AC4353 STMARY 57 BOROUGH OF ST. MARYLEBONE REPORT of the MEDICAL OFFICER OF HEALTH FOR THE YEAR 1952 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 Section A—Statistics and Social Conditions:— General Statistics 4 Extracts from Vital Statistics 4 Maternal Mortality 4 Marriages 4 Deaths 4 Infant Mortality 5 Mortuary 6 Crematorium 6 Section B—General Provision of Health Services :— Staff 6 Staff Medical Examinations 6 Laboratory Facilities 6 Representation upon other Bodies 6 Financial Contributions to Voluntary Organisations 7 Conferences 7 Care of Old People 7 Special Laundry Service 7 St. Marylebone Old People's Welfare Association 8 Section C —Sanitary Circumstances :— Sanitary Inspection 10 Nuisances 10 Sanitary Accommodation at Public Houses 10 Water 10 Drainage 11 Combined Drainage 11 Building Licences 11 Public Conveniences 11 Public Cleansing and Salvage 11 Shops 11 Pet Shops 11 Barbers' Shops 11 Diseased or Infirm Persons 12 Burial or Cremation of the Dead 12 Disinfestation 12 Verminous Persons 12 Shelter 12 Rodent Control 13 Dog Nuisance 13 Pigeons 13 Noise 13 Atmospheric Pollution 14 Poisons 15 Factories 15 Inspections and Defects Found 15, 16 Out-workers 17 Rag Flock and other Filling Materials 17 Rag and Bone Dealers 17 page Fireguards 18 Street Photographers 18 Section d—Housing:— Permanent Schemes 18 Barrow Hill Primary School 19 St. Marylebone Housing Association and Trust 19 Half-way Houses 19 Slum Clearance 19 Inspection of Dwelling-houses 19 Underground Rooms 19 Re-housing 19 Common Lodging Houses 19 Rent Restrictions Acts 20 Loans 20 Section E—Food :— Food and Drugs Analysis 20 Milk 23 Butter and Margarine Premises 23 Ice-Cream 23 Preserved Food 24 Fried Fish Vendors and Fish Curers 24 Bakehouses 24 Restaurants, etc. 24 Retail Food Shops 25 Horseflesh 25 Slaughter of Animals 25 Other Offensive Trades 25 Unsound Food 25 Clean Food Campaign 25 St. Marylebone Clean Food Association 25 Section f—Infectious and other Diseases:— Notifiable Diseases 26 Notifications 26 Public Health (Aircraft) Regulations, 1952 26 International Certificates of Vaccination and Inoculation 26 Diphtheria Immunisation 26 Suspected Poliomyelitis 27 Sonne Dysentery 27 Food Poisoning Outbreaks 27 Tuberculosis:— New Cases and Mortality 28 Notifications 28 Mass Miniature Radiography 28, 29 Venereal Diseases 29 Scabies 29 Impetigo 29 Disinfection 29 Bacteriological Examinations 30 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, Alongside all the advances and achievements of the personal health services, it will be evident from a perusal of this report that, despite the substantial progress already made in the betterment of the physical environment in the Borough, there is still room for further improvement and that much work yet remains to be done where man lives and works and eats. Activity in the environmental field was intensified throughout 1952 with special reference to disinfestation of verminous premises, abatement of atmospheric pollution, rodent control, factory inspection and food hygiene. Health conditions generally in the Borough continued to be satisfactory. The population, according to the Registrar General's estimate, numbered 74,290, a reduction of 1,474 on the 1951 census figure of 75,764. Both the birth-rate (12.49) and the death-rate (15.27) showed an increase over the figures for 1951 (12.18 and 13.77 respectively). Though the infant mortality rate of 24.78 was higher than the exceptionally low rate of 19.39 for 1951, it is of interest to note that in the Report of the Ministry of Health for the year 1951 the Chief Medical Officer comments that the steady fall in the national infant mortality rate is not reflected uniformly in the rates for individual local authorities, because with relatively small numbers there are chance fluctuations from year to year. He considers, however, that consistently low rates over three years can be regarded as satisfactory, and among the authorities in very different types of area quoted as giving rates well below the national figure for the three years 1949, 1950 and 1951 is St. Marylebone with 22, 22 and 19 respectively as compared with the national rates of 32, 30 and 30. The Chief Medical Officer states that local figures such as these demonstrate that what would formerly have been claimed as phenomenally low rates are now becoming the rule in quite a number of southern localities. Notifications of infectious and other diseases decreased from 1,108 (1951) to 846, nearly two-thirds of this number being accounted for by measles (445) and whooping cough (112). There were no deaths from measles or whooping cough, and again no ease of diphtheria was reported. The weather of 1952 produced features with few or no recorded parallels, and many gale and rainfall records—some over a century old—were broken. It was the coldest year in London for nine years. Sunshine and rainfall generally were above the average. In March the temperature rose 55 degrees in a month in London. On the 3rd it was 24 degrees ; on the 30th 79 degrees were registered. Snow fell in March—abnormally late—and returned mucli earlier than usual with a severe snowstorm in November. During December, London had one of its worst fogs for years, and in the central area dense fog persisted for a continuous period of 114 hours. The summer, though warm, had few really hot days. It was probably the coldest September since 1807. With only a few interruptions the cold weather continued until the end of the year, making the period September—December the coldest for at least 33 years. To the Rt. Hon. Lord Mancroft, M.B.E., T.D., Chairman of the Public Health Committee until May, to Councillor Herbert C. Garrard, who succeeded him in that position, and to the members of the Committee and, indeed, of the Council generally, I offer my thanks for the consideration and support always extended to me in connection with the public health work of the Borough. To the staff of the Public Health Department my obligations are too numerous to mention individually, but to all I gratefully acknowledge my indebtedness for their loyalty and continued zeal and efficiency. I am, Mr. Mayor, my Lord, Ladies and Gentlemen, Your obedient Servant, H. A. BULMAN, Medical Officer of Health. 4 PUBLIC HEALTH COMMITTEE. 1952. HIS WORSHIP THE MAYOR : * Alderman Frederick William Dean, J.P., D.L., F.I.A.S. † Alderman Howard Charles Rowe, J.P., F.R.T.C.S. COUNCILLORS: Dr. H. K. Ashworth, T.D. Mrs. E. M. Brown Frederick Frame Herbert C. Garrard (*Vice-Chairman; †Chairman) B. Hawley Mrs. M. E. 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. (*Chairman) Miss L. B. West Russell Capt. R. G. Whitney, M.B.E., J.P. (tVice-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 : £3,470,728. Sum represented by a penny rate : £13,912. Number of residential units (separate assessments) : 22,904. 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) : 1952—74,290. EXTRACTS FROM VITAL STATISTICS. Total M. F. Live Births—Legitimate 834 430 404 Birth-Rate per 1,000 estimated home population 12.49 Illegitimate 94 55 39 Stillbirths—Legitimate 17 11 6 Rate per 1,000 total (live and still) births 22.13 Illegitimate 4 3 1 Deaths (all ages) 1,134 553 581 Death-Rate per 1,000 estimated home population 15.27 Maternal Mortality—Deaths from "Pregnancy, Childbirth, Abortion" (Registrar-General's Code No. 30 *2 ♦Including one death at the age of 67 years where the interval between the maternal condition and death was stated to exceed 12 months. Total M. F. Deaths of Infants under one year of age—Legitimate 18 7 11 Illegitimate 5 3 2 Deaxh-Rate of Infants under one year of age—All infants per 1,000 live births, 24.78; legitimate infants per 1,000 legitimate live births, 21.58; illegitimate infants per 1,000 illegitimate live births, 53.19. Marriages.—The total number of marriages was 1,358, being 57 below the number for 1951 and 59 below the average for the previous 10 years. The rate for persons married in 1952 was 36 per 1,000 of the estimated home population. Deaths.—The total number of deaths (1,134) 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 stationed 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 10 4 1 7 1 3 2 2 Tuberculosis, other 3 — 3 Syphilitic disease 4 1 — — —- —- — — — — 2 — 2 1 4 Diphtheria — — — — — — — — — — — — — — 5 Whooping cough — — — — — — — — — — — — — — 6 Meningococcal infections 1 — 1 — — — — — — — — — — — 7 Acute poliomyelitis 2 — — — — — — — — — — — — — 8 Measles — — — — — — — — — — — v — — 9 Other infective and parasitic diseases 3 2 — —- — — — — 1 1 1 1 1 — 10 Malignant neoplasm, stomach 7 12 — — — — — — — — 3 4 4 8 11 Malignant neoplasm, lung, bronchus 33 5 — — — — — — — 20 — 11 5 12 Malignant neoplasm, breast — 28 — — — — — — — — — 13 — 13 13 Malignant neoplasm, uterus — 11 — — — — — — — — — 4 — 7 14 Other malignant and lymphatic neoplasms 58 44 — — — — — — 4 3 22 16 32 25 15 Leukaemia, aleukaemia 5 4 — — — — — — — 1 2 2 3 1 16 Diabetes 5 5 — — — — — — — — — 2 5 3 17 Vascular lesions of nervous system 70 88 — — — — — — — — 12 12 58 76 18 Coronary disease, angina 91 66 — — — — — — 1 1 33 15 57 50 19 Hypertension with heart disease 27 23 — — — — — — — — 4 1 23 22 20 Other heart disease 54 90 — — — — — — 1 — 7 6 46 84 21 Other circulatory disease 32 50 — — — — — — — 1 6 2 26 47 22 Influenza — — — — — — — — — — — — — — 23 Pneumonia 23 24 — — — — — — — 1 5 2 18 21 24 Bronchitis 52 25 — — — 1 — — 1 — 13 3 38 21 25 Other diseases of respiratory system 2 1 — — — — — — — — 1 1 1 — 26 Ulcer of stomach and duodenum 7 5 — — — — — — — — 1 — 4 5 27 Gastritis, enteritis and diarrhoea 1 5 — — — — — — — 2 — — 1 3 28 Nephritis and nephrosis 1 2 — — — — — — — — — — 1 2 29 Hyperplasia of prostate 10 — — — — — — — — — — 9 — 30 Pregnancy, childbirth, abortion — 2 — — — — — — — — — — — 1 31 Congenital malformations 3 8 1 4 — — 1 — — 1 1 1 — 2 32 Other defined and ill-defined diseases 33 47 8 8 — — 1 — 4 3 7 10 13 26 33 Motor vehicle accidents 1 2 — — — — — — 1 — — — — 2 34 All other accidents 9 20 — 1 — — — — 1 3 1 3 7 13 35 Suicide 6 6 — — — — — — 1 3 3 2 2 1 36 Homicide and operations of war — 1 — — — — — 1 — — — — — — Totals 553 581 10 13 — 1 2 1 22 24 152 101 367 441 1,134 23 1 3 46 253 808 TABLE 2.—Infant Mortality—According to Age-Group and Sex. CAUSES 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. M. F. M. F. M. F. Congenital malformation — 4 — — — — — — — — — — 1 — 1 4 Premature birth 7 6 — — — — — — — — — — — — 7 6 Atelectasis Meningococcal meningitis — — — — — — — — — — — — 1 — 1 — Suffocation — 1 — — — — — — — — — — — — — 1 Other causes 1 1 — — — — — — — — — 1 — — 1 2 Totals 8 12 — — — — — — — — — 1 2 — 10 13 20 — — — — 1 2 23 6 Mortuary.—Six bodies (5 male, 1 female) were received at the Public Mortuary, Chiltern Street. No post-mortem examinations were carried out. The Council's part of the value payment, agreed following destruction of the old Mortuary in l'addington Street by enemy action on the 18th October, 1940, amounting to £2,161 7s. Od. net, was received from the War Damage Commission. The lease of the premises in Chiltern Street, which are adjacent to the old mortuary site and have been used as a public mortuary since 1942, expired on the 24th March, 1952, and was extended by the freeholders (the Portman Estate) on a quarterly tenancy on the same conditions and terms, namely, £25 per annum exclusive. Towards the end of the year, when the site and other lands adjoining in the occupation of the Council were included in a part of the Portman Estate to be sold by public auction, negotiations were proceeding with a view to ensuring that the Council's occupation should not be disturbed. Crematorium.—The Medical Officer of Health is Medical Referee for the Council's Crematorium, situated in the St. Marylebone Cemetery at East Einchley. During 1952, 1,451 certificates authorising cremation were issued, as compared with 1,284 certificates in 1951, 759 in 1950, 669 in 1949, and 360 in 1948. Since the Crematorium was opened in December, 1937, 6,333 cremations have been carried out. SECTION B.—GENERAL PROVISION OF HEALTH SERVICES. Staff.—There were several changes in the staff of sanitary inspectors during the year, and some difficulty was experienced in filling the vacancies. Mr. E. E. Willis, M.M., Senior Sanitary Inspector and Drainage Inspector, retired on the 2nd October, 1952, on reaching the age limit. He had completed 40 years in the local government service, of which 32 years were spent in St. Marylebone. His great technical knowledge and experience of drainage and sanitation were widely recognised and left their mark in many important buildings in the Borough. The Council conveyed to Mr. Willis their appreciation of his long and valuable service. Mr. H. E. Scoble, M.B.E., Food Inspector and Sampling Officer, succeeded to the office of Senior Sanitary Inspector, and Mr. J. R. Baily, a District Sanitary Inspector, was transferred to the position of Drainage Inspector. Two vacancies on the inspectorial establishment were filled by the appointment of Mr. A- W. Mules-Berry, who took up work in the Department on the 9th June, 1952, and Mr. R. A. D. Gates, who commenced duty on the 16th June, 1952. Two Sanitary Inspectors resigned to take up similar appointments with other local authorities—Mr. R. H. W. Howard on the 6th April, 1952, and Mr. A. H. Chappell on the 6th September, 1952. Staff Medical Examinations.—The Medical Officer of Health is medical adviser for the purposes of the Council's superannuation scheme. During 1952, 53 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. 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. The Medical Officer of Health. Councillor F. Frame. Councillor Mrs. L. Lyons. 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. 7 Body Paddington and St. Marylebone District Nursing Association (Executive Committee). St. Marylebone Youth Centre Committee (Management Committee). St. Marylebone Clean Food Association—Executive Committee. Department of Scientific and Industrial Research— Standing Conference of Co-operating Bodies dealing with Atmospheric Pollution. Representatives Councillor the Hon. Mildred Lowther, O.B.E. Councillor R. T. Glenny. Councillor The Hon. Mildred Lowther, O.B.E Councillor H. C. Garrard. Councillor Miss L. West Russell (from July). Councillor Mrs. M. E. Henderson-Begg (until July). I he Chairman of the Public Health Committee. The Medical Officer of Health. Queen Mary was pleased to appoint the Medical Officer of Health a member of the Council of the Queen's Institute of District Nursing for the three-year period commencing 1st May, 1952, to represent the Association of Municipal Corporations. 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. The Medical Officer of Health accepted an invitation from the Rt. Hon. Iain Macleod, Minister of Health, to serve as a member of the Board of Governors of the National Heart Hospital. The Board acts as the agent of the Minister for the administration of the hospitals for which it is responsible. 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 1952 as indicated below Organisation Amount Statutory Authority £ s. d. Central Council for Health Education. 10 10 0 Public Health (London) Act, 1936, section 298. Family Welfare Association (Area 2). 100 0 0 Local Government Act, 1948, section 136. National Smoke Abatement Society. 5 5 0 Public Health (London) Act, 1936, section 298. Local Government Act, 1948, section 136. London and Home Counties Smoke Abatement Advisory Council. 2 2 0 Local Government Act, 1948, section 136. St. Marylebone Old People's Welfare Association—"Meals on Wheels" Service, etc. 594 15 5 National Assistance Act, 1948, section 31. Women's Voluntary Services. 67 5 8 National Assistance Act, 1948, section 31. St. Marylebone Youth Centre, Paddington Street. 800 0 0 Physical Training and Recreation Act, 1937, section 4 (4). Conferences.—The Council were officially represented at the under-mentioned conferences dealing with matters within the purview of the Public Health Department:— Conference Delegates Royal Sanitary Institute. Margate, 22nd to 25th April. Councillor Capt. R. G. Whitney, M.B.E., J.P., and the Medical Officer of Health. Sanitary Inspectors' Association. Brighton, 9th to 12th September. Mr. L. Newland, Sanitary Inspector. Central Consultative Committee on the Welfare of Old People. London, 19th June. Councillor Miss L. B. West Russell and Miss M. M. Sharp, Sanitary Inspector. Association of Public Health Lay Administrators. Oxford, 26th to 28th September. Mr. H. G. Brown, Senior Assistant Administrative Officer. Care of Old People.—Four hundred and ninety-one old people (including 3D 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 give valuable assistance to many aged inhabitants of the Borough. Special Laundry Service.—Under the scheme for dealing with the bed linen and clothing of acutely ill and incontinent old people, 27 cases were dealt with during 1952, each 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 since February, 1950, and continues to be 8 greatly appreciated by all who are concerned with the nursing of the aged in their own homes. Of those assisted some 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. During two weeks in October it was necessary, on account of machinery overhaul, 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 Executive Committee of the Association (Chairman—Mrs. L. Fewster ; Hon. Secretary—Miss M. K. C. Macintosh, Room 103, Town Hall, St. Marylebone, W.l) has kindly provided the following information on the work carried out during the year. The Association held no open meetings in 1952, but the Executive Committee met each month (except in August) and the monthly visitors' meetings were continued. The attendance at these varied but they proved a valuable feature of the Association's activities. The new Mayor, Alderman H. C. Rowe, became President of the Association in June, and continues in office during his second year of Mayoralty in 1953. His active interest in its affairs is greatly appreciated. In September, Alderman A. E. Reneson Coucher, O.B.E., was elected the Association's first Vice-President, thus becoming permanently associated with the work which his enthusiastic sponsorship during his Mayoralty did so much to place on a satisfactory basis. Representatives of the Association attended conferences held by the National Old People's Welfare Committee, the London Council of Social Service and the Central Consultative Committee for the Administrative County and the City of London. Their interesting reports have, it is hoped, enabled the Association to have a mental horizon wider than the confines of the Borough. For the same reason it is gratifying to record that a member of the Committee was invited to represent the Association on the Divisional Home Nursing Voluntary Committee No. 2 of the Central Council for District Nursing in London, and that the Hon. Secretary was elected as one of the five representatives of local old people's welfare committees on the Central Consultative Committee on the Welfare of Old People. During the year there were two additions to the facilities for old people in the Borough: (i) the reduced price of private baths at the public baths establishment, and (ii) the London County Council scheme for providing night sitters-up. During the year the Executive Committee had on several occasions discussed reports on voluntary schemes relating to the latter, and there was general satisfaction when the County Council decided to extend the home helps service in this way and to make it free for old age pensioners receiving a national assistance grant. The Association's own activities and services were maintained and developed. The following summary is only an outline which should be filled in by a mental picture of close on 100 voluntary workers, men and women, giving their time and energy to the service of St. Marylebone's old people. It is from their personal relationships with individuals that the work derives its value. The Women's Voluntary Services continued to deliver hot meals to the house-bound on five days a week. About 7,000 were provided during the year. The charge for meals had to be raised from 8d. to l0d. but the increase caused no difficulties either in the "meals on wheels" service or at the luncheon clubs. On Christmas Eve, "Frood" Christmas dinners, the gift of the Mayor, were taken to all old people on the list, with instructions for their preparation. In July a change was made in the arrangements for the delivery van. The Cleansing Committee of the Borough Council were unable to continue to spare one of their drivers, as they had done for four years. The Public Health Committee, however, made a driver available and provided garage space on Council property. The W.V.S. Luncheon Club was full every day from Monday to Friday. The dinners were transported from the London County Council restaurant in the Association's van, thus adding some 6,000 meals to its yearly total. The Cook Shop of the St. Marylebone Housing Association and Trust again served some 5,000 dinners to old age pensioners at the special price of lOd. They now receive assistance from the London County Council by way of subsidy for each meal on the same basis as the "meals on wheels" service and the W.V.S. luncheon club. The demand for the chiropody services continued. In June it was decided to hold a morning session (with one chiropodist and no students) as well as the afternoon one, and this for a time relieved the pressure. In the autumn the Chiropody School of the Chelsea Polytechnic were obliged to withdraw their students as they were all needed at the Polytechnic's own clinics. In place of the students a second chiropodist is now employed. This, and increased rent, necessitated the charge being raised from Is. to Is. 6d. Only two patients out of the 370 on the books made any objection to the increase. The pressure on the clinic is so great that new appointments can only be made six or eight weeks ahead, 9 and there is a long waiting list. The Committee consider the chiropody service as an important activity which they hope to be able to expand. No one is more eager for yet more work in this direction than the members of the St. Marylebone Red Cross, who help the patients at the afternoon- session, and Mrs. Cotford, the devoted Red Cross Associate, who does all the administrative work of both sessions. The home chiropody service provided two rounds each month except in February and March when the chiropodist was away ill. During the year she paid 195 visits to 83 patients (7 men and 76 women). 1 his was an increase of 22 (20 women and 2 men) in the year. One treatment was given free, and live at the reduced charge of Is. The other patients all willingly paid 2s. Arrangements were subsequently made for the chiropodist to have the use of a car for her rounds. Sixteen visitors continued their invaluable service of the regular "friendly visiting" of the housebound and the lonely. More volunteers for this, the basic activity of the Association, are urgently needed. Their numbers were doubled by the 16 parish visitors of the combined parishes of All Souls, Langham Place, and St. Peter's, Vere Street, who regularly report at the visitors' meetings through their liaison officer, who is also a member of the Executive Committee. The three W.V.S. Clubs, the St. John's Wood Club (under the auspices of the Women's Committee of the Liberal Jewish Synagogue), the Inner Wheel Club and the Fourth Feathers Club all continued to flourish. Their numbers were only limited by the seating capacity of the halls in which the weekly gatherings are held. They all had summer outings and Christmas parties, largely financed by their members' own efforts through jumble sales, etc. These clubs mean steady hard work for the organisers and their helpers who, in addition, visit sick members. The "Get Together" Club for the Hard of Hearing closed at the end of the summer owing to the ill-health of its organiser (Miss Stockwell). All its members subsequently joined one (or more !) of the other clubs. A new club—the Barrow Hill Club—meets fortnightly in the tenants' social room of the Barrow Hill Estate, although membership is not limited to tenants of the estate. In addition to the social functions held by these clubs and the summer outings and Christmas parties of the churches, the old people were again given a summer river trip, as well as a large Christmas tea party by St. Marylebone Rotary. The two Philanthropic Lodges also gave their usual most successful Christmas parties. The Association were only able to help six old people with the cost of a summer holiday in 1952, but towards the end of the year the Borough Council decided to make a grant of £200 for this purpose in the financial year beginning in April, 1953. Owing to the mild weather there was little call for emergency coal deliveries or wood blocks in the winter of 1951-52, or in 1952-53 until the very end of the winter. Through the kindness of the Wireless for the Bedridden Society, the loan of wireless sets for five more old people was arranged, and in four cases the Mayor paid for the first year's licence out of a fund at his disposal. There are now twelve of these sets under the Association's supervision. The Personal Service League have provided twelve pairs of sheets to lend out in cases of sudden illness or other emergency. They were all in constant use throughout the winter and proved a very useful supplement to the stocks held by the district nursing association and the Red Cross. Though the Association is not a relief agency, its small emergency fund was again able to give prompt help in a limited number of deserving cases. Warm congratulations are offered to the St. Marylebone Old People's Homes, Ltd., on the opening of "Newstead," Nos. 17-19, Greville Place, N.W.6, in April, 1952, and on the happy and successful home it has become. The Association arranged to pay a fortnight's rent for any St. Marylebone residents who did not wish to give up their own rooms until they were certain they were going to "settle." Two old men took advantage of the offer. One did settle and is still there. The other proved unsuited to communal life, and it was a relief both to him and to the committee of the home that his former room was still available. The Borough Council's grant to the Association was increased to £500 per annum as from April, 1952. This is the only source of regular income. There is no subscription list because all the Association's constituent bodies are charitable organisations which make their own appeals. The financial help given by the Borough Council is increased by their generosity in allowing the Association free office accommodation and permission to hold meetings in the Town Hall. But it is probable that even the £500 will not cover expenditure, and consideration will have to be given in the near future to means for raising more money for the Association's needs. The Committee wish to express their deep appreciation of the support given to the work of the Association by the Medical Officer of Health and the ready co-operation of Miss Margaret Sharp (Sanitary Inspector) and other officers of his Department, as indeed of all Departments of the Council with whom they are brought into contact. 16 SECTION C.—SANITARY CIRCUMSTANCES. Sanitary Inspection.—The number of complaints received (excluding those relating to rat and mouse infestations) was 1,380. Details of the various nuisances detected and remedied, to the total number of 2,512, are set out in Table 3. In 772 cases a preliminary (intimation) notice was issued, and in 233 instances this was followed by the service of a statutory notice to secure abatement of nuisances. In addition, 102 notices were served under London County Council Bye-laws made under the Housing, Metropolis Management or Public Health Acts, and one notice under the Borough Council Bye-law for securing the cleanliness of water storage tanks. Legal proceedings were instituted in seven cases under the Public Health (London) Act, 1936, in respect of failure to comply with statutory notices. In five instances penalties amounting to a total of £5 0s. 0d., were imposed, costs being awarded to the Council. Costs without the imposition of a fine were allowed in one other instance. In the remaining case the summons was withdrawn, the works having in the meantime been completed. Legal proceedings under County Council Bye-laws were taken in four instances. One resulted in a fine of £5 0s. 0d., with five guineas costs, and another in a fine of £1 0s. Od. with a guinea costs. The two remaining cases were withdrawn upon completion of the necessary work. TABLE 3.—Nuisances. Nuisance Abated or Defect Remedied Number Houses damp, dirty or dilapidated 682 Doors, windows, floors, ceilings, sash cords, grates and flues, etc., defective 835 Insufficient and unsuitable water-closet accommodation 20 Drain, water-closet and waste pipe stoppages 153 Drains, water-closets and waste pipes defective 151 Yard, area and wash-house defects 24 Roofs, gutters and rainwater pipes defective 427 Insufficient water supplies 18 Water cisterns dirty or defective 19 Ashpits, dustbins, etc., defective 42 Rubbish accumulations 89 Animal nuisances 2 Miscellaneous 50 Total 2,512 Sanitary Accommodation at Public Houses.—The special survey of sanitary accommodation at licensed premises carried out in 1949 revealed the standard to be unsatisfactory in 51 of the 133 premises. Since then there has been a steady improvement, despite building licence difficulties, and at the end of the year 17 premises remained to be dealt with, mainly from the point of view of absence of sanitary accommodation for women. 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. In no case was it necessary to draw the attention of the Board to the quality or quantity of the water, but four complaints of unpleasant taste at three premises were received during the year. The trouble in each instance appeared to be due to a dirt}' storage tank, and no further complaints were made after the tanks had been cleansed. In accordance with the provisions of the Public Health (London) Act, 1936, the Board notified two instances where water had been cut off in occupied premises for non-payment of rates, and another where waste of water had been reported. In all the supply was reinstated, in one instance after service of notice. Further examinations of the private well waters from the ten borings still in use (four in full operation and six for emergency purposes only) were made by the Council's Bacteriologist, and these indicated that since the last survey, made in 1947 at the request of the Ministry of Health, there has been no appreciable change. The reports for 1952 were generally satisfactory and no pathogenic contamination was found. There were, however, indications that, as a sole source cf 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 the wells supplying water for drinking purposes under observation and sample their waters every six months. Ten 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 five municipal blocks of flats. 11 Drainage.—The number of plans approved was 312, of which 12 related to new buildings, including a Borough Council housing scheme of four blocks comprising 121 flats. At the request of the Medical Officer of Health the drains and/or sewer connections of 21 premises were examined by the staff of the Borough Engineer's Department. In 11 cases defects were discovered which called for remedy; in the remaining 10 instances the sewer connections were found to be serviceable and fit for continued use. The drainage inspectors made a total of 3,617 visits. Combined Drainage.—Three orders under seal for combined drainage were issued. Building Licences.—During the year 180 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 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. On the occasion of the funeral of His Late Majesty King George VI the Council provided temporary conveniences for the use of the public viewing the procession as it passed along Edgware Road. The accommodation, which was set up by a contractor on a site normally used as a car park in Great Cumberland Place, Marble Arch, comprised a series of cubicles containing 12 chemical closets for men and 12 for women, the whole contained in a frame tent surrounded by canvas screening. Washing facilities, with paper towels, tablet soap and hot water, were also available. The temporary conveniences were open from 0 a.m. to 4.30 p.m. on the day of the funeral (Friday, the 15th February, 1952) and no charge was made for their use. Towards the end of the year preliminary arrangements were in hand for similar provision, on a larger scale, to be made available to the public on the occasion of the Coronation of Her Majesty Queen Elizabeth II on the 2nd June, 1953, when part of the processional route will be along Oxford Street, which forms the southern boundary of the Borough. In this connection the Medical Officer of Health attended two conferences called by the Commissioner of Police of the Metropolis to discuss the question of adequate sanitary accommodation throughout the whole line of the procession and to secure co-ordination of all proposals. At these meetings representatives of the Police, Ministry of Works, War Office and Westminster City Council were also present. It was decided, among other things, that the temporary conveniences should remain open for a minimum of three days, to be extended, if justified by circumstances, to a maximum of seven days. Preliminary work in connection with the construction of new public conveniences on the Wellington Place frontage of the St. John's Wood Burial Ground was commenced towards the close of the year, and negotiations were in hand for the erection of new conveniences in Paddington Street. On both sites accommodation will be provided for men and for women. Public Cleansing and Salvage.—The Director of Public Cleansing has kindly provided the following information on these services. The materials dealt with in 1952 were: house and trade refuse, 35,373 tons; street sweepings and gully slop, 2,865 tons; salvaged materials (including kitchen waste) 2,037 tons. The sum of £12,500 was obtained from the sale of salvaged materials. In addition, £715 was received for the removal of trade refuse and green offal and for the cleansing of petrol interceptors. During the year delivery was taken of twelve mechanically-driven four-wheeled tractors, complete with barrier loading articulated trailers, for the collection of salvage and refuse, and of two "Paladin" portable refuse container collection vehicles. Shops.—Inspections under the Shops Acts numbered 155. In four instances service of notice for the provision of adequate sanitary accommodation was necessary. Pet Shops.—The Pet Animals Act, 1951, which came into force on the 1st April, 1952, provides for a system of inspection and licensing annually of pet shops by local authorities. During the year seven licences were issued, the prescribed fee of 10s. having been paid in each case. Barbers' Shops.—The Metropolitan Boroughs' Standing Joint Committee asked for the Council's views on a proposal that legislation should be sought enabling borough councils to register and control barbers' and hairdressers' shops, and to make bye-laws to secure cleanliness of the premises, of the instruments, materials and equipment used therein and of the persons employed in the business. In order to obtain up-to-date information on conditions prevailing in hairdressing establishments in the Borough a special survey was carried out with the following result:— 12 TABLE 4.—Hairdressing Establishments. Saloons for: Satisfactory Unsatisfactory Total Fair Poor Ladies and Gentlemen 14 5 — 19 Ladies only 23 7 — 30 Gentlemen only 14 13 6 33 Totals 51 25 6 82 Having regard to this report, and being advised that no special difficulties were anticipated in enforcing any reasonable bye-laws, the Council informed the Standing Joint Committee that they were in favour of steps being taken to obtain the suggested powers. Diseased or Infirm Persons.—In no case was it necessary to make application to Court, under the National Assistance Acts, 1948 and 1951, for an Order authorising the removal of an infirm person to hospital or other suitable place. 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 1952 the burial of 19 bodies was undertaken by the Council. The total expenditure incurred in dealing with these cases was £358 Is. Id., of which £126 7s. 8d. had been recovered by the end of the year. Disinfestation.—During 1952, 459 dwellings, involving 730 rooms, were disinfested by an insecticide based on D.D.T. Included in the number of dwellings treated were 73 requisitioned premises and 13 municipal flats where bugs were found. Altogether 133 requisitioned dwellings were, on becoming vacant, inspected to ascertain if they were vermin infested. As already reported, a campaign against the bed-bug was launched in July, 1948, and Table 5 gives statistics covering the four months July—October (when bugs are in their most active state) for the past five years. TABLE 5.—Disinfestation. Month Number of Rooms Disinfested 1948 1949 1950 1951 1952 July 123 137 111 133 92 August 211 149 147 106 97 September 138 190 83 64 68 October 121 178 43 86 36 Totals 593 654 384 389 293 Erom this it will be seen that, compared with 1950 and 1951, there was a reduction in the number of rooms infested in 1952 of approximately 25 per cent., whilst the comparison with 1949 indicates rather more than a 50 per cent, decrease. These figures are regarded as being highly promising and provide ample justification for continuing the scheme in order that even better results may be achieved. Treatment of verminous furniture by hydrocyanic acid gas in specially constructed vans, which has been carried out under contract by the Council for many years, has been continued, more particularly in the case of removals to fresh housing accommodation. In 1952 the furniture of 94 families (of whom 79 were being rehoused) was dealt with by this method. In addition, 6,803 verminous articles of bedding were disinfested by steam. Verminous Persons.—The Council's Cleansing Station in Lisson Grove dealt with 1,116 verminous persons : adults 609 (men 558, women 51); children 507 (boys 86, girls 421). 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.—As indicated in Table 6, fewer premises were found to be infested with the ship rat and the common rat. The average size of the infestations also was smaller than formerly. Consequently, the demand for the Council's services was not so great as in recent years. A minimum charge of ten shillings was made in respect of each treatment at business premises but to private residents the service was free. The scheme of block treatment commenced late in 1040 was continued and most of the known areas of infestation within the Borough have been surveyed and treated. Mice were rather more troublesome than last year and although the baits used against them were varied from time to time, no bait was found to be completely satisfactory. TABLE 6.—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 1961 1,562 1,548 117 7,488 592 312 399 1,303 1,130 1952 1,261 1,261 116 6,630 438 221 408 1,067 987 Owners and occupiers co-operated generally by carrying out the proofing work advised and by giving attention to the drainage defects found. In no case was formal action under the Prevention of Damage by Pests Act, 1949, found to be necessary but 240 informal notices were served. Two notices were issued under the London County Council bye-laws in respect of drainage defects. Sewers were baited at 277 points in January and at 246 points in June. The Ministry of Agriculture and Fisheries expressed satisfaction with the work carried out by the Council since the 1949 Act came into operation. They considered the results most encouraging, and regarded the progress made, particularly in the extended use of the " block treatment " system, as having a high community value, especially in the present economic situation. It was further suggested that an easing of such an effort would be false economy, since rodent control measures are now of even greater importance than ever before. During the year two rodent operatives resigned to take up other employment. In view of the satisfactory progress of the work throughout the area the vacancies were not filled. 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 20 cases. In 14 of these convictions were secured and penalties imposed. The remaining six cases were dismissed on payment of costs. Metal plates bearing the warning " Any person in charge of a dog who allows it to foul the footway is liable to be prosecuted " were affixed to lamp-standards at numerous points in the Borough. Despite this and other forms of publicity, the nuisance is still troublesome although the condition of the pavements in the Borough has undoubtedly improved since the local bye-law came into operation in 1928 during which time a total of 506 prosecutions have been taken. The Council, however, felt that attention should be given to the problem over a wider area, and representations were therefore made to the Metropolitan Boroughs' Standing Joint Committee who agreed to invite all metropolitan borough councils to consider whether they could take any appropriate action to secure the enforcement of their own bye-laws in view of the nuisance and danger to public health resulting from the fouling of footways by dogs. Pigeons.—Section 121 of the Public Health (London) Act, 1936, empowers the Council, for the purpose of abating or mitigating nuisance, annoyance or damage, to arrange for the seizure or destruction of pigeons in excess of such numbers as the Council consider reasonable. Accordingly, an authorised pigeon catcher, who operates under the direction of the Medical Officer of Health, has been employed for many years, without cost to the Council, to seize and dispose of pigeons congregating at places in the Borough to which he is directed. During 1952, six complaints of nuisance from these birds, relating to four premises, were referred to the pigeon catcher after investigation. Noise.—Complaints of 32 noise nuisances were received. Their infinite variety may be gathered from the following selection of alleged causes: radio, piano practising, a club orchestra, a dance hall, factory machinery of many kinds, delivery of goods to tradesmen's premises, garages, a coach park, boys playing games, dogs, and shouting tenants. Most of these nuisances were abated after informal action by the sanitary inspector or streets nuisance inspector. In the remainder, where upon investigation it appeared that the Department had no power to take direct action, the complaints were referred to the appropriate authority. 14 The temporary parking place for motor coaches in Cosway Street was again the subject of numerous complaints of noise and other nuisances. Renewed protests were made about annoyance caused by the starting up of engines and shouting of passengers lasting long into the night, and the effect upon the sleep and comfort of nearby residents. The site was first used as a coach park in 1950 under planning permission granted by the London County Council, who own part of the land. Subsequently, in view of the repeated complaints, the Borough Council urged the County Council not to renew their consent to its continued use, and eventually occupation of the site was restricted and no further complaints were received. Atmospheric Pollution.—One hundred and eighty-one observations were made on a total of 77 premises. Twenty-four complaints were received in respect of smoke and/or grit nuisances arising from 13 premises, relating to hospitals, commercial undertakings, a block of flats, private houses, and to the two electricity generating stations. With the exception of those arising from the last named and a milk depot, the nuisances, although recurrent in some instances, were abated after informal action. The question of atmospheric pollution, more especially from grit emissions, in the vicinity of the electricity generating stations in Aberdeen Place and Lodge Road, was dealt with at length in last year's report, where it was stated that, following discussions with the British Electricity Authority and assurances by them that they would do all in their power to keep to a minimum the emission of grit from the two stations, it had been decided to continue observations and to review the whole position should that become necessary. Further investigation suggested that, in addition to the more obvious nuisance from grit and other carbon particles, serious troubles were being caused by the presence of sulphurous fumes. These fumes are a normal constituent of flue gases and unless specially removed at source or efficiently discharged at high level to disperse into the upper atmosphere they can, when produced in large quantities, cause injury to health and damage to property. Apart from a characteristic choking smell and a tendency to make the eyes water, sulphur dioxide gas is insidious in its action and is not easy to detect without special apparatus. It is colourless and therefore cannot itself be seen and may be in process of discharge from a chimney in quantity even when no black smoke or grit is apparent. It is readily soluble in water and when emitted in association with water vapour, under certain conditions, the droplets fall in a cloud carrying the gas with them, thereby producing a local concentration of sulphurous acid. This is one of the most harmful constituents of fog. Moreover, it is stated that the carbon particles penetrate further in a moist sulphurous mist and so do more damage and, according to a United States Government report, the deaths of 19 people who died as a result of exposure to fog in Donora, U.S.A., were found by post-mortem examination to have been due to the toxic effect of sulphur dioxide fumes which in this instance came from a zinc smelting works. It is not suggested that the air of St. Marylebone is being contaminated by sulphur gases in such lethal concentrations but there is little doubt that emanations from the generating stations added materially to the severity of the local conditions during the severe fog conditions in December, 1952. Table 7 shows the number of people who died in the Borough during the five weeks ended 3rd January, 1953, together with figures for the corresponding period of the previous year which can be taken as representing average conditions for the month of December. TABLE 7.—Deaths Registered in St. Marylebone—5 weeks ended 3rd January, 1953. (Corresponding figures for the previous year are shown in brackets). Week ended At Ages—Years Under 5 5 and Under 45 45 and under 65 65 and over Total 6th December, 1952 1 (-) 2 (2) 4 (5) 16 (8) 23 (15) 13th December, 1952 1 (2) 4 (— ) 13 (18) 52 (17) 70 (37) 20th December, 1952 -(-) — (4) 13 (5) 29 (20) 42 (29) 27th December, 1952 -(-) 5 (1) 2 (7) 21 (17) 28 (25) 3rd January, 1953 1 (2) 1 (4) 14 (7) 22 (20) 38 (33) Total for 5 weeks 3 (4) 12 (11) 46 (42) 140 (82) 201 (139) It will be seen that there was a marked increase in the number of deaths for December, 1952, particularly amongst people aged 65 and over and during the week ended 13th December, 1952, which was the peak fog period. So far as this increase could be attributed to the fog, the deaths were mainly certified as due to pneumonia or bronchitis but there were in all probability also patients with 15 chronic heart or lung conditions whose end was hastened by it. The December fog aroused widespread concern and the problem is still under consideration by the Ministry of Health and by various national scientific bodies and conferences. The Department of Scientific and Industrial Research were again consulted about the general problem of atmospheric pollution in and about the St. John's Wood Road area and in particular with regard to complaints received towards the end of the year from the management of a large block of flats in the vicinity. It was ascertained that the nuisance experienced at these premises was attributable more to the presence of sulphur gases than to grit or smoke, and whilst it was thought to be desirable to obtain more accurate evidence by transferring the deposit gauge from Lord's Cricket Ground to a site at or near North Gate, the Department of Scientific and Industrial Research strongly recommended the setting up at the same point of an apparatus for detecting and recording sulphur gases, together with a similar apparatus at a site down-wind from the generating stations and a third apparatus for control purposes at the Town Hall. It was understood that, in view of the greater attention being given to the factors contributing to the production of fog and to the question of atmospheric pollution generally, similar sulphur detection apparatus was being set up in several other parts of London upon the advice and with the co-operation of the Department of Scientific and Industrial Research. The long-standing nuisance from the milk depot, which affected the Lisson Grove area, was caused by the deposit of large quantities of grit from the chimney shaft of a coal-fired boiler at the premises. There was some improvement in conditions until mechanical stokers were installed in May, 1952, when the grit deposits increased. The matter was again taken up with the firm concerned, and eventually they undertook to install modern grit-arresting plant. The Metropolitan Boroughs' Standing Joint Committee were advised that it was competent for constituent Councils, as sanitary authorities responsible for dealing with smoke nuisances, to consider how far information about evening classes arranged by the London County Council, as education authority, could be brought to the notice of local firms and organisations so that their boiler and furnace men might be made aware of the best means of using fuel efficiently, thus avoiding smoke nuisance. Continuing the practice of the previous year, letters were sent by the Medical Officer of Health to the managements of 47 establishments operating sizeable boiler installations in St. Marylebone, reiterating the Council's desire to do everything possible to prevent nuisance caused by the emission of smoke and grit from chimney shafts in the Borough ; giving detailed information regarding forthcoming classes in boiler-house practice at six technical colleges in various parts of London ; and expressing the hope that arrangements would be made for the attendance of members of their boiler-house staffs at one or other of the courses mentioned. Poisons.—The names of 77 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 89. Factories.—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 300 238 38 — Factories with mechanical power 1,235 1,737 242 — Other premises* (excluding out-workers' premises) 160 330 — — Total 1,695 2,355 280 — * Electrical stations, institutions, sites of building operations and works of engineering construction. 16 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 70 100 7 2 — Overcrowding 2 2 6 — — Unreasonable temperature — — — — — Inadequate ventilation 6 13 4 — — Ineffective drainage of floors — — — — — Sanitary conveniences:— (a) insufficient 2 4 1 1 — (b) unsuitable or defective 656 709 — 3 — (c) not separate for sexes 27 29 1 3 — Other offences (excluding offences relating to outwork) 107 190 24 1 — Total 870 1,047 43 10 — † It will be noted that, with one exception, the number of defects remedied exceeds the number found. This is due to the fact that many of the defects found towards the end of 1951 were not remedied until 1952. A significant fact is the increasing number of complaints received by the Department in respect of factories. There is ample evidence to show that this is not associated with any worsening of conditions (indeed, the reverse is the case) but rather to a wider knowledge and a greater appreciation of the public health aspect of industrial welfare. Reviewing the work over the past three years it is apparent that factory workers will no longer tolerate the unsatisfactory conditions of earlier days. It will be noted from the statistics that three-quarters of the defective conditions found in factories relate to sanitary conveniences, and it has been necessary continually to urge occupiers to maintain their conveniences in a cleanly condition. Another aspect of sanitary accommodation is that many old-fashioned houses in the Borough have been acquired by factory owners and the water-closets in the majority of these premises are situated in front or rear areas and are so well ventilated as to be a serious danger to health when used in inclement weather. Too often the eaves are open and to allow for natural lighting and ventilation there is a considerable open space above and below the door. It would almost seem that only the fixing of a maximum as well as a minimum standard of permanent ventilation will meet these cases. The standard of one water-closet for every 25 employees has been found to be inadequate, especially where the only washing facilities are situated within the closet apartment. Frequently also the only available draw-off tap for drinking water is contained within the water-closet and apart from restricting accessibility to the tap, this is an unhygienic arrangement which, moreover, encourages the use of the water-closet and lobby as a place for preparing tea and storing utensils. In the past factory managements have had difficulty in obtaining cleaning staff and employees have been reluctant to do this type of work. Contractors specialising in the cleaning of factories and other premises are now being extensively employed to deal with this important aspect of factory maintenance and a general improvement has resulted. The year has shown a greater number of complaints from residents of nuisances from fumes, vibration and noise emanating from factories. The increase is believed to be due, not to any growing disregard by factory occupiers for their neighbours, but to the unwillingness of residents, with their increasing awareness of the town planning and nuisance-prevention powers of local authorities, to accept any longer conditions that tend to rob them of the comfort and quiet enjoyment of their homes. Nevertheless, without the thoughtful consideration and co-operation of the factory occupier and reasonable tolerance by the complainants it is often difficult to bring about a satisfactory solution in cases where it is doubtful if legal action would succeed. Two instances of co-operation on the part of factory owners may be mentioned : A manufacturing optician caused nuisance by using naptha as a solvent for removing pitch from lenses, the fumes escaping into the small ventilating shaft of a block of flats. When arrangements were made for this process to be carried out in a small booth and the fumes extracted and dispersed at a safe position, the cause for complaint was removed. This is a case where extractor plant installed to remove fumes and exhaust from inside a factory may serve its purpose admirably but often to the discomfort of nearby residents. In the other case the occupiers of a large printing works had installed an electrically-driven generator near the base of a party wall 17 of a block of tenements, and although it had been used during daytime without complaint, the commencement of a night-shift soon roused the tenants to seek assistance from the Department. After consultation with the firm the generator was transferred to a more suitable position and the nuisance ceased. It is difficult to comply with the requirement that the local authority shall maintain a register of factories within their area unless a duty is placed upon factory occupiers to notify the local authority, as well as H.M. Inspector of Factories, of their intention to occupy premises for factory use. This is a point worthy of consideration in connection with any amendment of factory legislation. During the latter part of 1951 and the first half of 1952 the clothing trade, which embraces the bulk of the factories in St. Marylebone, suffered a serious trade reverse. This arose out of the unwillingness of the public to buy ; many firms went out of business, whilst others were compelled to give up factory space or move to cheaper workrooms. During this period the factory register underwent considerable changes and many visits were necessary merely to maintain reliable records. Apart from its main purposes, the factory register has been of value in the mass radiography scheme, as registered firms have been advised of the facilities for X-ray examination of their workers. Out-Workers.—One hundred and eleven employers submitted lists in respect of a total of 937 out-workers (370 contractors and 567 workpeople). Of these, 62 contractors and 25 workpeople operated in the Borough. The nature of the work upon which the out-workers were engaged is indicated below :— Wearing apparel 852 Furs 8 Buttons 34 Umbrellas 4 Household linen 6 Textile weaving 4 Brushes 1 Jewellery 22 Electro-plate 1 Lampshades 3 Artificial flowers 1 Racquet and tennis balls 1 Total 937 The collection of this information twice a year, as required by section 110 of the Factories Act, 1937, its transmission to other local authorities concerned and the inspection of the outworkers' premises involve the Department in much work which at times seems unjustifiable. In cases of infectious disease at out-workers' premises the danger of transferred infection by articles of outwork may not be considered great ; even so, the information that the patient or contact is an outworker is revealed during routine infectious disease visits. Rag Flock and other Filling Materials.—In St. Marylebone there are many firms carrying out upholstery work, much of it in conjunction with the antique and second-hand furniture trade and involving the restoration and repair of articles. As re-conditioned and re-made articles are outside the scope of the Rag Flock and Other Filling Materials Act, 1951 (the provisions of which were summarised in last year's report) its application in this Borough is extremely limited. In 1952, only ten premises were registered under the Act, the prescribed fee of £1 being paid in each case. Craftsmanship of a high standard is the speciality at these registered premises, and it is only occasionally that the general work of re-making and re-upholstering is interrupted by the manufacture of new goods which alone come within the purview of the present legislation. During the year, three samples of hair, one of cotton felt, one of synthetic fibre and one of feathers were submitted to authorised analysts for examination. Of these samples, two of hair, which came from the same batch, failed to reach the prescribed standard of cleanliness. The matter was taken up with the firm concerned and the material sent for re-processing. The other four samples were reported to be satisfactory. The Act also requires premises used for the manufacture or storage of rag flock to be licensed, in respect of which an annual fee of £1 is payable, but no application in this connection was received. Rag and Bone Dealers.—Section 26 of the London County Council (General Powers) Act, 1952, extends the provisions of Part IV (Offensive Trades) of the Public Health (London) Act, 1936, and prohibits 18 —on pain of a fine not exceeding £5—dealers in rags, old clothes and similar articles from selling or delivering, whether gratuitously or not, any article of food or drink to any person, or any article whatsoever to a person under the age of 15 years. Fireguards.—The administration and enforcement of the Heating Appliances (Fireguards) Act, 1952, and of regulations to be made thereunder, were referred to the Public Health Committee, and it was arranged that the sanitary inspectors should undertake the Council's functions of inspection and testing of these appliances. The Act, which received the Royal Assent on the 1st August, 1952, provides that if any person in the course of a business sells, or lets under a hire purchase agreement or on hire, any appliance required by regulations under the Act to be fitted with a guard, and either the appliance is not fitted with a guard or the guard does not comply with the standards prescribed for it by the regulations, he shall be guilty of an offence unless (i) he does so as the agent of a person who is not acting in the course of a business or as the servant of such an agent, or (ii) he reasonably believes that the appliance will not be used in Great Britain, or (iii) in the case of a letting on hire, the letting is incidental to the letting of premises, or (iv) in the case of a letting under a hire-purchase agreement, he had at no time possession of the appliance and only became the owner thereof at the time of entering into the agreement, or (v) in the case of any letting, the letting was lawful at the time the hirer or the hirer's predecessors in title obtained possession of the appliance. A person guilty of an offence under the Act is liable on summary conviction to a fine not exceeding £50. The regulations to which reference is made had not been issued by the end of the year. Street Photographers.—A local bye-law, made by the Council under section 146 of the London Government Act, 1924, came into operation on the 1st August, 1952, prohibiting the importuning by a street photographer of any person in certain prescribed streets or public places for the purpose of taking or selling any photograph. An offender against the bye-law is liable on summary conviction to a fine not exceeding £5. As the administration and enforcement of most other " good rule and government " bye-laws have been referred to the Public Health Committee, a similar course was followed in regard to the new bye-law, more particularly as the officers of the Department, including the streets nuisance inspector, are continually about the streets. By the end of the year legal proceedings had been instituted by the Council in eleven cases, all on the reports of police officers. The first prosecution has developed into something of a test case. At the hearing on 25th November, 1952, the magistrate fined the defendant ten shillings and awarded a guinea costs to the Council. He appealed to the London Quarter Sessions and the Appeals Committee reversed the decision and awarded the appellant fifteen guineas, having come to the conclusion that upon the true construction of the bye-law "the word 'importune' must involve something more than just offering an invitation—that it means exercising some kind of pressure, whether that pressure takes the form of words, or expansive gestures, or obstruction in the sense of getting in another person's way, or following a person after that person has passed by." The Council subsequently decided to appeal to the High Court. Of the other cases, in five a fine of forty shillings was inflicted ; in one, thirty shillings; and in three, twenty shillings, the remaining defendant being found guilty but discharged absolutely. SECTION D.—HOUSING. Permanent Estates.—A further twelve flats at the Townshend Estate were completed during 1952, and work on block 6 (28 flats), which had been held up on account of shortage of steel, was resumed at the end of the year. The development of the third and final section (112 flats) is expected to commence in the near future. At the Abbey Road—Boundary Road site, 30 of the 54 flats were completed. Building works for the provision of flats were also in operation at other sites as follows:— No. of Flats Queen's Terrace—Section I 24 Hamilton Terrace—Carlton Hill 52 35-55, Boundary Road 48 Wellington Road 121 The programme for 1953 envisages the development of sites at Abercorn Place (34 flats); Queen's Terrace, section II (4 flats); 33-35, Townshend Road (15 flats); 147-149, Gloucester Place (8 flats). Further freehold and leasehold interests in the Church Street Extension site were acquired with a view to the ultimate erection of 60 flats with shops. 19 Barrow Hill Primary School.—In order to make way for a new London County Council primary school, tho removal of families from factory-made bungalows on the Henstridge Place site was completed at the end of the year, 18 families being rehoused by the London County Council and three by the Borough Council. St. Marylebone Housing Association and Trust—Cochrane Street Extension.—Good progress was made in the building of 24 flats by the Housing Association and Trust in co-operation with the Borough Council, and it is anticipated that the estate will be ready for occupation early next year. The Council will nominate the first tenants for six of the flats. Half-way Houses.—The two half-way houses in Beaumont Street and Nottingham Place, provided for persons in urgent need of accommodation whilst awaiting permanent homes, have been fully occupied. Slum Clearance.—Discussions took place during the year with the London County Council in regard to the resumption of the work of slum clearance which had been deferred by war-time and immediate post-war conditions. The division of responsibility between the County Council and the Borough Council was provisionally agreed and a programme drawn up for future operations. The first steps in this connection will be taken in 1953. Inspection of Dwelling-Houses.—The total number of houses and flats (separately assessed residential units) in the Borough at the end of 1952 was 22,904. Details of inspections made and resultant action are given in the following statement :— Houses inspected for defects under the Public Health or Housing Acts 1,946 Inspections made 8,016 Houses found not to be in all respects reasonably fit for human habitation 767 Defective houses rendered fit in consequence of informal action 371 Houses in which defects were remedied by owners after service of formal notices under the Public Health (London) Act, 1936 284 Underground Rooms.—Closing orders under section 12 of the Housing Act, 1936, were made on 27 rooms, and variations in the user of two rooms already subject to closing orders were approved by the Public Health Committee. Nine orders, involving 19 rooms, were determined. Five undertakings from owners not to use or permit to be used nine basement rooms for human habitation were accepted by the Committee during the year. Inspections of these rooms throughout the Borough numbered 622. Re-Housing.—During the year 624 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 order of priority of the various applicants. In 436 instances the application was supported by a confidential medical certificate which is considered by the Medical Officer of Health personally. 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. The occupants of rooms upon which closing orders are made receive additional "points" which increase their degree of priority for re-housing, and until thev obtain other accommodation the operation of the closing orders remains in abeyance. Common Lodging Houses.—Ninety-six inspections were made of the two lodging houses in the Borough ; one, accommodating 391 men, owned by the Salvation Army and situated at No. 2, Burne Street and premises in Lisson Street ; the other, registered for 85 women, conducted by the Church Army at Portman House, No. 10, Daventry Street. At the men's lodging house the range of 15 water-closets and 7 urinals in the basement has been a matter of concern to the Department for some time. These conveniences are of old design, dilapidated, frequently become choked and cannot be maintained in a cleanly state. The owners were therefore called upon to demolish them and to provide more suitable facilities. A proposed new installation in the basement beneath the front entrance in Lisson Street, which will comprise 11 water-closets, 7 urinals and 5 wash-basins, was subsequently approved in principle. This accommodation is to be mechanically ventilated, and the floors and walls of the apartment will be tiled. At the same time, it is the owners' intention to provide three new urinals in the ablutions room in the basement of the Burne Street frontage. It is hoped that these much-needed improvements may be completed early in 1953. 20 At the quarterly fire inspections it was found that the fire-fighting equipment provided and the precautions taken were satisfactory in both lodging houses. Rent Restrictions Acts.—During the year three disrepair certificates were issued in respect of two dwelling-houses. Loans.—One house was inspected in connection with an application to the Council for a loan under section 4 of the Housing Act, 1949, to enable the applicant to purchase it for his own occupation. SECTION E.—INSPECTION AND SUPERVISION OF FOOD. Food and Drugs Analysis.—Samples of 85 different kinds of foodstuffs and 12 varieties of drugs were taken and analysed under the Food and Drugs Act, 1938. The total number of samples submitted during 1952 was 673 (61 formal, 612 informal) and these included: milk 81, butter 60, margarine 59, cooking fat 55, sausages 46, ice-cream 36. The fee paid for analysis was £1 Is. Od. for each milk sample and £1 15s. Od. for each other sample. The Public Analyst (Mr. Thomas McLachlan) has submitted the following report on the year's work :— " The number of samples adulterated or incorrectly labelled was 26, or 3.86 per cent. The incidence of adulteration may be classified thus :— Number of Samples Examined. Adulterated Incorrectly Labelled Milk 81 — — Other Foods 570 25 1 Drugs 22 — — "An iced cake was examined and found to be badly burnt before icing with the result that most of the fruit on the outside of the cake and some of the floury material had been charred, creating the impression that the cake contained sand and grit. Your analyst considered it unfit for sale. "An apricot flan was submitted showing a green discolouration. The green colour appeared to be due to a dye contained in what may have been added greengage jam, but as greengage jam should not be in an apricot flan the sample was reported as adulterated. "A cake mixture was submitted with the complaint that it had a soapy flavour. Although the sample made up satisfactorily, the resulting cake possessed a soapy flavour, probably due to the packet having been stored near some soap. A sample of scone flour was found to be infested with larvae of a moth and was probably old stock. Some sweetened sponge mixture was reported adulterated as it contained only 30 per cent, of sugar, whereas sweetened sponge mixture must contain not less than 40 per cent, of sugar. "A slice of bread contained a dark stain which was found to be a mould growth, probably a mucor. "Samples of luncheon meat, chicken, ham, egg custard and junket were submitted from a hospital with the complaint that the foodstuffs left in a refrigerator acquired an oily taste. After examination your analyst was of the opinion that all the foodstuffs were placed in the refrigerator without covers and as a result were all contaminating each other. "A sample of oatmeal was found to be contaminated with weevils. "The label on a packet of flavoured essence of rennet was considered by your analyst to be misleading as the print stating that it was junket was very much larger than that stating that it was fruit flavoured essence of rennet. "A sample submitted as blackcurrant cordial was found to contain 130 per cent, excess of saccharin and therefore failed to comply with the requirements of the Soft Drinks Order. A sample submitted as cherry flavoured cordial with a bottle labelled ' Non-Alcoholic Cherry Flavour Wine ' was 74 per cent, deficient in sugar, and the print used for the words ' Non-Alcoholic ' was too small. "A tin of apple puree was found to be old stock and, as a result, the can was badly corroded and the tin content of the apple puree was 1.2 grains per lb. It was considered by your analyst to be fit for consumption if used with other fruits, and was reported inferior. It may be mentioned that a recent report issued by the Metallic Contamination Committee of the Ministry of Food adheres more or less to the old recommendation that 2 grains per lb. of tin should be permitted in tinned foods. "A sample of coffee and chicory, stated by a member of the public to have caused illness, was examined and found to contain 59 per cent, coffee and 41 per cent, chicory. It had a bitter flavour due to over-roasting, but your analyst personally drank some and felt no ill effect. The sample was reported as inferior. 21 " Some salad cream was examined and found to be rancid. "Two samples of tinned herring roes contained aerobic and anaerobic bacteria though none of them was pathogenic and the salt content would have been sufficient to prevent the development of pathogenic bacteria. Some of the tins were badly corroded and it was suggested that they should only be sold to a manufacturer, such as a fish paste manufacturer, who would open them under proper supervision. "Two cans of luncheon meat were found to contain meat which was completely decomposed and your analyst considered that the whole consignment should be condemned. "Some sausages contained 2.4 per cent, of added salt which was considered excessive as the amount of added salt should not be more than 0.5 per cent. Two samples of pork sausages were respectively 4.8 and 6 per cent, deficient in meat. Another sample of pork sausages contained a piece of fur with adherent hide. When an action was brought in the magistrate's court the defence unexpectedly produced witnesses to state that this was genuine bristle hide from a dermoid cyst of a pig, which could not have been discovered in the abattoir or by the sausage manufacturer. The hairs were, however, subsequently identified by an expert at Scotland Yard as being cattle hair. "A sample of chutney was received with the complaint that it contained black specks. These specks were merely the outer vegetable structure containing oil glands of spices. The sample was genuine. "Another member of the public complained that a sample labelled ' Potted Shrimps in Butter' did not contain butter, but the fat was examined and found to consist of butter. "Some tomatoes and a glove were submitted by a member of the public with the complaint that the tomatoes were contaminated with acid and that tomato stain on the glove had removed the dye. The tomatoes were found to be quite sound and showed no excessive signs of acidity, but it was thought that the lady had eaten a tomato, which was beginning to turn, with her glove on and the reducing substances in the juice of the tomato had discoloured the glove. "Some boiled sweets were examined because a member of the public complained that they contained black specks and that she had found a fly in one. The sweets contained specks which proved to be purple dye used in manufacture and which had not been properly dissolved. "After receiving a complaint that the bottled milk supplied by a dairy had been weak for several days, a sample taken from the diary was examined but was found to be genuine. "A piece of bread submitted was stated to have a peculiar taste and to have caused illness. The bread had been made as aerated bread and the complainant was probably accustomed to yeast bread. Your analyst and two members of his staff ate some of the bread and were unable to detect anything wrong with the flavour nor did they suffer any untoward symptoms. "Some tinned pork was submitted as the shopkeeper concerned suspected it of being bad. On examination it was considered that the meat had probably been filled into the tin cold and without a vacuum, with the result that in hot weather there was a slight interior pressure and the tin, in consequence, became a ' flipper.' "A sample of milk was submitted by a member of the public who suspected it was dried milk with water and not fresh cows' milk, but examination showed it to be genuine milk. "A sample of ice-cream suspected of containing a detergent was examined and found to contain glyceryl monostearate which probably gave the impression of the presence of a detergent. Most ice-cream now contains glyceryl monostearate and this requires sufficient flavouring to be added to the mix if the rather unpleasant taste is to be adequately masked. "During the year several items of legislation or recommendations of Committees of the Ministry of Food were issued, which are of general interest to the public from the point of view of quality. "No less than three separate Meat Products Orders were introduced. These orders were of particular interest, in that they were issued primarily as enforcement orders and not as standards under the Food and Drugs Act. For this reason local authorities and public analysts were not informed either in advance or at the time of their issue by the Minister, but it is probable that it is the standards, rather than the prices, which will eventually be resurrected from their ashes, even the last order having been revoked in 1953. The first order, Statutory Instrument 1952, No. 507, removed the restriction on the use of soya flour in sausages, but permitted the inclusion of not more than 6 per cent, of skim milk powder in such products, the milk powder to count as 60 per cent, of its weight of meat. For the first time minimum quantities were laid down for the meat content of many meat products. As a result of this order the general methods for the analysis of these meat products were reviewed in detail by public analysts and manufacturers. 22 "Later in the year this order was replaced by the Meat Products (No. 2) Order, 1952. From the public health standpoint the chief amendments introduced were the removal of the permission to use milk powder or fat of vegetable origin in place of part of the meat and to include tinned soups as meat products. "Owing to various difficulties in applying this order a third order was introduced at the end of the year revoking all standards other than those for sausages. To the layman it may appear that there has been a considerable amount of wasted legislation, much of which has caused considerable discussion and argument. There appears little doubt, however, that whilst numerous standards put forward and eventually withdrawn had been issued without sufficient consultation with all interested parties, many members of the trade and analysts will employ these standards as a basis for commercial and other purposes, and that they may again be issued at some future date when there is more knowledge regarding their application. "The Food Standards (Fish Paste) Order, 1951, which came into effect for retail sales on the 7th March, 1952, requires fish paste to contain not less than 70 per cent, of fish after all waste has been eliminated. Fish varies considerably in composition and public analysts are endeavouring to discover methods of analysis which can be used in connection with the enforcement of the order. "The Food Standards (Meat Paste) Order, 1951, came into effect for retail sales on the 7th March, 1952. This order fixes a standard of not less than 55 per cent, of meat in meat paste. "The Milk (Control and Maximum Prices) (Great Britain) (Amendment No. 4) Order, 1951, which came into effect on the 1st January, 1952, included both Jersey and Guernsey milk as Channel Island milk. "The Food Standards (Coffee Mixtures) Order, 1952, requires coffee and chicory mixtures, including French coffee, to be mixtures of coffee and chicory only and to contain at least 51 per cent, of coffee. It further requires coffee with fig flavour or fig seasoning, including Viennese coffee, to be a mixture of coffee with figs only and to contain at least 85 per cent, of coffee. This is the first time that there has been any standard for coffee and fig mixtures in this country. "The Food Standards (Edible Gelatine) Order, 1951, which came into force on the 1st February, 1952, requires a 3 per cent, solution of gelatine, unless labelled otherwise, to form a jelly at 60 degrees F., to contain not more than 3.25 per cent, of ash, and not more than specified traces of arsenic, lead, copper or zinc. "The Food Standards (Ice-Cream) (Amendment) Order, 1952, reduced the minimum fat content of ice-cream to 4 per cent, and milk solids other than fat to 5 per cent. The Food Standards (Ice-Cream) Order, 1951, had required ice-cream to contain not less than 5 per cent, of fat and 7.5 per cent, of milk solids other than fat. Before the last war reputable manufacturers included about 12 per cent, of milk fat in ice-cream. "The Food Standards (Suet) Order, 1952, requires block suet to contain not less than 99 per cent, by weight of beef suet. It also requires shredded suet to be free from fibrous tissue and to contain not less than 83 per cent, of beef fat, the permitted diluent being farinaceous material. "The Oils and Fats Order, 1952, although re-issued as a fresh order, introduced no fresh standards for oils and fats. "At the end of 1951 the Ministry of Food circulated a report and recommendations designed to limit the amount of lead in various foods and comment was invited from interested people. The proposals put forward were generally those which were expected, but one of the chief obstacles in the way of promulgation of final standards at the present time is the difficulty of finding satisfactory methods for the exact determination of minute quantities of this element. The maximum amounts of lead suggested vary from 0.2 parts per million in ready-to-drink beverages other than beer and cider to 20 parts in colourings or 10 parts in herbs, spices, flavourings and liquid pectin. "Revised standards were suggested by the Food Standards Committee for certain jams, although these are still left as short term standards and may be revised when conditions improve. The fruit content for full-fruit standard jams is generally still below the pre-war full-fruit standard of the Food Manufacturers' Federation, but is an improvement on the standards adopted in the Food Standards (Preserves) Order, 1944, in the case of blackcurrant, loganberry, and raspberry jams, the quantities of fruit being increased from 22 per cent., 25 per cent., and 25 per cent, respectively to 30 per cent, in each case. The minimum percentage of fruit in damson jam is, however, reduced from 38 per cent, to 35 per cent. "During the year the Ministry of Food consulted the home trade regarding the use of the term 'liqueur chocolates' as a description for chocolate confectionery containing liquid centres with nonspirituous flavoured syrup. It was arranged that the words 'imitation liqueur chocolates' followed immediately by the word 'non-alcoholic' would be used for the description of this confectionery in 23 the future and that the word 'non-alcoholic' should be in substantially the same size type as the other descriptive words. The Minister also drew attention to the fact that the majority of these products are imported from abroad and that he had been unable to hold discussions with the manufacturers. Since very few confectioners hold licences for the sale of alcoholic liquors it is illegal for them to sell real liqueur chocolates. "During the year the Minister of Food withdrew the Labelling of Food Advisory Service which had been operating very successfully for some years. Whilst this service had no legislative power it provided a most useful liaison between food manufacturers and packers on the one hand and local authorities on the other. Any manufacturer seeking advice was given the benefit of the experience of the legal and chemical advisers of the Minister and most manufacturers, having been given this advice, accepted it loyally. From the point of view of the public analyst the service was invaluable because, whenever he was in doubt regarding the description or labelling of any product, he had only to contact the Ministry to know whether the matter had received the approval of the Ministry and, if so, whether the Ministry had been informed correctly of the composition of the food. With the disappearance of this service every public analyst will be obliged to express his own opinion regarding the labelling of a product and its composition in regard to such label. In the event of the local authority supporting the public analyst it will have to be decided whether the matter is one which should be discussed amicably with the manufacturer or whether legal action should be taken. It is thus seen that the advice and opinion of one central advisory service are being replaced by some three hundred and fifty critics, who will not necessarily all be of the same opinion. The increase in eventual cost will be enormous and cannot but cause irritation to reputable manufacturers." A prosecution was taken in respect of a sample of sausages found to contain foreign matter described by the Public Analyst as a "piece of hide and fur" from the tip of a pig's tail. The defendants called expert evidence to refute that of the Public Analyst, and the magistrate said that he felt that the substance complained of came within the provisions of section 4 (4) of the Act, namely, that the presence of the foreign matter was an unavoidable consequence of the process of preparation. He said he would dismiss the summons in view of the conflict of evidence, and awarded the defendants £15 15s. Od. costs against 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. One other prosecution under the Food and Drugs Act concerning the presence of foreign matter in foods is reported under the heading " Bakehouses " on page 24. Milk.—There are 163 premises from which milk is sold, and inspections made numbered 235. During the year 226 applications under the Milk (Special Designations) (Raw Milk) Regulations, 1949, and the Milk (Special Designations) (Pasteurised and Sterilised Milk) Regulations, 1949, were received from 70 milk purveyors, and licences were granted as follows:— Tuberculin tested milk 52 dealer's and 14 supplementary. Pasteurised milk 1 pasteuriser's, 63 dealer's and 15 supplementary. Sterilised milk 1 steriliser's, 64 dealer's and 16 supplementary. The average composition of the 80 genuine samples of milk analysed was: total solids 12.31 per cent.; fat, 3.58 per cent.; solids not fat, 8.72 per cent., as compared with the legal minima, namely, 11.50 per cent., 3.00 per cent, and 8.50 per cent, respectively. One other sample of milk analysed, following a private complaint, had a deficiency of fat probably due to removal by the complainant. Fifty-four samples of milk taken at the premises of two authorised wholesale firms operating heat treatment plants were submitted to the tests prescribed for the various designations. All but one (which under the phosphatase test was a border-line case) were reported to be satisfactory. Of 88 other samples of milk examined by the Council's Bacteriologist, all were found to comply with the requisite standards. Butter and Margarine Premises.—Fifteen dealers in margarine and two butter manufacturers were on the register. Forty inspections of the premises were made. Ice Cream.—The number of premises on the register was 170, which includes four where ice cream is manufactured : 168 inspections were made. Forty samples of ice cream were examined bacteriologically. Of these, 36 passed the methylene blue test, 29 being grade 1 and seven grade 2. Of the remainder, three fell into grade 3 and one grade 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 officers of health of the districts in which the factories were situated. 24 Thirty-six samples submitted to the Public Analyst were all returned as genuine. The results of the analyses of 35 of these are indicated in Table 10. The remaining sample was examined for the possible presence of a detergent but was found to be satisfactory. TABLE 10.—Ice Cream Analyses. Sample No. Fat (%) Solids not fat (%) 1 8.80 24.50 2 7.60 24.90 3 11.20 23.10 4 8.40 23.40 5 8.80 23.00 6 9.20 29.40 7 9.60 27.40 8 8.60 25.00 9 15.20 27.00 10 8.80 25.70 11 9.20 21.40 12 7.20 25.60 13 10.80 23.20 14 9.20 26.00 15 10.80 26.20 16 9.20 24.90 17 8.80 28.70 18 11.60 23.00 19 10.00 25.10 20 8.40 24.80 21 8.80 25.50 22 8.40 24.70 23 14.40 30.20 24 8.40 26.30 25 10.40 23.20 26 7.60 25.60 27 8.40 27.40 28 9.00 26.20 29 8.00 27.00 30 8.00 27.80 31 8.40 25.70 32 9.20 25.10 33 13.20 30.00 34 0.80 26.00 35 7.00 26.00 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 152 inspections were made. Fried Fish Vendors and Fish Curers.—Eleven premises are used by vendors of fried fish and one by a fish curer. Twenty-three inspections of fried fish shops and 12 inspections of the fish curer's premises were carried out. Five notices were served in respect of fried fish shops. Bakehouses.—There are 14 basement bakehouses on the register; 84 inspections were made, and five bakehouses were cleansed and re-decorated after informal notice. Legal proceedings were instituted under the Food and Drugs Act, 1938, against a firm of bakers in a case where a loaf of bread supplied to a customer had been found to contain a label. The defendants pleaded guilty and were fined £4 0s. 0d., and £4 4s. Od. costs were allowed. Restaurants, etc.—Premises in which meals are provided or food is sold already cooked or is prepared for sale numbered 838, including 227 restaurants, 61 snack bars, 58 hotels, 333 staff and club canteens, 120 public houses, 12 other licensed catering establishments, 23 school and nursery canteens, and 4 coffee stalls ; 1,113 inspections were made and 45 notices served. During the year the kitchens of 13 restaurants 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. A fine of £20 0s. Od. was imposed in each case, and costs of £12 12s. Od. and £10 10s. Od. respectively awarded to the Council. In giving judgment in one of these cases the magistrate (Mr. Geoffrey Raphael) made some pertinent remarks to the effect that in inspecting food preparation places the Council were protecting the public who themselves had no opportunity or right to inspect restaurant and hotel kitchens, and it was only fitting that these places should be brought up to as high a standard as possible. 25 Retail Food Shops.—During the year work has continued in connection with the comprehensive survey 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 58 instances. Horseflesh.—Thirty visits were paid to the only shop in the Borough selling horseflesh for human food. Slaughter of Animals.—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. Seven inspections were made during the year. The Public Health (Meat) (Amendment) Regulations, 1952, which came into force on the 31st August, 1952, extend the definition of " animal " to include horses, asses and mules for the purposes of Part II of the Public Health (Meat) Regulations, 1924, which relate to slaughterhouses and the slaughter of animals for sale for human consumption and require, among other things, prior notice of slaughter to be given to the local authority. Other Offensive Trades.—Apart from the slaughterhouse there is only one offensive business carried on in the Borough, namely, that of tripe boiler. Eight inspections were made during the year, and service of a notice, calling for cleansing of the premises, was necessary. Unsound Food.—Forty-four tons of food condemned as unfit for human consumption included the following : meat, 15 cwts. 3 qtrs. 21 lbs.; bacon, 4 tons 18 cwts. 1 qtr. 14 lbs.; poultry and game, 5 cwts. 1 qtr.; fish, 7 cwts. 3 qtrs.; fruit and vegetables, 2 tons 1 cwt. 1 qtr. 10 lbs.; canned ham, 6 tons 4 cwts. 2 qtrs. 18 lbs.; other canned meat, 6 tons 18 cwts. 3 qtrs. 3 lbs.; canned foods (other than meat), 35,608 cans; miscellaneous, 1 ton 6 cwts. 1 qtr. 1 lb. Wherever possible, unsound food was salvaged and used for animal feeding. Clean Food Campaign.—Although most of 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, 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 greatly appreciate the activities of the local Clean Food Association in helping to bring this about and in arousing interest in the importance of cleanliness of the food supply. There are many signs that the general public are becoming increasingly " 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 third year of existence of this Association, membership increased to 142 with consideration of a further 18 applications deferred upon the report of the Medical Officer of Health in order that the persons concerned might do certain work or effect 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 again 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. In view of the large number of synthetic detergents appearing upon the market and the claims made for them by the manufacturers and others, the Association made special investigation into the matter. A series of practical tests were carried out and the members of the Association were advised of the 26 conclusions reached. Broadly, these were that, although synthetic detergents offered to the public vary in their value and efficiency, the use of the better types could be confidently recommended. Amongst other activities, instructional visits were made to factories where foods and drink arc manufactured on a large scale. Advantage continued to be taken of the arrangement whereby members of the Association are offered exceptionally favourable terms for insurance against food poisoning risks and other classes of business. SECTION F.—PREVALENCE OF, AND CONTROL OVER, INFECTIOUS AND OTHER DISEASES. Infectious and other diseases notifiable in St. Marylebone are listed in Table 11, which gives also information regarding notifications received during 1952. Enquiries relating to cases of infectious disease were carried out by one of the women sanitary inspectors who paid 1,080 visits in this connection during the year. TABLE 11.—Notifiable Diseases and Notifications. * Notifiable Disease Cases notified in whole Borough Cases removed to hospital Cases isolated at home At all ages At ages—years —1 1— 2— 3— 4- 5- 10— 15- 20— 35— 45— 65— Ophthalmia neonatorum 4 4 — — — — — — — — — — — 1 3 Erysipelas 4 — — — — — — — — 1 — 2 1 1 3 Scarlet fever 64 — 2 4 6 11 36 5 — — — — — 25 39 Puerperal pyrexia 38 — — — — — — — 1 34 3 — — 33 3 Poliomyelitis— Paralytic 4 — — — — — — — — 3 1 — — 4 — Non-paralytic 3 1 — — — — — 1 — 1 — — — 1 2 Pneumonia 18 — — 2 — — 2 — 2 — 4 4 4 5 13 Dysentery 37 — 1 2 2 1 1 — — 7 3 2 18 19 18 Measles 445 9 35 50 47 70 218 4 2 9 1 — — 29 416 Whooping cough 112 15 20 22 9 12 31 1 1 1 — — — 31 81 Scabies 13 — — 1 — — 1 1 — 4 4 2 — — 13 Meningococcal infection 1 1 — — — — — — — — — — — 1 — Acute encephalitis (infective) 1 — — — — — — — — 1 — — — 1 — tuberculosis— Pulmonary 78 — — 1 — — — 2 5 28 14 22 6 35 43 Non-pulmonary 8 — — — — — — — — 5 2 — 1 8 — Food poisoning 16 — 1 — — 3 — — 5 3 3 1 8 8 Totals 846 30 58 83 64 94 292 14 11 99 35 35 31 204 642 * There were no cases of the following diseases, which are also notifiable in the Borough : Smallpox, diphtheria, membranous croup, cholera, typhus fever, relapsing fever, continued fever, plague, leprosy, hydrophobia, glanders, farcy, anthrax, induced malaria, malaria, acute encephalitis (post-infectious), enteric fever, typhoid fever, paratyphoid fever. Public Health (Aircraft) Regulations, 1952.—These Regulations,- which came into force on the 1st October, 1952, replace earlier Regulations made by the Minister of Health providing for the sanitary control of aircraft arriving at or leaving aerodromes or other places in England or Wales. In the event of an emergency landing taking place in the Borough, the Medical Officer of Health would be called upon to take such steps as might be appropriate to prevent any possible spread of infection. International Certificates of Vaccination and Inoculation.—At the request of the Ministry of Health, arrangements were continued 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. During 1952, 2,841 applications were dealt with. Diphtheria Immunisation.—In a recent report of the Ministry of Health it is stated that 31 persons in England and Wales died from diphtheria in 1952 : in 1940 the number of deaths from the disease was 2,480, and in 1901 nearly 10,000. From being one of the most serious causes of death of children in this country, diphtheria has, it is pointed out, now fallen to a position of numerical insignificance. Of the total reduction in the mortality from diphtheria during the past century by far the greatest part has taken place in the last 10 years—the period of large scale immunisation : and during these 10 years there has been a sudden and enormous reduction in the incidence of notified cases as well as of deaths. 27 Turning to St. Marylebone, no death from diphtheria has occurred during the past 8 years, and no case lias been notified in the last 3 years. In 1928 there were 177 cases and 12 deaths. In that year diphtheria immunisation was started in the Borough—12 years before the nation-wide campaign was launched—and from 1943 onwards resulted in the immunisation of 78 per cent, of St. Marylebone children aged 1—5 and 72 per cent, of those in the 5—15 age-group. These percentages were above the minimum which the Ministry of Health considered necessary for the immunising campaign against the disease to achieve its full effect. The situation is now being reached—a situation scarcely dreamed of in 1940—when the eradication of diphtheria as an indigenous disease in this country can be foreseen as a real possibility within the next few years, providing there is no slackening in the immunisation efforts that have been so dramatically successful in the past 10 years. Suspected Poliomyelitis.—During the summer an outbreak of suspected poliomyelitis occurred amongst the nursing staff of a large general hospital in the Borough, the total number of cases and suspects reaching 19. Ultimately the question of diagnosis was reviewed and the opinion expressed that probably the disease was not poliomyelitis but an obscure virus infection. Treatment was first carried out at the hospital but early in September patients were transferred to a fever hospital as this course was urged in order to lessen the possibility of cross-infection arising. The Medical Officer of Health visited the general hospital frequently and maintained a close liaison with the Ministry of Health, whose specialist medical officers attended several conferences at the hospital with the medical staff in connection with investigations into the outbreak. Sonne Dysentery.—A small committee of officers in the Public Health Service was set up under the aegis of the London County Council to carry out an investigation into sonne dysentery in London. It was felt that useful information on the effect of environment on the spread of infection could be derived from an analysis of all notified cases, and the Department gladly arranged to co-operate in the enquiry by providing details of the circumstances of all St. Marylebone patients. 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.—One of seven cases and nine single unrelated cases. (b) Deaths.—None. (c) Organisms or other agents responsible, with number of outbreaks attributable to each. Salmonella typhi-murium.—One outbreak of seven cases and three single unrelated cases. Not ascertainable.—Six single cases. (id) 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. Thirty-two visits were paid by one of the women sanitary inspectors in connection with these cases. The outbreak affecting seven persons occurred in April in two wards of a general hospital in the Borough. In the stools of one of the patients a food poisoning organism (salmonella typhi-murium) was isolated. Further investigation showed that six other patients, together with a night nurse and a ward maid, had suffered from diarrhoea or vomiting or both since the 4th April. The ward maid reported sick on the 4th April, having, unknown to the medical staff, suffered from diarrhoea for a fortnight previously. It was considered possible that she might have been the source of infection but subsequent tests proved negative. Precautionary measures were immediately taken and these included closing the two wards to new admissions for a week, boiling of all ward crockery, barrier-nursing of all patients suffering from diarrhoea or vomiting, and bacteriological examination of faecal specimens from all such patients and from the entire nursing and kitchen staff involved. Food in the ward kitchens was suspended from use until proved bacteriologically innocent. Except in the case of the one patient referred to, the whole of the tests were negative to a specific organism. As the night nurse and the ward maid had been on leave prior to the 9th April, and one patient had been transferred to another hospital on that date, the medical officers of health of the areas in which the homes of the staff and the hospital were situated were informed of the outbreak. All the patients recovered, and no further cases were reported. It is possible that a symptomless carrier amongst the patients or staff may have been responsible for the outbreak, a full report of which was submitted to the Ministry of Health. Though no formal notifications of food poisoning or suspected food poisoning were received, it was learned that on the 1st July 40—50 members of the staff of a local telephone exchange had complained of feeling ill the previous evening and during the night, and had suffered from diarrhoea in varying 28 degrees of severity, accompanied in one case by vomiting. Of those taken ill all had partaken of the mid-day meal served in the staff canteen but there were some employees who had also taken the meal but were not ill. The article of food eaten in common by all who were afterwards affected appeared to have been roast beef, which had been cooked on Saturday, 28th June, removed from the oven and placed in a ventilated larder, having first been securely wrapped in grease-proof paper, and then served cold for lunch on Monday, 30th June. Fortunately, there remained portions of all the food used in the preparation of the meal, and samples were bacteriologically examined with negative results except in the case of the cold beef which showed a profuse growth of B. Coli. There seemed to be little doubt that the illness was caused by the organism, which had activated over the week-end on the cold beef, and the sharpness of the attack in all the cases indicated that the outbreak was toxic in origin. 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 N on-Pulmonary Pulmonary Non-Pulmonary M. F. M. F. M. F. M. F. 0—1 — — — — — — — — 1—5 1 — — — — — — — 5—15 3 — — — — — — — 15—25 9 15 — 1 — — — — 25—35 15 21 2 2 — 1 1 — 35—45 19 6 — 2 — — — — 45—55 9 3 — — 3 1 — — 55—65 14 3 4 — — — 65 and upwards 9 1 2 — 3 2 2 — Totals 79 49 4 5 10 4 3 — ‡ 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.—The Public Health (Tuberculosis) Regulations, 1952, which came into operation on the 1st May, 1952, revoked the Public Health (Tuberculosis) Regulations, 1930. The new regulations make similar provision for the notification of tuberculosis modified to accord with the structure and administration of the services now being provided under the National Health Service Acts. Table 11 (p. 26) gives information regarding notifications of pulmonary and non-pulmonary tuberculosis received during the year. Two hundred and thirty-six 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, 1952, was 822. Mass Miniature Radiography.—During October, 1952, a miniature radiography unit of the North-West Metropolitan Regional Hospital Board was installed at the Odeon Cinema, Marble Arch, for the examination of workers in the surrounding area. The findings are detailed in the following Tables. TABLE 13.—Mass Radiography: Miniature Film Analysis. Male Female Total Number of persons X-rayed 1,903 2,214 4,117 Number recalled for large films 59 57 116 Recall percentage 3.10 2.57 2.82 29 TABLE 14.—Mass Radiography: Large Film Recall Analysis. Male Female Total Further medical advice recommended 7 6 13 To return later to unit for re-check 16 4 19 No further action 34 46 80 Failed to attend for large film 3 1 4 Totals 59 57 116 TABLE 15.—Mass Radiography: Analysis of Persons Recommended for Further Medical Advice. Male Female Total Tuberculosis— Active primary lesions with symptoms — 1 1 Active primary lesions without symptoms 1 — 1 Post-primary unilateral with symptoms — 1 1 Post-primary unilateral without symptoms 1 — 1 Post-primary bilateral without symptoms — 1 1 Pleural effusion 1 — I Inactive primary lesions 1 — 1 Inactive post-primary lesions 2 1 3 Sarcoidosis — 2 2 Cardiovascular lesions (congenital) 1 — 1 Totals 7 6 13 It will be noted from the Tables that of 4,117 persons X-rayed, 13 (0.3 per cent.) were referred for further medical advice, and 19 (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 80 cases of scabies : adults 32 (men 18, women 14) ; children 48 (boys 23, girls 25). Domiciliary visits paid in connection with St. Marylebone cases numbered 16. Impetigo.—One boy and three girls received treatment for this condition at the Cleansing Station. Disinfection.—In some of the large towns in this country, generally throughout the United States, and in large European countries, terminal disinfection has been discontinued without any increase in the number of secondary cases. By " terminal" disinfection is meant the treatment of the room after the patient has been removed to hospital or has recovered from the disease. " Current " disinfection refers to the usual disinfection carried out in the sick-room during the course of the ailment. Continuance of the practice of terminal disinfection is due to the fact that many people still expect it as a necessary culminating feature of an infectious illness and look askance if the ritual is not carried out. It is analagous to the suspicion and disappointment of the patient for whom the doctor decides it is unnecessary to prescribe the customary bottle of medicine. It is now known that most organisms do not retain their virulence for long when separated from their host, and that human beings and not inanimate objects are the real source of infection. Abolition of terminal disinfection is not advocated in the case of the " dangerous infectious diseases " such as smallpox, the enteric group, diphtheria, scarlet fever and other streptococcal infections, but in the minor infections, e.g., measles, german measles, chickenpox and mumps, where the infective agent is short lived, there appears to be good reason, based on scientific data, for discontinuing the process and substituting the free use of soap and water, followed by thorough ventilation. For some time, therefore, the old procedure of disinfecting for all infections has been modified accordingly. 30 During the year, 413 rooms and 2,030 articles of bedding (mattresses, blankets, sheets, bolsters, pillows, etc.), together with 1,147 books, were disinfected, and 405 dressing drums from a local hospital were sterilised. From time to time the Department has been called upon by residents in the Borough to disinfect worn clothing intended for despatch to foreign countries whose postal regulations require a certificate of disinfection from the local sanitary authority to accompany each parcel, although invariably there has been no contact with infectious disease. The demand for this service increased towards the end of the year, and altogether 79 parcels were dealt with during 1952, no charge being made. Bacteriological Examinations.—Table 16 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 16.—Work of the Bacteriological Laboratory. Nature of Specimen and Examination Positive Negative Total Throat and nasal swabs for— B. diphtheriae — 78 78 Haemolytic streptococci 5 37 42 Vincent's organisms 13 4 17 Vaginal swab—for haemolytic streptococci 1 — 1 Cough plate—for H. pertussis — 1 1 Sputa—for tubercle bacilli 2 32 34 Faeces—for parasites — 1 1 Faeces—for dysentery, food poisoning organisms and typhoid — 73 73 Blood—for typhoid, paratyphoid and Brucella abortus 2 3 5 Blood—for glandular fever 1 1 2 Foods—for food poisoning organisms — 9 9 Totals 24 239 263