Ac, 4353 Cm STMARY 59 BOROUGH OF ST. MARYLEBONE REPORT OF THE MEDICAL OFFICER OF HEALTH FOR THE YEAR 1954 H. A. RULMAN, M.R.C.S., D.P.H. London: Vail & Co., Ltd., 170 Farrittgdon Road, E.C.I 1 CONTENTS page Members of the Public Health Committee 3 Staff of the Public Health Department 3 Section A—Statistics and Social Conditions:— General Statistics 4 Extracts from Vital Statistics 4 Marriages 4 Deaths 4 Infant Mortality 5 Mortuary 6 Crematorium 6 Section B—General Provision of Health Services:— Representation upon other Bodies 6 Financial Contributions to Voluntary Organisations 6 Conferences 7 Care of Old People 7 Special Laundry Service 7 Cleansing 7 Special Sub-Committee 7 St. Marylebone Old People's Welfare Association 10 Staff Medical Examinations 12 New Legislation 12 Section c—Sanitary Circumstances:— Sanitary Inspection 12 Nuisances 13 Water 13 Drainage 13 Combined Drainage 13 Ventilation of Sewers 13 Building Licences 14 Public Houses—Sanitary Accommodation 14 Public Conveniences 14 Public Cleansing and Salvage 14 Dustbins 14 Pet Shops 14 Diseased or Infirm Persons 15 Burial or Cremation of the Dead 15 Disinfestation 15 Verminous Persons 15 Shelter 15 Rodent Control 15 Dog Nuisance 15 Pigeons 15 Noise 15 Atmospheric Pollution 16 Poisons 17 page Factories 17 Inspections and Defects Found 17 Out-workers 18 Rag Mock and other Filling Materials 18 Fireguards 18 Street Photographers 19 Section d—Housing:— Permanent Estates 19 Requisitioned Premises 20 Factory-Made Bungalows 20 Inspection of Dwelling-houses 20 Closing Orders on Houses 21 Underground Rooms 21 Re-housing 21 Immigrants 21 Common Lodging Houses 21 Rent Restrictions Acts 21 Housing Repairs and Rents Act, 1954 21 Section e—Food:— Food and Drugs Analysis 22 Food and Drugs Amendment Act, 1954 24 Milk 25 Butter and Margarine Premises 26 Ice-Cream 26 Preserved Food 26 Fried Fish Vendors and Fish Curers 26 Bakehouses 26 Restaurants, etc. 26 Retail Food Shops 26 Horseflesh 26 Slaughter of Animals 26 Unsound Food 26 St. Marylebone Clean Food Association 27 Section f—Infectious and other Diseases:— Notifiable Diseases 27 Notifications 27 The Puerperal Pyrexia (Amendment) Regulations, 1954 . 28 International Certificates of Vaccination and Inoculation 28 Food Poisoning Outbreaks 28 Tuberculosis New Cases and Mortality 28 Notifications 28 Venereal Diseases 28 Scabies 28 Impetigo 28 Disinfection 29 Bacteriological Examinations 29 2 Public Health Department, Town Hall, St. Marylebone, W.l To the Mayor, Aldermen and Councillors of the Borough of St. Marylebone. Mr. Mayor, Ladies and Gentlemen, I have pleasure in presenting my Annual Report for the year 1954 which, at the request of the Minister of Health, is again a "non-survey" report. It follows closely the form of its immediate predecessors and is merely a record of the year's happenings, without any attempt to enter deeply into detail. Health conditions generally in the Borough continued to be satisfactory. Population, according to the Registrar General's estimate, rose slightly to 73,930. Both the birth-rate (11.59) and the deathrate (14.27) were lower than in 1953 (12.16 and 14.75 respectively) and there was no maternal mortality. Deaths of infants under one year of age increased, however, to 27, making the death-rate 31.50, the figures in 1953 being 19 and 21.16 respectively. Although these figures for infant mortality are the highest since 1948 no special significance can be attached to them. It was not a "measles year" and notifications of infectious and other diseases fell to the record low figure of 319. The numbers of notifications in the three preceding years were 1,108 (1951), 846 (1952) and 730 (1953). Again no diphtheria was reported—the last was in 1948—and there were only 19 cases of scarlet fever, all of which were of a mild type. There were no deaths from notifiable diseases other than tuberculosis and pneumonia. The weather was generally dull, wet and cold, although a dry spring followed the rather cold winter of 1953/4. Snow occurred for ten days in January, seven in February and six in March and after April, which was dry and sunny, the weather became wet and cold and remained so during practically the whole of the summer. June was the wettest for forty years and conditions did not improve appreciably until September, which produced the warmest day of the year with a temperature of 87 degrees F. October was comparatively warm and dry, but storms developed and November again was a wet month. There was, however, little fog and the remainder of the year was mild and dry with the amount of sunshine above the average until just after Christmas when it turned very cold. To His Worship the Mayor, to the Chairman, Councillor Dr. H. K. Ashworth, T.D., and his predecessor Councillor H. C. Garrard, and to members of the Public Health Committee I offer my thanks for many kindnesses and for the consideration and encouragement they gave me during the year. My thanks are also due 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. Finally, although on the occasion of his retirement early in 1955, the Council formally recorded their appreciation of the valuable services of Mr. A. H. James, who was with the Public Health Department for fifty years, I cannot allow this opportunity to pass without mentioning the fact. I wish to thank him for the great help he has been to me personally and hope that he may enjoy a long and happy retirement. I am, Mr. Mayor, Ladies and Gentlemen, Your obedient Servant, H. A. BULMAN, Medical Officer of Health. 3 PUBLIC HEALTH COMMITTEE. 1954. HIS WORSHIP THE MAYOR : *Alderman Howard Charles Rowe, J.P., F.R.I.C.S. fCouncillor Major Ronald Charles Orpen, j.p., a.c.a., l.c.c. ALDERMAN: Capt. R. G. Whitney, M.B.E , J.P. COUNCILLORS : Dr. H. K. Ashworth, T.D. (^Chairman) The Rev. Walter M. Long *Mrs. E. M. Brown 'Stafford C. Lorie †C. D. Denis-Smith *The Hon. Mildred Lowther, O.B.E. Frederick Frame Mrs. L. Lyons Herbert C. Garrard ('Chairman) Miss L. F. Nettlefold, M.A., LL.B., L.C.C. Mrs. Carr Q. Henriques Mrs. S. Rivington *G. T. Hesketh Miss F. E. Wilson J. P. Honour (f Vice-Chairman) * Until May. f 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.I Bacteriologist (Part-time) : C. J. C. Britton, M.D., D.P.H., 35, Harley Street, W.l Administrative and Clerical Staff : A. H. James (Chief Assistant) H. G. E. Brown J. H. Manning D. H. Drewell P. C. Bzdward S. P. Fleming F. W. Dines Miss C. A.' Cruickshank }Shorthand-Typists Sanitary Inspectors : H. E. Scoble, M.B.E. (a), (6)—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), (6)—District No. 1. (until 20th February, 19o4). H. Lawson (a), (b)—District No. 1. D. B. Hooper (a)—District No. 2. (from 30th August, 1954). J. A. Cummins (a), (b)—District No. 3 A. W. Mules-Berry (a), (b)—District No. 4. (until 3rd August, 1954). G. A. Fraser (a), (b)—District No 4 (from 19th May, 1954). Miss M. M. Sharp (a), (d), (e), (/)—Care of Old People and Re-housing. Mrs. M. I. Tiplady (a), (b), (d), (/)—-Restaurants. Miss B. Wilson (a), (b), (d), (e), (/)—Infectious Diseases. Streets Nuisance Inspector : D. Telford Outdoor Superintendent : R. G. Turner Mortuary Keeper. 1 Disinfectors 3 Rodent Operatives 5 Medicinal Baths Attendants 4 Public Convenience Attendants 36 Van Driver 1 Urinal Flushers 2 Messenger-Handyman 1 (а) Certificate for Sanitary Inspector—The Royal Sanitary Institute and Sanitary Inspectors' Examination Joint Board. (б) 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. (/) 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: £3,514,706. Sum represented by a penny rate: £14,186. Number of residential units (separate assessments) : 24,232. 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) : 1954—73,930. EXTRACTS FROM VITAL STATISTICS. Total M. F. Live Births—Legitimate 789 403 386 Birth-Rate per 1,000 estimated Illegitimate 68 27 41 home population 11.59 Stillbirths—Legitimate 12 5 7 Rate per 1,000 total (live and still) Illegitimate 2 1 1 births 16.07 Deaths (all ages) 1,055 577 478 Death-Rate per 1,000 estimated home population 14.27 Maternal Mortality—Deaths from "Pregnancy, Childbirth, Abortion" Nil (Registrar General's Code No. 30) Total M. F. Deaths of Infants under one year of age—Legitimate 22 13 9 Illegitimate 5 2 3 Death-Rate of Infants under one year of age—All infants per 1,000 live births, 31.50 ; legitimate infants per 1,000 legitimate live births, 27.87; illegitimate infants per 1,000 illegitimate live births, 73.52. Marriages.—The following table shows the number of marriages in St. Marylebone each year since the 1st January, 1944:— Year No. of Marriages Year No. of Marriages 1944 1,097 1950 1,439 1945 1,583 1951 1,415 1946 1,538 1952 1,358 1947 1,736 1953 1,290 1948 1,657 1954 1,262 1949 1,461 The 1954 figure is 28 below the number for 1953 and 195 below the average (1,457) for the previous ten years. The rate for persons married in 1954 was 34 per 1,000 of the estimated home population. Deaths.—The total number of deaths (1,055) 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 1954 were 34 fewer than in 1953 and the principal causes were diseases of the heart and circulatory system, which accounted for 38 per cent, of the totaldeaths, malignant diseases 20 per cent., and respiratory diseases including tuberculosis 11 per cent. Sixty-eight per cent, of the deaths registered were of persons of 65 years of age and over. The expectation of life at birth in England or Wales is now 67 years for a boy and 72 years for a girl, compared with 48 and 52 years respectively during the first decade of the present century. 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 1 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 9 — — — — — — — 2 — 6 — 1 — 2 Tuberculosis, other 1 — — — — — — — — — 1 — — — 3 Syphilitic disease 3 2 — — — — — — 1 — — 1 2 1 4 Diphtheria — — — — — — — — — — — — — — 5 Whooping cough — — — — — — — — — — — — — — 6 Meningococcal infections — — — — — — — — — — — — — — 7 Acute poliomyelitis — — — — — — — — — — — — — — 8 Measles — — — — — — — — — — — — — — 9 Other infective and parasitic diseases 2 — — — — — — — — — 1 — 1 — 10 Malignant neoplasm, stomach 12 5 — — — — — — — — 3 2 9 3 11 Malignant neoplasm, lung, bronchus 32 13 — — — — — — 1 1 19 3 12 9 12 Malignant neoplasm, breast — 28 — — — — — — — 3 — 11 — 14 13 Malignant neoplasm, uterus — 8 — — — — — — — — — 5 — 3 14 Other malignant and lymphatic neoplasms 70 49 — — — — — — 1 3 21 11 48 35 15 Leukaemia, aleukaemia 2 4 — — — — — 1 — — 1 2 1 1 16 Diabetes 3 3 — — — — — — — — 2 1 1 2 17 Vascular lesions of nervous system 70 74 — — — — — — 2 2 18 14 50 58 18 Coronary disease, angina 97 54 — — — — — — 3 — 48 10 46 44 19 Hypertension with heart disease 32 29 — — — — — — — — — 4 32 25 20 Other heart disease 60 66 — 1 — — — — 3 6 9 2 48 57 21 Other circulatory disease 35 31 — — — — — — — 1 4 1 31 29 22 Influenza — 1 — — — — — — — — — — — 1 23 Pneumonia 14 23 1 1 — — — — — — 3 3 10 19 24 Bronchitis 45 16 — — — — — — 1 — 5 — 39 16 25 Other diseases of respiratory svstem 6 4 — — — — — — — — 1 2 5 2 26 Ulcer of stomach and duodenum 4 2 — — — — — — 1 — 3 — — 2 27 Gastritis, enteritis and diarrhoea 3 4 1 — — — — — — 1 — 1 2 2 28 Nephritis and nephrosis 2 5 — — — — — — 1 — 1 3 — 2 29 Hyperplasia of prostate 9 — — — — — — — — — 2 — 7 — 30 Pregnancy, childbirth, abortion — — — — — — — — — — — — — — 31 Congenital malformations 6 5 1 4 2 — 1 1 1 — 1 — — — 32 Other defined and ill-defined diseases 31 31 10 6 — — — — 5 1 8 6 8 18 33 Motor vehicle accidents 2 3 — — — — — — 1 1 1 1 — 1 34 All other accidents 13 11 1 — — — — — 3 1 4 — 5 10 35 Suicide 13 7 — — — — — — 3 3 4 2 6 2 36 Homicide and operations of war 1 — 1 — — — — — — — — — — — Totals 577 478 15 12 2 — 1 2 29 23 166 85 364 356 1,055 27 2 3 52 251 720 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 1 2 — — — 1 — 1 — — — — — — 1 4 Premature birth 3 2 — — — — — — — — — — — — 3 2 Atelectasis 2 2 — — — — — — — — — — — — 2 2 Pneumonia — — — — — — — 1 — — 1 — — — 1 1 Gastro-enteritis — — — — — — — — 1 — — — — — 1 — Suffocation 2 1 — — — — — — — — 1 — — — 3 1 Homicide — — — — — — — — 1 — — — — — 1 — Other causes 3 2 — — — — — — — — — — — — 3 2 Totals 11 9 — — — 1 — 2 2 — 2 — — — 15 12 6 Mortuary.—Five bodies (2 male, 3 female) were received at the Public Mortuary, Chiltern Street. No post-mortem examinations were made. Crematorium.—The Medical Officer of Health is Medical Referee for the Council's Crematorium, situated in the St. Marylebone Cemetery at East Finchley. During 1954, 1,671 certificates authorising cremation were issued as compared with 1,801 certificates in 1953, 1,451 in 1952, 1,284 in 1951, 759 in 1950, 669 in 1949, and 360 in 1948. Since the Crematorium was opened in December, 1937, 9,814 cremations have taken place. SECTION B.~GENERAL PROVISION OF HEALTH SERVICES. 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 (until July). Councillor Miss L. F. Nettlefold, M.A., LL.B., L.C.C. (from July). Councillor Dr. Elizabeth Jacobs. Councillor Miss L. West Russell. The Medical Officer of Health. Councillor Miss L. West Russell. Councillor Mrs. S. Rivington. 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 Mrs. S. Rivington 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 1954 as indicated below :— Organisation Amount Statutory Authority £ s. d. Central Council for Health Education 10 10 0 Public Health (London) Act, 1936, section 298. Family Welfare Association (Area 2) 100 0 0 Local Government Act, 1948, section 136. National Smoke Abatement Society 7 7 0 Public Health (London) Act, 1936, section 298. St. Marylebone Old People's Welfare Association— " Meals on Wheels " Service, etc. 575 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 250 0 0 do. " Inner Wheel" Old People's Club—Rent of Hall 26 0 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—Scarborough, 27th to Alderman Capt. R. G. Whitney, J.P., 30th April. and the Medical Officer of Health. Sanitary Inspector's Association—Southport, 7th Mr. J. R. Baily, Sanitary Inspector, to 10th September. National Old People's Welfare Committee— Councillor Miss F. E. Wilson and Miss M. M. Bournemouth, 1st to 3rd April. Sharp, Sanitary Inspector. National Smoke Abatement Society— Councillor Dr. H. K. Ashworth, T.D. Scarborough, 22nd to 24th September. Care of Old People.—Six hundred and seventeen old people (including sixty-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, fifty-three new cases were dealt with during 1954, 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 been in operation since February, 1950, and continues to be greatly appreciated by all who are concerned with the nursing of the aged in their own homes. Of those assisted, some were awaiting admission to hospital but others, with the help of the service, were able to continue to be cared for at home. Certain of the cases require to be dealt with for short periods only, while others need assistance for a long time. Cleansing.—The Council decided to implement the provisions of section 43 of the London County Council (General Powers) Act, 1953, which gives power to sanitary authorities to make arrangements for the cleansing, including bathing in their own homes, of old people at their own request or with their consent. In suitable cases it was arranged that old people should be taken to the Council's Bathing Station at Lisson Grove, where, in addition to bathing, clothing could be disinfested and cleansed where necessary. For this purpose one of the Department's vans was converted to carry old people to the bathing station, where every facility for providing the service under good conditions in warm and convenient surroundings is available. The bathing and cleansing is under the supervision of one of the women sanitary inspectors, who also accompanies old persons to and from the bathing station. This scheme, which is experimental, came into operation on the 14th December, 1954. Special Sub-Committee.—Early in the year the Public Health Committee appointed a Sub-Committee to consider the position regarding the care and welfare of old people living in the Borough. After considering a summary of the services available to old people and the statutory powers and duties of the Council the Sub-Committee were of the opinion that such services were adequate to cover all the needs of old people but recognised that the diversity of official and voluntary bodies concerned in providing these services demonstrated the desirability of one authority being charged with the responsibility for the care and welfare of the elderly and with the co-ordination of the services. The Sub-Committee recommended that details of the help available to old people should be distributed as widely as possible. Accordingly the Council and the Old People's Welfare Association prepared and sent to local medical practitioners, to hospitals in and near the Borough, and to local clergy, a leaflet containing the following information :— SERVICES AVAILABLE FOR OLD PEOPLE IN ST. MARYLEBONE. GOVERNMENT. National Assistance Board, 177, Tottenham Court Road, W. 1. (Tel. MUS. 7002).—This Office assists old age pensioners whose income is insufficient for their needs, by financial grants and special grants for clothing, blankets, etc. Letters to be addressed to Area Officer. National Health Service.—All old people should be on the list of a doctor. This part of the service is controlled by the London Executive Council, Insurance House, Insurance Street, W.C.I. (Tel. : TER. 2266). A complete list of doctors can be seen at any Post Office, or advice can be obtained from the Public Health Department at the Town Hall. r 8 National Insurance : Local Offices— For Postal Area, W.l For Postal Area, N.W.\. For Postal Area, W.2 and N.W.8 36/38, Berkeley Square, W.l. 194, Euston Road, N.W.I. 5, Praed Street, W.2. Tel. : GRO. 6060. Tel. : EUS. 6451. Tel. : PAD. 3411. LONDON COUNTY COUNCIL. Homes.—Luxborough Lodge, 1, Luxborough Street, W.l. (Tel. : WEL. 5619).—Apply to Admissio11 Officer. As well as other large homes, the L.C.C. also have some small homes for old people in the London Area. Apply through Admission Officer as above. Welfare of the Blind.—This is the responsibility of the L.C.C. Apply to The Welfare of the Blind Department, 5, Princes Row, S.W.I. (Tel. : VIC. 0162, Ext. 22). Mental Illness.—Dealt with at County Hall, Westminister Bridge Road, S.E.I. This service is available for urgent cases at all times. Apply to Duly Authorised Officer. (Tel.". WAT. 5000 Ext. 273). Home Helps Services, Room 91, Town Hall, St. Marylebone, W.l. (Tel. : WEL. 7766, Ext. 30).— The organiser can send domestic helps to old people who by reason of age or infirmity can no longer manage all their own domestic work. ST. MARYLEBONE BOROUGH COUNCIL. Public Health Department, Town Hall, St. Marylebone, W.l. (Tel. : WEL. 7766, Ext. 105).—Miss Sharp, Sanitary Inspector, deals with any public health matters among old people which are brought to her notice. A special laundry service for incontinent old people is run by the Council. Public Baths, Seymour Place, W.l. Monday to Friday up to 4.30 p.m. Old age pensioners pay Id. (soap and towels extra). Holidays.—The Borough Council's grant towards the cost of holidays for old age pensioners is administered by the Old People's Welfare Association. Fuel.—Old people without coal owing to delayed delivery should be reported to the Fuel Officer or to Miss Sharp. The Fuel Officer can give an order to the coalman for priority delivery within 48 hours. Miss Sharp can arrange an immediate delivery of 28 lbs. of coal to tide over until the coalman calls. Other Services.—The Council under various statutory powers (i) may apply to the Courts for Orders for the removal to suitable premises of persons who are suffering from grave chronic diseases or, being aged, infirm or physically incapacitated, are living in insanitary conditions AND are unable to devote to themselves, and are not receiving from other persons, proper care and attention ; (ii) may cleanse verminous or infirm persons at the Cleansing Station in Lisson Grove or, if they are enfeebled, in their homes; and (iii) may undertake burial or cremation of the dead where no other suitable arrangements are being made. VOLUNTARY SOCIETIES. St. Marylebone Old People's Welfare Association.—Room 103, Town Hall, St. Marylebone. (Tel. : WEL. 7766, Ext. 97). Tuesdays and Thursdays 10.30 a.m. to 12.30 p.m. 2.30 to 4.30 p.m. Miss M. K. C. Macintosh, Hon. Secretary. At other times, 38, Clarence Gate Gardens, N.W.I. (Tel. : PAD. 5266). Visiting.—The Old People's Welfare Association has a panel of voluntary visitors, men and women, who pay regular friendly visits to old people. Three of these visitors are liaison officers between the Association and groups of lay visitors attached to churches. This is in addition to the visiting done by the Clergy and Church workers of all denominations. Meals on Wheels. (Dinners).—This service is financed by the Old People's Welfare Association (aided by a grant from the Borough Council and L.C.C.), and operated by the W.V.S. Hot dinners can be taken to the home, price lOd. for two courses. It is at present restricted to the ill or infirm. Apply either to the Old People's Welfare Association or to the W.V.S. W.V.S. Luncheon Club, 196, Marylebone Road, N.W.I.—Old age pensioners can obtain dinners for lOd. from Monday to Friday. Notice to attend must be given to W.V.S. beforehand. Home Nursing.—Paddington and St. Marylebone District Nursing Association, 117, Sutherland Avenue, W.9. (Tel. : CUN. 1462). Chiropody.—A clinic is run by the Old People's Welfare Association and the British Red Cross Society in Room 115, Town Hall, St. Marylebone, W.l, every Tuesday from 10 a.m. to 12.30 p.m. and from 2.15 to 5.15 p.m. Bookings to be made on that day in Room 115, A charge of l/6d. is made, 9 A Home Chiropody Service is also run by the Association, on the first three Thursdays in the month. Bookings to be made with the Secretary, Old People's Welfare Association. A charge of 2/- is made. Clubs.—There are three W.V.S. "Darby and Joan" Clubs:— (1) at 7, Wyndham Place, W.l, on Wednesdays, 2.30 to 4.30 p.m. (2) at 7, Wyndham Place, W.l, on Thursdays, 2.30 to 4.30 p.m. (3) at 139A, Cleveland Street, W.l, on Tuesdays, 2.30 to 4.30 p.m. Other "Darby and Joan" Clubs are:— (4) The Liberal Jewish Women's Club, St. John's Wood Road, N.W.8 (for old people of all denominations) on Wednesdays, 2.30 to 4.00 p.m. (5) The "Inner Wheel" Club on Fridays, 2.30 to 4.30 p.m. in Christ Church Hall, Shroton Street, N.W.I. (6) The Fourth Feathers Club, 28, Mulready Street, Church Street, N.W.8, on Thursdays, 2.30 to 4.30 p.m. This Club is open during the mornings from Monday to Friday between 9.30 a.m. and 12.30 p.m. as a reading and games room. (7) The Barrow Hill Club. Alternate Thursdays, 2.30 to 4.30 p.m. The women's organisations of Churches in the Borough have large numbers of old age pensioners among their members. Women's Voluntary Services, 196, Alarylebone Road, 2V.IF.1. (Tel. : WEL. 8977). Citizen's Advice Bureau, 196, Marylebone Road, N.W.I. (Tel. : WEL. 8614). The Wireless for the Bedridden Society, 55A, Welbeck Street, W.l. (Tel. : WEL. 0949).—Wireless sets can be installed on loan to bedridden or housebound persons, and maintenance paid if necessary. Applications must be backed by some person or agency who has investigated the applicant's financial position. Family Welfare Association, 8, Kensington Park Road, IF.11. (Tel. : PAR. 6683). Sailors' Soldiers' and Airmen's Families Association (S.S.A.F.A.), Room 103, Town Hall, St. Marylebone, W.l. (Tel. : WEL. 7766, Ext. 97).—Mondays, Wednesdays and Fridays, 10.00 a.m. to 12.30 p.m. Salvation Army Headquarters, 236, Portman Buildings, Lisson Grove, N.W.I. (Tel. : PAD. 8553). Church Army, 55, Bryanston Street, W.l. (Tel. : PAD. 9211). British Red Cross Society, 106, Crawford Street, W.l. (Tel. : WEL. 3416). HOMES. St. Marylebone Almshouses, St. John's Wood Terrace, iV.W.8. (Tel. : PRI. 0696).—For St. Marylebone residents of either sex, aged 65 or over and still able-bodied. Applications to the Secretary. Christian Union Almshouses, 21, Crawford Place, W.l. (Tel. : PAD. 7579).—This is a Church of England charity. Applications to the Secretary. Church Army Home for Men, 187, Marylebone Road, N. W. 1. (Tel. : PAD. 6649).—This Home has some beds for old men. Apply Secretary. Church Army Lodging House for Women, 10, Daventry Street, AMF.l. (Tel. : PAD. 4855).—Elderly able-bodied women, still at work, can be admitted, although the hostel is not specially for the aged. The Ladies' Home, 41, Abbey Road, iV.W.8.—For elderly ladies in reduced circumstances. Newstead, 17-19, Greville Place, AT.IF.6.—(Tel. : MAI. 5711). Maintained by the St. Marylebone Old People's Homes, Ltd., for the aged of either sex in need of care and attention. CINEMAS. The following local cinemas admit old age pensioners for 9d. on weekdays (excluding Saturdays) up to 3 p.m.:— The Gaumont, Edgware Road. The Odeon, Edgware Road. The Regal, Harrow Road. 10 The Sub-Committee also found that there was no complete and reliable record of old people in the Borough and that many old people, particularly those living alone, were not known to the official and voluntary bodies interested in their welfare and were probably unaware of the help that was available to them. In an effort to overcome this problem a small leaflet (a copy of which is shown below) was prepared and arrangements made for the leaflets to be handed out to old age pensioners as they drew their allowances at Post Offices in or near the Borough. The willing co-operation and invaluable assistance of the Postmasters and staffs of the Post Offices concerned in making possible such a wide distribution is gratefully acknowledged. TO OLD AGE PENSIONERS LIVING IN ST. MARYLEBONE Do you want help of any kind ? Are you interested in:— VISITORS CLUBS HOME HELPS FOOT TREATMENT DINNERS BROUGHT TO YOUR HOME HOLIDAYS These and many other services are available to all elderly folk who need them. Why not find out about them ? Call, write or 'phone—Miss Margaret Sharp, Public Health Department, Town Hall Extension, Upper Montagu Street, Marylebone Road, W.l. (WELbeck 7766). If you cannot enquire yourself, ask a friend or neighbour to do so for you. Issued by the St. Marylebone Borough Council and the St. Marylebone Old People's Welfare Association. That such a leaflet could solve all the problems of old people or satisfy their needs was not to be expected but, nevertheless, the many enquiries which followed the distribution showed that the information had been welcomed by many old people and, no doubt, many others were comforted in the knowledge that, if the need arose, they knew where to apply for assistance or advice. 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 1954 :— Visiting.—The problem of "ascertainment"—of hearing about lonely Old People before they are in actual trouble—is always with us. The Association hopes to solve it progressively by a further development of the liaison between our service of Friendly Visitors and the parochial work of the clergy of all denominations. During 1954 two more churches adopted the plan successfully initiated some years ago in the combined parishes of All Souls, Langham Place and St. Peter's, Vere Street. The new ones are Christchurch, Shroton Street, and the Presbyterian Church, George Street, through its Good Samaritan League of the City Temple. Each has now appointed a Liaison Officer between its own group of Visitors and our own service. These officers attend our monthly Visitors' Meetings, at which problems are discussed and news and views exchanged. Meals on Wheels.—One outstanding feature of 1954 was the removal of two longstanding anxieties over the Meals on Wheels. The useful life of our van came to its anticipated end in August; but instead of the expected worry over financing the purchase of a new one the emergency found us with the necessary funds in hand. The money came partly from our Flag Day in 1953, but chiefly from a munificent donation of £700 from the Mayor's Local Charities Fund, from the allocation made to St. Marylebone in the final distribution of the Lord Mayor's Air Raid Distress Fund. The new Austin van and its equipment are paid for, and we still have a balance in the Post Office Savings Bank. The van is giving excellent service and our petrol bill has been halved. The second anxiety was to find an alternative source of supply of the meals both for this Service and for the W.V.S. Luncheon Club when the L.C.C. Civic Restaurants closed in the autumn. In the end, with the kind permission of Messrs. Spencer Turner and Boldero Ltd. of Lisson Grove, we were able to make the necessary arrangements with Messrs. Factory Restaurants Ltd., who manage their Works Canteen. They have worked admirably. The meals are excellent in quantity, quality and variety. It has even been possible to supply kosher food. The price remains the same, i.e. l/6d., of which the Old People pay lOd. The L.C.C. has approved the new plan, and continues its subsidy of 8d. per meal. St. Marylebone is fortunate in its W.V.S. in many fields ; but in none 11 more than in the workers who operate this meals service. Once again they found pleasure in giving up hours of their time on Christmas Eve to take round to all their Meals on Wheels patients the Frood Christmas Dinners provided for them free by the generous gift of our President, the Mayor. Holidays.—For a second year the Borough Council made the Association a special grant of £200 to help Old People take holidays. 84 were assisted in this way by the Association and a further 12 by the Barrow Hill Darby and Joan Club at a Guest House which gave them reduced terms through our introduction. Of our 84, 68 went to Brighton for a week in three organised parties ; two in May and one in September. For the remaining 16, individual holidays were arranged. Four of them received help with fares to enable them to stay with relatives. One paid the full cost for herself at a Guest House which gave reduced terms through us. One had to go in August (when these reduced terms do not apply) because he is a school street crossing attendant and could only go during the school holidays. The remaining eleven were all sent for reasons of health. Some were very frail and had to go where special care could be given. All were needing a change but had not had a recent definite illness which would have brought them within the scope of the L.C.C. Recuperative Holiday scheme. All these, like the members of the organised parties, paid £1 10s. Od. but their holidays inevitably cost the Association more than the holidays at ordinary Guest Houses. We spent £40 12s. 5d. from our own funds in addition to the Borough Council's grant. Foot Clinic.-—At the Foot Clinic we started two extra sessions per month in July 1954, and decided to finance them ourselves for the first nine months in anticipation of the hoped-for increase of the grant. During the year, 1,973 treatments were given. There were 80 new patients. Until Christmas these two extra sessions more or less met the demand. There were only 15 names on the waiting list at the end of December. Thereafter the numbers mounted steadily, to the distress of the members of the St. Marylebone Red Cross who do all the administrative work and provide a rota of helpers. If we may anticipate, it became increasingly clear that still more sessions were imperative, and from July 1955, there will be four more each month. The increase in demand began as soon as the Public Health Committee's leaflet began to reach the Old People, but we are glad to think that it is also due to the good reports on our Chiropodists which our patients give their friends . Home Chiropody.—In the Home Chiropody Service 375 treatments were given during the year. There were 36 new patients, 28 women and 8 men. A fourth round each month began in January 1955, which is making it possible to keep the waiting list very small, at least during the summer. It always grows in winter, when some of our more frail Foot Clinic patients are temporarily transferred to the Home Service. Clubs.—The seven Darby and Joan Clubs all continued their active lives and had summer outings and Christmas parties as well as regular Club meetings. Their members love them—if only because " having fun " is an increasingly rare experience as one grows older; and the Clubs are fun. We hope their hard-working Organisers draw some comfort from this thought. Parties and Outings.-—The two Philanthropic Lodges and the Rotary Club gave their usual Christmas parties and Rotary its summer outing. In addition, the Association helped to provide two unusual treats for the residents in the five Voluntary Homes in the Borough. In May the L.C.C. invited ten Old People from St. Marylebone to reserved seats on the South Bank to see the Queen's arrival at Westminister Pier on her return from her tour of the Commonwealth. Two places were allotted to each Home. The Association provided transport and an escort and our Chairman paid for their teas. In spite of very chilly weather the party thoroughly enjoyed their outing. In October the City of London Old People's Welfare Association gave us two lambs out of a consignment of ten carcases sent to the Lord Mayor by a resident of South Australia for London's Old People. We divided them among the five Homes. At the three which have communal meals festive Lamb Luncheon Parties were held and visited by the Mayoress escorted by our Chairman. At the two Almshouses individual portions gaily wrapped in cellophane were distributed. The Association were most grateful to our Chairman for undertaking all the detail work involved. The Smaller Services.—Our smaller services have continued. During the year 31 deliveries were made from our Emergency Fuel Stock; sheets were lent in 22 cases of illness and the loan of wireless sets for 2 more housebound Old People was obtained from the Wireless for the Bedridden Society. Miss Sharp continues to keep under inspection the 14 sets we have now obtained in this way. 12 Home Safety.—All our Visitors were urged to be on the look-out for possible dangers and, as a result, we were able in the course of the year to help in the following ways:—replacing worn ferrules on sticks; providing fireguards; replacing worn-out floor coverings; having gas meters moved to accessible positions; helping with the cost of installing electricity in rooms with no lighting other than lamps or candles; and obtaining reductions in the cost of boot and shoe repairs. We owe this last facility to the kindness of two local firms of boot repairers who give a reduction of 2d. in the shilling to Old Age Pensioners vouched for by us. Staff Medical Examinations.—-The Medical Officer of Health is medical adviser for the purposes of the Council's superannuation scheme. During 1954, one hundred and three examinations of members of the staff and new entrants were carried out. New Legislation.—The following are among the more important Acts, Orders and Regulations affecting the work of the Public Health Department which came into operation :— Act, Order or Regulation Appointed Day L.C.C. (General Powers) Act, 1954 5.7.54 Slaughterhouse Act, 1954 5.7.54 Housing Repairs and Rents Act, 1954 30.8.54 Slaughter of Animals (Amendment) Act, 1954 1.10.54 Poisons List Order, 1954 1.4.54 Food Standards (Margarine) Order, 1954 12.5.54 Mineral Oil in Food (Amendment) Order, 1954 8.8.54 Food Standards (Soft Drinks) (Amendment) Order, 1954 22.8.54 Poisons List (No. 2) Order, 1954 16.9.54 Poisons Rules (No. 2) Order, 1954 16.9.54 Public Health (Aircraft) (Amendment) Regulations, 1954 12.6.54 Public Health (Ships) (Amendment) Regulations, 1954 12.6.54 Rag Flock and other Filling Materials Regulations, 1954 3.8.54 Rent Restrictions Regulations, 1954 30.8.54 Housing Repairs (Increase of Rent) Regulations, 1954 30.8.54 Milk (Special Designation) (Raw Milk) (Amendment) Regulations, 1954 30.9.54 Milk and Dairies (Amendment) Regulations, 1954 30.9.54 Slaughter of Animals (Prevention of Cruelty) Regulations, 1954 1.10.54 Slaughter of Animals (Prevention of Cruelty) (No. 2) Regulations, 1954 1.12.54 Housing (Form of Orders and Notices) (Amendment) Regulations, 1954 17.12.54 Housing (Declaration of Unfitness) Regulations, 1954 17.12.54 Puerperal Pyrexia (Amendment) Regulations, 1954 1,3.55 Poisons Rules, 1954 1.4.54 Rent (Restrictions) Rules, 1954 30.8.54 In addition, the Food and Drugs Amendment Act, 1954 received the Royal Assent on the 25th November, 1954 but the date from which it becomes operative has not yet been fixed. SECTION C.—SANITARY CIRCUMSTANCES. Sanitary Inspection.—The number of complaints received (excluding those relating to rat and mouse infestations) was 1,408. Details of the various nuisances detected and remedied, to the total number of 1,671, are set out in Table 3. In 547 cases a preliminary (intimation) notice was issued, and in 211 instances this was followed by the service of a statutory notice to secure abatement of nuisances. In addition, fifty-two notices were served under London County Council Bye-laws made under the Housing, Metropolis Management or Public Health Acts. Legal proceedings were instituted in twenty-eight cases under the Public Health (London) Act, 1936, in respect of failure to comply with statutory notices. Convictions were obtained in four of these, with the Court making Orders for the work to be done within a specified time and inflicting fines totalling £23 and awarding costs amounting to 14 guineas to the Council. The remaining summonses were either withdrawn or dismissed, the work having been done in the meantime. In respect of these the Council were awarded a further twenty-nine guineas costs. Legal proceedings under County Council Bye-laws were taken in five instances. In one of these the Court made an order for the necessary works to be completed within fifty-six days; two defendants were discharged on payment of four guineas costs each; and two summonses were withdrawn because the work had been completed. 13 TABLE 3.—Nuisances. Nuisance Abated or Defect Remedied Number Houses damp, dirty or dilapidated 462 Doors, windows, floors, ceilings, sash cords, grates and flues, etc., defective 464 Insufficient and unsuitable water-closet accommodation 12 Drain, water-closet and waste pipe stoppages 143 Drains, water-closets and waste pipes defective 131 Yard, area and wash-house defects 13 Roofs, gutters and rainwater pipes defective 243 Insufficient water supplies 31 Water cisterns dirty or defective 25 Ashpits, dustbins, etc., defective 50 Rubbish accumulations 58 Animal nuisances 6 Miscellaneous 33 Total 1,671 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 there was one complaint alleging that the tap water had a peculiar smell. Upon investigation the water was found to be wholesome, although the storage tanks required cleansing. Notice was served upon the owners but the necessary work was done only after the institution of legal proceedings. 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 two cases for non-payment of rates and in the other for waste of water. In all the supply was reinstated, in one instance after service of a 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 1954 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. Twenty-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.—During the year, 318 drainage plans were approved. Forty-six related to new buildings, including three Borough Council housing schemes of three blocks comprising forty-seven flats. At the request of the Medical Officer of Health the drains and/or sewer connections of twenty-one premises were examined by the staff of the Borough Engineer's Department. Defects which called for remedy were discovered at eight premises and at the remaining thirteen the sewer connections were found to be serviceable and fit for continued use. The drainage inspectors made a total of 4,047 visits. Combined Drainage.—Twelve orders under seal for combined drainage were issued. Ventilation of Sewers.—In the last Annual Report reference was made to the interim report of a working party of representatives of the London County Council and the Metropolitan Boroughs' Standing Joint Committee on the causes of complaints of cffensive emanations from sewers and on possible ways of improving conditions. It was considered that adequate ventilation, preferably by a greater number of small ventilators rather than by a few large ones, was needed to disperse the concentrations of gases which are mainly responsible for emanations. It was suggested that this ventilation should be provided by way of the soil pipes of the drainage systems of suitable premises and proposed that, as an experiment, the intercepting chambers of 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 provide effective remedy and might possibly cause nuisance on the municipal properties involved. In their opinion it would be better to ventilate selected lines of sewers, in which there are known to be high concentrations of gases, by obtaining 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 14 views were subsequently conveyed by the Standing Joint Committee to the working party for consideration. No further action was taken on the matter during 1954 but experimental work proceeded in other districts in London and this was kept under observation by the London County Council and the five Borough Councils concerned. The results of these experiments are awaited with interest. A survey of the St. Marylebone Borough Council's sewers was continued by the Borough Engineer and information on the present conditions will be of help when the matter is considered further. Building Licences.—Thirty-four 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. On 10th November, 1954, the Minister of Housing and Local Government freed all building work of control by licence. Public Houses.—Sanitary Accommodation.—Plans were approved for the provision of adequate accommodation in a further five licensed premises and in four of these work was completed during the year. Work in the fifth was proceeding as the year closed. One public house, which was completely destroyed during the war, is to be rebuilt with flats above the licensed premises. Drainage plans for the scheme have been approved. Public Conveniences.—The usual supervision was exercised over the public sanitary conveniences and urinals. There are in the Borough eight conveniences and five urinals for men and five conveniences for women. The free washing scheme, with paper towels and liquid soap, now in its sixth year, which was introduced to encourage personal hygiene and prevent the spread of disease, has become extremely popular with the general public and is a facility which they now appear to expect to find as a matter of course. In spite of the staffing problem, all the conveniences were fully manned during the usual opening hours throughout the year. A new public convenience for men and women, on the Violet Hill Gardens site, was in the course of construction during the year and should be completed and ready for use by the general public in May, 1955. It is proposed not to staff these premises but to arrange for their general cleansing and maintenance by the staff from nearby conveniences. Public Cleansing and Salvage.—The Director of Public Cleansing has kindly provided the following information on these services. The materials dealt with in 1954 were: house and trade refuse 37,179 tons; street sweepings and gully slop, 2,474 tons; salvaged materials (including kitchen waste) 1,564 tons. The sum of £10,267 was obtained from the sale of salvaged materials. In addition, £968 was received for the removal of trade refuse and green offal and for the cleansing of petrol interceptors. As from 8th February, 1954 the Council ceased to collect kitchen waste by direct labour, arrangements having been made for collection of this material to be undertaken by a private contractor on their behalf. At about the same time the street communal kitchen waste bin scheme was also discontinued and the bins withdrawn owing to the high proportion of unsuitable refuse placed in the bins, the relatively low quality and protein value of the waste collected and nuisance caused by animals interfering with the bins. Until the end of March the bulk of the street sweepings and slop collected by the Council was sent to Surridges Wharf at Nine Elms Lane for disposal. Since then, this Wharf having closed down, these materials have been sent to the Westminister City Council's Depot at Gatliff Road, S.W.I. Dustbins.—Following conflicting decisions from time to time reached in the Courts 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, at the request of the Metropolitan Boroughs' Standing Joint Committee, legislation was promoted in the London County Council (General Powers) Act, 1954, amending the law so that sanitary authorities are now empowered to require the owner of premises, and not the occupier, to provide dustbins. In default of the owner, the sanitary authority may supply dustbins and proceed against him to recover the cost. Pet Shops.—The Pet Animals Act, 1951, which came into force on the 1st April, 1952, provides for a system of inspection and annual licensing of pet shops by local authorities, a fee of 10s. being payable in respect of each licence. At the end of the year ten premises remained on the register. Eighteen visits were paid to pet shops by the sanitary inspectors. 16 Diseased or Infirm Persons. -It was necessary to obtain Court Orders for the removal to hospital or a home of seven infirm and physically incapacitated old people (six women, aged 75 to 90 years, and one man of 76 years), who were living alone under insanitary conditions and whose relatives or friends were unable to assist them. This action was taken under the National Assistance Act, 1948, in two cases and under the National Assistance (Amendment) Act, 1951 in five. 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 1954 fourteen burials and three cremations were undertaken by the Council. Disinfestation.—During the year, 436 dwellings (involving 820 rooms) were disinfested, an insecticide based on D.D.T. being used. Included in the number of dwellings treated were eighty-seven requisitioned premises and thirty-nine municipal fiats where bugs were found. Altogether 185 requisitioned dwellings were, on becoming vacant, inspected for evidence of vermin. Treatment of verminous furniture by hydrocyanic acid gas in specially constructed vans, which lias 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 1954 the furniture of seventyeight families (of whom seventy were being rehoused) was dealt with by this method. In addition. 4,158 verminous articles of bedding were disinfested by steam. Verminous Persons.—The Council's Cleansing Station in Lisson Grove dealt with 1,014 verminous persons : adults 641 (men 553, women 88) ; children 373 (boys 58, girls 315). Shelter.—It was not 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 743, and 570 infestations (ship rat 98, common rat 186. mice 286) were discovered. Treatment was carried out by the Council's staff at 570 premises. The scheme of block treatment commenced in 1949 was continued and thirty-one blocks involving 2,118 premises were dealt with. The original programme is nearing completion and by the end of the year only a further 15 blocks were waiting survey. The scheme has proved to be of great value in regard to the control of rats and mice generally and in discovering unreported infestations at places of potential harbourage. The number of rats in the Borough has now reached a relatively low level but mice continue to be troublesome. The known "black spots" will be re-surveyed and given special attention. The work entailed is tedious and non-spectacular and the co-operation of the public and of the business community in the Borough has been most valuable and has played a large part in the success of the block control scheme. For the most part, owners and occupiers have willingly carried out rat proofing work at their premises and have remedied defects. It was only once necessary to take formal action under the Prevention of Damage by Pests Act, 1949 but 72 informal notices were served and 10 statutory notices relating to drainage defects were issued under the Public Health (London) Act, 1936. Routine baiting of sewers again took place in January (at 356 points) and again in June (349 points) when recorded poison " take " was 66 per cent, and 57 per cent, respectively. Dog Nuisance.—Contraventions of the bye-law relating to the fouling of footways by dogs reported by the street nuisance inspector resulted in twenty-four summonses. In all of these, convictions were secured and penalties imposed. 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 1954, six complaints of nuisance from these birds were, after investigation, referred to the pigeon catcher. Noise.—Forty-eight complaints of noise, involving thirty-five premises, were received. Of these, nearly one half alleged nuisance from machinery at factories, and this problem is referred to under the paragraph " Factories " on page 17. The remainder concerned a wide variety of supposed causes. 16 including radio, loudspeaker reproduction from a church, musical instruments, an electricity supply transformer, garages, a club, milk lorries, building and engineering works, pneumatic road drills, noisy tenants, banging doors, dogs and cats. The complaints were not always justified but where upon investigation nuisances were found to exist these were nearly all abated or reduced after informal action by the sanitary inspector or streets nuisance inspector. In some cases the Department was unable to take direct action and the details were referred to other authorities possessing the necessary powers. Atmospheric Pollution.—There were 47 complaints alleging nuisance from smoke, grit or fumes and three hundred and twenty-eight observations and inspections were made. Forty-nine premises were involved and these were of a wide variety of types including commercial undertakings, blocks of flats, a hotel, a nursing home, private dwellings and the two electricity generating stations. The last named still remained a serious problem but in general the nuisances were abated, although sometimes only temporarily, after informal action. This included the giving of advice by the sanitary inspectors on stoking and the best use of boiler house plant at business premises. There was one prosecution for the emission of black smoke from a store in Oxford Street. As the magistrate was not satisfied that there had been negligence by the Company concerned he dismissed the case but said he appreciated the difficulty in proving such negligence. The final report of the Government Committee on Air Pollution, which was published towards the end of November, deals comprehensively with the causes of the many forms of air pollution and submits proposals for remedying the position. Air pollution is shown to be a social and economic evil of the first magnitude which in a year costs £250 million and wastes at least 10 million tons of coal. A "continuous programme urgently and insistently carried out" is essential and the report contains recommendations designed to reduce the smoke in heavily populated areas by 80 per cent, in ten to fifteen years. The Public Health Committee having previously made arrangements to ensure that their Smoke Abatement Sub-Committee should give the report immediate consideration, were able at their December meeting to make positive suggestions as to possible action by the Borough Council. As a result the Council decided among other things (1) to ask the Metropolitan Boroughs' Standing Joint Committee :— (a) to make representations in appropriate quarters that it be made compulsory to fit efficient filters to the exhaust pipes of all motor vehicles. (b) to consider as to the setting up of a Joint Committee in Greater London to cover the whole Metropolitan Police area. (c) to urge that the responsibility for the administration of any new legislation respecting smoke abatement in the County of London should be placed upon the metropolitan borough councils. (2) to invite the boroughs of St. Pancras, Hampstead and Paddington to join them in urging the British Transport Commission to accelerate their plans for modernising the motive power on main lines approaching London termini. (3) to hold a Smoke Abatement Week. Local propaganda to encourage the use of smokeless fuel was continued and the attention of firms having boiler installations was again drawn to the courses of instruction for stokers held at technical schools. The Department of Scientific and Industrial Research having proposed a scheme for increasing the number of instruments for the daily measurement of sulphur dioxide and suspended solids in air in the metropolitan area, the Council decided to co-operate by installing and maintaining two such instruments at points in the Borough in addition to the existing two deposit gauges and three sets of lead peroxide apparatus, which are subject to monthly readings. From the reports published by the Department of Scientific and Industrial Research summarising results it seems that St. Marylebone is not nearly so seriously affected by atmospheric pollution as many other districts. However there is much room for improvement, particularly in the vicinity of the Generating Stations. So far as domestic chimneys are concerned, essentials for the success of any scheme for smoke prevention are an adequate supply of suitable smokeless fuel and sufficient accommodation to store it. The modern tendency to extend the use of oil fuel is giving rise to increasing complaints alleging nuisance from fumes and the smell of oil. It is not always easy to decide how far some of these complaints are justified and to prove a nuisance is frequently very difficult. Nevertheless the owners of suspected oil burning plant have almost invariably shown a ready desire to co-operate and try to remove any cause for complaint. Where adjustment of the burners has not had the desired effect, an improvement has in some instances resulted from the use of " additives " to the fuel oil. 17 Poisons.—The names of seventy-five 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 eighty-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 277 287 41 - Factories with mechanical power 1,283 1,534 139 — Other premises* (excluding out-workers' premises) 145 409 — - Total 1,705 2,230 180 — *Electrical stations, institutions, sites of building operations and works of engineering construction. TABLE 5.—Factories: Defects Found. Particulars Defects †Found † Remedied Referred In respect of which prosecutions were instituted To H.M. Inspector of Factories By H.M. Inspector of Factories Want of cleanliness 198 208 9 3 - Overcrowding 2 2 8 1 — Unreasonable temperature 1 1 — — — Inadequate ventilation 12 15 2 — — Ineffective drainage of floors — — — — — Sanitary conveniences:— (a) insufficient 8 5 — 1 — (b) unsuitable or defective 132 133 — 6 — (c) not separate for sexes 4 6 — — — Other offences (excluding offences relating to outwork) 83 80 228 — — Total 440 450 247 11 — † It will be noted that in some cases the numbers of defects remedied exceed the numbers found. This is due to the fact that many of the defects found towards the end of 1953 were not remedied until 1954. The defects and unsatisfactory conditions found (440) showed a further decrease on the numbers discovered in previous years, and the greater proportion again related to want of cleanliness not only of workrooms but, to a marked degree, of sanitary accommodation. Complaints by residents of noise nuisance from industrial premises again increased during the year. To some extent this may have been due to the wide publicity given by the national press to the problem, with the result that more people have become aware of industrial noise about them. Machinery is being more extensively employed and too often it is sited in totally unsuitable premises. Power factories are being established in otherwise residential premises and the machines fixed directly on to wooden floors without any means of insulation, and no regard is paid to possible noise and vibration that will be caused. Factory occupiers tend to think that insulation is a costly business and do not always appreciate that production often increases when people are able to work in comparatively quiet surroundings. Several manufacturers whom the sanitary inspector has advised on this problem have been impressed by the low cost and resulting benefits. When taking official action on noise nuisance it is sometimes most difficult to determine whether, having regard to the nature of work performed, the amount of noise caused is unreasonable. It seems that legally the volume of noise that can be permitted is decided by the type of work and not by amount of noise actually created. Likewise, noise is often "unreasonable" in its effect upon complainants but 18 is not legally "unreasonable" Members of the public who complain to the department usually expect an official solution but more often than not it is only by unofficial action and the willing co-operation of factory occupiers that some of these difficulties are overcome. Basement workrooms present a special problem. Many of these underground rooms would not be considered fit for human habitation and it is therefore a matter of some surprise and concern that they are let for use as workrooms. It is hoped that legislation will soon be introduced applying standards to underground workrooms at least equal to those of the Underground Room Regulations. Since the end of building control most of the commercial buildings constructed in St. Marylebone have been designed for use as offices and showrooms. By comparison, it is an obvious disadvantage to use premises for manufacturing and industrial purposes as the wear and tear of the building is far greater. However, there is an enormous demand for factory space within the Borough and there is a need for specially constructed factory units of between 2,000 and 3,000 square feet, with adequate and suitable sanitary accommodation, washing facilities and welfare services, the availability of which would reduce the extent of the use of unsuitable premises. It is most difficult to maintain an accurate and complete factory register (as required by section 8 of the principal Act) as, although factory owners must give to Her Majesty's Inspector of Factories at least one month's notice of their intention to occupy a factory, there is often delay in transferring this information to the Borough Council. Section 113 of the principal Act, as amended by section 5 of the 1948, Act, could therefore be usefully further amended by making it an additional requirement that the Borough Council should also receive one month's notice from the owner of his intending occupation. This provision would also assist the Borough Council to prevent contraventions of the Town and Country Planning Acts. It is interesting to note from the 1950 Census of Distribution published recently by the Board of Trade that the wholesale trade turnover of the Borough during that year was £175 million, of which £66 million was for the gown and piece goods trade and £45 million for car parts and office equipment, thus making St. Marylebone one of London's biggest wholesaling boroughs. Out-Workers.—One hundred and thirteen employers submitted lists in respect of a total of 982 outworkers (273 contractors and 709 workpeople). Of these, fifty-seven 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 901 Furs 8 Buttons 32 Umbrellas 3 Household linen 6 Textile weaving 3 Brushes 1 Jewellery 21 Electro-plate 1 Lampshades 4 Artificial flowers 1 Racquet and tennis balls 1 Total 982 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 coir fibre and one of washed rag flock 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. Fireguards.—The Heating Appliances (Fireguards) Act, 1952, came fully into effect on 1st October, 1954, and from that date all domestic heating appliances exposed for sale, sold, or let under a hirepurchase agreement or on hire, must be fitted with a guard complying with the Regulations made under the Act. Thus, heating appliances are now fitted with guards designed to give maximum safety. Previously the only legislation concerned with fireguards was that enacted in 1933 which, in effect, made it an offence to leave a child under the age of 7 years in a room with an open unguarded fire if the child should sustain injury or death through that cause. During 1953 one hundred and ninety-five 19 fatalities were caused through heating appliances, other than open solid fuel fires, in the home and in residential institutions throughout England and Wales. No figures are available to show how many non-fatal accidents were due to the same cause. Legislation designed to reduce this unnecessary toll is therefore most welcome. Danger still exists, however, through the continued use of heating appliances brought into homes and workplaces before the legislation came into force and there must necessarily be a lapse of some years before these appliances are replaced by safer models. Meanwhile the constant propaganda on the part of The Royal Society for the Prevention of Accidents, and advice given by the child health authorities, sanitary inspectors and others on the problems of fireguards in homes and workplaces will be of the greatest value in the endeavour to reduce these appalling accidents and fatalities. One criticism of the Act is that auctioneers can still sell, offer or expose for sale, heating appliances which do not comply with the Regulations unless they do so as agents for a person normally in the business of selling heating appliances. Apart from the administrative difficulties involved, it seems wrong that any such apparatus that does not comply can be sold by auction (which in view of the possibly smaller cost to the purchaser must necessarily make the transaction more attractive) and it is hoped that this provision will be reviewed. The task of enforcing the Regulations, however, has its problems. Apart from frequent difficulty in obtaining power, fuel, or gas supply, etc., at the traders' premises, and the necessity for breaking manufacturers' seals, the full test is a lengthy process and spoils the immaculate new appearance so that in the retailer's opinion the appliance is reduced to second-hand value. Of appliances tested so far, half were below the prescribed standard and traders were told not to sell or otherwise dispose of them until adequate guards had been fitted and approved. An extract of the main provisions of the Regulations was sent for their information and guidance. In the main the greatest offenders against the Regulations are second-hand dealers and frequent visits are necessary to inspect appliances offered or exposed by them for sale. In all cases, however, on receipt of a letter pointing out an offence, vendors have immediately withdrawn appliances from sale, fitted new guards and sought approval before again displaying for sale. In no case, so far, has it been necessary to institute legal proceedings. 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 1954 the Council instituted legal proceedings in twelve cases, in respect of which fines and costs awarded to the Council amounted to £21 18s. 6d. SECTION D.—HOUSING. Permanent Estates.—The Council had provided the following permanent housing accommodation up to the 31st December, 1954 :— 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 (part) 110 Abbey Road/Boundary Road 54 Hamilton Terrace 52 Queen's Terrace (Block 1) 24 35/55, Boundary Road 48 Wellington Road (part) 31 Total 836 20 At the close of the year, the following additional permanent accommodation had reached the stage indicated :— Townshend— No. of Flats Block 8—finishing work in progress 42 Block 7-—site work commenced 28 Block 9—working drawings nearing completion 42 Wellington Road—(121 flats, bank, post office and eight shops) 90 Good progress is being made on three blocks. The shops on the south side were complete and the post office and shops on the north side were in progress. Abercorn Place—including twelve lock-up garages and space for parking six cars ; contract nearing completion 34 33/35, Townshend Road—tenders for this scheme expected to be invited shortly 12 Church Street Extension—approval in principle to the completion of the Church Street Estate was given by the Minister of Housing and Local Government 17/19, Balcombe Street—tenders were received at the close of the year 4 1/7, Aquila Street—tenders were received at the close of the year 6 22/30, Balcombe Street—-working drawings being prepared 14 147/165, Lisson Grove—purchase under negotiation Abercorn Place-Violet Hill—Compulsory Purchase Order made in respect of this site 36 (approx.) Queen's Terrace—Block 2—contract entered into 4 147/149, Gloucester Place (1-room flats)—contract entered into 10 Requisitioned Premises.—The total number of residential units held under requisition was 931, as compared with 967 at the beginning of the year. Factory-Made Bungalows.—Fifty-five families are housed in factory-made bungalows. Inspection of Dwelling-houses during the Year:— (1) (a) Dwelling-houses inspected for housing defects (under Public Health or Housing Acts) 2,124 (b) Inspections made for the purpose 5,462 (2) (a) Dwelling-houses (included under sub-head (1) above) which were inspected and recorded under the Housing Consolidated Regulations, 1925 and 1932 579 (b) Inspections made for the purpose 690 (3) Dwelling-houses found to be in a state so dangerous or injurious to health as to be unfit for human habitation 1 (4) Dwelling-houses (exclusive of those referred to under the preceding sub-head) found not to be in all respects reasonably fit for human habitation 663 Remedy of Defects during the Year without Service of formal Notices:— Defective dwelling-houses rendered fit in consequence of informal action by the Local Authority or their officers 329 Action under Statutory Powers during the Year:— (a).—Proceedings under sections 9, 10 and 16 of the Housing Act, 1936: (1) Dwelling-houses in respect of which notices were served requiring repairs — (2) Dwelling-houses which were rendered fit after service of formal notices: (a) By owners — (b) By Local Authority in default of owners — 21 (b).—Proceedings under Public Health Acts: (1) Dwelling-houses in respect of which notices were served requiring defects to be remedied 264 (2) Dwelling-houses in which defects were remedied after service of formal notices:— (a) By owners 235 (b) By Local Authority in default of owners — (c).—Proceedings under sections 11 and 13 of the Housing Act, 1936 : (1) Dwelling-houses in respect of which Demolition Orders were made — (2) Dwelling-houses demolished in pursuance of Demolition Orders — (d).—Proceedings under section 12 of the Housing Act, 1936: (1) Separate tenements or underground rooms in respect of which Closing Orders were made 65 (2) Closing Orders determined, the tenement or room having been made fit 6 Closing Orders on Houses.—Section 10 of the Local Government (Miscellaneous Provisions) Act, 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 buildings. During the year one such closing order was made on a twelve-roomed house. Underground Rooms.—Closing orders under section 12 of the Housing Act, 1936, were made on sixtyfive rooms, and six orders, involving thirteen rooms, were determined. Re-Housing.—During the year, 459 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. The Medical Officer of Health considered 332 confidential medical certificates submitted in support of applications for re-housing. 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.—Under an arrangement which has operated for the past six years, the London Commissioner of the Cyprus Government, with the object of avoiding possible overcrowding by sponsored immigrants from Cyprus, consulted the Medical Officer of Health on twenty-three occasions regarding the suitability of accommodation offered by Cypriots residing in St. Marylebone to their compatriots. In twenty of these cases (involving thirty-one immigrants) the accommodation was of the standard required by the Housing Act, 1936, but in the other three it was reported that overcrowding would result. Common Lodging Houses.—Seventeen inspections were made of the two lodging houses, one of which is run by the Salvation Army at No. 2, Burne Street and premises in Lisson Street to accommodate 391 men ; the other, conducted by the Church Army at Portman House, No. 10, Daventry Street, is registered for 85 women. 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.—In the first eight months of the year one disrepair certificate only was issued. During the remainder of the year the new procedure under the Housing Repairs and Rents Act, 1954 applied. Housing Repairs and Rents Act, 1954.—This much-publicised Act, which came into operation on the 30th August, 1954, allows the landlord of a dwelling-house subject to rent control to charge a repairs increase after complying with conditions dealing with the state of repair of the house and its suitability for occupation. The Act provides that before charging a repairs increase the landlord must serve notice on the tenant, who can apply to the local authority for a certificate of disrepair on the grounds that the house is not in a state of good repair or reasonably suitable for occupation. The 22 landlord is prevented from obtaining increased rent for the period a certificate of disrepair is in force and must satisfy the local authority that the condition of the house complies with the requirements of the Act before the certificate can be revoked. Applications for certificates were dealt with by the Town Clerk and referred to the Medical Officer of Health for decision. Each application necessitated a visit by the Sanitary Inspector and on his report the Medical Officer of Health was able to recommend the issue or refusal of a certificate. By the end of the year 26 applications had been made by tenants of 11 houses, 22 certificates had been issued and 12 revoked. Although there were fewer applications for certificates of disrepair than might have been expected it is probable that the number of notices of repairs increase served by landlords was also less than expected. Many landlords considered they could not fulfil the requirements necessary before a repairs increase could be obtained and others, no doubt, were awaiting experience of the administration and interpretation of the Act by the courts and local authorities before making a decision. One company with extensive property in the borough was unable to serve notices of repairs increases until late in the year, owing to the amount of work involved in calculating the increases and preparing the notices, and consequently the applications for certificates of disrepair which followed were not made until 1955. SECTION E.—INSPECTION AND SUPERVISION OF FOOD. Food and Drugs Analysis.—Samples of eighty-five different kinds of foodstuffs and twelve 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 the year 1954, 622 samples of foods and drugs were examined. Of these 571 were taken formally and 51 informally. The number adulterated or incorrectly labelled was 46, or 7.3 per cent. The incidence of adulteration may be classified as follows:— Number of samples Number and percentages examined. incorrect. Milk 238 16 (2.5%) Other foods 368 29 (4.6%) Drugs 16 1 (6.25%) Adverse reports were made on two samples of pasteurised milk and 14 samples of hot milk. One sample of pasteurised milk was 5.1 per cent, deficient in fat, and another contained 1 per cent, of added water. One hot milk was found to contain 23 per cent, of added water and was also 37 per cent, deficient in fat, whilst another was 11 per cent, deficient in fat. Ten further samples contained respectively 1, 4, 9, 9, 11, 13, 13, 14, 18 and 25 per cent, of added water, whilst two samples were reported as inferior because they contained 0.6 per cent, and 0.8 per cent, of added water. A sample of unsalted butter was submitted for analysis because a purchaser complained that it was rancid. It possessed a cheesy odour and taste, and analysis showed it to contain 0.7 per cent, acidity calculated as oleic acid and 0.9 per cent, of salt. Although unpleasant, it was not considered to be dangerous and was reported as inferior. Products such as fresh butter can only be made and sold quickly. A sample of margarine contained 16.4 per cent, of water. The Food and Drugs Act, section 32 (1) (b) requires margarine to contain not more than 16 per cent, of water, and this sample therefore contained 2.5 per cent, excess water. Two samples of brie cheese contained respectively 16.9 per cent, fat, equivalent to 39.5 per cent, fat calculated on the dry matter, and 16.7 per cent, fat, equivalent to 41.5 per cent, fat calculated on the dry matter. A sample of camembert cheese (45 per cent, de Matiere Grasse) contained 16.3 per cent, of fat, equivalent to 37.2 per cent, of fat calculated on the dry matter, and was therefore 17 per cent, deficient in milk fat. In this country brie cheese and camembert cheese are generally considered to be full cream milk cheeses and not to be made from partially skimmed milk. A cheese labelled "Double Creme Fromage de Monsieur Fromage, 60 per cent, de Mat. Grasses", was found to contain 60 per cent, of fatty matter but a double cream cheese should contain not less than 65 per cent, of milk fat. A sample of fresh orange drink contained from 1.2 to 2.5 lbs. orange per 10 gallons, and 0.4 to 1.0 mg. of vitamin C. per fl. oz. and .was considered to be at least 50 per cent, deficient in orange and to possess insufficient vitamin C to warrant the description " Fresh Orange Drink". Since 23 the rejected portion of the oranges is generally used for the manufacture of marmalade, which also has to comply with a standard under the Food Standards (Preserves) Order, it is difficult to see how one batch of oranges can supply essential fruit for two different products to comply with different Orders. A seed crescent roll was submitted because of a complaint by the purchaser. It contained a mark due to the presence of mineral oil and vegetable fibres, probably derived from shafting used for plant in making the dough. A sample of brown bread was musty on receipt but, as it was four days old and there was no information regarding the conditions under which it had been kept, it was difficult to make any statement about it. The mustiness had probably been acquired in the bread bin of the complainant. A chelsea bun was submitted because of the complaint that it was so bitter it was inedible. Your analyst ate some but was unable to detect any bitterness. The bun appeared, however, to have been made with unwashed currants and was very gritty ; this may have been partially responsible for making the member of the public complain that the bun was bitter. A complaint was made about the offensive odour of a Christmas cake. The odour emanated essentially from the white icing, and was due to the albumen used in its manufacture. Some of the albumen was examined and found to be of poor quality, but the albumen solution had evidently been made up and allowed to stand for some time before use. A bulletin issued by the Ministry of Health recommends that dried egg should not be mixed with cold water and allowed to stand, but should be used immediately after reconstitution. A sample of marmalade and three samples of gooseberry jam were found to be slightly caramelised and badly crystallised, due to having been boiled down too far in manufacture. The marmalade contained 76.2 per cent, of soluble solids, and the jams 77.2 per cent., 77.0 per cent., and 76.8 per cent, iespectively. The Food Standaids (Preserves) Order, requiies preserves to contain not less than 68.5 per cent, of soluble solids, calculated as sucrose, so that these samples were all approximately 12 per cent, above the minimum figure. Once crystallisation has commenced it spreads rapidly as soon as the preserve is stirred. Some canned strawberries labelled as being in light syrup contained only 16.5 per cent, of sugar in the syrup, whilst the sugar in the fruit was only 15.9 per cent. The Ministry of Food, S. R. & O. 1946, No. 1724 as amended by S. I. 1948, Nos. 397 and 1884, stipulates that home canned strawberries shall be packed in a syrup of not less than 39 Brix, which is a heavy syrup. This is, of course, only binding on home produced goods, but it should be a guide to importers. The strawberries when cooked with added sugar were found to have a very good aroma and flavour, but as packed they were too sour for the British palate. A sample of advocaat was examined because it was alleged to be very bitter and unfit to drink. The sample contained 3.6 per cent, of fat, of which the free fatty acids calculated as oleic acid were 4.4 per cent. The advocaat was bitterish and curdled, probably due to the oxidation and rancidity of the egg at present. Whilst advocaat is a well known drink it is a preparation which requires to be consumed fairly soon after manufacture, and certainly soon after a bottle is opened. Some beef suet contained only 77.1 per cent, of fat whereas according to the Food Standards (Suet) Order, 1952, shredded suet must contain not less than 83 per cent, by weight of beef fat. This sample was therefore 6 per. cent, deficient in fat. A piece of beef steak submitted because a member of the public suspected it to be horseflesh was examined and found to be horseflesh. A sample submitted as beef steak and chips was examined and again the meat consisted of cooked horseflesh. Some pork sausages contained only 50 per cent, of total meat and were therefore 23 per cent, deficient in meat. Pork sausages must contain not less than 65 per cent, of meat. The structure of the flesh of some canned rock lobster was very soft and ill defined. It was probably slightly decomposed before being canned, but had been sterilised during the canning process. A sample of haematinic compound with hog stomach was stated to contain a haematinic compound, but there is no such compound. It was considered that the label should be restricted to the use of the description blood tablets or capsules. A member of the public complained of the unpleasant taste of some sugared almonds. These were examined but only the one which had been in the person's mouth possessed an unpleasant taste. The ash on the sugar was 0.2 per cent, and it not only possessed an unpleasant flavour but the chief constituent of the ash was calcium. This sugared almond must therefore have been placed somewhere where it had been splashed with a calcium chloride brine from a refrigerator or alternatively some person must have contaminated it with calcium chloride brine. Some nutty toffees were examined and out of 12 pieces submitted 3 contained faecal matter from some form of larva, but the actual insect could not be detected. 24 Two samples of chocolate confectionery contained excessive quantities of lead. One contained 12 parts per million and the other 18 parts per million of lead. Chocolate must not contain more than 2 parts per million of lead. The liquid filling of a chocolate sweet had seeped through the base and become mouldy. The remainder of the sample was satisfactory. A sample labelled "spearmint" was made to look like chewing gum but disappeared rapidly in the mouth and was in no way similar to chewing gum. Legislation during 1954. Although the most important piece of food and drug legislation passed during the year was undoubtedly the Food and Drugs Amendment Act, 1954, comment upon it has been omitted as reference to its main provisions is made elsewhere in the Annual Report of the Medical Officer of Health. The Food Standards (Margarine) Order, 1954, made it compulsory to add vitamin A and vitamin D to margarine and prescribed the method for the determination of vitamin A. The Food Standards (Soft Drinks) (Amendment) Order, 1954, permitted soft drinks to be made from fruit juice with or without added sugar and in concentrated or frozen form. During the year all ordinary control Orders relating to the rationing, manufacture, or consumption of foods have been revoked leaving the manufacture and sale more flexible. These revocations, unless controls are introduced under the new Food and Drugs Consolidation Act, may entail greater care before manufacturers are prosecuted or warned.. A report was issued by the Food Standards Committee on Antioxidants in foods and recommended that propyl, octyl or dodecyl gallates or mixtures of these should be permitted up to 0.01 per cent, in edible oils and fats and 0.1 per cent, in essential (that is volatile flavouring) oils. Alternatively butylated hydroxyanisole should be permitted in quantities up to 0.02 and 0.1. per cent, respectively. A fresh report on lead was issued by the Food Standards Committee proposing that a general limit of 0.2 parts per million should be imposed on ready-to-drink beverages and 2.0 parts per million in other foods. Various exceptions to these general limits are suggested and in certain cases, such as food colours and solid pectin, the quantities rise to 20 and 50 parts per million respectively. The Food Standards Committee issued a report suggesting that ready-to-drink beverages should not contain more than 5 parts per million of zinc and that other foods should not contain more than 50 parts per million, but that these limits should be exercised with discretion if it could be proved that the presence of the zinc is a natural occurrence. Although the Minister of Food has stated more than once in Parliament that he does not wish to fix a standard for the meat content of sausages, the Ministry issued a circular showing the average meat content of pork sausages is greater than 65 per cent, and of beef sausages greater than 50 per cent. The Ministry issued a circular drawing the attention of Local Authorities to the use by certain exporters in other countries of thiourea as a fungicide to prevent deterioration in citrus fruits and that this was a contravention of the Public Health (Preservatives etc. in Food) Regulations. The Ministry issued a circular which stated that cream soups should contain either not less than 2£ per cent, of butter fat, or not less than 1£ per cent, of butter fat and not less than 3 per cent, of total edible fat, or not less than 3£ per cent, of edible fat. Food and Drugs Amendment Act, 1954.—This Act, which amends the Food and Drugs Act, 1938 and the Food and Drugs (Milk,Dairies and Artificial Cream) Act, 1950, received the Royal Assent on 25th November, 1954. The Act, with the exception of Section 28 (relating to private slaughterhouses outside London) which is now in force, is to come into operation on such day as the Minister of Food by Order may appoint. The act is arranged in three parts, dealing respectively with matters of composition and labelling and precautions against danger to health: administration and legal proceedings : miscellaneous and general. The following note, which has been prepared by the Town Clerk, summarises the more important provisions affecting the Borough Council:— Section 1 makes it an offence to add any substance to food; to use any substance as an ingredient in the preparation of food ; to abstract any constituent from food; or to subject food to any other process of treatment so as to render the food injurious to health with the intent that the food shall be sold for human consumption in that state. It is also made an offence to sell for human consumption, offer, expose or advertise for sale for human consumption or be in possession of for the purpose of such sale, any food rendered injurious to health by means of any operation described above. 25 By Section 3 the Ministers of Food and Health are empowered to make regulations as to the composition of food ; the use of any process or treatment in preparing food; the sale, consignment or delivery of all food which does not comply with any of the regulations and as to the sale or possession of any specified substance for use in the preparation of food. In exercising their functions under this section the Ministers must have regard to the desirability of restricting so far as practicable the use of substances of no nutritional value as foods or as ingredients of foods. Section 5 deals with the labelling, etc., of food and drugs and extends the powers of the Courts in dealing with labelling offences. Section 6 enables the Ministers to make regulations for securing the observance of sanitary and cleanly conditions and practices in connection with the sale of food for human consumption or the importation, preparation, transport, storage, packaging, wrapping, exposure for sale, service or delivery of food intended for sale or sold for human consumption. Section 7 gives the Court power, on convicting a person for an offence under the foregoing regulations in respect of any catering premises, to make an order disqualifying that person from using those premises as catering premises for a period not exceeding two years. A person subjected to such an order is guilty of an offence if he uses the said premises as catering premises or participates in the management of any business in which the premises are so used by another person, during the currency of the order. Provision is made for revocation of the order on application by the person affected. Section 8 extends Section 14 of the principal Act dealing with the registration of premises used for or in connection with the manufacture and sale of ice cream, sausages and certain preserved foods. Any application for the registration must specify the purpose or purposes for which registration is applied for and all rooms or accommodation in the premises proposed to be used for such purposes. The same premises maybe registered under Section 14 for more than one of the purposes described in this section. The Minister may by order direct that this Section may be extended to other businesses dealing with the sale or preparation for sale or the storage of food. The Minister may make regulations under Section 10 providing for the licensing by local authorities of the use of vehicles, stalls etc. for the sale of food. Section 12 deals with cream substances and makes it an offence to sell or offer or expose for sale for human consumption (a) any substance which resembles cream in appearance but is not cream or (b) any article of food containing such a substance, under a description or designation which includes the word " cream " (whether or not as part of a composite word). This does not apply to reconstituted or imitation cream as long as they are so described. Section 13 provides for the setting up of a food hygiene advisory council which will consist of a chairman appointed by the Minister and such other number of members as the Minister may determine to advise the Minister on matters arising under the Act. Section 25 extends the time within which proceedings for an offence on formal sampling must commence. In the case of a sample of milk the period is still limited to 28 days but in any other case the period is now two months. The penalties imposed by the Act are set out in Section 26 and provide for a fine not exceeding £100 or imprisonment for a term not exceeding 3 months or both and in the case of a continuing offence a further fine not exceeding £5 for each day during which the offence continues after conviction. The penalty imposed under Section 79 of the Food and Drugs Act, 1938 was, in the case of a first offence, a fine not exceeding £20 and in the case of a subsequent offence a fine not exceeding £100 or imprisonment for a term not exceeding three months or both such fine and imprisonment. Milk. — There are 70 premises from which milk is sold, and inspections made numbered 158. During the year, 213 applications under the Milk (Special Designation) (Raw Milk) Regulations, 1949—1954 and the Milk (Special Designation) (Pasteurised and Sterilised Milk) Regulations, 1949— 1953 were received from seventy milk purveyors, and licences were granted as follows:— Tuberculin tested milk 46 dealer's and 13 supplementary Pasteurised milk 1 pasteuriser's, 63 dealer's and 15 supplementary Sterilised milk 1 steriliser's, 59 dealer's and 15 supplementary The average composition of the 223 genuine samples of milk analysed was: total solids 12.46 per cent.; fat 3.70 per cent.; solids not fat 8.76 per cent.; as compared with the legal minima, namely, 11.50 per cent.; 3.00 per cent, and 8.50 per cent, respectively. Thirty-two 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 80 other samples of milk examined by the Council's Bacteriologist, all were found to comply with the requisite standards except one which failed to satisfy the methylene blue test and one which failed the phosphatase test. 26 Butter and Margarine Premises.—Three dealers in margarine and two butter manufacturers are on the register. Seventy-one inspections of the premises were made. Ice-Cream.—The number of premises on the register was 214, which includes three where ice-cream is manufactured ; 195 inspections were made. Preserved Food.—There were 115 shops and other establishments on the register of premises approved for the preparation or manufacture of preserved foods (sausages mainly) intended for sale ; 312 inspections were made and one notice served. Fried Fish Vendors and Fish Curers.—Eleven premises are used by vendors of fried fish and one by a fish curer. Twenty-six inspections of fried fish shops and twenty inspections of the fish curer's premises were made. Two notices were served in respect of fried fish shops. Bakehouses.—There are now only three basement bakehouses left in St. Marylebone. Twenty-five years ago there were forty-nine, and fifty years ago seventy-five. Among the reasons for their gradual disappearance is that since 1904 no new ones have been permitted 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, 147 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 817, including 324 restaurants and snack bars, 48 hotels, 266 staff and club canteens, 118 public houses, 29 other licensed catering establishments, 15 school and nursery canteens, and 6 coffee stalls; 2,723 inspections were made and 40 notices served. For selling as "hot milk" milk containing added water, summonses were issued against nine restaurant proprietors. One defendant who pleaded guilty was discharged absolutely on payment of twentyfive guineas costs, the magistrate saying he accepted the company's explanation of how the offence came to be committed. Others were fined respectively £3 0s. 0d., £2 0s. 0d. and two guineas costs, £1 0s. Od. and three guineas costs and a fifth who pleaded guilty was discharged absolutely on payment of one guinea costs. One defendant was, in addition, fined £3 0s. 0d. for wilful obstruction of the sampling officer. The remainder were discharged absolutely without fines being imposed or costs awarded to the Council. For selling horseflesh as beefsteak a restaurant proprietor, who was also amongst those mentioned above charged with selling " hot milk " containing added water, was fined £5 with five guineas costs. Retail Food Shops.—The inspection of retail food shops continued and 2,526 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, light 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 twelve informal notices. Horseflesh.—Ten visits were paid to the only shop in the Borough selling horseflesh for human food. For selling horseflesh as beefsteak, the proprietor of a restaurant was prosecuted and fined. (See item under Restaurants, etc., above). 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. Eight 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 46 tons of food which included the following : meat and offal, 2 tons 11 cwts. 1 qtr. 10 lbs.; bacon and ham, 8 tons 5 cwts. 1 qtr. 27 lbs.; poultry and game, 4 cwts. 3 qtrs. 9 lbs.; fish, 2 cwts. 3 qtrs. 12 lbs.; fruit and vegetables, 4 cwts. 2 qtrs. 4 lbs.; canned meat, 5 tons 7 cwts. 3 qtrs.; canned food (other than meat), 25,331 cans; miscellaneous, 1 cwt. 3 qtrs. 27 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. 27 St. Marylebone Clean Food Association.—The Executive Committee of the Association (Chairman Mr. H. A. Hale, Hon. Secretary Mr. W. S. Moss, Hon. Treasurer Mr. D. W. Moeran) have kindly provided the following information which is extracted from their report for the year 1954:— " Membership of the Association. During the year 13 applications for membership have been granted and of these 8 were new proprietors of businesses which had changed hands and where the previous owners had also been members. 12 members have withdrawn from the Association, 6 premises having closed down and the remaining 6 had changed hands and the new occupiers have either not yet applied for membership or their applications have been deferred. The total number of members at present registered is 169. Code of Practice. We are again happy to record that no complaints have been made by members of the public alleging the infringment of the Code of Practice by any member of the Association. Food and Drugs Amendment Act 1954. At the last Annual General Meeting mention was made of the Food and Drugs Amendment Bill which was then before Parliament. It was anticipated that the Act would be one of major significance so far as the food trades and food hygiene generally are concerned and, as was suggested by the President in his address, the expectation of far reaching new requirements was bound to have an unsettling effect. So far as the Association is concerned, these considerations have overshadowed the year under review. During its passage through Parliament the Bill received many and sometimes fundamental modifications and when finally it received the Royal Assent at the end of November the long awaited Act proved to be little more than a piece of codifying legislation which empowers the Minister to make regulations. These regulations have still not appeared and meanwhile the Association can do little more than mark time. Although our activities have thus been restricted during the year it is felt that the Association continues fully to justify itself. If all members faithfully adhere to the Code of Practice their standard of hygiene can leave little to be desired and in so doing they will inevitably strengthen the confidence of the public in their own business and enhance the reputation of the Association." 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 1954. Enquiries relating to cases of infectious disease were carried out by one of the women sanitary inspectors who paid 815 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—vears -1 1- 2- 3- 4- 5- 10- 15- 20- 35- 45- 65- Erysipelas 1 - - - - - - - - - - 1 - - 1 Scarlet fever 19 - 1 2 1 1 10 1 2 1 - - - 6 13 Puerperal pyrexia 25 - - - - - - - 1 20 4 - - 24 1 Poliomvelitis— Paralytic 2 - — — — — - — — 1 - 1 - 1 1 Non-paralytic 1 - - - - - 1 - - - - - - 1 - Pneumonia 16 1 - 1 - - 1 1 - - 1 10 1 2 14 Dysentery 63 4 9 9 1 3 3 1 1 4 2 2 24 23 40 Measles 32 2 1 5 3 6 11 2 2 - - - - 1 31 Whooping cough 52 3 1 4 8 9 26 1 — - - - - 3 49 Scabies 20 - - - - 1 4 1 1 8 3 2 - - 20 Meningococcal infection 4 1 - 2 - - - - - - 1 - - 3 1 Malaria 5 - - - - - - - - 4 1 - - 5 - T uberculosis— Pulmonary 60 — 1 1 — — 3 2 3 16 13 16 5 21 39 Non-pulmonary 6 — 1 1 — — - — — 3 — 1 — 5 1 Food poisoning 13 - - - - - - - - 4 3 6 - 1 12 Totals 319 11 14 25 13 20 59 9 10 61 28 39 30 16 223 * There were no cases in the Borough of the following diseases which are also notifiable: Smallpox, diphtheria, membranous croup, cholera, ophthalmia neonatorum, typhoid fever, typhus fever, relapsing fever, continued fever, plague, leprosy, hydrophobia, glanders, farcy, anthrax, induced malaria, acute encephalitis (infective or post-infectious), paratyphoid fever. 28 The Puerperal Pyrexia (Amendment) Regulations, 1954.—These regulations, which come into operation on the 1st March, 1955, amend the principal Regulations made in 1951 by prescribing a new form of certificate for the notification of cases of puerperal pyrexia by medical practitioners. The new form requires the cause of the disease, if known, to be stated and it is hoped this information will help to distinguish those cases where epidemiological action is required. 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 1954, 3,951 applications were dealt with as compared with 3,119 in 1953. 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 two cases and eleven single unrelated cases. (b) Deaths.—None. (c) Organisms or other agents responsible, with number of outbreaks attributable to each.— Salmonella typhi-murium.—Two single cases. Salmonellosis Group " C "—salmonella Thompson.—One single case. Not ascertainable.—The outbreak of two cases and eight 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. Tuberculosis—New Cases and Mortality.—Table 8 contains information with regard to age and sex distribution of, and mortality from, all forms of tuberculosis. TABLE 8.—Tuberculosis: New Cases and Deaths. At ages— years ‡ NEW CASES DEATHS Pulmonary Non-Pulmonary Pulmonary Non-Pulmonary M. F. M. F. M. F. M. F. 0—1 - - - - - - - - 1—5 2 - 1 1 - - - - 5—15 3 2 - - - - - - 15—25 7 10 2 - - - - - 25—35 11 23 1 - - - - - 35—45 14 11 1 - 2 - - - 45—55 14 2 - 1 4 - - - 55—65 8 2 - - 2 - - - 65 and upwards 7 1 — — 1 — — 1 Totals 66 51 5 2 9 — — 1 ‡ Including all primary notifications and also any other new cases of tuberculosis which came to the knowledge of the Medical Officer of Health during the year. Notifications.—Table 7 (p. 27) gives information regarding notifications of pulmonary and nonpulmonary tuberculosis received during the year. Two hundred and twenty-two 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, 1954, was 868. 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 89 cases of scabies: adults 40 (men 31, women 9) ; children 49 (boys 16, girls 33). Ten patients were visited in their homes. Impetigo.—No cases of impetigo were treated at the Cleansing Station. 29 Disinfection.—During the year, 184 rooms and 1,216 articles of bedding (mattresses, blankets, sheets, bolsters, pillows, etc.) together with 1,163 books, were disinfected, and 326 dressing drums from a local hospital were sterilised. The Department continued to be called upon by residents in the Borough to certify that worn clothing intended for despatch to foreign countries was free from infection. Disinfection was carried out only when clothing had actually been in contact with infectious disease but during the year 430 certificates, relating to a total of 6,577 articles, were issued to indicate that no infectious disease had been reported for at least one month at the premises from which the clothing was purported to have come. 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 1 54 55 Haemolytic streptococci — 23 23 Vincent's organisms 27 10 37 Monilia 7 3 10 Vaginal swab for— Trichomonas — 1 1 Sputum for— Tubercle bacilli 4 25 29 Laryngeal swab for— Tubercle bacilli — 5 5 Cough plate for— H. pertussis — 1 1 Faeces for— Parasites 2 2 4 Dysentery and food poisoning organisms 6 135 141 Blood for— Glandular fever — 1 1 Tubercle bacilli — 1 1 Foods for— Food poisoning organisms — 25 25 Urine for— Paratyphoid — 1 1 Totals 47 287 334