that the quantity of material collected by the gauge will have arisen mainly from this generating station, since nothing is known about the relative rates of emission of pollution by the three sources. Further information on this matter might be obtained by siting another gauge downwind, i.e., to the north-east of the Lodge Road generating station. "Although the deposited matter at Lisson Grove is higher than that at the Town Hall, it cannot, in comparison with other similarly situated areas, be regarded as abnormally high. This is illustrated by the accompanying Table (No. 7) which shows the average monthly rates of deposit over the same 15 period in a number of areas, ranging from country districts to heavy industrial areas. It will, of course, be appreciated that the conclusions which can be drawn from a single year's observations are necessarily somewhat limited." TABLE 7.—Atmospheric Pollution. Total solids deposited at various stations in England— April, 1950—March, 1951. Station Tons per square mile per month St. Marylebone—Lisson Grove 26.50 Town Hall 17.35 Westminster-King Charles Street 30.65 Devonshire Street 29.32 Southwark—Bankside 118.83 Walworth Road 28.75 Kensington—Science Museum 18.71 Billingham—Council Offices 78.04 Derby—Central Police Station 25.31 Halifax—Wade Street 26.24 Sheffield—Attercliffe 36.34 Godalming—King George V Sanatorium 5.85 Market Drayton—Cheshire Joint Sanatorium 6.41 The Town Clerk and the Medical Officer of Health subsequently interviewed the Chief Generation Engineer (Operations) of the London Division of the British Electricity Authority. They reiterated the Council's concern at the further complaints of nuisance from the emission of grit from the Aberdeen Place and Lodge Road generating stations and drew attention to the special observations kept by the Council over a period of a year which showed definitely that there were larger deposits of grit in the vicinity of the generating stations than at the control on the Town Hall. It emerged that the Electricity Authority had themselves been keeping observations, and they did not deny that close to the generating stations there was some pollution of the atmosphere. It was stated that the Electricity Authority had been doing all that they could to improve conditions by increasing the efficiency of the existing grit-arresting plant at the two stations and had made arrangements to burn only the best available fuels; that they had discontinued burning coke breeze at these stations; that the grit plant serving two of the boilers at the Lodge Road Station had been modernised in 1950, and that four further boilers were to receive attention during 1951. These two stations were intended to be stand-bys, and when more of the new generating stations throughout the country were brought into use it might be possible to reduce their hours of running, particularly during the summer. Questioned about the substitution of modern grit-arresting plant for the existing plant in these two stations, the Electricity Authority's representative said that such a course would be against their policy. It would take three years to obtain and instal the equipment, and that would mean merely a diversion of manpower and materials from new stations to old ones. It was considered better to get the new and more efficient stations working as soon as possible and so reduce the demand on the old stations. It was hoped to discontinue generation at Aberdeen Place in the reasonably near future, but the outlook regarding Lodge Road was uncertain. The results of this discussion were reported to the Council who, in view of all the circumstances, accepted the assurance of the British Electricity Authority that they would continue to do all in their power to keep to a minimum the emissions of grit from the two stations. At the same time, the Council decided to continue observations and to review the whole position should that become necessary. To meet the suggestion of the Superintendent of Observations, Atmospheric Pollution Research, the gauge at Welfare Centre No. 2 was transferred to a site at Lord's Cricket Ground towards the end of the year. An appeal by the Ministry of Fuel and Power to the managements of the larger undertakings in St. Marylebone to send their boiler engineers and attendants to special courses of instruction met with an encouraging response. Invitations were issued to firms who use 100 tons or more of coal and/or coke per annum and, as a result, a total of 35 enrolments for the course on boilerhouse practice and 26 for the fuel technology course were made at the two technical colleges nearest to the Borough. The object of these lectures and demonstrations was to raise the standard 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. Poisons.—The names of 79 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 91. 16 Factories.—The survey of factories in the Borough, commenced late in 1949, was completed during the year by the sanitary inspector who specialises in this work, with the part-time assistance of one of the women sanitary inspectors. In the course of these inspections several points emerged which are considered worthy of mention. It became apparent, for example, that there was room for much improvement in the general cleanliness of factory premises, the bulk of which are used by the clothing trade. In all too many instances, owing to lack of proper containers, waste and refuse were piled under the cutting tables and large numbers of empty milk bottles left to accumulate in rear yards and under stairs. In many cases there were either no floor coverings at all or they were so badly worn as to render cleansing difficult. Buildings occupied by several firms-even when controlled by managing agents-frequently revealed little or no cleansing of the water-closets, staircase, landings and passages, whereas in premises occupied by one firm reasonable standards were generally maintained. With the continued restriction of building work many factories were still without adequate washing facilities. There is no general requirement in the Factories Act for the provision of hot water as part of washing facilities, and it is considered that the time has arrived when such facilities should not be classed as "adequate and suitable" without the provision of hot water. Deficient ventilation, particularly in furriers premises, was attributable in some cases to electrical burglar alarm systems, where the apparatus or cabling was fixed in such a way that windows could only be partly opened or not at all. The heating of workrooms was usually maintained well above the statutory limit and there was an increasing appreciation of the modern and safer designs in gas and electrical heating units. It is gratifying to be able to report a close liaison between the Public Health Department and the district office of the Factory Department of the Ministry of Labour and National Service. This has led to the ready exchange of information on various aspects of factory supervision, and not least that affecting the constantly changing register of factories, which has enabled more accurate records to be available in both offices. 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 8 and 9. TABLE 8.—Factories : Inspections for Purposes of Provisions as to Health. Premises Registered Inspections Written notices Occupiers prosecuted Factories without mechanical power 247 400 65 - Factories with mechanical power 1,211 1,740 196 - Other premises* (excluding out-workers' premises) Total 180 381 - - 1,638 2,521 261 — *Electrical stations, institutions, sites of building operations and works of engineering construction. TABLE 9.—Factories: Defects Found. Particulars Defects †Found †Remedied Referred In respect of which prosecutions were instituted To H.M. Inspector of Factories By H.M. Inspector of Factories Want of cleanliness 80 180 2 5 — Overcrowding — — - — — Unreasonable temperature — — - — — Inadequate ventilation 10 26 1 — — Ineffective drainage of floors 3 2 - — — Sanitary conveniences:— (a) insufficient 7 10 - 3 — (b) unsuitable or defective 737 551 - 5 — (c) not separate for sexes 15 20 - — — Other offences (excluding offences relating to outwork) 130 287 2 — — Total 982 1,076 5 13 — †It will be noted that, with two exceptions, the number of defects remedied exceeds the number found. This is accounted for by the fact that many of the defects found during the special survey of factories in progress towards the end of 1950 were not remedied until 1951. 17 Out-Workers.—Eighty-two employers submitted lists in respect of a total of 1,178 out-workers (250 contractors and 928 workpeople). Of these, 86 contractors and 122 workpeople operated in the Borough. The nature of the occupation concerned is indicated below:— Wearing apparel—making, etc 1,149 Electro-plate 1 Artificial flowers 2 Carding of buttons, etc 6 Textile weaving 18 Lampshades 2 Total 1,178 There was no case of default in sending lists to the Council. Rag Flock and other Filling Materials.—In July, 1946, the Ministry of Health published the report of an inter-departmental committee which had been appointed to examine whether the Acts and regulations governing the use of rag flock in upholstery and bedding were adequate or required amendment; and also whether or not they should be extended to other filling materials. The committee considered the existing legislation to be inadequate for securing the proper cleanliness of rag flock and submitted detailed proposals for new legislation. These proposals are embodied in the Rag Flock and Other Filling Materials Act, 1951, which came into operation on the 1st November, 1951, and repeals the Rag Flock Acts, 1911 and 1928, and section 136 of the Public Health (London) Act, 1936. The new Act brings under control and supervision a much wider range of activities than those covered by the repealed Acts, requiring various types of premises connected with the upholstery trade to be registered with or licensed by the local sanitary authority. On the application of an occupier and payment of a fee of £1 the authority are required to register premises on which filling materials to which the Act applies are used in the course of the business of upholstery or of stuffing or lining bedding, toys, baby carriages and such other articles as may be prescribed by regulations. The use of unregistered premises for the purposes mentioned is unlawful. It is also an offence, subject to certain defences, for an occupier to have unclean materials (i.e., materials not complying with a standard of cleanliness prescribed for the materials in question) on his registered premises. The Act applies to such filling materials as rag flock, unwoven cotton, unwoven wool, pit hairs, feathers, down, kapok, seaweed and straw, but other materials may be added to the list by regulations. Rag flock may only be delivered to registered premises from premises licensed under the Act for its manufacture or storage, and it is an offence to supply a purchaser who asks for rag flock from licensed premises with material from unlicensed premises. The authority, on application from the occupier of any premises and payment of an annual fee of £1, may grant him a licence authorising him to manufacture rag flock on those premises for use on premises registered under the Act. Similar provision is made for the licensing of premises for storing rag flock. The sale or offer or exposure for sale of articles containing unclean filling materials are made offences subject to certain defences and exceptions in the case of second-hand articles and for auctioneers acting as such. Duly authorised officers of the authority have power of entry into and inspection of premises, and provision is made for the taking of samples of filling materials to test them for cleanliness. A person guilty of an offence against the Act is liable for a first offence to a fine not exceeding £50 and for a second or subsequent offence to a fine not exceeding £100 and/or imprisonment not exceeding six months. All offences under the Act may be prosecuted summarily, and a court on convicting an offender under the Act may order forfeiture to the local authority of any materials or articles owned by him in respect of which the offence took place. Provision is made for a person summoned to have brought before the court any other person who he alleges is responsible for the offence in question, the provisions for this being similar to those contained in the Food and Drugs Act, 1938. The Rag Flock and Other Filling Materials Regulations, 1951, which also came into operation on the 1st November, 1951, prescribe standards of cleanliness for each kind of filling material to which the Act applies. They name the analysts for carrying out tests, and fix the fees which may be charged therefor. They also prescribe the form in which records are to be kept by occupiers of premises registered or licensed under the Act. Towards the end of the year applications for registration of premises in the Borough were under consideration. Rivers (Prevention of Pollution) Act, 1951.—This Act, which came into force on the 1st October, 1951, contains new provisions and confers wider powers for maintaining or restoring the wholesomeness of rivers and other inland or coastal waters. In its original form the Bill provided for the powers to be enforceable by the London County Council but, following representations, amendments were inserted 18 to ensure that metropolitan borough councils should be the responsible authorities. The only water in the Borough which may be affected is the Grand Union Canal, in respect of which the Inland Waterways Executive already possess adequate powers to prevent pollution, etc. The lake in Regent's Park is not involved as it does not discharge into a "stream" as defined in the Act. While little action has been found necessary in St. Marylebone under the 1876 Act, the functions, duties and certain powers under the new Act have been formally delegated by the Council to the Public Health Committee. Methylated Spirit Drinking.—Following the report to the Public Health Committee on the 4th October, 1950, in which attention was drawn to an increase in drunkenness due to the consumption of methylated spirit, representations were made through the Metropolitan Boroughs' Standing Joint Committee to the Home Office and H.M. Commissioners of Customs and Excise. Both these Government Departments at once appreciated the seriousness of the issue and gave it the fullest possible consideration. The Customs and Excise authorities, who are responsible for the control and proper use of surgical spirit (the less unpalatable form of methylated spirit) conducted investigations through their local officers, and it is interesting to note that retail chemists in the Borough who were interviewed agreed that addicts to this form of alcohol were readily identifiable. Moreover, chemists in the vicinity of the common lodging house for men (in Burne Street and Lisson Street) round which most of the problem centred, showed an awareness of the habit and willingness to co-operate in suppressing misuse of the spirit. The Customs and Excise authorities also sought the assistance of the two chemists' organisations—the Pharmaceutical Society of Great Britain (the statutory body) and the National Pharmaceutical Union (the professional association) and the latter circularised its members throughout the country drawing attention to their legal obligations and inviting their help by not displaying surgical spirit for sale and by refusing to sell it to anyone they considered might be likely to use it improperly. It was felt that to allow surgical spirit to be sold on prescription only would prove irksome to chemists and bona fide customers. The Home Office, for similar reasons and from knowledge of experience elsewhere, was unwilling to include surgical spirit in the Part I Poisons Schedule because of the relatively small number of addicts. It is to be hoped that, as a result of the action taken by the Council in bringing this matter to the notice of the Government Departments concerned and the subsequent thorough investigations and suggested measures of control, there may be at least a lessening of the problem and that practice of the habit of methylated spirit drinking may be rendered more difficult. Certainly, it is gratifying to be able to report that the last twelve months have shown a decline in this form of drunkenness, and recently the number of incidents at the lodging house has been the lowest for many years. It is largely due to the approach made by the St. Marylebone Customs and Excise officers to local chemists that this improvement in the position has been secured, and the Council expressed their appreciation of this active co-operation and practical assistance. SECTION D.—HOUSING. Permanent Schemes.—The Barrow Hill Estate, comprising 172 flats, was completed early in 1951. The first section of the Townshend Estate, providing 70 flats in three blocks, was also completed during the year; 12 of the 40 flats in the second section were nearing completion but the section could not be finished owing to shortage of steel. The Council obtained the freehold of Notcutt House, Nos. 35-38, Dorset Square, at a cost of £18,750. The premises, which were completely rebuilt after war damage, consist of 19 flats. Arrangements were made to purchase refrigerators and hire them to tenants of permanent housing estates. Progress was made with negotiations for the acquisition and development of the following sites Abbey Road—Boundary Road (54 flats); Queen's Terrace (28 flats); Hamilton Terrace—Carlton Hill (52 flats) ; Wellington Road (120 flats): Nos. 35-55, Boundary Road (48 flats); Abercorn Place— Hamilton Terrace (34 flats) and Church Street Extension (60 flats and 10 shops). The Council decided to acquire compulsorily six small sites to provide a further 101 flats. County of London Development Plan.—The Council requested the London County Council to designate a site in Church Street in the development plan for municipal housing, with a view to the erection thereon of an extension to the existing Church Street Housing Estate. Barrow Hill Primary School.—The Council agreed to relinquish the factory-made bungalows on the Henstridge Place site to enable the London County Council to build a new county primary school. This involves the displacement of 19 tenants during 1952 and the remaining 9 tenants at a later date. All will be rehoused by the County Council. 19 St. Marylebone Housing Association and Trust.- The Council decided to co-operate, under the Housing Acts, 1936-1949, with the St. Marylebone Housing Association and Trust in the development for housing purposes of a site adjoining the existing Cochrane Street Estate. By this arrangement the Council obtain the exchequer subsidy in respect of the flats and transfer it to the Association. The Council also make a contribution from the general rate. It was agreed during the year to lend the Association the sum of £37,000 under section 93 of the Housing Act, 1936, to enable development to proceed. Inspection of Dwelling-Houses.—The total number of houses and flats (separately assessed residential units) in the Borough at the end of 1951 was 22,772. Details of inspections made and resultant action are given in the following statement:— Houses inspected for defects under the Public Health or Housing Acts 2,721 Inspections made 7,914 Houses found not to be in all respects reasonably fit for human habitation 946 Defective houses rendered fit in consequence of informal action 474 Houses in which defects were remedied by owners after service of formal notices under the Public Health (London) Act, 1936 328 Underground Rooms.—Closing orders under section 12 of the Housing Act, 1936, were made in respect of 13 rooms, and variations in the user of four rooms already subject to closing orders were approved by the Public Health Committee. Three orders, involving five rooms, were determined. Two undertakings from owners not to use or permit to be used three basement rooms for human habitation were accepted by the Committee during the year. The underground room problem, in the south-east area of the Borough particularly, has demanded special consideration. With the prevailing high rents for business premises, the restrictions on factory building and the willingness of foreign elements to occupy sub-standard accommodation, there is a growing tendency to utilise underground rooms for commercial purposes. Some have been officially closed for living purposes, others vacated though not covered by an order, and the remainder are still occupied but unsatisfactory. This move to occupy basements as workrooms cannot be condemned altogether as generally they make better workrooms than they do homes. There are, however, drawbacks which affect the occupants of living accommodation above basements: among these are smells from manufacturing processes, noise from machinery, the sharing of sanitary accommodation, and the ever-open street door. On the other hand, these objections may be offset by certain advantages to the residents: the basement rooms are kept in repair and no longer are they the playground for stray animals, the dumping place for refuse or the source of discomforting draughts from windowless and doorless rooms. Inspection of many of these basements indicates that inherent defects can be sufficiently overcome and reasonable standards achieved to safeguard workers at a cost which need not prove excessive. The main defects in these basements are concerned with ventilation, lighting and dampness. Ventilation and lighting do not usually present great difficulties, and in the majority of cases the question of dampness should not prove to be insuperable. After reviewing the situation it is felt that the Council could be recommended to give favourable consideration to applications to use basement rooms for business purposes, subject to the carrying out of essential works and involving, where necessary, the determination or modification of closing orders. Re-Housing.—During the year 598 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. Nearly all requests 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 356 of these cases the application was supported by a medical certificate. The use of the special form of certificate adopted in November, 1950, was continued. These certificates are considered by the Medical Officer of Health personally, and the medical practitioner is invited to give fuller and more precise information than he would ordinarily provide. The detailed medical evidence made available in this way, 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 taken full advantage of the new arrangement, and their co-operation has been most helpful in this further endeavour to improve methods of assessement as to need for re-housing. Common Lodging Houses.—There are two lodging houses in the Borough: one for men, owned by the Salvation Army and situated at No. 2, Burne Street and premises in Lisson Street; the other for women, conducted by the Church Army at Portman House, No. 10, Daventry Street. The 20 permitted number of lodgers was reduced in both cases: in the men's lodging house from 436 to 391 in order to meet the model bye-law standard, and in the women's lodging house from 100 to 85 because of the dormitory space having been reduced by the completion of the scheme for providing additional sanitary accommodation, baths and washing facilities. The defective wood-boarded floor in the basement of the men's lodging house, where the day-room and dining-room are situated, was taken up during the year and replaced by red quarry tiles laid on concrete. This is a great improvement and enables cleansing to be carried out with ease and efficiency. Rent Restrictions Acts.—During the year one disrepair certificate was issued. SECTION E.—INSPECTION AND SUPERVISION OF FOOD. Food and Drugs Analysis.—Samples of 83 different kinds of foodstuffs and 55 varieties of drugs were taken and analysed under the Food and Drugs Act, 1938. The total number of samples submitted during the year was 700 (30 formal, 670 informal) and these included: milk 58, butter 71, margarine 69, cheese 14, cooking fat 70, sausages 70. The sum paid in respect of each analysis was £1 1s. 0d. The 85 samples reported as adulterated or otherwise irregular are referred to by the Public Analyst (Mr. Thomas McLachlan) in the following report: "The percentage of samples on which adverse reports or comments were made is higher this year than it was last year, 12.1 per cent. of the samples submitted being reported as adulterated or failing to comply with various Labelling Orders. "Some slices of bread were received from a member of the public who complained of blackish marks on one side. This was due to the growth of a penicillium mould, and the bread was unfit for sale if it had been sold in this condition. Another sample of bread was found to be contaminated with 'rope' due to a spore-forming organism and caused by septic conditions in the bakery. A third sample of bread contained excessive salt. "Some cream biscuits received were reported as inferior. They were of poor flavour and quality and the cream filling was caramellised instead of being of a fondant nature. "Some beef sausages suspected of being deficient in beef were found to contain 51 per cent. of meat. Another sample of sausages was 25.8 per cent. deficient in meat and in your analyst's opinion contained far too much dye, but it does not appear to be illegal to dye sausages. Other samples of sausages were respectively 23.6 and 26 per cent. deficient in meat. Some pork sausages were 26 per cent. deficient in meat, whilst others contained only 51.8 per cent. of meat, instead of the 55 per cent. necessary when milk powder is present. As these last were not very deficient in meat it was suggested that the matter might be taken up informally. A further sample of sausages was found to contain 4.13 per cent. ash, including 2.71 per cent. of salt, an excess of over 1 per cent. of salt calculated on the original sausage material. The total ash content of sausages varies normally between 2 and 3 per cent., with about 0.5 per cent. of salt. A liver sausage was submitted and found to contain a small piece of hide with attached bristles. Your analyst considered that the liver and other meat used in the preparation of these sausages had not been removed from the carcasses and slaughterhouse under hygienic conditions. Some tinned cooked sausages were stated to possess a strong taste and to be full of preservative, but were found to be satisfactory on examination. "Several cans of ham were received and on examination were nearly all found unsatisfactory. Some had been improperly cured and rusty needles had been used to inject the pickling brine. The fat was liquidy and soft, and the flavour poor. The meat was hard and showed black marks. "A sample of beefsteak was tested and found to consist of horseflesh. Some minced beef was received as a complaint from a member of the public. The sample weighed 2lbs. 2ozs. and was found to contain ⅛oz. of small stones. As chopped onion had been added to the minced beef your analyst was unable to state whether the stones were present before the onion was added. "A sample of ox tongue was submitted because a member of the public complained that it neither tasted nor smelt like tongue. The tongue had been tinned and was probably of foreign origin. The meat, known as the root of the tongue, had not been removed before canning. It was an unsatisfactory looking preparation and was reported as inferior. "Two samples of chicken, one canned and the other part of a meal served in a restaurant, were received owing to complaints, but both were found to be genuine. "One pork pie was mouldy in the interior. Another was received with the complaint that it contained only bread but it did, in fact, contain some pork. Owing to a decision in the High Court it is rather difficult to state how much meat should be contained in a meat pie. "The label on a sample of savoury mixture stating that it contained the rich meat of sunflour (? sunflower) seed was considered by your analyst to be misleading. 21 "A report was made on a rissole mixture, which contained no meat, that it must be described as a vegetarian product or as a cereal and vegetable rissole mixture. "A member of the public complained of the smell and taste of some peach jam, and after examination your analyst considered that the slight odour and taste were due to the action of the jam on the tinplate. This odour and taste soon passed off after the jam was removed from the tin, so that it would be satisfactory if taken from the container immediately on opening. It was, however, reported as inferior. "A sample was received labelled 'lime jam.' It contained no lime peel or pulp and should, therefore, have been described as lime marmalade jelly. It was also found to be 2 per cent. deficient in soluble solids. "A sample of margarine was reported as inferior as it contained 16.37 per cent. of water, whereas it must not be more than 16 per cent. "Two samples of tea were submitted as complaints, but on examination nothing could be found wrong with either of them. "A sample submitted as vinegar had not been brewed and was, therefore, not vinegar. It contained 4.7 per cent. acetic acid. "A sample of new potatoes was submitted and found to possess a taste of paraffin, although they did not smell of paraffin. These potatoes had been imported from Corsica. "A sample labelled as tapioca dessert was received, and contained only 15 per cent. tapioca and 30 per cent. farina; your analyst was of the opinion that this was incorrectly described seeing that the amount of tapioca was only half that of the farina. "Some juice from tinned plums was received on account of the presence of a fruit fly. After examination your analyst was of the opinion that this fly had been cooked and was present before the can was sealed. "A sample of crystallised pineapple was submitted which had an unpleasant flavour, but this flavour had been developed in the process of boiling out the pineapple to make it crystallise, and the sample was reported as genuine. "A tin of tomato juice was examined and the amount of tin present was found to be two-thirds of a grain per pound or 110 parts per million. There is no statutory maximum amount of tin permitted in canned foods and, although a Local Government Board Report suggested many years ago that the quantity should not exceed 2 grains per pound, this amount is now considered to be much greater than is necessary. The sample was, therefore, reported as inferior. "A fish preparation received was stated to have been sent to the Mayor by an inmate of a local institution for old people. It consisted of smashed pilchards and added sauce, and if served in this condition it was considered unsatisfactory by your analyst, and was reported as inferior. "Two cans labelled as containing hard herring roes were found to contain soft roes. The tin present in the samples was 0.6 grains per pound due to the action of salt on the tinplate. "A bottle of milk was received with the complaint that it was a dirty bottle, but the marks were found to be due to iron contained in the glass and could not be removed even with concentrated acid. Another bottle received on account of a complaint of dirt was found to have a large number of minute specks of brown gritty material in the interior, which could not be removed by ordinary washing. These specks were not very visible when the bottle was full of milk and might have passed inspection. "A milk whipping compound was received in a carton, which was very dirty on the outside. Examination of the contents showed them to be partially dried and their volume had decreased by 50 per cent. owing to evaporation. "A sample of oatmeal was contaminated by the presence of seed tapioca, probably emptied into it by mistake. A member of the public complained of a sample of porridge oats, but nothing could be found wrong with this. "Some mussels in butter were received with the complaint that they were full of sand, but the grittiness was found to be due to minute pearls attached firmly to the flesh of the fish. No objection could be taken to them from the health standpoint. "A sample of cocoa was stated to have made a consumer sick, but examination failed to reveal the presence of any deleterious substance. "A sample submitted as paregoric, or compound tincture of camphor, was found to be Gee's linctus or compound tincture of squill. "Some ammoniated tincture of quinine was 27 per cent. deficient in ammonia, 22 "A sample of liquid paraffin, which contained excessive quantities of carbonisable substances, failed to comply with the requirements of the British Pharmacopoeia. "A 'nerve tonic' contravened the Pharmacy and Medicines Act as the constituents were incorrectly stated. It also contravened the Labelling of Food Order as the dose for one day would only supply one-quarter of the total daily requirement of vitamin B1. Another 'nerve tonic' which contained only 0.33 per cent. of liquid extract of malt, was labelled as an excellent combination of malt, iron, phosphorus and bromine. This is rather more than an exaggerated statement. "Some balsam of liquorice and blackcurrant contained insufficient blackcurrant to warrant the description, and there were several mistakes in the label. "A 'vitamin tonic' did not give the information on the label regarding vitamin B, required by the Labelling of Food Order. It was also a 'Part 1 Poison' according to the Poisons Rules, and the name and address of the retail seller were not given on the label. "A tonic containing nux vomica was not labelled with the warning: 'Caution, it is dangerous to exceed the stated dose.' "Some paraffin flavoured with orange was found to contain 5 per cent. of volatile oil of orange—a quantity which is 3½ times the maximum dose. "Twenty-four other samples of drugs failed to comply with the labelling requirements of the Pharmacy and Medicines Act, 1941, and nine, which contained poisons, were not properly labelled according to the Poisons Rules." A prosecution taken in respect of a sample of sausages found to be 23.6 per cent. deficient in meat resulted in a fine of £3 0s. 0d., with £3 3s. 0d. costs awarded to the Council. Legal proceedings were not advised in connection with any other samples adversely reported upon by the Public Analyst, and the matters were taken up, with satisfactory results, with the manufacturers, wholesalers or retailers concerned. Two other prosecutions under the Food and Drugs Act concerned the presence of foreign matter in foods. A fine of £5 0s. 0d. (with £5 5s. 0d. costs) was imposed in the case of a packeted table jelly containing specks of china-like material; in the other instance, where particles of glass were found amongst boiled sweets, the case was dismissed on payment of £2 2s. 0d. costs. The Food and Drugs (Milk, Dairies and Artificial Cream) Act, 1950, and the Diseases of Animals Act, 1950, both of which are consolidating measures, came into operation on the 1st January, 1951. Milk.—There are 162 premises from which milk is sold, and inspections made numbered 210. During the year 219 applications under The Milk (Special Designations) (Raw Milk) Regulations, 1949, and The Milk (Special Designations) (Pasteurised and Sterilised Milk) Regulations, 1949, were received from 68 milk purveyors, and licences were granted as follow:— Accredited milk 12 dealer's. Tuberculin tested milk 50 dealer's and 12 supplementary. Pasteurised milk 1 pasteuriser's, 59 dealer's and 14 supplementary. Sterilised milk 1 steriliser's, 58 dealer's and 12 supplementary. The average composition of the 48 genuine samples of milk analysed was: total solids 12.29 per cent.; fat, 3.53 per cent.; solids not fat, 8.76 per cent., as compared with the legal minima, namely, 11.50 per cent., 3.00 per cent. and 8.50 per cent. respectively. Fifty-two 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 but two (which failed the methylene blue test and were referred to the Area Milk Officer) were reported to be satisfactory. Of 54 other samples of milk examined by the Council's Bacteriologist, all were found to comply with the requisite standards. Pursuant to section 23 of the Food and Drugs (Milk, Dairies and Artificial Cream) Act, 1950, the Minister of Food made an Order providing that, as from the 1st October, 1951, all milk sold by retail within the London area must be specially designated milk. Cream.—Restrictions on the manufacture and supply of cream were removed by the Cream (Revocation) Order, 1951, made by the Minister of Food and operative as from the 9th May, 1951. Minimum standards for cream and clotted cream were prescribed by the Food Standards (Cream) Order, 1951. Butter and Margarine Premises.—Fifteen dealers in margarine and two butter manufacturers were on the register. Forty-three inspections of the premises were made. Ice Cream.—The number of premises on the register was 159, which includes three where ice cream is manufactured: 161 inspections were made, 23 Nineteen samples of ice cream were examined bacteriologically. Of these, twelve passed the methylene blue test and seven fell into grades 3 or 4, which cannot be considered as satisfactory. The question of these latter samples was in each case taken up with the manufacturers either direct or through the medical officer of health of the district in which the factory was situated. Ten samples submitted to the Public Analyst were all returned as genuine. The results of the analyses are indicated in Table 10. TABLE 10.—Ice Cream Analyses. Sample No. Fat (%) Solids not fat (%) 1 10.0 30.3 2 8.8 27.0 3 10.0 25.0 4 8.0 26.5 5 9.6 24.6 6 8.4 26.3 7 7.2 26.4 8 11.2 27.8 9 7.6 25.1 10 11.2 25.9 The Food Standards (Ice Cream) Order, 1951, provides that, except where ice cream contains fruit and "Parev" (Kosher) ice, ice cream shall contain not less than 5 per cent. fat, 10 per cent, sugar and 7½ per cent. milk solids other than fat. Although the standard as set out is low, it is a step in the right direction which may eventually lead to further improvement. 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 186 inspections were made. The Meat Products and Canned Meat (Amendment No. 2) Order, 1951, which came into operation on the 14th June, 1951, restricted the use of milk powder in sausages to "skimmed milk powder " ; permitted whale meat to be mixed with other meats provided that the product is labelled and sold as a whale meat product; and freed meat paste from control both as regards price and composition. Fried Fish Vendors and Fish Curers.—Eleven premises are used by vendors of fried fish and one by a fish curer. Twenty-eight inspections of fried fish shops and 16 inspections of the fish curer's premises were carried out. One notice was served in respect of a fried fish shop. Bakehouses.—There are 14 basement bakehouses on the register; 94 inspections were made, and seven bakehouses were cleansed and re-decorated after informal notice. Legal proceedings were instituted under the Food and Drugs Act, 1938, against three different firms of bakers. In one case, where a loaf of bread supplied to a customer had been found to contain a metal rivet, the defendants were fined £15 0s. 0d. and £10 10s. 0d. costs. A second case concerned the presence of a button in a loaf of bread sold ready sliced. In this instance the defendant company were discharged on payment of £5 5s. 0d. costs to the Council. The third case arose from a complaint about a custard tart containing a maggot. The baker pleaded guilty and the magistrate imposed a fine of £4 and awarded £4 4s. Od. costs to the Council. Restaurants, etc.—Premises in which meals are provided or food is sold already cooked or is prepared for sale numbered 834, including 230 restaurants, 60 snack bars, 2 railway refreshment rooms, 56 hotels, 339 staff and club canteens, 120 public houses, 12 other licensed catering establishments, 23 school and nursery canteens, and 4 coffee stalls: 1,124 inspections were made and 27 notices served. During the year the kitchens of 10 restaurants, 3 snack bars, 2 clubs, and 2 public houses were completely reconstructed. Legal proceedings were taken under section 13 of the Food and Drugs Act, 1938, against two 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 £26 0s. 0d. and £15 0s. 0d. were imposed and costs awarded to the Council. For serving horseflesh when beefsteak was demanded, another restaurant proprietor was fined £7 0s. 0d. with £3 3s. 0d. costs. Canteens at Government Premises.—Difficulties were encountered in the efficient conduct of the clean food campaign by reason of the Council's inspectors being denied access to Government-sponsored canteens. Representations were therefore made by the Council to the Ministers of Food and Health with a view to the removal of these obstacles. A copy of the representations was forwarded to the Postmaster General, who subsequently agreed to afford facilities for post office canteens in the Borough to be visited by members of the Council's inspectorial staff. 24 Retail Food Shops.—With the completion of the comprehensive survey of restaurants and other eating places, attention was directed to retail food shops and towards the end of the year a commencement was made in the systematic inspection of premises used by grocers and provision merchants, butchers, fishmongers, greengrocers, bakers and pastrycooks, and others selling food to the public for human consumption. The object of this extended survey is to ascertain if the requirements of section 13 of the Food and Drugs Act, 1938, are being complied with and to encourage a high standard in such matters as construction of premises, light and ventilation, storage arrangements, cleansing and redecoration, provision of sanitary accommodation, and washing facilities with hot and cold water, towels, soap and nailbrush. A separate card index register is being compiled and routine inspections will follow, and the opportunity will again be taken to impress upon proprietors and employees the essentials of hygienic practice in the handling of food. During the course of the initial inspections it was found necessary to serve informal notices in 16 instances. Horseflesh.—Twenty-two visits were paid to the only shop in the Borough selling horseflesh for human food. Slaughter of Animals.-The Slaughter of Animals (Amendment) Act, 1951, which amends the Slaughter of Animals Act, 1933, and implements certain recommendations of the departmental committee on the export and slaughter of horses, came into operation on the 1st October, 1951. The Act makes provision regarding the supply of water and food to animals in slaughterhouses and knackers' yards and while in lairages awaiting slaughter, and amends paragraph 3 of the Second Schedule to the Act of 1933 which deals with the fastening of the heads of certain animals before stunning. The only 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. Ten inspections were made during the year. Unsound Food.—Some 45 tons of food condemned as unfit for human consumption included the following : tinned ham, 23 tons 1 cwt. 3 qtrs. 4 lbs.; other canned meats, 3 tons 5 cwts. 1 qtr. 15 lbs.; meat and offal, 18 cwts. 1 qtr. 5 lbs.; bacon, 4 tons 10 cwts. 24 lbs.; poultry and rabbits, 2 cwts. 11 lbs.; fish, 1 cwt. 2 qtrs. 15 lbs.; fruit and vegetables, 5 cwts. 1 qtr. 2 lbs.; miscellaneous, 16 cwts. 3 qtrs. 24 lbs.; canned goods (other than meat), 14,854 tins. A large proportion of this unsound food was salvaged and used for animal feeding. The marked increase in the quantity of food condemned was due mainly to the large amount of unsound canned meat delivered to food shops in the Borough during the autumn. In a period of two months it was necessary to condemn more than 17 tons of such food, including over 11 tons of ham, the bulk of which was of German origin. An examination by the Public Analyst showed that, while the tins were not "blown" and appeared to be sound, the hams had been insufficiently processed and the contents were unfit for human consumption. The Council brought the matter to the notice of the Metropolitan Boroughs' Standing Joint Committee, who requested the Ministry of Food to ensure that the importation of unsound ham or ham of doubtful keeping quality from European countries was stopped and that, in the meantime, adequate steps were taken to safeguard the public health so far as existing stocks were concerned. Clean Food Campaign.-Practically all the preceding paragraphs in section E of this report (Inspection and Supervision of Food) may be claimed to refer to the "clean food campaign" from the statutory point of view. Though much useful work has been dope in this direction, it is realised that there are also other approaches to the problem which rely for their success on something more than mere official action on the part of the local authority. They depend upon co-operation between the authority, the food trader and the shopping public, particularly the housewife. The Council fully appreciate the activities of the local Clean Food Association in helping to bring this about and in arousing interest in the cleanliness of the food supply. The Department's educational services, which are also directed to this end, have been augmented during the year by new propaganda features which included a stand at the local civic exhibition, the use of "clean food" slogans on postmarks of the Council's franking machine, and the circulation of a leaflet with the rate demand notices. There is little doubt that the general public are becoming more "clean food" conscious. They are more fastidious and are beginning to realise that disease can be spread by dirty food. This is an encouragement to continue the campaign vigorously and to lose no opportunity of extending its scope wherever possible. St. Marylebone Clean Food Association.—During the second year of existence of this Association, membership increased to 136 with consideration of a further 24 applications deferred upon the report of the Medical Officer of Health in order that the persons concerned might do certain work or effect 25 other improvements in conditions at their premises to bring them up to the standard required of members. This standard is relatively high and the policy is to keep it so and not to relax the requirements in any way for the sake of increasing membership. Strict observance of the Code of Practice is the sine qua non of membership of the Association—a fact which must be kept continuously before every member of a food-handling staff—and it is gratifying to record that no infringements were reported during the year. Continuing the programme of education for food-handlers, further lectures, illustrated by film strips, were given by the Council's restaurant inspector on the subject of clean food handling. To meet the convenience of employers and workpeople, these lectures were held, by request, both at the Town Hall and at traders' premises at various times during and after normal working hours. Amongst other activities, instructional visits were made to factories where foods and drink are manufactured on a large scale. It is interesting to note that members of the Association have been offered exceptionally favourable terms for insurance against food poisoning risks and other classes of business. The Executive Committee continued to meet regularly and it is felt that the Association is now well established. The Hon. Secretary is Mr. D. W. Moeran, 2, Princes Street, Cavendish Square, W.l. Dogs in Food Shops.—After consultations with local authority associations and national representative bodies of the retail food trades, the Ministry of Food, in Circular 20/51, dated 24th October, 1951, recommended local authorities to issue notices for display in food shops asking customers not to bring their dogs into such premises. The St. Marylebone Clean Food Association had earlier decided that, as a first step towards the ideal of completely excluding dogs, customers should be urged to keep them on a lead and under control while in food shops. The Association accordingly issued suitably worded notices for display at their members' premises and as this campaign was already in being it was considered better to extend its scope to all food shops in the Borough rather than commence publicity on the lines suggested by the Ministry. Glass-washing in Public Houses.—A survey of the 128 licensed premises in the Borough revealed that all but 12 have running hot water provided for glass-washing. Sixty-six, however, including 8 of those without running hot water, do not use a detergent. Further investigation into this matter is proceeding. SECTION F. PREVALENCE OF, AND CONTROL OVER, INFECTIOUS AND OTHER DISEASES. Notifiable Diseases.—Diseases notifiable in St. Marylebone are listed below, together with the authority for requiring notification:— Disease Acute encephalitis Acute influenzal pneumonia Acute poliomyelitis Acute primary pneumonia Anthrax Cholera Continued fever Diphtheria Dysentery Enteric fever (including typhoid and paratyphoid). Erysipelas Food poisoning Glanders Hydrophobia Authority for Notification Public Health Act, 1936, section 143. Regulation (No. 2259) made by Minister of Health, 1949 (1st January, 1950). Public Health Act, 1936, section 143. Regulation (No. 1207) made by Minister of Health, 1927 (1st January, 1928). Public Health Act, 1936, section 143. Regulation (No. 2259) made by Minister of Health, 1949 (1st January, 1950). Public Health Act, 1936, section 143. Regulation (No. 1207) made by Minister of Health, 1927 (1st January, 1928). London County Council Order, 1909—Public Health (London) Act, 1936, sections 192 and 305. Public Health (London) Act, 1936, sections 192 and 304. do. do. Public Health Act, 1936, section 143. Regulation (No. 1207) made by Minister of Health, 1927 (1st January, 1928). Public Health (London) Act, 1936, sections 192 and 304. Regulation (No. 1207) made by Minister of Health, 1927 (1st January, 1928). Public Health (London) Act, 1936, sections 192 and 304. Food and Drugs Act, 1938, section 17, as amended by National Health Service Act, 1946 (10th schedule). London County Council Order, 1909—Public Health (London) Act, 1936, sections 192 and 305. do, 26 Disease Leprosy Malaria Measles Membranous croup Meningococcal infection Ophthalmia neonatorum Plague Puerperal pyrexia Relapsing fever Scabies (first case in house within four weeks). Scarlatina or scarlet fever Smallpox Tuberculosis Typhus fever Whooping cough Authority for Notification Public Health Act, 1936, section 143. Regulation (No. 1036) made by Minister of Health, 1951 (22nd June, 1951). Public Health Act, 1936, section 143. Regulation (No. 1207) made by Minister of Health, 1927 (1st January, 1928). Public Health Act, 1936, section 143. Regulations (Nos. 1100, 205 and 420) made by Minister of Health, 1938, 1940 and 1948. Public Health (London) Act, 1936, sections 192 and 304. Public Health Act, 1936, section 143. Regulation (No. 2259) made by Minister of Health, 1949 (1st January, 1950). London County Council Order, 1910— Public Health (London) Act, 1936, sections 192 and 305, and Regulation (No. 971) made by Minister of Health, 1926 (1st October, 1926), amended by Statutory Rules and Orders, 1928, No. 419, and 1937, No. 35. Public Health Act, 1936, section 143. Regulations of Local Government Board, 1900. Public Health Act, 1936, section 143. Regulation (No. 1081) made by Minister of Health, 1951 (1st August, 1951). Public Health (London) Act, 1936, sections 192 and 304. Public Health Act, 1936, section 143. Regulation (No. 1016) made by Minister of Health, 1943 (1st August, 1943). Public Health (London) Act, 1936, sections 192 and 304. do. Public Health Act, 1936, section 143. Regulation (No. 572) made by Minister of Health, 1930 (1st January, 1931). Public Health (London) Act, 1936, sections 192 and 304. Public Health Act, 1936, section 143. Regulations (Nos. 1100, 205 and 420) made by Minister of Health, 1938, 1940 and 1948. Notifications.—Information regarding notifications received during 1951 is contained in Table 11. Enquiries relating to cases of infectious disease were carried out by one of the women sanitary inspectors who paid 1,667 visits in this connection during the year. TABLE 11.—Infectious Diseases—Notifications. Disease Cases notified in whole Borough Cases removed to hospital Cases isolated at home At aU ages At ages—years —1 1— 2— 3— 4- 5- 1°- 15— 20— 35— 45— 65— Ophthalmia neonatorum 1 1 - - - - - - - - - — - 1 Erysipelas 13 — — — — — — — — — 2 5 6 1 12 Scarlet fever 25 1 1 2 — 3 14 3 — 1 — — — 7 18 Puerperal pyrexia 24 - - - - - - - 2 21 1 - — 24 — Poliomyelitis- Paralytic 2 - - - - - - - - - - - - 2 - Non-paralvtic 4 - - - - - - 2 1 1 — - - 4 — Pneumonia 38 2 — 1 — 1 2 — — 2 5 11 14 11 27 Dysentery 79 4 14 8 9 8 17 1 — 7 4 3 4 22 57 Measles 678 24 75 74 78 104 271 13 8 22 6 2 1 30 648 Whooping cough 135 13 15 22 12 23 42 3 — 2 1 2 — 12 123 Scabies 13 - 1 1 — — 2 — — 4 1 — 4 — 13 Meningococcal infection 2 — — — — — — 1 — 1 - -- - 1 1 Malaria 1 - - - - - - - - 1 - — — — 1 Tuberculosis— Pulmonary 77 — — 2 — — 2 1 8 29 12 20 3 20 57 Non-pulmonary 8 — 1 - - - - - - 4 1 1 1 7 1 Food poisoning 8 — 1 — — — — 1 - - — 4 2 1 7 Totals 1108 45 108 110 99 139 350 25 19 95 35 48 35 142 966 27 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.—No case of smallpox occurred in St. Marylebone during 1951. Forty-two passengers from the R.M.S. "Strathmore," which arrived at Tilbury in February from Sydney via Bombay, were kept under close observation at various addresses in the Borough as a girl aged 12 years, taken ill on the voyage and isolated in the ship's hospital as a case of chicken-pox, was subsequently found to be suffering from smallpox. On the 1st May, when the S.S. "Ranchi" called at Marseilles, a case of smallpox was landed and taken to hospital. A week later the ship arrived in the Port of London, and 11 passengers who proceeded to addresses in the Borough were kept under daily observation for the requisite period. Leprosy.—The Public Health (Leprosy) Regulations, 1951, required medical practitioners attending a person suffering from leprosy to notify the Chief Medical Officer of the Ministry of Health direct. As it was felt that this might create a precedent, leading to further centralisation and curtailment of the powers of local authorities, the Metropolitan Boroughs' Standing Joint Committee decided to make representations to the Ministry of Health with a view to securing an amendment of tinRegulations so that any such cases are notified to the local sanitary authority as in the case of other infectious diseases. Food Poisoning Outbreaks.—Details of cases of food poisoning notified during the year are given below in the form required by the Ministry of Health:— (a) Number of outbreaks.—Eight single unrelated cases. (b) Deaths.—None. (c) Organisms or other agents responsible, with number of outbreaks attributable to each. Salmonella enteritidis.—One case. Salmonella typhi-murium.—One case. Not ascertainable.—Six single cases. (d) 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. Twenty-nine visits were paid by one of the women sanitary inspectors in connection with these cases. Tuberculosis—New Cases and Mortality.—Table 12 contains information with regard to age and sex distribution of. and mortality from, all forms of tuberculosis. TABLE 12.—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 1 1 — 1 - — — 5—15 2 1 — - — — 15—25 16 11 - 1 1 - — - 25—35 15 18 1 3 - 3 — — 35—45 14 8 — 1 1 2 — — 45—55 9 5 - 1 6 - — — 55—65 20 2 - - 9 1 — — 65 and upwards 5 3 — 1 5 1 — — Totals 82 49 2 7 23 7 — - ‡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 11 (p. 26) gives information regarding notifications of pulmonary and nonpulmonary tuberculosis received during the year. Two hundred and three visits from the housing and sanitary viewpoints were paid by one of the women sanitary inspectors to new cases and those moving into the Borough from other areas. The total number of cases of tuberculosis remaining on the register at the 31st December, 1951, was 814. 28 Mass Miniature Radiography—During January and February, 1951, a miniature radiography unit of the North-West Metropolitan Regional Hospital Board was installed on premises of the British Electricity Authority, Winsley Street, Oxford Street, W.l, for the examination of workers in the surrounding area. The findings are detailed in Tables 13 and 14. TABLE 13.—Mass Radiography : Miniature Film Analysis. Male Female Total Number of persons X-rayed 2,747 2,579 5,326 Number recalled for large films 65 55 120 Recall percentage 2.36 2.13 2.25 TABLE 14.—Mass Radiography: Large Film Recall Analysis. Male Female Total Further medical advice recommended 13 14 27 To return later to unit for re-check 15 10 25 No further action 37 30 67 Failed to attend for large film - 1 1 Totals 65 55 120 It will be noted from the Tables that of 5,326 persons X-rayed, 27 (0.5 per cent.) were referred for further medical advice, and 25 (0.46 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 these 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 57 cases of scabies: adults 27 men 17, women 10) ; children 30 (boys 19, girls 11). Domiciliary visits paid in connection with St. Marylebone cases numbered 12. Impetigo.—One boy received treatment for this condition at the Cleansing Station. Disinfection.—During the year, 340 rooms and 2,116 articles of bedding (mattresses, blankets, sheets, bolsters, pillows, etc.), together with 1,286 books, were disinfected after infectious diseases generally. In addition, 870 dressing drums from a local hospital were sterilised. Bacteriological Examinations.—Table 15 shows the number of specimens examined for the purposes of diagnosis and indicates also the organisms in relation to which the examinations were made. TABLE 15.—Work of the Bacteriological Laboratory. Nature of Specimen and Examination Positive Negative Total Throat and nasal swabs for- B. diphtheriae - 104 104 Haemolytic streptococci 3 30 33 Vincent's organisms 5 6 11 Swabs—for Staphylococcus aureus - 1 3 Cough plates and swabs—for H. pertussis — 6 6 Sputa—for tubercle bacilli I 44 45 Faeces—for parasites 2 5 7 Faeces—for dysentery, food poisoning organisms and typhoid 45 234 279 Blood—for typhoid, paratyphoid and Brucella abortus — 2 2 Blood—for glandular fever 1 — 1 Blood—for malarial parasites — 1 1 Foods—for food poisoning organisms 13 13 Totals 59 446 505