AC4353 STMARY 58 P.C. Ack. 25.10.54 cat. BOROUGH OF ST. MARYLEBONE REPORT OF THE MEDICAL OFFICER OF HEALTH FOR THE YEAR 1953 H. A. BULMAN, M.R.C.S., D.P.H. 1 CONTENTS page Members of the Public Health Committee 3 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 3,6 Staff Medical Examinations 6 Representation upon other Bodies 6 Financial Contributions to Voluntary Organisations 6 Conferences 7 Maternity and Child Welfare 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 Water 11 Drainage 11 Combined Drainage 11 Ventilation of Sewers 11 Building Licences 11 Public Houses 11 Sanitary Accommodation 11 Glass Washing 12 Public Conveniences 12 Public Cleansing and Salvage 12 Dustbins 12 Shops 13 Pet Shops 13 Diseased or Infirm Persons 13 Burial or Cremation of the Dead 13 Disinfestation 13 Verminous Persons 13 Shelter 13 Rodent Control 13 Dog Nuisance 14 Pigeons 14 Noise 14 Atmospheric Pollution 14 Poisons 15 page Factories 15 Inspections and Defects Found 15 Out-workers 16 Rag Flock and other Filling Materials 16 Fireguards 17 Street Photographers 17 Section d—Housing :— Permanent Estates 17 Playground Areas in Housing Estates 18 Requisitioned Premises 18 Factory-Made Bungalows 18 Maintenance and Re-decoration 18 Slum Clearance 18 Inspection of Dwelling-houses 18 Closing Orders on Houses 19 Underground Rooms 19 Re-housing 19 Immigrants 19 Common Lodging Houses 19 Rent Restrictions Acts 19 Section e—Food :— Food and Drugs Analysis 19 Milk 23 Butter and Margarine Premises 24 Ice-Cream 24 Preserved Food 25 Fried Fish Vendors and Fish Curers 25 Bakehouses 25 Restaurants, etc. 25 Retail Food Shops 25 Horseflesh 25 Slaughter of Animals 25 Unsound Food 25 St. Marylebone Clean Food Association 26 Section f—Infectious and other Diseases :— Notifiable Diseases 27 Notifications 27 Public Health (Infectious Diseases) Regulations, 1953 27 International Certificates of Vaccination and Inoculation 28 Food Poisoning Outbreaks 28 Tuberculosis :— New Cases and Mortality 28 Notifications 29 Venereal Diseases 29 Scabies 29 Impetigo 29 Disinfection 29 Bacteriological Examinations 29 2 Public Health Department, Town Hall, St. Marylebone, W.1 To the Mayor, Aldermen and Councillors of the Metropolitan Borough of St. Marylebone. Mr. Mayor, Ladies and Gentlemen, The state of the public health in the Borough continued to be maintained at a satisfactory level throughout the Coronation Year of 1953. The population, according to the Registrar General's estimate, numbered 73,860, a reduction of 430 on the estimated figure of 74,290 for 1952, and a reduction of 1,904 on the 1951 census figure of 75,764. The death-rate (14.75) again exceeded the birth-rate (12.16), and both rates were lower than the 1952 figures of 15.27 and 12.49 respectively. The low infant mortality rate of 21.16 compared favourably with the rate of 24.78 for the previous year. Notifications of infectious and other diseases decreased from 1,108 (1951) and 846 (1952) to 730, more than two-thirds of this number being accounted for by measles (429) and whooping cough (71). There were no deaths from measles, whooping cough or acute poliomyelitis, and again no case of diphtheria was reported. The clean food campaign was pursued vigorously in every possible way and received active support from the St. Marylebone Clean Food Association. Atmospheric pollution received special consideration and a sub-committee of the Public Health Committee was appointed to go fully into this question. The local Old People's Welfare Association, working in close collaboration with the Public Health Department, reported another year of great and expanding activity in various directions. One of the outstanding public health problems of our time is noise. While this has lessened in some directions since the beginning of the century, modern life has brought with it other and more fearful noises. Bye-law control of noise is limited and, generally speaking, it is necessary to prove injury to health—usually an extremely difficult matter. There is room for further research into the whole question and a need for more effective legislation against the creation of unnecessary and avoidable noise. A reminder of the pioneer work carried out in St. Marylebone in connection with maternity and child welfare was given by the award to the Borough of the Astor Silver Challenge Shield by the National Baby Welfare Council. The weather of 1953 set up new records. The outstanding incident was the great gale on the night of 31st January, which caused flooding along the east coast of England with the loss of several hundred lives. The first three months were noteworthy for a prolonged dry spell, including the longest absolute drought in London, so early in the year, since 1893. The sunshine total of 1,586 hours exceeded the average by 126 hours, and it was the sixth year in succession with more than the average. June was a relatively poor month, and the day after Coronation Day was the coldest June day since before 1815, except for one in 1909. After three years with more than average rainfall, the total of 19.7 inches in 1953 was 4.2 inches below the average. The month of December was the mildest since that of 1934. My thanks are due to His Worship the Mayor, and to the Chairman (Councillor Herbert C. Garrard) and members of the Public Health Committee for the consideration and encouragement they gave me during the year; to my colleagues in other Departments of the Council for their co-operation and assistance; and to the staff of the Public Health Department for their continued loyalty and efficient support in the public health work of the Borough. I am, Mr. Mayor, Ladies and Gentlemen, Your obedient Servant, H. A. BULMAN, Medical Officer of Health. 3 PUBLIC HEALTH COMMITTEE. 1953. HIS WORSHIP THE MAYOR : Alderman Howard Charles Rowe, J.P., F.R.I.C.S. ALDERMAN: Capt. R. G. Whitney, M.B.E., J.P. ("Vice-Chairman) COUNCILLORS : Dr. H. K. Ashworth, T.D. (†Vice-Chairman) Mrs. E. M. Brown Frederick Frame Herbert C. Garrard (Chairman) *B. Hawley *Mrs. M. E. Henderson-Begg †Mrs. Carr Q. Henriques †G. T. Hesketh J. P. Honour *Dr. Elizabeth Jacobs * Until May. *Elliott Levy †The Rev. Walter M. Long Stafford C. Lorie The Hon. Mildred Lowther, O.B.E. Mrs. L. Lyons †Miss L. F. Nettlefold, M.A., LL.B., L.C.C. †Mrs. S. Rivington *Miss L. B. West Russell †Miss F. E. Wilson † From June. STAFF OF THE PUBLIC HEALTH DEPARTMENT. Medical Officer of Health and Medical Referee for Cremation : H. Allen Bulman, M.R.C.S.(Eng.), L.R.C.P.(Lond.), D.P.H. Occasional Deputy Medical Officer of Health and Deputy Medical Referee for Cremation : C. J. C. Britton, M.D., D.P.H. Public Analyst (Part-time) : T. McLachlan, A.C.G.F.C., F.R.I.C., 4, Hanway Place, W.1 Bacteriologist (Part-time) : C. J. C. Britton, M.D., D.P.H., 35, Harley Street, W.1 A dministrative and Clerical Staff: A. H. James (Chief Assistant) H. G. E. Brown J. H. Manning D. H. Drewell P. C. Bedward S. P. Fleming F. W. Dines Miss M. L. Shaul Miss C. A. Cruickshank Shortland-Typists. Sanitary Inspectors : H. E. Scoble, M.B.E. (a), (b)—Senior Sanitary Inspector and Sampling Officer. V. A. Bignell (a), (b), (c)—Drainage. J. R. Baily (a), (6)—Drainage. L. Pearson (a), (b), (c)—Food. L. Newland (a), (6)—Factories. J. E. Broadhead (a)—Rodent Control. R. A. D. Gates (a), (b)—District No. 1. R. C. Lillis (a), (6)—District No. 2 (until 12th January, 1053). H. Lawson (a), (b)—District No. 2. J. A. Cummins (a), (b)—District No. 3 (from 23rd February, 1953). A. W. Mules-Berry (a), (6)—District No. 4. Miss M. M. Sharp (a), (d), (e), (f)—Care of Old People and Re-housing. Mrs. M. I. Tiplady (a), (6), (d), (f)—Restaurants. Miss B. Wilson (a), (b), (d), (e), (f)—Infectious Diseases. Streets Nuisance Inspector : D. Telford Outdoor Superintendent : R. G. Turner Mortuary Keeper 1 Rodent Operatives 5 Public Convenience Attendants . 36 Urinal Flushers 2 Disinfectors 3 Medicinal Baths Attendants . 4 Van Driver 1 Messenger 1 (а) Certificate for Sanitary Inspector—The Royal Sanitary Institute and Sanitary Inspectors' Examination Joint Board. (b) Certificate for Inspector of Meat and Other Foods—The Royal Sanitary Institute. (c) Certificate for Smoke Inspector—The Royal Sanitary Institute. (d) Certificate for Health Visitor—The Royal Sanitary Institute. (e) Certificate of the Central Midwives' Board. (f) Certificate of State Registration for Nurses. 4 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 : £3,495,253. Sum represented by a penny rate : £14,007. Number of residential units (separate assessments): 23,114. 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) : 1953—73,860. EXTRACTS FROM VITAL STATISTICS. Total M. F. Birth-Rate per 1,000 estimated home population 12.16 Live Births—Legitimate 802 397 405 Illegitimate 96 46 50 Stillbirths—Legitimate 10 6 4 Rate per 1,000 total (live and still) births 13.19 Illegitimate 2 2 – Deaths (all ages) 1,089 583 506 Death-Rate per 1,000 estimated home population 14.75 Maternal Mortality—Deaths from " Pregnancy, Childbirth, Abortion" (Registrar General's Code No. 30) 1 Total M. F. Deaths of Infants under one year of age—Legitimate 17 6 11 Illegitimate 2 2 — Death-Rate of Infants under one year of age—All infants per 1,000 live births, 21.16; legitimate infants per 1,000 legitimate live births, 21.20 ; illegitimate infants per 1,000 illegitimate live births, 20.80. Marriages.—The following table shows the number of marriages in St. Marylebone each year since the 1st January, 1943 :— Year No. of Marriages Year No. of Marriages 1943 1,119 1948 1,657 1944 1,097 1949 1,461 1945 1,583 1950 1,439 1946 1,538 1951 1,415 1947 1,736 1952 1,358 1953 1,290 The 1953 figure is 68 below the number for 1952 and 150 below the average (1,440) for the previous ten years. The rate for persons married in 1953 was 35 per 1,000 of the estimated home population. Deaths.—The total number of deaths (1,089) 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. Deaths in 1953 were 45 fewer than in 1952, and after comparing the causes of death for the two years there are no marked variations to which it is necessary to draw attention. Pneumonia (43) showed a slight decrease over the 1952 figure (47), and bronchitis (105) an increase of 28 on the number (77) for the previous year. Deaths from motor vehicle accidents (3) remained the same, but suicides increased from 12 in 1952 to 27 in 1953. 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 13 1 – – – – – – – – 10 – 3 1 8 Tuberculosis, other – 1 – – – – – – – 1 – – – – 3 Syphilitic disease 1 3 – – – – – – – – 1 – – 3 4 Diphtheria – – – – – – – – – – – – – – 5 Whooping cough – – – – – – – – – – – – – – 6 Meningococcal infections – – – – – – – – – – – – – – 7 Acute poliomyelitis – – – – – – – – – – – – – – 8 Measles – – – – – – – – – – – – – – 9 Other infective and parasitic diseases 1 – – – – – – – – – – – 1 – 10 Malignant neoplasm, stomach 13 8 – – – – – – – – 3 2 10 6 11 Malignant neoplasm, lung, bronchus 28 2 — – – – – – 2 – 13 – 13 2 12 Malignant neoplasm, breast — 15 — — – – — – – 4 – 7 – 4 13 Malignantneoplasm, uterus – 11 – – – – – – – – – 8 — 3 14 Other malignant and lymphatic neoplasms 36 36 – – – – – – 1 1 11 11 24 24 15 Leukaemia, aleukaemia 6 3 — – — – — – 2 — 3 2 1 1 16 Diabetes 4 — — — — – – — – – 1 — 3 — 17 Vascular lesions of nervous system 83 94 – – – – – – – 3 15 13 68 78 18 Coronary disease, angina 91 57 – – – – – – 4 — 34 12 53 45 19 Hypertension with heart disease 40 36 – – – – – – – – 2 – 38 36 20 Other heart disease 38 40 – – – – – – 1 1 9 5 28 34 21 Other circulatory disease 53 58 – – – – – – 2 — 5 2 46 56 22 Influenza 4 2 1 – – – – – – – – – 3 2 23 Pneumonia 21 22 — 3 – – – — 1 – 6 3 14 16 24 Bronchitis 68 37 – – – – – – – – 12 1 56 36 25 Other diseases of respiratory system. 6 2 – – – – – – – – 2 1 4 1 26 Ulcer of stomach and duodenum 9 4 — — – – — 1 – 2 – 6 4 27 Gastritis, enteritis and diarrhoea 3 2 1 1 – 1 – – – – – – 2 — 28 Nephritis and nephrosis 1 8 – – – – – – – – 1 2 – 6 29 Hyperplasia of prostate 6 – – – – – – – – – – – 6 – 30 Pregnancy, childbirth, abortion – 1 – – – – – – – 1 – – – – 31 Congenital malformations 7 3 2 2 1 – – – 1 1 1 – 2 – 32 Other defined and ill-defined diseases 26 36 3 5 – – 1 1 – 2 8 9 14 19 33 Motor vehicle accidents 2 1 – – – – – 2 — – 1 – – 34 All other accidents 8 10 1 – – – – – – 1 3 2 4 7 35 Suicide 15 12 – – – – – – 4 2 7 9 4 1 36 Homicide and operations of war — 1 – – – 1 – – – – – – – – Totals 583 506 8 11 1 2 1 1 21 17 149 90 403 385 1,089 19 3 2 38 239 788 TABLE 2.—Infant Mortality—According to Age-Group and Sex. CAUSE OF DEATH Under 1 week 1 and under 2 weeks 2 and under 4 weeks 1 and under 3 months 3 and under 6 months 6 and under 9 months 9 and under 12 months Total M. F. M. F. M. F. M. F. M. F. M. F. M. F. M. F. Congenital malformation 2 2 – – – – 2 2 Premature birth 1 1 – – – – 1 i Pneumonia – 2 – — – – — 1 3 Gastro-enteritis 1 — – – – – 1 — — — — 1 I Influenza — — 1 – – – — — — 1 – Suffocation – – – – – – 1 — 1 — Other causes 1 1 – – – – — 2 — 1 1 — — — 2 4 Totals 5 6 1 — — — — 3 1 2 i — — — 8 11 6 Mortuary.—Six bodies (2 male, 4 female) were received at the Public Mortuary, Chiltern Street. No post-mortem examinations were carried out. Crematorium.—The Medical Officer of Health is Medical Referee for the Council's Crematorium, situated in the St. Marylebone Cemetery at East Finchley. During 1953, 1,810 certificates authorising cremation were issued, as compared with 1,451 certificates in 1952, 1,284 in 1951, 759 in 1950, 669 in 1949, and 360 in 1948. Since the Crematorium was opened in December, 1937, 8,143 cremations have been carried out. SECTION B.—GENERAL PROVISION OF HEALTH SERVICES. Staff.—Up to 1940 a list of the staff of the Public Health Department was published annually in these reports. The practice was discontinued during the war period but has been resumed this year in accordance with the suggestion of the Ministry of Health, and a table appears on p. 3. Staff Medical Examinations.—The Medical Officer of Health is medical adviser for the purposes of the Council's superannuation scheme. During 1953, fifty-six examinations of members of the staff and new entrants were carried out. 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. 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 Mrs. E. M. Brown. Councillor Dr. Elizabeth Jacobs. Councillor Miss L. West Russell. The Medical Officer of Health. Councillor Miss L. West Russell. Councillor Miss L. West Russell. The Medical Officer of Health. Councillor F. Frame. Councillor Miss L. West Russell. Councillor the Hon. Mildred Lowther, O.B.E. The Chairman of the Public Health Committee. The Medical Officer of Health. Councillor the Hon. Mildred Lowther, O.B.E. Mrs. S. Rivington (from October). Councillor R. T. Glenny. Councillor The Hon. Mildred Lowther, O.B.E. Councillor H. C. Garrard. Councillor Mrs. Carr Q. Henriques. The Chairman of the Public Health Committee. The Medical Officer of Health. 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 1953 as indicated below :— Organisation Amount Statutory Authority Central Council for Health Education £ 10 s. 10 d. 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 7 7 0 Public Health (London) Act, 1936, section 298. St. Marylebone Old People's Welfare Association— " Meals on Wheels " Service, etc. 582 0 0 National Assistance Act, 1948, section 31. Assisted Holidays Scheme 200 0 0 do. St. Marylebone Housing Association and Trust—Meals for Old People 246 0 0 do. " Inner Wheel" Old People's Club—Rent of Hall 6 10 0 do. Women's Voluntary Services 40 0 0 do. 7 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—Hastings, 28th April Alderman Capt. R. G. Whitney, M.B.E., J.P., to 1st May. and the Medical Officer of Health. Sanitary Inspectors' Association—Morecambe, Mr. L. Pearson, Sanitary Inspector. 8th to 11th September. Central Consultative Committee on the Welfare Councillor Herbert C. Garrard and Miss M. M. of Old People—London, 19th June. Sharp, Sanitary Inspector. National Smoke Abatement Society—Glasgow, Councillor Dr. H. K. Ashworth, T.D. 30th September to 2nd October. Maternity and Child Welfare.—The National Baby Welfare Council awarded the Astor Silver Challenge Shield to the Boroughs of St. Marylebone and St. Pancras for Coronation Year, 1953, in recognition of the fact that both Boroughs were pioneers in maternity and child welfare work in this country. The Citation accompanying the Award to St. Marylebone is in these terms :— In 1906, what was believed to be the first infant welfare clinic in London was inaugurated, in collaboration with the St. Marylebone Borough Council and the St. Marylebone Health Society, by the late Dr. Eric Pritchard, a foremost paediatrician of his day, at the St. Marylebone General Dispensary, 30, Marylebone Lane. At that time a woman inspector from the Public Health Department visited a certain number of newly-born infants and reported that the mothers " show a real anxiety to follow the advice given to them." In 1912, three specially trained women inspectors devoted a considerable part of their time to what was then known as " baby work." Side by side with home visitation, the St. Marylebone Health Society continued, from 1907, to open centres—or schools of mothercraft as they were named—in parts of the Borough where there appeared to be a need for them. Of the existence of the need there was no doubt, as with the proposed establishment of ante-natal clinics in 1914, for example, it was found that of 46 women questioned, 14 only had been examined or seen by a doctor during pregnancy, and of these 14,11 were first confinements. In 1919, after many changes of premises during the intervening twelve years, there were five centres providing ante-natal, post-natal, and infant consultations under medical supervision. Four other welfare centres, also maintained by voluntary organisations, were established later at hospitals in the Borough. Thereafter there gradually came into being modern welfare centres with a host of ancillary services, including dental treatment, diphtheria immunisation, actinotherapy, massage, remedial exercises, chiropody and child guidance. The National Baby Welfare Council recognises the pioneer work carried out in St. Marylebone and presents to the Borough Council the Astor Challenge Shield. (Signed) VERULAM, June, 1953. Chairman. The functions of the Borough Council as Maternity and Child Welfare Authority passed into the hands of the London County Council on the 5th July, 1948, under the provisions of the National Health Service Act, 1946. It is of special interest to note that the St. Marylebone Health Society, a voluntary organisation established nearly 50 years ago, though no longer concerned with the running of maternity and child welfare centres and day nurseries, is still actively engaged in auxilliary services for the benefit of mothers and young children in the Borough. During the summer of 1953 arrangements were made for 41 families to have a holiday, the Society's funds bearing practically the whole of the cost. Christmas parcels were sent to 55 families. The Chairman of the Society is Lady Brain, who has been closely associated with its work for many years, and the Hon. Secretary, Councillor Miss L. B. West Russell. Care of Old People.—Five hundred and five old people (including thirty-nine 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 of the London County Council 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, thirty-five new cases were dealt with during 1953, 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 greatly appreciated by all who are concerned with the nursing of the aged in 8 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. 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 of the work carried out during 1953:— The year was marked for the Association by three outstanding features—the Coronation ; the initiation of the Borough Council's assisted holidays scheme for old age pensioners; and our Flag Day in September. Coronation Festivities.—All over the country the old people enjoyed special consideration in the general rejoicing over the Coronation. St. Marylebone was no exception to the rule. All the seven "Darby and Joan" Clubs had Coronation teas and coach tours to see the decorations. In addition, members of the Executive Committee provided coaches for 90 of the more infirm old people who do not belong to clubs to drive round the Coronation route. Twenty of the more mobile were guests of the Odeon Cinema in Leicester Square to watch the all-day television on Coronation Day. The Borough Council invited all the more needy old age pensioners to see the Technicolour film "A Queen is Crowned." Volunteers from the Association did the clerical work involved in sending out the 1,700 invitations and acted as additional ushers and usherettes at the two performances. We were most grateful to the Area Officer of the National Assistance Board for help in preparing the list of guests and for placing a room at the disposal of our addressing parties. Food Parcels.—These lists were again useful later in the year in the Mayor's two distributions of food parcels most generously sent to him as gifts for our old people in Coronation year. In October there were 480 from the Premier of Victoria, Australia. In December there were 1,000 from the United States. These came too late for Christmas but were distributed in January by the Mayor and Mayoress. A band of volunteers from the Association helped on this occasion, reinforced by Red Cross Cadets, the St. Marylebone Sea Scouts, and the boys of the St. Marylebone Grammar School. Assisted Holidays.—The Borough Council made a grant of £200 to the Association for this purpose and were so well satisfied with our administration of the scheme that the grant is to be repeated in 1954. We hope that it will become a permanent feature of the Borough's provision for its older citizens. Our aim is to stretch the grant as far as it will go for the benefit of those who have not been able to afford a holiday for many years, or who need a change for reasons of health but have not had a definite illness such as would bring them within the scope of the recuperative holiday scheme of the London County Council. The Borough Council's grant assisted eighty-five old age pensioners in 1953. The main body of sixty-six went to Brighton for a week. For the others individual arrangements were made, varying from paying their fares for visits to relatives to helping with the cost of a stay at a special guest house for the infirm. The old people themselves contributed £1 10s. Od. each, and the collection of their weekly instalments kept our office very busy all through the early spring. In December our Hon. Secretary attended a conference at Brighton at which hoteliers from the Sussex seaside resorts met the secretaries of old people's welfare committees which organise holiday schemes. From her report we were satisfied that the St. Marylebone scheme, although small in comparison with those of some other boroughs, is on the right lines. The Wider Aim.—In addition to promoting the welfare of our own old people, it is one of the chief aims of the Association to keep its members in touch with the general movements of thought on the subject. Our representatives sit on the Home Nursing Voluntary Committee for our Division of the Central Council of District Nursing, and on the London County Council Central Consultative Committee for the Welfare of Old People. They have given us interesting reports on the deliberations of these two bodies. Delegates from the Association attended the annual conference of the latter in June and also the annual conference for Greater London held by the Old People's Committee of the London Council of Social Service in October, at which the main subjects were housing for old people and the further employment of the elderly. During the year we had an interesting report on the Finsbury Old People's Workshop. We had been asked to investigate the desirability of starting a similar scheme in St. Marylebone, but we decided that, however admirable in itself, a scheme which incurs a loss of £1,000 a year in the employment of only sixty people was beyond our scope. New Interests : Road Safety.—We have this year turned our attention to the question of road safety for old people, following reports from our representatives who attended a conference on the subject held by the Pedestrians' Association in March. We believe that old people should 9 receive special consideration from other road users and from road and traffic authorities. We also recognise that old people require special education in road safety. During the year all our seven " Darby and Joan " Clubs have had talks on the subject kindly given by the Hampstead Road Safety Officer. We distributed 500 road safety maps, and followed this up early in 1954 by distributing over 1,000 of the excellent leaflets entitled " Get Home Safely." To our great satisfaction the St. Marylebone Road Safety Committee now includes a representative of the Association in the person of our Chairman, Mrs. Fewster. The Regular Services.—Behind all these special interests and activities, the regular services have gone on steadily. The "Darby and Joan" Clubs continue to bring pleasure, interest and friendship to their 500 members ; and only those who run them know how much work they entail. As well as their Coronation treats they all had summer outings and Christmas parties, largely financed by the members themselves. Both Luncheon Clubs continue. We report this with great pleasure because at the end of the year, when the St. Marylebone Housing Association and Trust gave up " The Cookshop," there was a danger that its old people's section might have to close. Fortunately, its new proprietor was willing to continue the old people's luncheon club on a non-profit-making basis, sponsored by the Housing Association. This made it possible for the Borough Council to recommend it for a continued subsidy from the London County Council. "Meals on Wheels."—The Women's Voluntary Services run this scheme so well, thanks to the admirable relations they have established with the London County Council restaurant which supplies the meals, that the anxiety it caused the Association in the early days has largely been forgotten. The main concern remaining was the van, a 1937 model which will at some stage have to be replaced. Now, thanks to our Flag Day, £250 is safely deposited in the Post Office Savings Bank as the nucleus of a replacement fund. Chiropody.—The demands on both branches of this service increased so much during the year that by October it became clear that an extra session at the foot clinic and an extra monthly round of the home service must be provided. It was decided to apply to the Borough Council for an increase of £75 in their grant for the financial year beginning in April, 1954, but to start the extra facilities at once, financing them for the first six months from the proceeds of the Flag Day. The application to the Council was, we are happy to report, successful. In the home service the third round per month started in November. There have been twenty-eight new patients this year. The total number of treatments was 280 : one patient received free treatments; two paid a reduced fee ; the rest paid the 2s. we ask. Mrs. Simmonds, a volunteer driver of the St. Marylebone Red Cross, continues to provide transport for the chiropodists, the only cost to the Association being 5d. a mile for petrol, etc. Since October the clinic has held four sessions a week, i.e., two chiropodists both working morning and afternoon. There were 127 new patients during the year and in all 1,418 treatments were given. The charge of 1s. 6d. is cheerfully paid by the patients. Miss Cotsford, the Red Cross Associate who does the bookings, and the rota of Red Cross members who attend to help, all deserve our grateful thanks. We are fortunate in the excellent premises we are able to rent from the London County Council at a nominal charge. Visiting.—The basis of all our endeavour is personal friendliness towards individual old people. We feel, therefore, that our voluntary home visitors to the infirm are a very special embodiment of that general sympathy for the old which our Association exists to express in practical ways. We had twenty visitors at the end of the year. There were also the sixteen from the parishes of All Souls and St. Peter's, Vere Street, whose representative attends our visitors' meetings as well as being a member of the Executive Committee. We have a similar liaison with the visiting done by the Red Cross and, of course, with the seven-days-a-week service of the Borough Public Health Department in the person of Miss Sharp. In May we established a very useful working arrangement with the Divisional Health Office of the London County Council by virtue of which one of the sisters of the school medical service helps in the visiting of old people. She may visit those suffering from any physical defect, keeping them under observation until only social visits are needed. This same sister also visits any old people in St. Marylebone referred to the County Council by hospital almoners and reports on them to us as well as to her own service. She attends our visitors' meetings, and also represents the County Council senior nursing officer for the division on our Executive Committee. During the year we were given by the Personal Service League four more pairs of sheets to lend in cases of emergency, and obtained the loan of four more wireless sets from the Wireless for the Bedridden Society. Miss Sharp kept all the fifteen sets for which we are responsible under regular supervision. 10 Emergency Coal.—Only fifty-six deliveries from our stock of emergency coal were necessary in 1953. Finance : Flag Day.—This very successful effort was held on the 12th September, and resulted in the addition of £520 9s. 2d. to our funds. For this splendid result we have to thank its honorary organiser, Mrs. Cedric Venables, and the special sub-committee who assisted her. We are deeply grateful, too, to our President, the Mayor, for allotting the day to us and for the special appeals he issued in connection with it; to all our members who helped us on the day or sold tickets for the members' draw beforehand; and to the generous friends of the Association who gave the prizes for the draw and who defrayed so large a proportion of the expenses. In Conclusion.—It will be realised that all the extra office work of Coronation year was not done by our Hon. Secretary alone. The Committee wish to express their deep appreciation of the help given by Mrs. Venables in connection with the holiday scheme and the Coronation coach drives as well as with the Flag Day; and by Miss Lewis, who for six months has given two mornings a week regularly to the necessary clerical routine. But in expressing these remarks the Committee are very conscious of the untiring and devoted work which has been undertaken by the Hon. Secretary, Miss M. K. C. Macintosh. Her service to this Association since its inception has never failed, and her patience and personal interest in all our old people's welfare in this Borough has been a true example of very real "social service." The active support and interest of the Mayor and Mayoress have heartened us throughout the year. The Medical Officer of Health and the officers of his Department have been behind us at every turn. The Borough Council has continued its generous provision of free office accommodation as well as promising an increased grant in 1954. Finally, the Committee desire to place on record their gratitude to their Chairman for the admirable way in which she has conducted their meetings and promoted the interests of the Association throughout the year. SECTION C.—SANITARY CIRCUMSTANCES. Sanitary Inspection.—The number of complaints received (excluding those relating to rat and mouse infestations) was 1,247. Details of the various nuisances detected and remedied, to the total number of 1,957, are set out in Table 3. In 675 cases a preliminary (intimation) notice was issued, and in 318 instances this was followed by the service of a statutory notice to secure abatement of nuisances. In addition, forty-four 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 nineteen cases under the Public Health (London) Act, 1936, in respect of failure to comply with statutory notices. In each of two instances penalties of £2 0s. Od. were imposed and £2 2s. Od. costs awarded to the Council. In another there was a nominal fine of 2s. 6d. and an order for the work to be done. Costs amounting to £2 2s. Od. without the imposition of a fine were allowed in each of two other instances. Of the remaining cases, in nine the summonses were withdrawn, the works having in the meantime been completed, three were adjourned sine die, one was withdrawn after action by the District Surveyor and another dismissed because of insufficient evidence of ownership. Arising out of the last-named case the Council requested the Metropolitan Boroughs' Standing Joint Committee to consider the introduction of legislation conferring upon local authorities the power, on similar lines to that contained in section 168 of the Housing Act, 1936, to require information as to ownership for the purpose of serving notices under the Public Health (London) Act, 1936. Legal proceedings under County Council Bye-laws were taken in six instances but all were withdrawn upon completion of the necessary work. TABLE 3.—Nuisances. Nuisance Abated or Defect Remedied Number Houses damp, dirty or dilapidated 507 Doors, windows, floors, ceilings, sash cords, grates and flues, etc., defective 678 Insufficient and unsuitable water-closet accommodation 17 Drain, water-closet and waste pipe stoppages . 119 Drains, water-closets and waste pipes defective 97 Yard, area and wash-house defects 4 Roofs, gutters and rainwater pipes defective . 318 Insufficient water supplies 23 Water cisterns dirty or defective 16 Ashpits, dustbins, etc., defective 62 Rubbish accumulations . 58 Animal nuisances . 8 Miscellaneous 50 Total 1,957 11 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 three complaints of dirty or contaminated water at separate premises were received during the year. The trouble in two instances appeared to be due to a dirty storage tank, and no further complaints were made after the tanks had been cleansed. In the third case the supply was found to be satisfactory. In accordance with the provisions of the Public Health (London) Act, 1936, the Board notified three instances where water had been cut off in occupied premises, in one case for non-payment of rates, in another where waste of water had been reported, and in the third for use of irregular fittings. In all the supply was reinstated, in one instance after service of notice. Further examinations of the private well waters from the twelve borings still in use (eight in full operation and four 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 1953 were generally satisfactory and no pathogenic contamination was found. 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. Eight certificates relating to the provision of a proper and sufficient supply of water in dwelling-houses were granted under section 96 (2) of the Public Health (London) Act, 1936, in respect of newly-erected and rebuilt premises, including three municipal blocks of flats. Drainage.—The number of plans approved was 316, of which thirty-six related to new buildings, including two Borough Council housing schemes of four blocks comprising seventy-two flats. At the request of the Medical Officer of Health the drains and/or sewer connections of thirty premises were examined by the staff of the Borough Engineer's Department. In eight cases defects were discovered which called for remedy ; in the remaining twenty-two instances the sewer connections were found to be serviceable and fit for continued use. The drainage inspectors made a total of 3,733 visits. In the case of two separate blocks of flats application was made to discharge sink wastes, without trap ventilating pipes, into stack pipes in direct communication with the drain (the so-called " single pipe " system). This practice is permitted in many metropolitan areas, but as the arrangement is still in the experimental stage under the observation of the Government Building Research Station at Garston, Herts., and, moreover, does not comply with the Drainage Bye-Laws of the London County Council, permission to carry out the work on the lines suggested was given only on condition that the applicants would accept full responsibility should the operation of the system prove unsatisfactory. The County Council were fully informed of the circumstances in each instance. Combined Drainage.—Nine orders under seal for combined drainage were issued. Ventilation of Sewers.—A working party of representatives of the London County Council and the Metropolitan Boroughs' Standing Joing Committee submitted an interim report on the causes of complaints of offensive emanations from sewers and possible ways of improving conditions. It was considered that adequate ventilation, preferably by a greater number of small ventilators father than by a few large ones, was needed to disperse the concentrations of gases which are mainly responsible for emanations. The working party suggested that this ventilation should be afforded by way of the soil-pipes of the drainage systems of suitable premises and proposed that, as an experiment, the intercepting chambers in the drains of the county council and borough council properties should be slightly altered for this purpose. The St. Marylebone Borough Council felt that experiments on the lines proposed would be too indiscriminate and inadequate to produce effective results and might possibly cause nuisance on the municipal properties involved. In their opinion it would be better to ventilate selected lines of sewer in which there are known to be high concentrations of gases by seeking the co-operation of the owners of suitably disposed premises draining into those sewers and, where desirable, of neighbouring authorities, in giving effect to the working party's suggestions. These views were subsequently conveyed by the Standing Joint Committee to the working party for consideration. Building Licences.—During the year eighty-seven 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 Houses.—Sanitary Accommodation.—The special survey of licensed premises carried out in 1949 revealed the standard of sanitary accommodation to be unsatisfactory in fifty-one of the 133 premises. Since then there has been a steady improvement and at the close of the year 1953 only 12 eleven premises remained to be dealt with from the point of view of absence of accommodation for women. Of these eleven, plans embodying the necessary provision have been approved in six instances and two public houses are to be completely re-built. Glass Washing.—By the end of 1951 all but twelve of the public houses had a hot water supply for glass-washing purposes. It is gratifying to be able to report that, as a result of representations made to brewers and licensees, running hot water has now been provided in all licensed premises in the Borough. Public Conveniences.—The usual supervision was exercised over the eighteen public sanitary conveniences (13 for men, 5 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 with the public. On the occasion of the Coronation of Her Majesty Queen Elizabeth II on Tuesday, the 2nd June, 1953, when the procession passed along Oxford Street, which forms the southern boundary of the Borough, the Council, after conferring with the police and other authorities, set up temporary conveniences at Great Cumberland Place Car Park (for men and women); in Cavendish Square (for men and women); and in Barrett Street (for women only). Each unit comprised a series of cubicles containing twelve chemical closets for men and/or twelve 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 provided. No charge was made for the use of the temporary conveniences. In addition, the permanent accommodation at Oxford Circus Convenience (for men and women) and at Barrett Street Convenience (for men only) was available. All these conveniences were open day and night from mid-day, Monday, 1st June, 1953, until 10 p.m. on Wednesday, 3rd June, 1953, and in view of the large crowds coming to the West End to see the decorations and floodlighting, the permanent conveniences remained open later in the evening before and after this three-day period. From reports received from various sources there seemed to be no doubt that the arrangements made were adequate and satisfactory and generally appreciated by the public. A new public convenience (for men and women) on the Wellington Place frontage of the St. John's Wood Burial Ground was opened on the 24th June, 1953. This coincided with the start of the Test Match at Lord's Cricket Ground close by and, such was the demand on the accommodation, it was necessary to keep the convenience open continuously during the period of the match to meet the needs of the large numbers of spectators who, throughout the night, joined the queue to obtain admission to the ground. Apart from these special occasions, there is already evidence that the facilities are welcomed by people using the Recreation Ground, more especially the women and children, and by the occupants of vehicles of all kinds passing along the adjacent main road to and from the north. At the close of the year negotiations were proceeding for the erection of new conveniences in Paddington Street. Public Cleansing and Salvage.—The Director of Public Cleansing has kindly provided the following information on these services. The materials dealt with in 1953 were : house and trade refuse, 37,538 tons; street sweepings and gully slop, 2,681 tons; salvaged materials (including kitchen waste) 1,945 tons. The sum of £9,932 was obtained from the sale of salvaged materials. In addition, £1,039 was received for the removal of trade refuse and green offal and for the cleansing of petrol interceptors. During the year orders were placed for one breakdown van, and for two additional vehicles for the collection of refuse from the increasing number of portable containers installed at premises in the Borough. Dustbins.—Following conflicting decisions reached in the Courts in 1947 and 1948 on the question whether the owner or occupier of premises was liable to provide a dustbin, some boroughs experienced difficulty in securing the provision of dustbins under section 105 of the Public Health (London) Act, 1936, as amended by the London County Council (General Powers) Act, 1951. As a result, the Metropolitan Boroughs' Standing Joint Committee proposed that an effort should be made to obtain another amendment of the law to place the liability to provide, maintain and replace a dustbin definitely on the owner of the premises, and that in cases where there was some contractual obligation on the part of the tenant to do so the owner be authorised to recover the cost from the tenant. The Standing Joint Committee were informed that the Council were in favour of the suggested further amendment, subject to the owners being empowered to require tenants to contribute towards the cost. The Standing Joint Committee also considered the question of the provision and maintenance of dustbins by sanitary authorities. Section 67 of the London County Council (General Powers) Act, 1939, empowers borough councils to provide this service but it is not certain whether or not a charge 13 may be made therefor. The Council supported a suggestion of the Standing Joint Committee that an amendment of the Act should be sought to make it clear that a sanitary authority may provide and maintain dustbins at any premises without charge. Shops.—Late in the year a survey of shops was commenced and a start made on the compilation of a new card index register. Inspections numbered seventy-four, and in five instances service of notice under the Shops Acts 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, a fee of 10s. being payable in respect of each licence. At the end of the year nine premises remained on the register. A licence was refused in one case in which the applicant proposed to trade from a kiosk, entirely open on one side, where there was inadequate provision for the protection from damp and cold of the animals and birds intended to be offered for sale. Fifteen visits were paid to pet shops and three notices were served. Diseased or Infirm Persons.—In the case of two infirm and physically incapacitated old ladies, aged 75 and 80 years, who were living alone under insanitary conditions and whose relatives or friends were unable to render assistance, it became necessary to resort to action under the National Assistance (Amendment) Act, 1951. In both cases the magistrate made orders for removal to Paddington General Hospital for a period not exceeding three weeks. In the first a subsequent X-ray examination revealed a fractured femur and the patient remained voluntarily in hospital for nearly seven months. On her discharge she returned to her home where she managed very well with the assistance of friends and a home help. The other patient remained in hospital for seven weeks and then, owing to her mental condition, was transferred to Tooting Bec Hospital. Burial or Cremation of the Dead.—Under the provisions of section 50 of the National Assistance Act, 1948, it is a duty of the Council to cause to be buried or cremated the body of any person who has died or been found dead in the Borough, where no other suitable arrangements for disposal of the body have been or are being made. The arrangements set up when the section became operative on the 5th July, 1948, continued to work satisfactorily and during 1953 ten burials and one cremation were undertaken by the Council. Disinfestation.—During the year 439 dwellings (involving 699 rooms) were disinfested, an insecticide based on D.D.T. being used. Included in the number of dwellings treated were seventy-one requisitioned premises and ten municipal flats where bugs were found. Altogether 116 requisitioned dwellings were, on becoming vacant, inspected for evidence of vermin. Treatment of verminous furniture by hydrocyanic acid gas in specially constructed vans, which has been carried out by the Council through a contractor for many years, has been continued, more particularly in the case of removals to fresh housing accommodation. In 1953 the furniture of seventy families (of whom fifty-nine were being rehoused) was dealt with by this method. In addition, 5,131 verminous articles of bedding were disinfested by steam. Verminous Persons.—The Council's Cleansing Station in Lisson Grove dealt with 1,086 verminous persons: adults 648 (men 534, women 114); children 438 (boys 85, girls 353). Providing they consent, aged and feeble persons in need of cleansing may now be cleansed in their homes under the power given to sanitary authorities by section 43 of the London County Council (General Powers) Act, 1953. It was unnecessary to take advantage of this new provision during the year. 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. Rodent Control.—Complaints numbered 932, and 779 infestations (ship rat 206, common rat 231, mice 342) were discovered. The scheme of block treatment commenced late in 1949 was continued and thirty-five blocks, involving 2,203 premises, were dealt with. Treatment was carried out by the Council's staff at 808 premises. It is believed that the rat population has now reached a relatively low level, but mice were again more in evidence. Owners and occupiers co-operated generally by carrying out proofing work and by giving attention to drainage defects. In no case was formal action under the Prevention of Damage by Pests Act, 1949, necessary but fifty-two informal notices were served. In addition, ten statutory notices relating to drainage defects were issued under the Public Health (London) Act, 1936. Sewers were baited at 356 points in January and at 352 points in June. On both occasions the recorded poison " take " was approximately 67 per cent. 14 The Ministry of Agriculture and Fisheries continued their experimental work on new methods of control, and from time to time exchanged information with the Council with a view to improving the service. Expenditure incurred by a local authority on the destruction of rats and mice ranks for a 50 per cent. grant from the Ministry of Agriculture and Fisheries, on condition that the cost of treatments at premises other than private dwellings is recovered from the owners or occupiers. As the charges fixed in 1945 were no longer adequate to cover the cost incurred, the minimum was raised from 10s. to £1 per treatment as from the 1st August, 1953, larger infestations being charged for according to the work involved. To private residents the service continued to be available free of charge. Dog Nuisance.—Contraventions of the bye-law relating to the fouling of footways by dogs reported by the streets nuisance inspector resulted in twelve summonses. In eleven of these, convictions were secured and penalties imposed. In the remaining case the defendant was discharged absolutely. 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 1953, five complaints of nuisance from these birds, relating to four premises, were referred to the pigeon catcher after investigation. Noise.—Forty-two complaints of noise, involving twenty-nine premises, were received. Their variety may be gathered from the following selection of alleged causes : radio, factories and machinery of many kinds, garages, night club, milk lorries, pneumatic road drills, noisy tenants, dogs and cats. Most of these nuisances were abated after informal action by the sanitary inspector or streets nuisance inspector. In some cases the Department was unable to take direct action and these were referred to other authorities possessing the necessary powers. Atmospheric Pollution.—Two hundred and seventy-six observations were made on a total of eighty-four premises. Forty-six complaints were received of smoke and/or grit nuisances arising from twenty-nine premises, comprising commercial undertakings, blocks of flats, a hospital and other institutions, private houses, and the two electricity generating stations. With the exception of those arising from the last named the nuisances, although sometimes recurrent, were abated after informal action which included the giving of advice by the sanitary inspectors on stoking and the efficient use of boiler plant at business premises. Guidance on smoke prevention was also offered during forty-one visits to residential properties, though these are outside the scope of existing legislation. The question of atmospheric pollution, more particularly in the vicinity of the electricity generating stations, again received the close attention of the Council and a special sub-committee of the Public Health Committee was appointed to consider the matter in its widest aspects. The sub-committee received reports on the legal provisions regarding the abatement of smoke nuisances and on a survey of boiler installations in the Borough. From the latter it was found that there were 130 premises with boiler plants consuming annually more than 100 tons of either coal, coke or fuel oil. In total approximately 150,000 tons of coal, 106,600 tons of coke and 10,550 tons of fuel oil were consumed in St. Marylebone in the year 1952-53, the two power stations accounting for 105,000 tons of the coal. The remaining 128 larger installations used 12,000 tons of coal, 30,800 tons of coke and 10,550 tons of fuel oil, leaving a balance of 33,000 tons of coal, 75,800 tons of coke and an unknown (but probably small) quantity of fuel oil for the smaller business and industrial users and for domestic purposes. It will thus be seen that when generation of electricity at the Aberdeen Place Station is finally discontinued and the plant at the Lodge Road Station is replaced by modern equipment, both of which are due to take place within a few years, the position regarding the emission of smoke, grit and fumes within the Borough should be greatly improved. The Council noted with satisfaction the setting up by the Government of a Committee " to examine the nature, causes and effect of air pollution, and the efficacy of present preventive measures ; to consider what further preventive measures are practicable; and to make recommendations." National bodies concerned with the problem of atmospheric pollution sought the Council's views to assist them in the preparation of evidence for submission to the Committee, and the Council suggested that the possibility of establishing smokeless zones in London should be examined (St. Marylebone being willing to participate in such a scheme) and that the production of smokeless fuels should be increased. At a later meeting the Council decided to make representations to the Metropolitan Boroughs' Standing Joint Committee urging, not only the immediate introduction of legislation authorising the establishment of smokeless zones in London, but also the implementation 15 of schemes for the electrification of railways in the London area, and the launching by all boroughs of publicity campaigns directed to the reduction of atmospheric pollution. Locally, propaganda was undertaken to encourage the use of smokeless fuels in the hope that some relief from the smoke nuisance might be secured in the meantime. In addition, the attention of firms having boiler installations was again drawn to the courses of instruction for stokers available at technical schools. As regards the Council's own housing accommodation, the Committee responsible was asked to do all in its power to encourage tenants to use smokeless fuel, and to give special consideration to non-smoke-producing methods of heating (including central heating and the possibility of a form of district heating) to be employed on future estates. There appeared to be grounds for a belief that in some areas atmospheric pollution was attributable more to the presence of sulphur gases than to grit or smoke, and in order that information on this aspect of the problem might be studied, detecting apparatus was set up in various parts of London on the recommendation of the Department of Scientific and Industrial Research, to whom the readings from three points in St. Marylebone are sent monthly. Poisons.— The names of sixty-eight 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 seventy-seven. 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 4 and 5. TABLE 4.—Factories : Inspections for Purposes of Provisions as to Health. Premises Registered Inspections Written notices Occupiers prosecuted Factories without mechanical power 310 368 97 — Factories with mechanical power 1,440 1,406 125 — Other premises* (excluding out-workers' premises) 110 355 — — Total 1,860 2,129 222 — *Electrical stations, institutions, sites of building operations and works of engineering construction. TABLE 5.—Factories : Defects Found. Defects Particulars †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 244 305 6 19 Overcrowding 5 6 6 4 — Unreasonable temperature — — — — — Inadequate ventilation 6 23 1 — — Ineffective drainage of floors — — — — — Sanitary conveniences :— (a) insufficient 4 1 — 5 — (b) unsuitable or defective 124 169 — 11 — (c) not separate for sexes 3 9 — 1 — Other offences (excluding offences relating to outwork) 120 186 166 1 — Total 506 699 178 41 — † 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 1952 were not remedied until 1953. The defects and unsatisfactory conditions found (506) showed a decrease on the number (870) discovered last year, and the greater proportion related to want of cleanliness not only of workrooms but, to a marked degree, of sanitary accommodation. Artificial lighting of such accommodation also called for constant attention as owners were often reluctant to install electric lighting. 16 Generally speaking, the larger manufacturers were able to achieve a higher standard of hygiene than owners of small factories; financial considerations no doubt influence this matter but it is realised that many benefits, though not always easily measured, are to be derived from well-maintained premises. On the staffing side there is keen competition to persuade machinists to enter factories and all manner of inducements are offered. One small employer, with a staff of eight, who was faced with this problem, carpeted his workrooms and passages, and claimed that this type of approach removed his labour difficulties. The plague of seaweed flies in various south coast resorts had its repercussions even within central London. After consultations with interested bodies it was discovered that these flies were attracted by certain organic chlorides employed as solvents in metal de-greasing, dry cleaning processes, and with adhesives used in the millinery and dress belt manufacturing trades. The flies apparently associated the smell of the solvent with the seaweed to which they are normally attracted. The many instances in which these insects were found in premises in the Borough were dealt with successfully by the Department's disinfestation service. Nuisance from fumes, noise and vibration coming from factories generally continued to be the subject of numerous representations by residents. Many complaints of this nature came from occupants of mews dwellings. Originally used for stabling horses on the ground floor with living quarters for the servants above, these premises are now in great demand and much money is spent on converting the upper floors into modern flats. The stables have long since been replaced by garages and factories, frequently with attendant noise from such things as panel beating and nuisance from paint-spraying and other plant. Town planning legislation tends to curb the establishment of new businesses but has no effect upon existing occupiers with pre-planning rights. It was again found that only by the ready and willing co-operation of the factory occupiers could some of these difficulties be overcome. Nuisance from fumes is also sometimes caused by gas boilers extensively used in the garment manufacturing trade to generate steam for pressing. The flues of these boilers usually project through the window or wall to the open air and the fumes emitted can be a source of serious nuisance to neighbouring occupiers. A contributory cause is often the corroded condition of the plant, due to prolonged use without proper cleaning, and this can give rise to dangerous pollution within the workrooms as well as affecting nearby tenants. Apart from regular cleaning, it is strongly recommended that the flues should be carried above the roof level and away from adjacent windows. This applies especially where there are large boilers. Out-Workers.— One hundred and nine employers submitted lists in respect of a total of 927 out-workers (362 contractors and 565 workpeople). Of these, fifty-four contractors and twenty-three workpeople operated in the Borough. The nature of the work upon which the out-workers were engaged is indicated below :— Wearing apparel 850 Furs 9 Buttons 30 Umbrellas 4 Household linen 6 Textile weaving 3 Brushes 1 Jewellery 18 Electro-plate 1 Lampshades 3 Artificial flowers 1 Racquet and tennis balls 1 Total. 927 Rag Flock and Other Filling Materials.— At the end of the year there remained on the register ten premises where rag flock or other specified filling materials are used in the manufacture of cushions, pillows and other articles of upholstery. Five samples of hair, two of felt, one of coir fibre and one of wadding were taken and submitted to a prescribed analyst. All were found to comply with statutory requirements. The Rag Flock and Other Filling Materials Act, 1951, 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. 17 Fireguards.— The Heating Appliances (Fireguards) Regulations, 1953, made by the Secretary of State in pursuance of section 2 of the Heating Appliances (Fireguards) Act, 1952, came into force on the 1st October, 1953. They require fireguards of a standard set out in the schedule to the regulations to be fitted to gas fires, electric fires and oil heaters so designed that they are suitable for use in residential premises and are of such a type that, without a guard, there is a likelihood of injury by burning. Towards the end of the year retailers of heating appliances were visited, and it was noted that the leading manufacturers were already embodying in new apparatus guards in conformity with statutory requirements. To ascertain whether or not heating appliances comply with the regulations, the necessary test probes and other equipment, as laid down in the specification (B.S. 1945 : 1953) of the British Standards Institution, were obtained for the use of officers engaged in duties under the Act. 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. During 1953 the Council instituted legal proceedings in ten cases, five on the reports of police officers and five on reports of the Council's streets nuisance inspector. In one case a fine of £20s. Od. was inflicted with 10s. 6d. costs, seven cases resulted in fines of £20s. Od. each, one £10s. Od. and one 10s. with 10s. 6d. costs. In the Annual Report for 1952 mention was made of a prosecution which had developed into something of a test case. At the hearing on 25th November, 1952, the magistrate fined the defendant 10s. and awarded £1 ls. Od. costs to the Council. He appealed to the London Quarter Sessions and the Appeals Committee reversed the decision and awarded the appellant £15 15s. Od., 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 and the following is an extract from the judgment of the Lord Chief Justice in the case : "I am not going to proceed to give what will be an extra judicial opinion, because it would only be obiter, as to whether a street photographer can carry on his business after this bye-law at all; I think it is quite possible he can carry on some business, but I am quite certain that a man is meant to be stopped from touting in the street for custom ; therefore I think that the magistrate was perfectly right in convicting him and the justices were wrong in quashing the conviction and the appeal succeeds." SECTION D.—HOUSING. Permanent Estates.—The Council had provided the following permanent housing accommodation up to the 31st December, 1953 :— Pre-War Estates— No. of Flats Crawford Place Dwellings 52 Fisherton Street Housing Estate 130 Post-War Estates— Barrow Hill 172 Church Street 140 Winchilsea House 23 Townshend (first stage and part of second stage of development) 82 Abbey Road—Boundary Road 54 Hamilton Terrace (part) 12 Total 665 At the close of the year, the following additional permanent accommodation had reached the stage indicated :— 18 No. of Flats Townshend (second stage)—internal work in progress 28 Townshend (third stage)—tenders received 112 Block 8—work commenced during year 42 Block 9—drawings in preparation for final block 42 Hamilton Terrace (12 completed) 52 Block 1 being roofed and good progress made on the remainder of the flats ; twelve garages will be provided. 35-55, Boundary Road—completion expected early next year 48 Site of 57-73, Boundary Road—site purchased and drawings in preparation 50 Wellington Road—estate will include a bank, post office and eight lock-up shops underneath : first block will be ready for occupation in 1954 ; there are thirteen lock-up garages 121 Abercorn Place—estate will include twelve lock-up garages and space for parking six cars; work commenced 34 Queen's Terrace—under construction 28 Aquila Street—plans being prepared by the Housing Department 6 147-149, Gloucester Place—this is a block of one-room flatlets; tender accepted 10 17-19, Balcombe Street—compulsory purchase order confirmed ; plans approved and. tenders invited 4 Further projects at preliminary stage :— Church Street Extension 50 147-165, Lisson Grove 18 18-46, Lisson Grove 23 3-9, Abercorn Place—Violet Hill 36 1-5, Pembroke Terrace 8 Clipstone Street and Great Titchfield Street 60 Playground Areas in Housing Estates.— Provision has been made or is planned for playground areas on the following estates:— Barrow Hill, Townshend, Church Street, Fisherton Street, Abbey Road and a new estate at 35-55, Boundary Road. The practicability of installing play equipment is being discussed and, as an experiment, it has been provisionally decided to spend £200 next year on playground equipment for the Church Street Estate. Requisitioned Premises.— A number of premises were released from requisition during the year, leaving 947 families housed in this type of temporary accommodation. Factory-Made Bungalows.— Fifty-five families are housed in factory-made bungalows. Maintenance and Re-decoration.— External repainting has been carried out during the year at four estates at a cost of £8,876. Maintenance and re-decoration work to requisitioned premises has cost £21,163. Slum Clearance.— The London County Council made an Order under the Housing Act, 1936, for the clearance of a site referred to as the "Ashbridge Street Area" which comprises Nos. 1-19 (odd) Whitehaven Street, Nos. 39-43 (odd) Ashbridge Street and Nos. 22-42 (even) Broadley Street. The County Council also made an Order for the compulsory purchase of the premises with a view to development and the extension of the Portman Day Nursery. Officers of the County Council and the Borough Council conferred in regard to the slum clearance programme for the years 1956-60, and a survey of the Borough is to be undertaken to ascertain the condition of dwellings in areas previously scheduled for development in the second phase of the programme. Inspection of Dwelling-Houses.— The total number of houses and flats (separately assessed residential units) in the Borough at the end of 1953 was 23,114. Details of inspections made and resultant action are given in the following statement :— Houses inspected for defects under the Public Health or Housing Acts 1,506 Inspections made 5,931 Houses found not to be in all respects reasonably fit for human habitation 867 Defective houses rendered fit in consequence of informal action 561 Houses in which defects were remedied by owners after service of formal notices under the Public Health (London) Act, 1936 258 19 Closing Orders on Houses.— Section 10 of the Local Government (Miscellaneous Provisions) Act, 1953, which came into operation on the 14th August, 1953, enables a local authority to make a closing order, instead of a demolition order under section 11 of the Housing Act, 1936, where a demolition order is inexpedient because of the effect of demolition on another house or building. Section 11 extends this power to a case where a demolition order had already been made before the commencement of this Act, and also extends the time limit in section 2 of the Housing Act, 1949, for applying to a local authority to quash a demolition order made before 1st January, 1946, where the house has since been made fit for human habitation, to twelve months from the passing of this Act. Underground Rooms.—Closing orders under section 12 of the Housing Act, 1936, were made on forty-eight rooms, and variations in the user of six rooms already subject to closing orders were approved by the Public Health Committee. Twelve orders, involving twenty-two rooms, were determined. Re-Housing.—During the year, 482 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 340 instances the application was supported by a confidential medical certificate which is considered by the Medical Officer of Health personally. The occupants of rooms upon which closing orders are made receive additional "points" which increase their degree of priority for re-housing, and until they obtain other accommodation the operation of the closing orders remains in abeyance. Immigrants.—In accordance with an arrangement which has been in operation for the past five years, the London Commissioner of the Cyprus Government, with the object of avoiding possible overcrowding in the Borough by sponsored immigrants from Cyprus, asked the Medical Officer of Health to report if suitable accommodation to the standards laid down in the Housing Act, 1936, could be offered in thirty-nine cases where Cypriots residing in St. Marylebone proposed to offer accommodation in their homes to fellow-countrymen. It was possible to report that the accommodation would be suitable in thirty-five cases (involving forty-five immigrants) and that in the remaining four (relating to five immigrants) overcrowding would result. Common Lodging Houses.—Forty-three 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 old and defective range of fifteen water-closets and seven urinals, situated in a restricted open area near the kitchen, was abolished and replaced by a new installation, comprising eleven water-closets, seven urinals and five wash-basins, in the basement beneath the front entrance in Lisson Street. This accommodation is mechanically ventilated, and the floors and walls of the apartment are tiled. At the same time, three new urinals were provided in the ablutions room in the basement of the Burne Street frontage. As a result of the carrying out of these works, greatly improved sanitary accommodation is now available for the users of the premises. 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 no disrepair certificates were issued. One application was received but could not be granted as the condition of the dwelling involved did not warrant it. SECTION E.—INSPECTION AND SUPERVISION OF FOOD. Food and Drugs Analysis.—Samples of ninety-nine different kinds of foodstuffs and eleven varieties of drugs were taken and analysed under the Food and Drugs Act, 1938, the fee paid for analysis being £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 :— During 1953, 678 samples of foods and drugs were examined. Of these 421 were taken formally and 257 informally. The number adulterated or incorrectly labelled was forty-eight, or 7.1 per cent. The incidence of adulteration may be classified as follows :— 20 Number of Samples Examined Numbers and Percentages Incorrect Compositional Labelling Milk 193 2 (1.0%) — Other Foods 472 28 (6.0%) 10 (2.1%) Drugs 13 — 8 (61.0%) In general, the food situation throughout the country is now improving rapidly, and whilst the public need the protection of the Food and Drugs Acts as much as ever to protect them from skilful sophistication, there is little doubt that many inferior products will disappear or be forced to improve in order to meet the natural competition of other foods. With the reappearance of proprietary products, however, the shelf life of foods in shops will tend to be prolonged and greater care will have to be devoted to the keeping properties of food on storage. With the improvement in the food supply, however, the public have tended to become more critical and, as a result, more complaint samples have been submitted for analysis through the Public Health Department than has been usual. Some of these complaints were justified and are the subject of comments later in this report whilst no fault could be found with others. A piece of bread was submitted because of the complaint that it contained what looked like tobacco ash. It was found to contain gear oil and traces of corroded iron from shafting. The bread had probably been made by machinery with the shafting placed vertically above the mixer so that some oil drops had fallen into the dough. A jam tart was alleged to have a bitter taste and on examination it was found that the pastry contained fat of which the free fatty acid content, calculated as oleic acid, was 2.6 per cent, and that the jam portion contained a red fibre which was derived from the fruit. The slightly bitter flavour was due to the poor quality of the fat. Some scones were submitted because of a complaint that they left a horrible taste in the mouth after eating. No bitter flavour could be detected, but analysis showed that they contained 8 per cent, only of sugar which is very small for scones. As a result they possessed a very dry flavour due to this lack of sugar. Some cream crackers were alleged to have caused food poisoning, but although they were very stale and out of condition no appreciable quantity of lead, arsenic or copper could be detected. Biscuits are usually made in large quantities and cooked on travelling belts, so that it is hardly likely that a few biscuits out of one batch would cause food poisoning unless they have been contaminated by something of a bacteriological nature. The only irregular sample of milk, according to the Sale of Milk Regulations, contained only 2.10 per cent, of fat, but this loss was probably due to the cream having been accidentally lost during transit. An unopened bottle of pasteurised milk contained floating pieces of brown matter and adherent brown matter at the bottom of the bottle, which consisted of dried decomposed milk. Your analyst was of the opinion that the bottle into which the milk had been filled had been improperly cleaned, but that it had passed through the sterilising plant since, although the milk was four days old, it was still not decomposed. A third sample of milk was submitted because of a peculiar flavour. The milk was examined and found to be genuine but it possessed a taint due to the cows having been fed on fish meal. A sample of double cream contained only 46.1 per cent, of fat and was therefore 4 per cent, deficient in fat, as according to the Food Standards (Cream) Order, 1951, it must contain not less than 48 per cent, of fat. A sample submitted as pure Devon cream contained only 23.5 per cent, of fat. In the opinion of your analyst Devon cream is synonymous with clotted cream and Devon cream must contain not less than 48 per cent, by weight of milk fat. This sample was, therefore, reported as being 53 per cent, deficient in fat. Two samples of table jelly were reported as inferior because the sugar had crystallised out. Whereas jellies normally contain about 25-27 per cent, of water, these had dried to such an extent that there was less than 18 per cent, of water present. A sample of raspberry syrup was reported as inferior as it was badly crystallised, and in view of its appearance it would not be attractive to buy. It contained only 67.8 per cent, by weight of sugar, so that it must have been very old stock for so much sugar to have crystallised. Some prunes were submitted by a lady who complained that she had collapsed after eating a portion. Your analyst ate some without any ill effects. The prunes possessed an unsavoury flavour and gave off an unpleasant odour while cooking. This was due to the fact that they had been dried by the modern method of smoking and not by sun drying. 21 The Food Standards (Preserves) Order is interesting in that it requires fruit curds to contain either oil of orange or oil of lemon so that, legally, it is impossible to make fruit curds in which these oils are incompatible. Two samples of fruit curd fell within this category, but two others were very different in that they showed an illustration of a freshly-cut pineapple on their labels and contained only artificial flavour, there being no genuine oil of pineapple or juice of pineapple present. A sample of sauerkraut was alleged to have caused food poisoning. It was examined for poisonous metals, but no detectable quantities of these were found. In your analyst's opinion the flavour was not satisfactory, due either to the fermentation not having been quite right initially or to the effects of sterilising a fermented product. The product was harmless but the abnormal flavour might have caused some psychological reaction to the complainants. A member of the public complained that a paprika had caused violent choking. Examination showed that the white pithy pulp at the base of the stalk had a strong flavour and the typical pungent taste associated with Nepal or strong Cayenne pepper. Paprikas, Cayennes, Nepal peppers and Pimientoes all belong to the same family and a throw back of this type is merely something which is beyond man's control. The flavour was not due to spraying with a dangerous chemical as the complainant had suspected. A sample of pork sausages was found to contain only 57 per cent, of meat. Your analyst is of the opinion that pork sausages must contain not less than 65 per cent, of meat and this sample was therefore 12 per cent, deficient. Two samples of salami were submitted for examination, but neither of them was entirely satisfactory. One sample contained 49 per cent, of water and only 2.7 per cent, of salt, whilst the other contained 35.6 per cent, of water and 2.8 per cent, of salt. Salami is a type of uncooked sausage, made essentially of meat or fish with added seasoning and smoked. It is then hung in the factory to dry and should only be sold when in a satisfactory condition. If too much water and too little salt are present there is a risk that any pathogenic organisms may multiply and flourish. Although it is recognised that cuts and abrasions on the hands of workers making these products should be covered with a completely sealed antiseptic dressing, one knows that ideal conditions do not always operate in every factory all over the world. The fat in a sample of parsley and thyme stuffing was extremely rancid, rendering the product unfit for sale. Seven samples of imported chocolate confectionery examined were found to contain excess lead ranging from six to fifty-five parts per million. An ice lolly contained two parts per million of lead and in view of the large amount of ice lollies likely to be consumed this quantity might even prove dangerous. Several samples were incorrectly labelled or had misleading labels. Some French mustard was quite a satisfactory product but the disclosure of ingredients failed to comply with the requirements of the Labelling of Food Order. A sample of horseradish sauce was incorrectly labelled as the ingredients were not declared in the correct order. Some tomato vitamin made a claim for vitamin content but gave no indication of what vitamins were present or of their quantity. Analysis indicated that it was an ordinary sample of tomato puree. Seven samples of fruit juice and vegetable juice products sold at a health store were examined and all contained parahydroxybenzoic acid, a prohibited preservative. Whilst there is a possibility that these juices might be held to be drugs and not foods under the definition of food, according to the Food and Drugs Act, 1938, they are foods within the meaning of the Labelling of Food Order and they will be foods according to the definition of food contained in the Food and Drugs Bill now before Parliament. They contravened the Pharmacy and Medicines Act, 1941, if they were drugs in that they claimed to have been prepared by a secret process. A packet of dextrose tablets bore the interesting statement on its label : "All carbohydrates (starch food) must be converted into dextrose by the digestion before the body can absorb them." Cane sugar, beet sugar and milk sugar are all carbohydrates, but only one-half of these is converted to dextrose before they are absorbed into the body. Seven other proprietary drugs were incorrectly labelled according to the Pharmacy and Medicines Act, 1941, although they appeared to comply with the requirements of the Food and Drugs Acts. Whilst manufacturers are responsible in practice for these irregularities, the retail pharmacist is responsible at law under the Pharmacy and Medicines Act. Some of the mistakes which occur are due to a failure to look up the relevant monographs of the British Pharmacopoeia 22 or the British Pharmaceutical Codex, whilst others are the result of a deliberate attempt to mislead the purchaser. The Pharmacy and Medicines Act was introduced in order to ensure that the public were informed of the composition of medicines they purchased, and was a direct reversal of the Patent Medicines Acts. The following legislation or proposed legislation was introduced during the year :— The most important was the Food and Drugs Bill, which had its first reading in the House of Lords in November. This Bill is primarily a consolidating Bill and will enable a large volume of emergency legislation to be made permanent. It will also tidy up some of the law under the existing Food and Drugs Acts, 1938-1950. Unless an Act of this nature were passed it would be difficult to retain many Statutory Orders introduced by the Minister of Food during and since the war. Unlike much of the temporary legislation of the last few years a considerable amount of thought is being given to this Bill and all interested parties should find an opportunity to have their views expressed in one or other of the Houses of Parliament. The Labelling of Food Order, 1953, was largely a re-enactment of the previous Labelling of Food Order, but it released what are commonly known as biscuits from the necessity of declaring their ingredients. It permits the labels of intoxicating liquors to be printed either with a light block print on a dark background or the reverse ; it permits the addition of emulsifying salts and edible starch, merely to be defined as such, when added to stated foods, and it allows preparations specified in the British Pharmacopoeia or the British Pharmaceutical Codex to be sold without a declaration of composition. On the other hand it requires French coffee and Vienna coffee to be labelled " coffee and chicory mixture " or " coffee with fig seasoning " in substantially as conspicuous wording as "French coffee" or "Viennese coffee." It also prohibits the sale of solutions containing more than 15 per cent, of acetic acid by anyone other than a pharmacist or an authorised seller of poisons unless the labels are marked " Dangerous—not to be used unless diluted" together with the relevant wording showing the concentration of acetic acid present. The Cream and Use of Milk (Revocation) Order, 1953, enabled home-produced cheese and cream to come on to the market again by removing restrictions on manufacture and sale. It also permits the use of milk in the manufacture of bread, biscuits, pastries, cakes, ice-cream and confectionery generally. The Food Standards (Ice-Cream) Order, 1953, re-enacted the Food Standards (Ice-Cream) Order, 1951, and reintroduced the minimum fat content of 5 per cent., sugar 10 per cent., and milk solids-not-fat 7.5 per cent. Seventy-five per cent, of the sugar must be sucrose, i.e., cane or beet sugar, and the other 25 per cent, may be invert sugar or sugars derived from the hydrolysis of starch. The Milk (Great Britain) Order, 1953, replaced with amendments the Milk (Control and Maximum Prices) Order, 1951, and from the public analysts' point of view the essential factor in this Order is the permission to sell Channel Islands and South Devon milk containing less than 4 per cent, of fat under their own names, so long as the prices charged are only those permitted for other milks in the same categories, i.e., as ordinary milk, tuberculin tested milk, or tuberculin tested farm bottled milk. The Public Health (Condensed Milk) (Amendment) Regulations, 1953, re-enacted the provisions of Regulation 60CAA of the Defence (General) Regulations and permit the sale of full-cream unsweetened condensed milk imported by the Minister, containing not less than 7.8 per cent, of fat and not less than 25.5 per cent, of all milk solids including fat. The Flour Order, 1953, and the Bread Order, 1953, allow some relaxation in the control of flour and bread. Any flour, other than that obtained by the grinding of the whole wheat, must have prepared chalk added to it at the rate of 14 oz. per 280 lb. sack, and all flour of an extraction rate of less than 80 per cent, is required to have added to it iron, vitamin Bl, and nicotinic acid in sufficient quantity to ensure a minimum stated quantity of each. The Bread Order permits the sale of breads other than national bread, so long as national bread is available for sale when other varieties are sold. Mention was made in the report last year of the number of Meat Orders introduced. The Canned Corned Meat (Prices) Order, 1953, and its amending Order, and the Offals in Meat Products Order, 1953, removed all controls on meat products other than the prohibition of the use of certain offals in the composition of uncooked open meat products for sale for human consumption and the control of the retail price of canned corned meat. During the year there were three Orders relating to the use of oils and fats in food : the Oils and Fats Order, 1953, the Oils and Fats (Amendment) Order, 1953, and the Oils and Fats (No. 2) Order, 1953. These Orders relate primarily to the oils which may be sold with or without 23 a licence from the Minister of Food, but whereas the first Order laid down standards for dripping and for horsefat for edible purposes, these standards were revoked by the repeal of the Order and the promulgation of the No. 2 Order. In many ways it is to be regretted that, when standards of quality, such as those relating to the quantity of free fatty acids in fats and oils, have once been introduced, they are not carried forward in some way in later Orders. The Public Health (Preservatives, etc., in Food) (Amendment) Regulations, 1953, and the amending Order brought into permanent legislation the permission to employ diphenyl for the treatment of wrappers for citrus fruits. The Regulations also allow the use of sulphur dioxide as a preservative for certain dried vegetables and, for a limited period, the continuance of the addition of borax to margarine. During the year the Food Standards Committee by its Preservatives Committee issued a report regarding the addition of anti-oxidants to foods. This report stated that there is no objection to the continuation of the use of certain anti-oxidants in the preparation of foods, such as ascorbic acid (vitamin C), lecithin (a natural substance generally associated with fat in foods, especially in yolk of egg), tocopherols (vitamin E, present especially in the germ portions of seeds), and citric and tartaric acids, all of which are naturally occurring products and therefore not considered as preservatives in the legal sense of the word. The Committee also considered that iso-ascorbic acid may be considered as similar to ascorbic acid. The Committee recommended, however, something new to British, though not to foreign, law—the legalisation of two other anti-oxidants, namely, propyl gallate not exceeding 0.01 per cent, and butylated hydroxyanisole not exceeding 0.02 per cent, the use of both of which is permitted in the United States and in Canada. The Committee expressed the opinion, however, that no additions should be made to butter and that a periodic review should be made of the necessity to use any anti-oxidants or to permit the use of others not so far allowed. The Food Standards (Preserves) Order, 1953, replaced the earlier Food Standards (Preserves) Order, as modified in 1950, which had been in force since 1944, i.e., since one of the worst periods of the war. It abolished the distinction between fresh fruit and full fruit jams and modified the quantity of fruit required to be present in various jams. The main provisions remain, however, unaltered. Arising from the effects of this Order it is interesting to note that various manufacturers have endeavoured recently to place on the market various types of fruit flavoured spread analogous to lemon curd. Lemon cheese or lemon curd has been known for many years and shortly before the outbreak of the last war orange curd appeared on the market. The Food Standards (Preserves) Order makes provision for orange and lemon curds by requiring fruit curds to contain 4 parts of fat, 0.33 part of citric acid, and 0.125 part of oil of lemon or 0.25 part of oil of orange, together with a certain quantity of egg and the soluble solid matter not less than 65 per cent. It will be appreciated that the stipulation that a fruit curd must contain either lemon or orange oil renders it almost impossible to market products such as banana or apricot curd without inventing a fresh description for them. The Saccharin Order, which had been in force in various forms since early in the war, was revoked and a new Artificial Sweeteners in Food Order, 1953, introduced. This new Order prohibits the use of any artificial sweeteners other than saccharin in food, and results from doubts as to the harmlessness of dulcin and the believed harmful effects of P.4000. The Soft Drinks Order was revoked during the year and the Food Standards (Soft Drinks) Order, 1953, introduced to take its place. The chief effects of the new Order are to make provision for medicated and glucose beverages, which had hitherto been manufactured since the outbreak of the last war under licence, the application of minimum standards to drinks for diabetics and to ginger beer and herbal and botanical beers, and the omission of specific reference to non-alcoholic wine, non-alcoholic cider and non-alcoholic perry, which are now considered to fall under the heading of "any other description of soft drink containing fruit juice." The Order similarly makes allowance for soft drinks made from whole fresh oranges. This Order may give rise to questions of interpretation and legality. The High Court decided that there can be no such thing as " non-brewed vinegar" because vinegar must be the product of double fermentation and many people believe that there can, therefore, be no such thing as " nonalcoholic wines, non-alcoholic cider, and non-alcoholic perry." The term " non-alcoholic wine " has been used for many years, but non-alcoholic cider and non-alcoholic perry have not even the custom of long use to support them. Similarly, there would appear to have been considerable confusion regarding the names by which drinks made from whole orange should be described and how much orange should be contained therein, but this point is one to be settled in the future. Milk.—There are 169 premises from which milk is sold, and inspections made numbered 224. Owing to the closing of thoroughfares south of Marylebone Road during the greater part of Coronation Day 24 (Tuesday, 2nd June, 1953) arrangements were made by distributors to deliver extra milk on the previous day to premises on and beyond the northern side of Oxford Street, which formed part of the processional route. During the year, 220 applications under the Milk (Special Designations) (Raw Milk) Regulations, 1949, and the Milk (Special Designations) (Pasteurised and Sterilised Milk) Regulations, 1949, were received from sixty-eight milk purveyors, and licences were granted as follows :— Tuberculin tested milk 44 dealer's and 16 supplementary Pasteurised milk 1 pasteuriser's, 62 dealer's and 16 supplementary Sterilised milk 1 steriliser's, 64 dealer's and 16 supplementary The average composition of the 191 genuine samples of milk analysed was : total solids 12.56 per cent.; fat, 3.72 per cent. ; solids not fat, 8.84 per cent., as compared with the legal minima, namely, 11.50 per cent., 3.00 per cent, and 8.50 per cent, respectively. Forty-six 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 were reported to be satisfactory. Of 122 other samples of milk examined by the Council's Bacteriologist, all were found to comply with the requisite standards except three samples which failed to satisfy the methylene blue test and one which failed the phosphatase test. Butter and Margarine Premises.—Three dealers in margarine and two butter manufacturers are on the register. Fifty-three inspections of the premises were made. Ice-Cream.—The number of premises on the register was 192, which includes three where ice-cream is manufactured : 254 inspections were made, and two notices served. Twenty samples of ice-cream were examined bacteriologically, all of which passed the methylene blue test, eighteen being grade 1 and two grade 2. Thirty-seven samples submitted to the Public Analyst were all returned as genuine. The results of the analyses of these are indicated in Table 6. TABLE 6.—Ice Cream Analyses. Sample No. Fat (%) Solids not fat (%) 1 11.60 25.53 2 10.00 31.00 3 10.00 27.50 4 9.20 24.40 5 11.60 27.20 6 12.00 25.40 7 9.20 25.60 8 9.60 26.01 9 9.60 26.86 10 9.20 25.87 11 10.80 24.69 12 10.40 24.83 13 10.40 25.16 14 10.80 28.81 15 10.80 26.90 16 9.60 25.17 17 6.80 29.77 18 9.40 24.50 19 9.20 25.30 20 8.60 25.10 21 8.20 26.20 22 10.20 22.50 23 7.60 26.56 24 6.00 28.61 25 10.80 21.57 26 10.80 23.76 27 11.20 25.87 28 9.90 25.80 29 9.40 25.76 30 7.40 27.98 31 9.20 26.36 32 9.60 23.97 33 9.20 26.68 34 8.00 28.31 35 8.80 25,58 36 9.02 29.08 37 9.71 27.29 25 Preserved Food.— There were 113 shops and other establishments on the register of premises approved for the preparation or manufacture of preserved foods (sausages mainly) intended for sale ; 197 inspections were made and seven notices served. Fried Fish Vendors and Fish Curers.—Nine premises are used by vendors of fried fish and one by a fish curer. Twenty-six inspections of fried fish shops and eighteen inspections of the fish curer's premises were made. One notice was served in respect of a fried fish shop. Bakehouses.—Re-inspection of the fourteen basement bakehouses on the register was carried out in accordance with the provisions of section 54 of the Factories Act, 1937, which require a local authority to examine, every fifth year, all basement bakehouses for which a certificate of suitability has been issued. As a result, three certificates were renewed after repairs and alterations had been carried out; notice of termination of occupation was given in five cases where the bakehouse was found to be totally unsuitable ; certificates were not renewed in respect of five bakehouses closed voluntarily ; and an entry relating to a bakehouse which had not been used as such for a period exceeding twelve months was removed from the register. It will thus be noted that there are only three basement bakehouses left in St. Marylebone; twenty-five years ago there were forty-nine ; fifty years ago the number was seventy-five. Among the reasons for the gradual disappearance of the underground bakehouse is the fact that no new ones have been permitted to be established since 1904 and, with the passage of time, costly structural repairs have become necessary to maintain a satisfactory standard of hygiene. Rather than face this, occupiers have preferred to discontinue baking and to obtain their bread and cakes from bakeries outside the district. During the year 170 inspections were made of bakehouses generally in the Borough, and service of notice was necessary in four cases. Restaurants, etc.—Premises in which meals are provided or food is sold already cooked or is prepared for sale numbered 778, including 305 restaurants and snack bars, 53 hotels, 248 staff and club canteens, 117 public houses, 32 other licensed catering establishments, 15 school and nursery canteens, and 8 coffee stalls; 2,026 inspections were made and 83 notices served. During the year the kitchens of 5 restaurants were completely reconstructed. Legal proceedings were taken under section 13 of the Food and Drugs Act, 1938, against four 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 £10 0s. Od. with £10 10s. Od. costs was imposed in one case, and £5 0s. Od. with £3 3s. Od. costs in another. A third case was adjourned sine die on payment of costs, and in the remaining case the summons was withdrawn after extensive work had been done. Retail Food Shops.—The inspection of retail food shops continued and 1,754 visits were made to 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 these inspections is to ascertain whether 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, fight and ventilation, storage arrangements, cleansing and redecoration, provision of sanitary accommodation, and washing facilities with hot and cold water, towels, soap and nailbrush. The co-operation of retailers generally has been secured and considerable improvement has taken place in many shops as a result of the advice given. During the course of the inspections conditions were found which necessitated the service of twenty-four informal notices. Horseflesh.—Forty-six 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. Nine inspections were made during the year. Unsound Food.—No special examinations of stocks or consignments of food were necessary, but in the ordinary course of their duties the inspectors condemned, as unfit for human consumption, approximately 35 tons of food which included the following : meat and offal, 1 ton 14 cwts. 1 qtr. 12 lbs. ; bacon and ham, 7 tons 2 cwts. 1 qtr. 27 lbs. ; poultry and game, 3 cwts. 3 qtrs. 11 lbs.; fish, 5 cwts. 3 qtrs. 16 lbs.; fruit and vegetables, 7 cwts. 2 qtrs. 11 lbs. ; canned meat, 3 tons 13 cwts. 27 lbs.; canned food (other than meat), 23,045 cans ; miscellaneous, 5 cwts. 3 qtrs. 24 lbs. Practically the whole of this unsound food was removed by the Council and, wherever possible, salvaged and used for animal feeding, the remainder being destroyed. 26 St. Marylebone Clean Food Association.— Since its formation in 1951, under the aegis of the Borough Council, this Association has made steady progress and by the end of the year under review had 168 members, all of whom undertake to follow a code of practice in advance of the minimum legal requirements in regard to food hygiene. Enquiries are received from time to time for details of this code of practice ; no apology is therefore made for reproducing it in full :— Code of Practice.—The Management shall provide all reasonable facilities for the personal cleanliness of their staff, whilst at work, and shall encourage and as far as possible ensure that all persons engaged in the preparation, distribution and handling of food-stuffs on their premises shall do so in a hygienic manner and comply with the under-mentioned rules :— (а) Foodstuffs shall be treated with care and not handled unnecessarily. (b) All utensils and equipment used for the preparation, distribution, etc., of food shall be kept clean. (c) Hands and finger nails shall be scrubbed clean before commencing work, and after every visit to a sanitary convenience, and as often as necessary to ensure that the hands are kept clean. (d) Water-closets shall be maintained in a clean condition and an adequate supply of toilet paper provided. (e) Any cut or sore on the hands shall be properly covered with a plastic or other waterproof dressing. (f) Overalls shall be changed as frequently as necessary to maintain cleanliness. (g) Head-coverings should be worn and maintained in a clean condition in kitchens and other premises where food is in course of preparation. (h) Smoking shall be forbidden during the preparation of foodstuffs and during the handling or distribution of unprotected foodstuffs. (i) Employees shall immediately notify the management if they suspect that they are in an infectious condition or have been in contact with any infectious or contagious disease. (j) Employees shall be required to do everything possible to support the efforts of the management to ensure that the preparation, handling, and distribution of food are carried out in a thoroughly hygienic manner. (k) Personal clothing shall not be hung or stored in food preparation rooms, but shall be kept in lockers or similar accommodation which shall be provided by the management for the outdoor clothing of members of the staff. (l) All food shall be stored off the floors and clear of the walls, thus facilitating cleansing. (m) Where cooked foods, or articles of food requiring no further preparation before eating, are displayed the quantity displayed shall be limited to the barest minimum, and this shall be protected from contamination by flies, dirt, dust, etc., by means of glass, cellophane, or other adequate covering. (n) Foods such as butcher's meat, fish, game, poultry, etc., shall be stored in a refrigerator or cold store in bulk, and only a minimum displayed which shall be adequately protected from contamination by flies, dirt, dust, etc. (o) All opened sacked-goods shall be transferred to galvanised bins with close-fitting covers when in store to prevent contamination by rats, mice, insects, pests, etc. At the annual general meeting of the St. Marylebone Clean Food Association held on the 19th May, 1953, the Articles of Association were amended to establish the office of President, and His Worship the Mayor, Alderman Howard C. Rowe, J.P., F.R.I.C.S., who presided became the Association's first President. Mr. F. J. Mitchell and Mr. H. A. Hale were re-elected Chairman and Vice-Chairman, respectively. Mr. W. S. Moss was elected Honorary Secretary and Mr. D. W. Moeran, who had been Honorary Secretary and Treasurer since the formation of the Association, was re-elected Honorary Treasurer. During the year the reputation and value of the Association to the community have been enhanced and, with the help of the Borough Council, publicity has been given to their activities by the printing and distribution of pamphlets and bookmarks. The programme of education of food handlers in hygiene has continued by means of lectures illustrated by film strips. Unfortunately, however, the numbers participating in this scheme have been rather disappointing, due particularly to the fact that so many of the smaller firms are unable to spare members of their staff during normal working hours and the staff are unwilling to attend lectures during their evenings or other free time. Among other matters with which the Association has been specially concerned during the year were the transport and handling of meat and washing-up in restaurants and food establishments. 27 Investigation was also made into the question of cracked cups. The possible prohibition of the use of cracked and chipped crockery in catering establishments was considered by the Metropolitan Boroughs' Standing Joint Committee in 1947, when they were advised that there was no conclusive evidence that the diseases, loosely termed " trench mouth," were contracted from such crockery. It was then suggested that in dealing with the problem local authorities should rely on the enforcement of the requirements of Section 13 of the Food and Drugs Act, 1938, under which cleanliness is enjoined in respect of " all articles, apparatus and utensils " in any room in which food is " prepared for sale or sold or offered or exposed for sale or deposited for the purpose of sale or of preparation for sale." The Advisory Body of Medical Officers of Health are unaware of anything which has occurred to invalidate the Standing Joint Committee's decision. They feel, however, that the matter should not be treated lightly. From its own enquiries the Association is satisfied that, because defective crockery undoubtedly harbours bacteria and other organisms and is therefore always a possible source of danger, cracked cups should not be tolerated, more particularly now that the position with regard to the supply of chinaware is easier. In this connection and from the point of view of hygiene generally, a great deal of the responsibility rests upon the pubhc themselves. So long as customers are content to put up with second-rate service and to patronise restaurants and food establishments which give it, so long will one of the chief incentives for better conditions be lacking. The St. Marylebone Clean Food Association is representative of the best elements in the food trades and catering industry in the Borough and is worthy of full support. SECTION F.—PREVALENCE OF, AND CONTROL OVER, INFECTIOUS AND OTHER DISEASES. Infectious and other diseases notifiable in St. Marylebone are listed in Table 7, which gives also information regarding notifications received during 1953. Enquiries relating to cases of infectious disease were carried out by one of the women sanitary inspectors who paid 945 visits in this connection during the year. TABLE 7.—Notifiable Diseases and Notifications. * Notifiable Disease Cases notified in whole Borough Cases removed to hospital Cases isolated at home At all ages At ages—years —1 1— 2— 3— 4— 5— 10- 15- 20— 35— 45- 65— Ophthalmia neonatorum 2 2 — — — — — — — — — — — 1 1 Erysipelas 3 — — — — — — — — — 2 1 1 2 Scarlet fever 44 — — 1 3 6 29 2 2 1 — — — 10 34 Puerperal pyrexia 27 — — — — — — — 2 23 2 — — 26 1 Poliomyelitis— Paralytic 6 — — 2 — — — — 2 1 — 1 — 4 2 Non-paralytic 3 — — — — — 2 1 — — — — — 2 1 Pneumonia 16 1 1 — — 1 2 — 1 I — 5 4 6 10 Dysentery 13 2 1 2 2 1 — 1 — — — 4 2 11 Measles 429 13 42 54 70 65 159 8 4 9 3 2 19 410 Whooping cough 71 9 7 6 9 12 27 1 — — — — — 3 68 Scabies 8 — — — — — — — 1 6 — 1 8 Meningococcal infection 1 1 — — — — — — — — — — — 1 — TyphoidFever 1 — — — — — — — 1 — — — — 1 — Tuberculosis— Pulmonary 78 1 1 — — — 1 2 4 37 18 10 4 38 40 Non-pulmonary 10 — — — — — — 1 1 3 1 2 2 6 4 Food poisoning 18 — — 1 — — 1 — — 2 2 12 — 14 4 Totals 730 29 52 66 84 85 221 16 18 83 26 35 15 134 596 * There were no cases in the Borough of the following diseases which are also notifiable : Smallpox, diphtheria, membranous croup, cholera, typhus fever, relapsing fever, continued fever, plague, leprosy, hydrophobia, glanders, farcy, anthrax, induced malaria, malaria, acute encephalitis (infective or post-infectious), paratyphoid fever. Public Health (Infectious Diseases) Regulations, 1953.—-These regulations, which came into operation on the 1st April, 1953, are generally similar to those issued in 1927, which they supersede, with amendments necessitated by the present working of the health services. The new regulations also amplify the precautionary measures against food poisoning (i) by relating these (instead of to enteric 28 fever and dysentery, as formerly) to typhoid fever, paratyphoid fever or other salmonella infections (which include the diseases previously known as enteric fever), dysentery and staphylococcal infection likely to cause food poisoning ; (ii) by applying these measures to persons shown to be carriers of these diseases as well as to persons suffering from them; (iii) by preventing such persons (in either class) not only from continuing employment involving the handling of food, as formerly, but also from entering such employment, and (iv) by enabling a local authority to authorise the Medical Officer of Health to issue notices in emergency in order to check the spread of these diseases. 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 going abroad. During 1953, 3,119 applications were dealt with. 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 thirteen cases and five single unrelated cases. (ib) Deaths.—None. (c) Organisms or other agents responsible, with number of outbreaks attributable to each—- Salmonella typhi-murium.—One case. Not ascertainable.—The outbreak of thirteen cases and four single unrelated cases. (d) Foods involved, with number of outbreaks associated with each food.—It was not possible to identify a particular foodstuff as being the source of infection in any instance. Twenty-three visits were paid by one of the women sanitary inspectors in connection with these cases. The outbreak affecting thirteen persons occurred in June amongst the members of a motor coach party who came to London from the North and were taken ill with what appeared to be acute food poisoning after taking a meal in a restaurant just outside the Borough. They were admitted to a hospital in St. Marylebone and all were discharged within twenty-four hours. The Medical Officer of Health of the district in which the restaurant was situated made an investigation but was unable to trace the source of infection. A full report of the outbreak was sent to the Ministry of Health. It was learned that on the 24th September there had been an outbreak of diarrhoea amongst the pupils and staff of a local school, though no formal notifications of food poisoning or suspected food poisoning were received. The onset of the illness was about five hours after the school mid-day meal and, as similar outbreaks had occurred at two schools in an adjoining borough which obtain meals from the same kitchen, this seemed to be the probable source of infection. Investigation showed that a joint of silverside of beef served cold for lunch on 23rd September to all the people taken ill, had been boiled at mid-day on the previous day, cut up into six joints and left to cool overnight in its own liquid, thus probably affording an excellent medium for bacterial growth and being the likely cause of the outbreak. Unfortunately, none of the suspected food was available for bacteriological examination and faecal specimens obtained from the children and staff proved negative. The attacks were very mild and the patients soon recovered. Tuberculosis—New Cases and Mortality.—Table 8 contains information with regard to age and sex distribution of, and mortality from, all forms of tuberculosis. TABLE 8.—Tuberculosis : New Cases and Deaths. At ages— years t NEW CASES deaths Pulmonary Non-Pulmonary Pulmonary N on-Pulmonary m. f. m. f. m. f. m. f. 0—1 1 — — — — 1—5 — 1 — — — — — — 5—15 2 1 2 — — — 15—25 9 21 3 — — — 25—35 23 17 1 2 — — — — 35—45 21 6 1 — 45—55 7 3 1 5 — — 1 55—65 7 1 1 5 — — — 65 and upwards 7 — — 2 3 1 — — Totals 76 51 6 7 13 1 — 1 ‡ Including all primary notifications and also any other new cases of tuberculosis which came to^the knowledge of the Medical Officer of Health during the year. •29 Notifications.— Table 7 (p. 27) gives information regarding notifications of pulmonary and non-pulmonary tuberculosis received during the year. Three hundred and thirty-one visits for enquiries into housing and sanitary conditions 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, 1953, was 893. 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 104 cases of scabies : adults 55 (men 35, women 20) ; children 49 (boys 27, girls 22). Domiciliary visits paid in connection with St. Marylebone cases numbered seven. Impetigo.—No cases of impetigo were treated at the Cleansing Station. Disinfection.—During the year, 224 rooms and 2,600 articles of bedding (mattresses, blankets, sheets, bolsters, pillows, etc.) together with 956 books, were disinfected, and 437 dressing drums from a local hospital were sterilised. The Department continued to be called upon by residents in the Borough to disinfect worn clothing intended for despatch to foreign countries, although invariably there had been no contact with infectious disease. During the year 208 certificates, relating to a total of 2,341 articles, were issued. From the 3rd November, 1953, the form of certificate was varied to indicate that no infectious disease had been reported for at least one month as occurring at the premises from which the clothing was purported to have come. From that date disinfection was carried out only when clothing had actually been in contact with infectious disease. Bacteriological Examinations.—Table 9 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 9.—Work of the Bacteriological Laboratory. Nature of Specimen and Examination Positive Negative Total Throat and nasal swabs for— B. diphtheriae — 55 55 Haemolytic streptococci ... 3 28 31 Vincent's organisms 12 6 18 Monilia 1 — 1 Gum swab for— Haemolytic streptococci — 1 1 Swab from umbilical cord for— Haemolytic streptococci 1 — 1 Vaginal swab for— Gonorrhoea... 1 3 4 Trichomonas — 1 1 Monilia 1 — 1 Haemolytic streptococci 4 1 5 Sputum for— Haemolytic streptococci — 1 1 Tubercle bacilli 1 24 25 Laryngeal swab for— Tubercle bacilli — 1 1 Cough plate for— H. pertussis — 3 3 Faeces for— Parasites ... " ... 3 2 5 Dysentery, food poisoning organisms and typhoid 2 99 101 Gastro enteritis — 3 3 Blood for— Typhoid, paratyphoid and Brucella abortus — 2 2 Malaria — 3 3 Foods for— Food poisoning organisms 1 32 33 Urine for— Paratyphoid — 1 1 Tubercle bacilli — 2 2 Totals 30 268 298 .