STE 40 Metropolitan Borough of Stepnen ANNUAL REPORT For the Year 1935 BY A. FERGUSON, M.B., D.P.H., Medical Officer of Health AND Administrative Tuberculosis Officer TOGETHER WITH THE REPORT OF THE PUBLIC ANALYST. Vail & Co., L.td., Printers to the Council, 170, Farringdon Road, E.C.l. MATERNITY AND CHILD WELFARE COMMITTEE. (November, 1934, to October, 1935.) Chairman: Councillor (Mrs.) L. Frankel. Vice-Chairman: Councillor (Mrs.) A. P. Bunn. The Members of the Public Health Committee. 2 PUBLIC HEALTH COMMITTEE (November, 1934, to October, 1935.) Ex Officio: His Worship The Mayor (Councillor I. M. Vogler, J.P.) Chairman: Councillor (Mrs.) H. Roberts. Vice-Chairman: Councillor (Dr.) M. L. Barst.*^ Alderman H. F. Kober Alderman (Miss) M. Moses, J.P. Councillor (Mrs.) C. Aylward Councillor I. J. Kudish „ (Mrs.) A. Barnes „ (Mrs.) H. Long „ D. J. Berry „ B. G. Purdy (Mrs.) A. P. Bunn „ (Mrs.) H. Rampling „ (Mrs.) R. V. Dubury ,, J. Sambrook „ S. Elsbury „ F. J. Shirley„ „ J. L. Fine, J.P. „ (Mrs.) S. Spicer „ (Mrs.) L. Frankel „ L. Tanaman 3 STAFF OF THE PUBLIC HEALTH DEPARTMENT on the 31st December, 1935. Medical Officer of Health and Administrative Tuberculosis Officer: A. Ferguson, m.b., b.s. (lond.), m.r.c.s., l.r.c.p., d.p.h. Deputy Medical Officer of Health : F. Roantree O'Shiel, l.r.c.p., d.p.h. (Liverpool). Public Analyst: D. Henville, f.i.c. Analytical Assistant: W. M. Paulley, b.a.. f.i.c. Sanitary Inspectors: District. W. E. Anstee. (1, 3) H. J. Green. (1, 2, 4) R. Roper. (3, 4) C. F. Brockett. (3, 4) C. F. Guy. (2) R. Simpson. (1, 4) J. H. Brownlee. (1, 3, 4) W. H. Haworth. (3) W. F. Smith. (2, 4) W. Cue. (1,.3) W. H. Howard. (1, 3) W T. Twynham. (2) R. W. G. Day. (3) S. S. Lowther. (3, 4) R. H. Waterman. (1, 2, 4) G. D. Freeland. (1, 3, 4) J. G. McCarthy. (3) Food. H. Abson. (1, 2, 4) T. W. Dee (2, 4) A. C. Brown. (2, 4) S. Vogler. (3, 4) Others G. Bottomley. (1, 2, 4) Housing and Canal Boats. E. J. Edwards. (2. 4) In charge of disinfestation. †Mies H. A. Whitty. Disinfestation and Female Common (3, 4, 5, 6, 8) Lodging Houses. Clerical Staff: W. F. Lellow, Chief Clerk (2) R. Bach. . M. Fitzgerald, (m. & c.w.) J. McMullon. G. boulton. (m. & c.w.) H. Hiles. (m. & c.w.)M. Pliskin. G. A. Carthy. (m. & c.w. W. P. Howard. P. Romaine. (m.&c.w.) J. J. Coveney. M. w. Hunt. (m. & c.w.) E. P. Simpson. T. W. Dawson. J. Keniry. E. P. Webber. W. J. Dixon. H. T. Kightley. S. Embleton. C. H. Lowry. Vaccination Officers: E. Price. (3) E. J. Robertson. Medical Officers for Maternity and Child Welfare (Part Time): N. Cotter, m.b., b.ch. E. C. Phelps, l.r.c.p., m.r.c.s. D. M. Pullen, m.b., Ch.b. M. Ward, m.b., Ch.b., d.p.h. †Health Visitors: M. Bailey. (5, 6, 7) E. Clements. (5, 6) A. E. Gibbs. (5, 6) D. E. Blackmore. (5, 6, 7) A. Clifford. (5, 6, 7) M. F. E. Styles. (5, 6, 7) W. Brazier. (6, 7) A. M. Cordwell. (1, 6, 8) A. Carty, (5, 6, 7) S. Foucar. (2, 5, 6, 7) Senior Clinical Tuberculosis Officer : W. E. Goss, M.B., Ch.B. (Ed.) Assistant Tuberculosis Officer: E. Harley Stevens, m.b., m.r.c.p., ch.m. Tuberculosis Visitors : M. C. Hurley. (5, 6, 7) M. Prickman. (5, 6, 7) E. Lindsley. (7) M. F. Weatherilt. (5, 6, 7) Nurse Dispensers : M. Coulman. (5, 6, 7, 9), A. O. Jones. (7, 8, 9) Cleric and Secretary to Care Committee : M. Grant. Clerk: P. Goldsmith. Consulting Gynaecologist: R. Christie-Brown, M.B., M.S., F.R.C.S. Dental Surgeon (part-time): F. L. Payne, L.D.S. Ancesthetist (part-time): J. P. Reidy. b.a., m.r.c.s., l.r.c.p. 1. Certificate Royal San. Inst. 5. Health Visitors Certificate. 2. „ San. Insp. Exam. Bd 6. Central Midwives Bd. 3. ,, Royal San. Inst, and San. Insp. 7. State Reg. Nurse. Joint Board. 8. Trained Nurse. 4. ,, Meat and Other Foods. 9. Certificate Soc. of Apothecaries † Also Infant Protection Officers. 4 Public Health Department, 43, White Horse Street, Stepney, London, E. 28th May, 1936. To the Mayor, Aldermen and Councillors of the Metropolitan Borough of Stepney. Your Worship, Ladies and Gentlemen, I have the honour to present to you my annual report upon the health and sanitary conditions of the Borough of Stepney for 1935, this being my third Annual Report. The year has been a momentous and busy one, many important changes in staff having taken place, many new important activities having been started, and several very important new Acts having come into force. I discuss the important changes in staff on page 10 and at this juncture I wish to refer only to the splendid uphill work of the Food Section in its first year and to my very sincere regret at the premature retirement of Sanitary Inspectors Shepherd, Trimming, Harris and Flint. The important new activities were, the completion and opening of the new Tuberculosis Dispensary, the modernisation of the Mortuary by the installation of a refrigeration plant and by the provision of two new post-mortem tables, the establishment of a Bug eradication section under the charge of a specialist Sanitary Inspector, the notification of Measles in children of 5 years of age and under, the provision of Home Helps and of the services of certified midwives as maternity nurses, and the establishment of a new ante-natal clinic in Whitechapel. I refer to each of these new activities elsewhere in this report. The important new acts were the Housing Act 1935 and the Shops Act 1934. The Housing Act 1935 was particularly important in that it led to the survey of the Borough for the purpose of discovering the amount of overcrowding. I refer to this Survey in detail elsewhere and I also give the summary of the results. The Public Health Department helped in the Silver Jubilee and Local Government Centenary Celebrations from the 7th to 15th May by organising 2 stalls of Public Health and Maternity and Child Welfare Exhibits and by arranging a Toddlers' Competition. A Health Week and Exhibition was held during the week 28th October to 2nd November—an account is given elsewhere in this report. 5 Finally I was able to represent one large slum area and 7 small areas. A Local Inquiry was held on the 17th September regarding the large area, upon which the Council had made a Compulsory Purchase Order, and regarding 2 of the small areas, upon which the Council had made Clearance Orders. In due course all these orders were confirmed by the Minister of Health without modifications. Whilst on the subject of slum clearance and Local Inquiries there is one new aspect of the Housing Act 1935 which I would like to mention. Owners may now claim and obtain compensation for "well maintained" houses and it is hoped that this will lead to fewer Local Inquiries which are generally a complete waste of time and money. It is my ambition to obtain a reputation for being perfectly fair in my "colouring" of the slum clearance map and that when I mark a property pink the colouring is always confirmed by the Minister. So far I have been successful, and I hope that owners will come to realise how useless are their objections and to realise that their most paying procedure is to refrain from objecting and only to put in a claim that their property has been well maintained. It is very pleasant to be able to report a great improvement in the Maternal Mortality (6 deaths or 1.9 per 1,000 births as compared with 18 deaths or 5.45 per 1,000 births in 1934) and in the Infant Mortality (191 deaths or 63 per 1,000 births as compared with 288 deaths or 87.2 per 1,000 births in 1934). There were 272 births less than in the previous year and the birth rate decreased from 15.3 to 14.3. The population of Stepney continues to decrease. There was a drop of 3,490 compared with the previous year. This is the first year since the Borough was formed in which no deaths from Measles were recorded. Deaths from all causes numbered 2,393, which is 264 less than last year. Deaths from Pulmonary tuberculosis were 36 less than in the previous year, though there were 2 more deaths from non-pulmonary tuberculosis. There was a big decrease in the deaths from Zymotic diseases. Last year the number of deaths was 204 and this year it was 77. The notifications of infectious disease showed a decrease of 305 over the previous year. There were 372 less cases of Scarlet Fever though there were 29 more cases of Diphtheria. The Borough was quite free from small-pox during the year. 6 There were 32 cases of food poisoning brought to my notice ; an increase of 17 cases over last year. A report on these will be found on page 124. There were 15 new appointments in the Department during the year and I would like to take this opportunity of wishing the newcomers every success in their new posts. Especially do I welcome Dr. Harley Stevens and I congratulate Messrs. Lowther and Brockett on their promotion. We in the Public Health Department were very sorry when Mr. Simpson retired having reached the age of 65 years and having put in 38 years of service and also when Miss Michell resigned. We wish them many years of happy and healthy retirement. I wish to express my warm appreciation of all the help and encouragement I have received throughout the year from all members of the Council and especially from the Chairman and members of the Public Health, the Maternity and Child Welfare and the Housing Committees. Finally, I wish to pay a very special tribute to the members of my staffit would be invidious for me to pick out any special members. I ended my last year's report in a spirit of despondency owing to the occurrence of so much upset of routine due to illness. That despondency continued in 1935- in fact at one time it grew worse. I am particularly grateful to the whole staff for the splendid way in which they carried on in the face of those difficulties. I end this report, however, in a spirit of definite optimism, for the department can now look forward to many years ot uninterrupted routine. I have the honour to be, Your Worship, Ladies and Gentlemen, Your obedient servant, A. Ferguson, Medical Officer of Health. 7 SUMMARY OF STATISTICS, 1935. Area of Borough (in acres) 1902766 Population (1935) (Registrar-General's estimate) 211,500 Number of inhabited houses (end of 1935) according to Rate Books 37,766 Rateable value 31st. December, 1935 £1,737,255 Sum represented by a penny rate £6,913 Total. Male. Female. Birth rate 14.3 Live Births Legitimate 2,920 1,505 1,415 Illegitimate 107 53 54 Still Births 91 52 39 Rate per 1,000 total births 30.0 Deaths 2,393 1,290 1,103 Crude Death rate 11.3 Comparative Death rate 12'8 Number of women dying in, or in consequence of childbirth: From sepsis 1 From other causes 5 The death rate was 1.9 per 1,000 births. Death rate of Infants under one year of age per 1,000 live births: Legitimate 60.9 Illegitimate 121.4 Total death-rate 63.0 Deaths from Measles (all ages) nil „ „ Whooping Cough (all ages) 6 „ „ Diarrhoea (under 2 years of age) 44 ,, „ Respiratory Tuberculosis 147 „ „ Other Tuberculosis Diseases 23 ,, ,, Cancer 333 „ „ Heart Disease 704 „ „ Zymotic diseases 77 I.—STATISTICS AND SOCIAL CONDITIONS OF THE AREA. The estimate of the Registrar-General to the mid-year 1935 is 211,500. Population. The total number of births of Stepney residents during the year was 3,027 —1,558 males and J,469 females—or 272 less than in the previous year. The birth-rate was 14.3 per 1,000 of the population. Births. 8 Births in Public Institutions in the Borough. 4,083 births occurred in Public Institutions in the Borough, of which belonged to Stepney and 1,969 belonged to other Boroughs 1,570 births occurred in the East End Maternity Hospital:— 420 belonged to Stepney, and 1150 to outlying Districts. 771 births occurred in the London Hospital:— 385 belonged to Stepney, and 386 to outlying Districts. '267 births occurred in the St. George-in-the-East Hospital:— 249 belonged to Stepney, and 18 to outlying Districts. 731 births occurred in the Mile End Hospital:— 587 belonged to Stepney, and 144 to outlying Districts. 52 births occurred in the St. Peter's Hospital:— 44 belonged to Stepney, and 8 to outlying Districts. 692 births occurred at 24, Underwood Street:— 284 belonged to Stepney, and 408 to outlying Districts. Births in Outlying Districts. 167 births occurred outside the Borough, the parents being residents of Stepney. Twins. 34 sets of twins were born in the Borough during the year. Notification of Births Act. The Notification of Births Act applies to the notification of any child which is born after the 28th week of pregnancy whether alive or dead. The net number of births notified under the Act was as follows:— Live Births. Still Births. (a) In Institutions 2232 68 (b) At home:— Notified by doctors 82 2 ,, private midwives 160 4 ,, doctors and midwives from Institutions 605 16 „ parents 9 — 3,088 90 Marriages. The total number of marriages which took place during the year was 2,264, or 90 more than in the previous year. The proportion of persons married was 21.4 per 1,000 of the population. 9 The total number of deaths, after deducting deaths of non-residents who died in the Borough and adding those residents who died in Outlying Institutions was 2,393—1,290 males and 1,103 females—or 264 less than in the previous year. Deaths The death-rate for the whole Borough was 11.3 per 1,000 of the population. Deaths in Public Institutions in the Borough. 2,078 deaths occurred in Public Institutions in the Borough, of which 1,330 belonged to Stepney and 748 belonged to other Boroughs. Belonging to Stepney. Belonging to other Boroughs East End Maternity Hospital, Commercial Road 8 13 Princess Elizabeth of York Hospital for Children, Shadwell 29 39 London Hospital, Whitechapel Road 144 538 London Jewish Hospital, Stepney Green 60 32 Mile End Hospital, Bancroft Road 464 50 St. George's Hospital, Raine Street 268 18 St. Peter's Hospital, Vallance Road 329 44 Sick Room Help Society, 24, Underwood Street 7 7 Stepney Institution, South Grove 21 7 There were 414 deaths of persons belonging to the Borough in various Institutions outside the Borough:— Mental Hospitals 81 Hospitals for Infectious Diseases 28 Hospitals and Institutions 305 Deaths in Outlying Districts. In addition there were 19 deaths of Stepney residents in private houses outside the Borough. The Chief Officer of Public Assistance and the Ministry of Labour have kindly supplied me with the following information:— (a) Stepney residents in receipt of domiciliary relief:— 1935. Men. Women. Children. Total. 5th January 2,255 3,140 3,720 9,115 28th December 1,865 2,721 2,539 7,125 1934. 6th January 1,704 2,666 3,018 7,388 29th December 2,159 3,027 3,481 8,667 (b) Number of registered unemployed:— December, 1935 7,833 males and 1,320 females. Total 9,153 1934 10,800 „ „ 3,250 „ „ 14,050 Public Assistance and Unemployment. 10 II.—GENERAL PROVISION OF HEALTH SERVICES. As already stated 1935 was a year of momentous changes not only in the personnel of the staff but also in the organisation of that staff. Formation of a Food Section. Previously, all the sampling and most of the supervision of food premises was performed by the District Sanitary Inspectors. On January 1st the Food Section took over all duties appertaining to sampling and food-stuffs. This section consists of the following Sanitary Inspectors—Messrs. Abson, Dee, Brown and Vogler. Appointment of a Housing Inspector. Mr. Bottomley was appointed as Housing Inspector on 27th February. This appointment was made necessary by the great amount of special work under the Housing Acts which was taking place and which is likely to increase very rapidly. Appointment of a Specialist Inspector for Bug Eradication. Mr. Edwards was appointed to this position on 29th May. This appointment was made necessary by the determination of the Council to eradicate the bed-bug from the existing Council property and to prevent its access to the future property. Plans are prepared for the construction of a Disinfestation Chamber and a start will be made on the building of this chamber early in the new year. Appointment of Two Additional Clerks. These appointments were made in order that the work of the department, greatly increased during the past few years and still increasing, could be carried out satisfactorily. Appointment of a Clerk to the Tuberculosis Dispensaries. Miss Goldsmith was appointed on the 6th August in a temporary capacity pending the opening of the new Tuberculosis Dispensary. In the meantime she was taught the routine of the Notification Register and other routine duties. On December 2nd she took over her duties as clerk to the Dispensaries. Changes MEDICAL. On December 2nd, the date on which the new Tuberculosis' Dispensary was opened for patients, Dr. O'Shiel ceased his part-time duties as Tuberculosis Officer and became a full-time Maternity and Child Welfare Medical Officer and Deputy Medical Officer of Health. Reorganisation of Staff. 11 In future there will be 2 Tuberculosis Officers only—a senior and an assistant. Dr. Kin resigned his post as assistant Tuberculosis Officer on February 3rd on his appointment as Senior Tuberculosis Officer to the Metropolitan Borough of Battersea. Dr. Harley Stevens was appointed and began his duties as Assistant Tuberculosis Officer on the 6th August. Dr. Pritchard was engaged as temporary Tuberculosis Officer from 4th February to 3rd August. Dr. Pullen was appointed as part-time Medical Officer (Maternity and Child Welfare) on 4th June. Other. Retirements. Mr. Shepherd Mr. Trimming Mr. Harris Mr. Flint Mr. Simpson Miss Michell Sanitary Inspector 1st February. „ 1st February. „ 20th July. „ 7th September. „ 31st December. Health Visitor 2nd November. Appointments. Promotions. On 27th February, Messrs. Lowther and Brockett as District Sanitary Inspectors. Other. Mr. Brownlee Mr. Freeland Mr. Howard Mr. Anstee Mr. Cue Miss Clifford Mr. Coveney Mr. Dawson Mr. Simpson Mr. Webber Sanitary Inspector Health Visitor Clerk 8th July, commenced duty. 15th July 15th July 2nd December „ „ 2nd December „ „ 2nd December „ „ 22nd July 29th July 12th August „ 29th July 12 The following is a list of the hospital facilities in the Borough, showing particulars of each:— Situation. No. of beds. In-patients admitted during the year. Out-patients. No. dealt with during the year. Purpose. Management. London Hospital, Whitechapel Road. Male 362 14,717 101,050 General Voluntary. Female 398 Cots and Others 105 Mile End Hospital, Bancroft Road. Male 158 6,616 6,420 General. L.C.C. Female 237 Children 139 Cots 46 St. George-in-the-East Hospital, Raine Street. Male 164 4,314 9,742 General. L.C.C. Female 158 Children 88 5t. Peter's Hospital, Vallance Road. Male 224 3,334 4,895 General. L.C.C. Female 180 South Grove Institution, South Grove. 663 — — Public Assistance. L.C.C. London Jewish Hospital, Stepney Green. Male 41 1,551 15,180 General. Voluntary. Female 51 Children 12 Other 5 Princess Elizabeth of York Hospital for Children, Glamis Road. Children 135 1,679 53,904 General. Voluntary. East End Maternity Hospital, Commercial Road. 56 1,590 328 Maternity Voluntary. Jewish Maternity Hospital, Underwood Street. Maternity beds 34 730 midwifery 17 observation 39 midwifery 663 maternity & infants 313 general nursing Maternity. Voluntary. Observation cots 4 Nursing in the home. The arrangements made with the East London Nursing Society for the nursing of cases of Measles, Pneumonia following Measles, Ophthalmia Neonatorum, Puerperal Fever, Puerperal Pyrexia and Pemphigus Neonatorum were continued. The Council pay this Society 1s. 3d. per visit to such cases and 66 visits were made by them during the year, i.e., 26 Measles, 35 Ophthalmia Neonatorum and 5 Pemphigus Neonatorum. Midwives. There are 9 Midwives practising in the Borough, and in addition there are 29 employed by the voluntary associations. The midwives are under the supervision of the London County Council. Laboratory Facilities. The number of bacteriological examinations made at the Mile End Hospital on behalf of the Public Health Department during the year was 2,545. These consisted of:— No. Positive. No. Negative. Totals Swabs (for Diphtheria bacilli) 263 2,280 2,543 Blood (for Typhoid bacilli) — 1 1 Faeces „ — 1 1 Hospital facilities. There were 459 specimens of sputa examined at the Tuberculosis Dispensaries. 102 of these were found to be positive. NEW TUBERCULOSIS CLINIC—ENTRANCE IN STEEL'S LANE NEW TUBERCULOSIS CLINIC—WAITING ROOM NEW TUBERCULOSIS CLINIC-NURSES' ANTE-ROOM—OPEN DOOR TO CONSULTING ROOM 13 On the 6th November, 1935, His Worship the Mayor (Councillor I. M. Vogler, J.P.) officially opened the new Dispensary in Steel's Lane, the Chairman of the Public Health Committee (Councillor (Mrs.) H. Roberts) being in the chair. Tuberculosis Dispensaries. The Dispensary was opened for patients on December 2nd. The completion of this new dispensary starts a new era in the Tuberculosis Service in Stepney. In future there will be 2 dispensaries only—Steel's Lane, the Main dispensary and Stepney Green, the Branch dispensary. The new dispensary which will serve the greater part of the Borough consists of a large waiting hall, 2 Nurse ante-rooms, 2 consulting rooms, Care-Secretary's room, Clerk's room, Laboratory, Staff room and large Committee room (this room is also used for the Handicraft class). The hours of sessions are as follows (they are provisional and will be altered in the light of experience):— Main. Branch. (Steels Lane). (Stepney Green). Monday 10-12 noon Special Cases 6-8 p.m. Workers 2-5 p.m. Women & Children Tuesday 10-12 noon Men 10-12 noon Women & Children 6-8 p.m. Workers Wednesday 10-12 noon Special Cases Thursday 2-5 p.m. Women & Children 10-12 noon Men Friday 10-12 noon Men 2-5 p.m. Men Saturday 10-12 noon Special Cases The Tuberculosis Care Committee held twenty-four sub-Committee meetings during 1935. After Care. There was no full meeting of the whole committee as no special business arose which could not be dealt with at the respective sub-Committees. Two meetings of the Standing Conference of Metropolitan Borough Tuberculosis Care Committees were held as usual at County Hall, our Care Committee being represented by two members from each sub-Committee and the secretary. 14 There were not so many important items on the agenda for these conferences this year, as several matters concerning the welfare of patients for which the Care Committees have pressed for some years have now been sanctioned by the London County Council. They now give or lend clothing to necessitous patients going to sanatorium when this is not available from charitable sources. They pay small fares to hospitals or sanatoria near London when patients are too poor to pay their own, and when necessary they provide free dental treatment and spectacles for patients receiving residential treatment for tuberculosis. 426 cases came before the Care Committee for consideration during the year, and of these 152 needed help of some kind. As usual, a good deal of this assistance was obtained through the various voluntary charitable organisations and the Public Assistance Committee. The Jewish Board of Guardians again helped many of our patients. They have given clothes, extra relief allowances, help towards the cost of dental treatment, and practically every kind of assistance that was asked for. The Charity Organisation Society paid for the relatives of three patients to have a much needed holiday, and have also helped with clothes, payment for dental treatment, and removal expenses. The United Services Fund and the Red Cross Society have given assistance to ex-service men or their families, and the Invalid Kitchens have helped with dinners or milk and eggs, patients who were not eligible for this from other sources. Four new patients returning from sanatorium have had the loan of Borough Council beds and bedding to enable them to sleep alone, in addition to patients who have had the use of them for several years. The Public Assistance Committee gave clothing and extra help to sixty-two patients or their families and co-operated in dealing with several difficult cases referred to them by the Care Committee. With the small fund which the secretary had in hand the Committee has been able to help several patients for whom there would otherwise have been no response to their appeals, 15 From this Fund six destitute patients at sanatorium were sent small sums of pocket-money.' Work was secured for two ex-patients through advertising in a weekly journal, and a boy of fifteen whose father is in a sanatorium at Lowestoft was enabled to spend his week's summer holiday there and visit his father daily. This boy intended cycling to Lowestoft and sleeping for two nights under the hedges. This seemed a very unsuitable arrangement for a boy of fifteen so we communicated with the matron of the hospital, and the wife of one of the hospital orderlies agreed to give him board and lodging for a week for the small sum of £l. This we paid for him, and by buying him a railway ticket for part of the journey, he was able to cycle the rest of the way in a day. It would have been quite impossible for his mother to pay anything towards his expenses as she has seven dependent children and is in receipt of Public Assistance. The father, who has been in hospital since March, 1934, and cannot read or write, was greatly cheered by his boy's visit. Now that there is no assessing of incomes to be done by the Care Committee a great deal more actual Care and After Care work can be done while we have in hand a small amount of money without which it is impossible to help certain cases needing assistance which cannot be obtained through other societies. The attendance at the Handicraft class has been very satisfactory during 1935. 46 classes were held with an average attendance of 16. New cases continue to come along to whom the class is a welcome means of passing some of their enforced leisure. Handicraft Class. In June a Jumble Sale was held to augment the funds, and at the stall at the Health Week in October much of the work done during the year was disposed of. The work of the ex-service men was again sent to the Imperial Institute Armistice Week Exhibition, and as in former years was practically all sold. Many members of the Care Committee gave valuable help to the secretary during the year and I would like to take this opportunity of thanking them on behalf of the patients whom it has been possible to assist through their generosity. 16 Special Treatment. 17 Children who were contacts of infectious cases of pulmonary tuberculosis were boarded out during the year. The Council has arrangements by which they pay for the attendances of patients undergoing certain forms of treatment at various hospitals as follows: No of Patients. No. of Attendances Finsen Light treatment at the London Hospital 9 146 Pneumo-Thorax Refills at Brompton ,, 1 7 „ „ Victoria Park „ 22 280 ,, „ „ Colindale „ 4 25 „ „ „ Grove Park „ 1 7 „ „ „ Margaret Street,, 1 14 „ „ „ St. George-in-the-East Hospital 7 52 ,, ,, „ St. Andrew's Hospital 1 1 Sanocrysin treatment at Victoria Park Hospital 1 10 Supply of Extra Nourishment. Grants to Tuberculous patients were made on the recommendation of the Tuberculosis Officers for a period of 28 days in the first instance. The grant consists of one and a half pints of Grade A (T.T.) Milk per day, seven eggs per week, and a half pound of butter per week. During the year 337 grants were made to 129 persons, the total cost being £323 13s. 11½d. 17 Memo. 37/T (Revised). Ministry of Health Form T. 145. A. Return showing the work of the Dispensaries for the year 1935:— Diagnosis Pulmonary. Non-Pulmonary. Total Grand Total Adults. Children Adults. Children Adults. Children M. F. M F. M. F. M. F. M. F. M. F. A—New Cases examined during the year (excluding contacts):— (a) Definitely tuberculous 146 66 10 10 12 2 12 10 158 68 22 20 *(b) Diagnosis not completed - - - - - - - - 21 25 17 10 650 (c) Non-tuberculous — — - - — — — — 107 106 54 42 B.—Contacts examined during the year — (a) Definitely tuberculous 3 1 - 1 - - 3 — 3 1 3 1 *(b) Diagnosis not completed - - - - - - - - 3 2 7 8 549 (c) Non-tuberculous - - - - - - - - 91 135 140 155 C.—Cases written off the Dispensary Register as:— (a) Recovered 16 23 9 - 11 1 8 5 27 24 10 5 (b) Non-tuberculous (including any such cases previously diagnosed and entered on the Dispensary Register as tuberculous) - - - - - - - - 217 254 216 214 967 D.—Number of Cases on Dispensary Register on December 31st:— (a) Definitely tuberculous 760 459 91 73 59 52 133 98 819 511 224 171 1,868 (b) Diagnosis not completed — — — — — — — — 37 37 37 32 1. Number of cases on Dispensary Register on January 1st 1,952 2. Number of cases transferred from other areas and cases returned after discharge under Head 3 in previous years 74 i. Number of cases transferred to other areas, cases not desiring further assistance under the scheme, and cases "lost sight of " . 250 4. Cases written off during the year as Dead (all causes) 140 5. Number of attendances at the Dispensary (including Contacts) 6,171 6. Number of Insured Persons under Domiciliary Treatment on the 31st December 578 7. Number of consultations with medical practitioners:— (а) Personal 75 (b) Other 120 8. Number of visits by Tuberculosis Officers to homes (including personal consultations) 198 9. Number of visits by Nurses or Health Visitors to homes for Dispensary purposes 5,548 10. Number of:— (а) Specimens of sputum, etc , examined 581 (b) X-ray examinations made in connection with Dispensary work 196 11. Number of ' Recovered" cases restored to Dispensary Register, and included in A(a) and A(b) above 2 12. Number of "T.B. plus" cases on Dispensary Register on December 31st 795 B. Number of Dispensaries for the treatment of Tuberculosis (excluding centres used only for special forms of treatment):— Provided by the Council 2 Provided by Voluntary Bodies 0 * i.e., remaining undiagnosed on 31st December. 19 Form T145a. (a) PULMONARY TUBERCULOSIS. Supplementary Annual Return showing in summary form (a) the condition at the end of 1935 of all patients remaining on the Dispensary Register; and (b) the reasons for the removal of all cases written off the Register. The Table is arranged according to the years in which the patients were first entered on the Dispensary Register as definite cases of pulmonary tuberculosis, and their classification at that time. Condition at the time of the last record made during the year to which the return relates Previous to 1926 1926 1927 1928 1929 Class T. B. minus Class T.B. plus Class T.B. minus Class T.B. plus Class T.B. minus Class T.B. plus Class T.B. minus Class T.B. plus Class T.B. minus Class T.B. plus Group 1 Group 2 Group 3 Total (Class T.B. plus) Group 1 Group 2 Group 3 Total (Class T.B.plus) Group 1 Group 2 Group 3 Total (Class T.B. plus) Group 1 Group 2 Group 3 Total (Class T.B. plus) Group 1 Group 2 Group 3 Total (Class T.B, plus) (a) Remaining on Dispensary Register on 31st December. Disease Arrested. Adults M. 15 12 8 — 20 1 — — — — 3 — — — — 4 2 6 — 8 9 3 3 — 6 F. 9 8 7 — 15 — — 3 — 3 1 — 1 — 1 2 4 1 — 5 3 6 — — 6 Children 3 1 — — 1 2 — — — — 2 3 — — 3 4 2 — — 2 7 — 1 — 1 Disease not Arrested Adults M. 3 15 12 2 29 1 1 5 1 7 — 5 3 — 8 1 — 4 — 4 5 5 8 1 14 F. 3 6 6 1 13 — — 1 — 1 1 1 4 — 5 — 3 4 — 7 1 9 1 — 3 Children 1 2 — — 2 1 — — — — 1 — — — — 1 — — — — 2 — 1 - 1 Condition not ascertained during the year 24 13 19 — 32 8 5 7 — 12 13 4 2 — 6 20 5 5 — 10 17 7 5 — 12 (b) Not now on Dispensary Register and reasons for removal therefrom. Total on Dispensary Register at 31st December 58 57 52 3 112 13 6 16 1 23 21 13 10 — 23 32 16 20 — 36 44 23 19 1 43 Discharged as Recovered Adults M. 20 11 7 — 18 7 5 — — 5 9 4 — — 4 8 1 2 — 3 6 2 2 — 4 F. 17 23 3 — 26 3 5 — — 5 11 3 1 — 4 5 6 — — 6 12 2 — — 2 Children 7 2 — — 2 4 — — — — 6 2 — — 2 5 5 — — 5 — — — — — Lost sight of, or otherwise removedfromDispensary Register 73 50 34 1 85 6 10 6 — 16 12 10 14 1 25 11 14 8 2 24 22 11 14 1 26 Dead. Adults M. 9 7 22 7 36 5 4 4 1 9 7 4 9 2 15 4 2 7 3 12 11 4 9 2 15 F. 9 6 11 1 18 — — 3 3 6 2 4 3 — 7 4 3 2 1 6 6 5 9 2 16 Children 1 - - - - - - - - - - - - - - - - - - - - - - - - Total written off Dispensary Register. 136 99 77 9 185 26 24 13 4 41 47 27 27 3 57 37 31 19 6 56 57 24 34 5 63 Grand Totals 194 156 129 12 297 39 30 29 5 64 68 40 37 3 80 69 47 39 6 92 101 47 53 6 106 PULMONARY TUBERCULOSIS—continued. Condition at the time of the last record made during the year to which the return relates 1930 1931 1932 1933 1934 1935 Class T.B. minus Class T.B. plus Class T.B. minus Class T.B. plus Class T.B. minus Class T.B. plus Class T.B. minus Class T.B. plus Class T.B. minus Class T.B. plus Class T.B. minus Class T.B. plus Group 1 Group 2 Group 3 Total (Class T.B. plus) Group 1 Group 2 Group 3 Total (Class T.B. plus) Group 1 Group 2 Group 3 Total (Class T.B. plus) Group 1 Group 2 Group 3 Total (Class T.B. plus) Group 1 Group 2 Group 3 Total (Class T.B. plus) Group 1 Group 2 Group 3 Total (Class T.B. plus) (a) Remaining on Dispensary Register on 31st December. Disease Arrested. Adults M. 6 6 5 — 11 7 5 4 — 9 5 4 — 1 5 4 — 1 — 1 — — — — — — - — — — F. 3 7 1 — 8 11 8 6 — 14 4 1 1 — 2 2 1 - - 1 - - - - - - - - - - Children 8 2 - — 2 8 1 — — 1 5 1 — — 1 2 — — — — — — — — — — — — — — Disease not Arrested. Adults M. 4 10 10 2 22 8 8 19 1 28 8 12 33 2 47 20 17 32 4 53 27 29 29 1 59 40 20 59 2 81 F. 4 7 6 — 13 2 6 9 1 16 4 18 13 1 32 17 13 14 1 28 21 11 15 3 29 23 14 19 1 34 Children 1 - - - - 2 - - - - 8 - - - - 9 - - - - 14 2 3 — 5 16 4 1 — 5 Condition not ascertained during the year 17 7 5 1 13 25 4 7 — 11 37 6 8 — 14 21 6 3 — 9 24 6 — 1 7 — — - — — Total on Dispensary Register at 31st December 43 39 27 3 69 63 32 45 2 79 71 42 55 4 101 75 37 50 5 92 86 48 47 5 100 79 38 79 3 120 (b) Not now on Dispensary Register and reasons for removal therefrom. Discharged as Recovered Adults M. F. 1 - - - - - - - - - - - - - - - - - - - - - - - - - - - - - 3 3 - - 3 - - - - - - - - - - - - - - - - - - - - - - - - - Children 1 - - - - - - - - - - - - - - - - - - - - - - - - - - - - - Lost sight of, or otherwise removed from Dispensary Register 19 8 16 3 27 32 18 25 1 44 38 13 21 1 35 40 23 17 2 42 19 4 10 1 15 2 2 1 — 3 Dead Adults M 4 7 10 4 21 7 3 14 10 27 7 9 18 11 38 7 11 20 16 47 5 9 13 27 49 4 1 9 11 21 F. 7 2 6 5 13 6 8 9 3 20 2 6 6 6 18 — 2 10 12 24 — 3 9 6 18 2 — 3 3 6 Children — 2 — — 2 — — — - — 1 1 — — 1 2 1 — 2 3 1 — 1 — 1 — — — 1 1 Total written off Dispensary Register 35 22 32 12 66 45 29 48 14 91 48 29 45 18 92 48 37 47 32 116 25 16 33 34 83 8 3 13 15 31 Grand Totals 78 61 59 15 135 108 61 93 16 170 119 71 100 22 193 123 74 97 37 208 111 64 80 39 183 87 41 92 18 151 20 (b) NON-PULMONARY TUBERCULOSIS. Supplementary Annual Return showing in summary form (a) the condition at the end of 1935 of all patients remaining on the Dispensary Register; and (b) the reasons for the removal of all cases written off the Register. Condition at the time of the last record made during the year to which the return relates. Previous to 1926 1926 1927 1928 1929 Bones and Joints Abdominal Other Organs Peripheral Glands Total Bones and Joints Abdominal Other Organs Peripheral Glands Total Bones and Joints Abdominal Other Organs Peripheral Glands Total Bones and Joints Abdominal Other Organs Peripheral Glands Total Bones and Joints Abdominal Other Organs Peripheral Glands Total (a) Remaining on Dispensary Register on 31st December. Disease Arrested Adults M. 2 — 2 1 5 — — 1 — 1 — — — — — 2 — — — 2 2 — — 1 3 F. — — — 1 1 1 — — 1 2 1 — — — 1 1 — — 1 2 — — — — — Children 10 — 1 1 12 2 1 1 1 5 2 — — 3 5 3 — 1 4 8 3 2 2 4 11 Disease not Arrested Adults M. - - - - - 2 - - - 2 - - - - - - - - - - - - - 1 1 F. 1 - 2 - 3 - - 1 - 1 - - - - - - - - - - - - - - - Children 1 — 1 1 3 — — — 1 1 1 3 1 — 5 2 - 3 2 7 3 1 — 1 5 Condition not ascertained during the year 3 — 2 3 8 1 — — — 1 1 — 2 1 4 2 - — 2 4 3 1 3 2 9 Total on Dispensary Register at 31st December 17 — 8 7 32 6 1 3 3 13 5 3 3 4 15 10 — 4 9 23 11 4 5 9 29 Transferred to Pulmonary - - - - - - - - - - - - - - - - - - - - - - - - - (b) Not now on Dispensary Register and reasons for removal therefrom. Discharged as Recovered Adults M. — — 1 3 4 — 2 — 2 4 1 — — — 1 1 — — 2 3 — 1 — 1 2 F. — — — 1 1 — — 1 1 2 — — — 1 1 — — — - — — — 1 2 3 Children 3 1 2 5 11 3 1 — 3 7 2 1 — 6 8 1 1 — 12 14 3 — — 5 8 Lost sight of, or otherwise removed from Dispensary Register 9 3 4 14 30 2 2 — 4 8 3 1 1 5 10 3 1 2 1 7 6 2 2 2 12 Dead Adults M. — — — 1 1 — — — — — 1 — — — 1 — — 1 — 1 — — 1 — 1 F. - - - - - - - 2 - 2 - - - - - - - - - - - - - - - Children — 1 — 1 2 — — — — — 1 — — 1 2 — — — — — — — — — — Total written off Dispensary Register 12 5 7 25 49 5 5 3 10 23 8 2 1 12 23 5 2 3 15 25 9 3 4 10 26 Grand Totals of (a) and (b) (excluding those transferred to Pulmonary). 29 5 15 32 81 11 6 6 13 36 13 5 4 16 38 15 2 7 24 48 20 7 9 19 55 21 NON-PULMONARY TUBERCULOSIS—continued. Condition at the time of the last record made during the year to which the return relates. 1930 1931 1932 1933 1934 1935 Bones and Joints Abdominal Other Organs Peripheral Glands Total Bones and Joints Abdominal Other Organs Peripheral Glands Total Bones and Joints Abdominal Other Organs Peripheral Glands Total Bones and Joints Abdominal Other Organs Peripheral Glands Total Bones and Joints Abdominal Other Organs Peripheral Glands Total Bones and Joints Abdominal Other Organs Peripheral Glands Total (a) Remaining on Dispensary Register on 31st December. Disease Arrested Adults M. 2 — 1 1 4 1 1 1 1 4 1 1 1 — 3 1 — 2 1 4 - - - - - - - - - - F. 1 — — 1 2 3 — — — 3 — 2 1 — 3 1 — 1 3 5 - - - - - - - - - - Children 4 4 5 13 26 2 1 3 12 18 5 1 1 9 16 — — 1 7 8 — 1 — — 1 — — — — — Disease not Arrested Adults M. - - - - - - - - - - - - - - - - - 1 1 2 3 - 1 — 4 4 1 3 — 8 F. - - - - - - - - - - 1 - - 1 2 1 1 — 1 3 — 2 1 2 5 — — — 1 1 Children 3 — — — 3 — 1 1 — 2 2 1 1 4 8 5 1 1 5 12 4 1 4 9 18 5 — 3 12 20 Condition not ascertained during the year 2 — 4 4 10 4 1 2 4 11 3 — 1 3 7 — — 2 6 8 3 1 1 3 8 - - - - - Total on Dispensary Register at 31st December 12 4 10 19 45 10 4 7 17 38 12 6 5 17 40 8 2 8 24 42 10 5 7 14 36 9 1 6 13 29 Transferred to Pulmonary - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - (b) Not now on Dispensary Register and reasons for removal therefrom. Discharged as Recovered Adults M. 2 — — 2 4 — — — 1 1 - - - - - - - - - - - - - - - - - - - - F. - - - - - - - - - - - - - 1 1 - - - - - - - - - - - - - - - Children 1 — — — 1 1 2 Lost sight of, or otherwise removed from Dispensary Register 2 2 2 5 11 7 1 5 5 18 7 2 — 10 19 2 2 1 9 14 — — 1 5 6 2 — — 1 3 Dead Adults M. — — 1 1 2 — 1 1 — 2 — — — — — — — 1 1 2 1 1 1 — 3 — 3 — — 3 F. - - - - - - - - - - - - - - - - - - - - - - - - - - - 1 — 1 Children — — — 1 1 — — — 1 1 1 — 3 1 5 — — 1 1 2 1 1 2 — 4 — — 3 — 3 Total written off Dispensary Register 5 2 3 9 19 8 4 6 7 25 8 2 3 12 25 2 2 3 11 18 2 2 4 5 13 2 3 4 1 10 Grand Totals of (a) and (b) (excluding those transferred to Pulmonary) 17 6 13 28 64 18 8 13 24 63 20 8 8 29 65 10 4 11 35 60 12 7 11 19 49 11 4 10 14 39 22 23 The following is a copy of the Report on Health Week which I submitted to the Public Health Committee:— Health Week. With the exception of a cinemotor which gave displays at street corners throughout the Borough, all the activities were concentrated at the Whitechapel Art Gallery in the form of a Health Exhibition. The Exhibition was opened by His Worship the Mayor (Councillor I. M. Vogler, J.P.) on Monday evening, the 28th October in the presence of an audience of about 300 persons. The Chairman was Councillor (Mrs.) Roberts, and the other speakers, in order of speaking, were Councillors (Dr.) Barst, Fine and (Mrs.) Bunn, and Alderman (Miss) Moses, J.P. The activities at the Art Gallery were:— (A) The Exhibition proper. (B) Health Lectures. (C) Talks to School Children. (D) Cooking Demonstrations. A. The Exhibition. This was confined to the ground floor and consisted of stalls, tables, or spaces which were devoted to definite public health subjects and to trades which have a bearing on the health and comfort of the community; this year more space was given to the former and less to the latter. The stalls devoted to public health subjects were:— (1) General Sanitation. (Sanitary Inspectors.) (2) Food Inspection. (Food Inspectors.) (3) Pestology. (Bug specialist and Sanitary Inspectors.) (4) Maternity and Child Welfare. (Health Visitors.) (5) Housing and traffic control. (Borough Engineer and Surveyor.) (6) Public Cleansing. (Public Cleansing Officer.) (7) Literature on health matters. (2 tables by Public Health Department clerks.) (8) Maternity and Child Welfare. (Voluntary Organisations.) (9) Tuberculosis. (National Association for the Prevention of Tuberculosis.) (10) Venereal Disease. (British Social Hygiene Council.) (11) Cleanliness. (Health and Cleanliness Council.) (12) Dental Hygiene. (Dental Board of the United Kingdom.) These stalls were all presided over by experts who answered questions and gave short talks upon their particular subjects. 24 The stalls devoted to trades and other concerns which have a bearing on health and comfort were:— (1) Electricity. (Borough Electrical Engineer and Manager.) (2) Foam Baths. (Central Baths Superintendent.) (3) Milk. (National Milk Publicity Council.) (4) Dried Milk. (Cow and Gate, Ltd.) (5) Dried Milk. (Ambrosia, Ltd.) (6) Gas. (Commercial Gas Company.) (7) Ovaltine. (A. Wander, Ltd.) (8) Fumigants. (British Fumigants Company, Ltd.) (9) Brown bread. (Hovis, Ltd.) (10) Tower Hill Improvement Scheme. These stalls comprised a good selection of such concerns for a health exhibition. There was one other stall—exhibits of work done by the Borough Handicraft Class, the exhibits being for sale. This was presided over by the Care Committee Secretary, helped by the Tuberculosis Visitors and voluntary workers. The Exhibition was attractively laid out and there was plenty of room for those who came to see and learn. I am confident that good value was obtained from this Exhibition, and it would be invidious for me to pick out any particular stall. I would like to mention, however, that the pestology stall, together with the Chairman's remarks at the opening, must have helped in no small way to a production of " bug-mindedness " in the Borough. All the stalls were well patronised and the supervisors were kept busy throughout the whole week. B.—Health Lectures. The following lectures were given in the upper hall of the Art Gallery:— " Happy Childhood " by Dr. Browne Kutschbach. " Nutrition " by Dr. Sloan Chesser. " Cancer " by Dr. Cramer. " Tuberculosis " by Dr. Harley Williams. " Venereal Disease " by Dr. Forgan. These lectures were well attended by very attentive audiences who showed by their questions and their applause their keenness to learn and their appreciation of the lectures. After each lecture a cinema film was shown indicating some public health activity. 25 C.—Talks to School Children. This was a feature which was introduced into a Stepney Health Week for the first time. It was a huge success and the talks were very much appreciated by both children and teachers. It was possible to cater only for certain children over the age of 13 years owing to the limited time at our disposal. Unfortunately, it was impossible, owing to half-term holidays in the schools, to arrange for a proper representation from all schools in the Borough. The talks were attended by 915 children, and I wish to pay a special tribute to Mr. Lellow for the care and attention he gave to the very intricate problem of arranging parties of children from all over the Borough, not only to meet at the proper time at the Art Gallery, but to pass from stall to stall in a properly organised manner. Talks were given at the following stalls:— General Sanitation—by the Sanitary Inspectors. Food Inspection—by the Food Inspectors. Pestology—by the Specialist Inspectors. Maternity and Child Welfare—by the Health Visitors. Dental Hygiene—by an expert from the Dental Board. After the talks a short time was given to each party of children to have a further look at the various exhibits. D.—Cooking Demonstrations. These were given each afternoon in the upper hall by Miss Lees of the National Milk Publicity Council. The attendances reached only 220 persons, but Miss Lees considered that though few in number they were very keen and that the demonstration had served a very useful purpose. Record of Attendances. At the Exhibition. Evening Lectures. Talks to School Children. Cooking Demonstrations. Cinemotor. Monday, 28th Oct. 1,157* — — — 600 Tuesday, 29th „ 4,090 350 — 30 1,000 Wednesday,30th „ 3,480 420 370 30 650 Thursday, 31st „ 1,962 400 306 20 400 Friday, 1st Nov. 3,262 430 239 60 350 Saturday, 2nd „ 4,384 450 — 80 — Totals 18,335 2,050 915 220 3,000 *Of these 300 were at the opening ceremony. 26 SUMMARY OF WORK DONE AT THE DENTAL CLINIC—(a) TUBERCULOSIS. Particulars of Patients. Number of Fillings. Number of Scalings. Extraction Cases. Dentures Number of Dressings. Number for Advice. Denture Visits. Number of New Patients. Number of Attendances. Simple. .. Root. Without Anaesthetic. Local Administrations. Gas Administrations. Number of Teeth Extracted. Upper. Lower. Re-models Repairs. Women 131 5 — 11 — 1 24 130 11 9 — 4 6 23 71 13 Children – – – – – – – – – – – – – – – – Men 95 — — 6 — 2 15 97 7 6 — 4 1 16 67 10 Total 226 5 — 17 — 3 39 227 18 15 — 8 7 39 138 23 No. of Ordinary sessions held 11 No. of Gas „ „ 13 (b) MATERNITY. Women 866 40 — 103 — 48 358 954 61 57 2 14 6 143 380 101 Children 46 2 — — — 5 37 64 – – – – – 23 — 23 Total 912 42 — 103 — 53 395 1018 61 57 2 14 6 166 380 124 No. of Ordinary sessions held 27 No. of gas „ „ 26 27 (Form M.C.W. 96 revised) Maternity and Child Welfare. Return (1) showing the arrangements made for maternity and child welfare Maternity by the Council and by Voluntary Associations providing maternity and child and Child welfare services in respect of which the Council pay contributions under Section services 101 of the Local Government Act, 1929, or otherwise; and (2) giving particulars of the work done during the year 1935. 1.—Population of the area served by the Council:—211,500. 2.—Number of births notified in that area during the year under the Notification of Births Act, 1907, as adjusted by any transferred notifications: (a) Live births, 3,088. (b) Still births, 90. (c) Total, 3,178. (d) By midwives, 2,818. (e) By doctors and parents, 360. 3.—Health Visiting. (i) Number of officers employed for health visiting at the end of the year: (a) by the Council 10. (b) by Voluntary Associations, 15. (ii) Equivalent of whole-time services devoted by the whole staff to health visiting (including attendance at infant welfare centres):— (a) in the case of Health Visitors employed by the Council, 10. (b) in the case of Health Visitors employed by Voluntary Associations, 14.5. (iii) Number of visits paid during the year by all Health Visitors:— (a) to expectant mothers:—First visits, 1,338. Total visits, 2,060. (b) to children under 1 year of age:—First visits, 2,796. Total visits, 19,810. (c) to children between the ages of 1 and 5 years:—Total visits, 37,491. 4.—Infant Welfare Centres. (a) Number of Centres provided and maintained by the Council, 7. (b) Number of Centres provided and maintained by Voluntary tions, 9. (c) Total number of attendances at all Centres during the year:— (i) by children under 1 year of age, 32,765. (ii) by children between the ages of 1 and 5 years, 23,187. (d) Total number of children who first attended at the Centres during the year and who, on the date of their first attendance, were : (i) under 1 year of age, 2,396. (ii) between the ages of 1 and 5 years, 397. (e) Total number of children under 5 years who attended at the Centres during the year and who, at the end of the year, were : (i) under 1 year of age, 2,320. (ii) over 1 year of age, 3,847. 28 (f) Percentage of notified live births represented by the number in (d) (i), 77.59. 5.—Ante-natal and Post-natal Services. (a) Ante-natal and Post-natal Clinics (whether held at Infant Welfare Centres or at other premises):— (i) Number of Clinics provided and maintained Ante-natal. Post-natal. by the Council 2 2 (ii) Number of Clinics provided and maintained by Voluntary Associations 3 2 (iii) Total number of attendances at all Clinics during the year 24,231 1,423 (iv) Total number of women who attended at the Clinics during the year* 6,476 1,396 (b) Total number of expectant mothers natally examined and of cases post-natally examined during the year, under arrangements made by the Council with private medical practitioners, excluding cases included under 5 (a) (iv) nil. nil. (c) Percentage of total notified births (live and still) represented by the total numbers of women shown under 5 (a) (iv) and 5 (b) — — *Figures in 5 (a) (iv) include women not residing in Stepney. 6.—Supply of Milk and Food. Terms of Supply. Milk. Meals supplied at Dining Centres. Other Food. Expectant mothers. Nursing mothers. Children under 5 years of age. Expectant mothers. Nursing mothers. Children under 5 years of age. Expectant mothers. Nursing mothers. Children under 5 years of age. Free, or at less than cost price, in necessitous cases. Yes Yes Yes Yes Yes Yes Yes Yes Yes At cost price in other cases (e.g., sale of dried milk at Centres) Yes Yes Yes No. No. No. Yes Yes Yes 7.—Maternity Homes and Hospitals. I. Separate maternity institutions provided by the Council Institutions (with maternity wards) transferred to the Council under Part I of the Local Government Act, 1929. Institutions provided by Voluntary Associations and subsidised by the Council. Number of Institutions nil nil The council make a frant of £100 per annum to the East End Maternity Hospital. Number of maternity beds (exclusive of isolation and labour beds) nil nil 1 Total number of women admitted to these beds during the year nil nil 24 II. Number of women (if any) sent by the Council during the year to other Maternity Institutions, nil. 8.—Homes and Hospitals for Sick or Ailing Children under 5 years of age. 29 I. Separate Institutions provided by the Council for these cases. Institutions (with accommodation for these cases) transferred to the Council under Part I of the Local Government Act, 1929. Institutions provided by Voluntary Associations and subsidised by the Council. Number of Institutions nil nil nil Number of beds provided for such children nil nil nil Total number of children admitted to these beds during the year nil nil nil II. Number of such children (if any) sent by the Council during the year to other institutions, 4. 9.—Convalescent Homes. (a) Number of convalescent institutions with accommodation for expectant or nursing mothers or children under 5 years of age:— (i) provided by the Council nil (ii) provided by Voluntary Associations 1 (b) Number of beds for such cases in convalescent institutions:— (i) provided by the Council nil (ii) provided by Voluntary Associations 12 (c) Total number of cases admitted to the beds included in (b) during the year, 134. (d) Total number of such cases sent by the Council during the year to other convalescent institutions, 121 (389 sent by voluntary associations). 10.—Homes for Mothers and Babies. (a) Number of such homes:— (i) provided by the Council nil (ii) provided by Voluntary Associations nil (b) Number of beds in homes:— (i) provided by the Council nil (ii) provided by Voluntary Associations nil (c) Number of:— (i) maternity beds (exclusive of isolation and labour beds) included under (b) (i) or (ii) above nil (ii) women admitted to these maternity beds during the year nil (d) Total number of cases admitted to these homes during the year (i) expectant mothers nil (ii) mothers and babies nil (iii) babies nil 30 (e) Total number of such cases sent by the Council during the year to other homes for mothers and babies nil 11.—Day Nurseries. (a) Number of day nurseries:— (i) provided by the Council nil (ii) provided by Voluntary Associations 5 (b) Number of places for children under 5 years of age in the nurseries:— (i) provided by the Council nil (ii) provided by Voluntary Associations 197 (c) Total number of attendances of children at these nurseries during the year, 35,624. 12.—Infectious Diseases. Disease. Number of cases notified during the year. Number of cases visited by officers of the Council. Number of cases for whom home nursing was provided by the Council. Number of cases removed to hospitals. (1) Ophthalmia Neonatorum *6 6 1 6 (2) Pemphigus Neonatorum — 1 1 — (3) Puerperal fever 11 11 — 10 (4) Puerperal pyrexia 27 27 — 27 (5) Measles and German measles (in children under 5 years of age) 89 128 1 63 (6) Whooping Cough (do.) — — — — (7) Epidemic Diarrhoea (do.) — — — — (8) Poliomyelitis (do.) 2 — — 2 *Number of cases in which vision was unimpaired 2, impaired—, or lost— „ „ „ the patient died 1, removed from district 2, or was still under treatment at the end of the year 1 „ „ any other category— 13.—Home Nursing. (a) Number of nurses employed at the end of the year for the nursing of expectant mothers and children under 5 years of age, maternity nursing, or the nursing of puerperal fever:— (i) by the Council nil (ii) by Voluntary Associations 2 (b) Total number of cases attended during the year by these nurses, 663. 31 14.—Consultants. Number of cases in which the services of a consultant have been provided during the year for a private medical practitioner under the Council's maternity arrangements nil 15.—Home Helps. Number of cases in which home helps have been provided during the year (the numbers of cases where this assistance has been given by Voluntary Agencies, by arrangement with the Council, should, if possible, be stated separately) nil 16.—Midwives. I. (a) Number practising in the area served by the Council for maternity and child welfare at the end of the year 9 (b) Number (i) employed by the Council nil (ii) directly subsidised by the Council nil (iii) employed by Voluntary Associations 29 (c) Number of cases during the year in which the Council paid or contributed to the fee of a midwife nil 17.—Maternal Deaths. (a) Number of women who died in, or in consequence of, childbirth in the area served by the Council for maternity and child welfare during the year:— (i) from sepsis 1 (ii) from other causes 5 (b) Number of these cases which died:— (i) at home nil (ii) in institutions 6 18.—Administration of Part I. of the Children Act, 1908, as amended by Part V. of the Children and Young Persons Act, 1932. (a) Number of persons on the Register who were receiving children for reward at the end of the year 22 (b) Number of children on the Register:— (i) at the end of the year 24 (ii) who died during the year nil (iii) on whom inquests were held during the year nil 32 (c) Number of Infant Protection Visitors at the end of the year who were:— (i) Health Visitors 10 (ii) Female, other than Health Visitors 1 (iii) Male nil (d) Number of persons (in addition to or in lieu of Visitors under (c) above) or societies authorised to visit under the proviso to Section 2 (2) of the Act of 1908 nil (e) Proceedings taken during the year:— No. of cases. Act and Section under which proceedings were taken. 1 Section 7, Part 1, Children Act 1908. (f) Number of cases in which the local authority has given a sanction during the year:— (i) under (a) of Section 3 of the Act of 1908 nil (ii) „ (b) „ „ „ nil (iii) „ (c) „ „ „ nil (g) Number of orders obtained during the year under Section 67 of the Act of 1932 (i) from a court of summary jurisdiction nil (ii) from a single Justice 1 Feeding Of Infants. Breast fed 2,630 Artificially fed 166 No. of infants dead before the visit of Health Visitor 65 „ removed before the visit of the Health Visitor 92 Maternity Outfits. Two sterilized maternity outfits were supplied at cost price through the Municipal Ante-natal Clinic. 33 Health Visiting. There are 7 Municipal Infant Welfare Centres and 9 Voluntary Centres in the Borough. Details of the work of the Health Visitors and Centres are given on pages 35 and 36. Prevention of Deafness. Six cases received treatment under the arrangements with the London County Council for the treatment of children, suffering from ear defects. Convalescent Treatment. During the year, mothers and children were sent away to the homes mentioned below:— Home. Mothers. Children. St. Mary's, Dover 31 43 All Saints' Convalescent Home, Eastbourne 5 42 36 85 Provision of Milk and Meals to Expectant and Nursing Mothers and to Children. The following table shows the approximate quantity and cost of milk, etc., distributed during the year:— No. of Grants. Quantity. Cost. Cows' Milk— £ s. d. Free 9,672 33,03¼ gals. 3,383 13 11 Half-Price 194 669¼ „ 32 19 11½ Dried— Free 2,593 10,668 packets. 854 17 4 Half-Price 42 178 „ 7 4 6 Virol, etc.— Free 2,731 2,636¼ lbs. 178 15 10 Half-Price 34 33¼ „ 1 2 9½ Total 15,266 33,704½ gals. 10,846 packets 2,669¾ lbs. £4,458 14 4 The number of dinners supplied by the Stepney Invalid Kitchen, White Horse Street, on the grounds of health, to expectant and nursing mothers who are in necessitous circumstances, was 2,210, at a cost to the Council of £55 5s. 0d. 34 Infant Life Protection. It is still extremely difficult to find in this Borough a sufficient number of really suitable women with satisfactory home conditions who are willing to act as foster-mothers. Most of the nurse children already under supervision have maintained a very fair standard of health and well being in spite of the fact that some are not housed in really ideal homes. In some cases the parents do not keep up regular payments and there are cases where the payments have stopped altogether. Without exception no foster-mother during this past year has given up her charge on that account. Periodical visits are continued in every case and the children have not lacked proper care and attention from the foster mother. It has not been found possible to bring into practice any scheme whereby assistance could be given towards the payment of foster mothers' fees owing to the many pitfalls and difficulties associated. 35 HEALTH VISITORS' REPORT. DISTRICT Whitechapel, S. St. George's, W Tower. Mile End, N.W. Spitalfields. Whitechapel, M Mile End, W. and part S. Whitechapel, E. Limehouse, S. Ratcliff, S. St. George's, N and part S. Shad well, N. Mile End. S.E. Mile End, N.E., part N. part S. Mile End, C. Limehouse, N.W. Whitechapel and Spitalfields Whitechapel, E Mile End, W. and part S. Limehouse, N. Ratcliffe, N. Mile End, part S. Wapping Shadwell, S.W. NAME Miss Bailey Miss Blackmore Miss Brazier Miss Carty Miss Clements Miss Cordwell Miss Foucar Miss Gibbs Miss Michell Miss Peverett (3 months temporary) Miss Styles Miss A. Clifford Total Visits:— Primary 353 400 208 245 277 210 349 306 89 7 321 31 2,796 Revisits:– To infants under 1 year 261 334 241 504 385 750 553 677 417 3 580 42 4,747 To Children between l-5 years 845 771 435 1,184 1,044 1,018 1,156 1,350 554 19 1,328 72 9,776 Ante-natal:– Primary 23 140 61 3 57 54 56 32 26 – 24 2 478 Subsequent 3 11 — — — 2 1 2 38 3 6 66 Ophthalmia Neonatoum — 3 1 — — — — – – – – – 4 Puerpeal Fever — 4 1 — — 1 1 — — – 1 — 8 „ Pyrexia 3 4 — 1 3 — 7 2 4 – 24 Measle 8 11 3 5 10 12 10 31 – – 8 1 99 „ Revisits – 1 — 1 — — — — – – 1 – 3 Miscellaneous 533 810 588 335 431 519 487 312 316 35 142 104 4,612 Totals 2,029 2,489 1,538 2,278 2,207 2,566 2,620 2,712 1,440 64 2,412 258 22,613 CENTRES ATTENDED:— Municipal 230 230 101 199 205 118 133 37 143 2 175 13 1,586 Voluntary 2 – 3 — — 12 95 115 – – – – 227 Totals 232 230 104 199 205 130 228 152 143 2 175 13 1,813 Visits by Health Visitors. 36 Municipal Details of the work at the Municipal Centres will be seen in the following centres. table. MUNICIPAL CENTRES. Limehouse. Mile End. St. George's. Spitalfields. Wapping. Whitechapel. Total. Mile End Road Burdett Road Mon. Wed. Thurs. Thurs. Wed. Tues. Fri. Tues. Thurs. Tues. Fri. Wed. No. of Sessions (total) 48 50 — 51 51 53 51 62 51 53 50 51 561 „ Attendances of Infants 1,308 1,334 — 1,561 1,998 1,656 1,176 673 1,585 1,429 204 1,009 13,933 „ „ Children 1 to 5 978 1,032 — 1,286 995 1,358 1,022 417 1,262 817 135 819 10,121 „ Infants on Registers at end of the year 1258 — 1,167 746 1,732 968 778 720 7,369 „ Children on Registers at end of the year 1918 — 1,092 644 1,092 1,475 700 500 7,838 „ Ante-Natal Sessions — — 50 — — — — 20 — — — — 70 „ „ New Cases — — 127 — — — — 47 — — — — 174 „ „ Subsequent Attendances — — 274 — — — — 89 — — — — 363 „ Doctors' Consultations 46 50 50 51 48 44 43 20 52 53 — 51 508 37 The deaths from stated causes at various ages under one year of age are shown in the table below:— Cause of Death Under 1 week. 1-2 weeks. 2-3 weeks. 3-4 weeks. Total under 1 month. 1-3 months. 3-6 months. 6-9 months. 9-12 months. Total Deaths under One Year All Causes. Certified M 34 5 3 2 44 22 26 15 13 120 F 16 4 1 4 25 13 15 8 10 71 Small-pox M. ... ... ... ... ... ... ... ... ... ... F. ... ... ... ... ... ... ... ... ... ... Chicken-pox M. ... ... ... ... ... ... ... ... ... ... F. ... ... ... ... ... ... ... ... ... ... 2 Measles M. ... ... ... ... ... ... ... ... ... ... F. ... ... ... ... ... ... ... ... ... ... 3 Scarlet Fever M. ... ... ... ... ... ... ... ... ... ... F. ... ... ... ... ... ... ... ... ... ... 4 Whooping Cough M. ... ... ... ... ... 2 1 ... ... 3 F. ... ... ... ... ... ... 1 ... ... 1 5 Diphtheria and Croup M. ... ... ... ... ... ... ... 1 ... 1 F. ... ... ... ... ... ... 1 ... ... 1 10 Tuberculous Meningitis M. ... ... ... ... ... ... ... ... ... ... F. ... ... ... ... ... ... ... 1 ... 1 10 Abdominal Tuberculosis M. ... ... ... ... ... ... ... ... ... ... F. ... ... ... ... ... ... ... ... ... ... 10 Other Tuberculous Diseases M. ... ... ... ... ... ... ... 1 1 2 F. ... ... ... ... ... ... ... ... ... ... 11 Syphilis M. ... ... ... ... ... ... ... ... ... ... F. ... ... ... ... ... ... ... ... ... ... 19 Bronchitis ... M. ... 1 ... ... ... 2 1 ... ... 4 F. ... ... ... ... ... 1 ... 2 ... 3 20 Pneumonia (all forms) M. 1 ... 1 ... 2 2 3 2 5 14 F. ... 2 1 2 5 6 2 1 6 20 23 Diarrhoea M. ... ... ... ... ... 3 10 5 4 22 F. ... ... ... 2 2 1 3 1 2 9 23 Enteritis M. ... ... ... ... ... 1 2 4 1 8 F. ... ... ... ... ... ... 2 ... 1 3 27 Gastritis M. ... 1 ... ... 1 ... ... ... ... 1 F. ... ... ... ... ... ... 1 ... ... 1 31 Congenital Malformations M. 3 2 ... ... 5 1 2 ... ... 8 F. 2 2 ... ... 4 2 1 ... ... 8 31 Premature Birth M. 15 1 1 1 18 4 ... ... ... 22 F. 10 ... ... ... 10 ... ... ... ... 10 31 Atrophy, Debility & Marasmus M. 1 ... ... ... 1 3 ... ... ... 4 F. 1 ... ... ... 1 1 ... ... ... 2 31 Atelectasis M. 8 ... ... ... 8 1 ... ... ... 9 F. 2 ... ... ... 2 ... ... ... ... 2 31 Injury at Birth M. 1 ... ... ... 1 ... ... ... ... 1 F. 1 ... ... ... 1 1 ... ... ... 2 31 Convulsions M. ... ... ... ... ... ... ... ... ... ... F. ... ... ... ... ... ... ... ... ... ... 34 Suffocation, overlying M. ... ... ... ... ... ... ... ... ... ... F. ... ... ... ... ... ... ... ... ... ... 35 Rickets M. ... ... ... ... ... ... ... ... ... ... F. ... ... ... ... ... ... ... ... ... ... 35 Meningitis (not tuberculous) M. ... ... ... ... ... 1 3 ... 1 5 F. ... ... ... ... ... ... ... ... 1 1 35 Laryngitis M. ... ... ... ... ... ... 1 ... ... 1 F. ... ... ... ... ... ... ... ... ... ... 35 Erysipelas M. ... ... ... ... ... ... ... ... ... ... F. ... ... ... ... ... ... ... ... ... ... 35 Other causes M. 5 ... 1 1 7 2 3 2 1 15 F. ... ... ... ... ... 1 4 2 ... 7 36 III defined M. ... ... ... ... ... ... ... ... ... ... F. ... ... ... ... ... ... ... ... ... ... Totals 50 9 4 6 69 35 41 23 23 191 For Mortality rates in other London Boroughs, see Appendix II. 38 LIST OF MATERNITY AND CHILD WELFARE CENTRES, ETC., IN THE BOROUGH. CENTRES. MONDAY. TUESDAY. WEDNESDAY. THURSDAY. FRIDAY. REMARKS: morning. afternoon. morning. afternoon. morning. afternoon. morning. afternoon. morning. afternoon. (a) Municipal : Limehouse Town Hall, Commercial Road 2 to 5* 2 to 5* Advice to mothers, health talks and knitting classes are held in connection with these Centres. St. George's Town Hall, Cable Street 10 to 12 2 to 5* 2 to 5* Riverside Mansions, New Gravel Lane 10 to 12 2 to 5* 2 to 5 Hughes Mansions, Vallance Road 2 to 5 2 to 5* Congregational Buildings, Burdett Road 2 to 5* St. Phillips Institute, Newark Street 2 to 5* 401, Mile End Road 2 to 5* (b) Voluntary : Mission Hall, Carr Street 2 to 5* (also sewing) Stepney Infant Welfare Centre and Babies Home, 587, Commercial Road 10.30 (sunlight) 2* 10.30* (sunlight) 2.15 to 4.10 (sewing) 10.30 (dental) 2.30 (lectures on home nursing and infant care) 10.30 (sunlight) 2* The Superintendent is available at her flat nearby for consultation any day from 8 a.m. to 10 p.m. Memorial Hall, High Street, Shad well 2 to 4* 2 to 4* 2.30 to 4 Dame Colet House— 29, Duckett Street also 9.15 to 11 (minor dressings) 2* 9.15 to 11 (minor dressings) 2* 9.15 to 11 (minor dressings) 2.30 (sewing and health talk) 9.15 to 11 (minor dressings) (sewing) 9.15 to 11 (minor dressings) 10, Duckett Street 3 (sunlight) 2.30 (sunlight) 2.30 (sunlight) Sunlight with the doctor by arrangement. 12, St. Clare Street, Minories 2 to 4* 2.30 to 4 (knitting and lecture) 2.30 to 4 (sewing and lectures) 2 to 4* Toddlers' dinners daily, 12.30. Mothers dinners daily, 2. Jewish Infant Welfare Centre, Bernard Baron Settlement, Berner Street 2 to 5* 2 to 4 (sewing) 2 to 5* Jewish Mothers Welcome, Bernard Baron Settlement, Berner Street also 9 to 11 (advice to mothers and minor ailments) 2 to 4 (sewing) 9 to 11 (advice to mothers and minor ailments) 1.45 to 4* 9 to 11 (advice to mothers and minor ailments) 9 to 11 (advice to mothers and minor ailments) 1.45 to 4* 9 to 11 (advice to mothers and minor ailments) Toddlers first Tuesday in each month, 11 to 12.30. 17, Leman Street 1 1.30 to 2.30 (dental) *Denotes that there is a Doctor in attendance. 39 LIST OF maternity and CHILD welfare centres, etc., in the borough—continued. centres. monday. tuesday. wednesday. thursday. friday. REMARKS : morning. afternoon. morning. J afternoon. morning. afternoon. morning. afternoon. morning. afternoon. Jewish Maternity Hospital, 24, Underwood Street 9.30 to 12 (dental) 2.30 to 5.30 (sewing) 2 to 4* 2 to 4* 2.30 to 5.30 (sewing) East Stepney Jewish Centre, Beaumont Hall, Beaumont Square 10 to 12.30 2 to 4* 10 to 12.30 ANTE-NATAL CLINICS. (a) Municipal : Limehouse Town Hall, Commercial Road 10 to 1* Hughes Mansions, Vallance Road 10 to 1* (b) London County Council : Mile End Hospital, Bancroft Road 10 a.m. 2 10 a.m. 2 to 4 2 St. George's Hospital, Raine Street 2 Also Saturdays 11.30. (c) Voluntary : East End Maternity Hospital, 396, Commercial Road 9 2 2* 9 9 Jewish Maternity Hospital, 24, Underwood Street 10 to 12* 10 to 12* London Hospital, Whitechapel Road 9* 9* CRECHES. Voluntary : Day Nursery, Memorial Hall, High Street, Shadwell This is an open air one and it is open from May to October. Jewish Day Nursery, 23, New Road Port of London Day Nursery, 5, Pier Head, Wapping Marie Hilton Creche, Stepney Causeway St. Paul's Day Nursery, Wellclose Square BABIES' NURSING HOME. 587, Commercial Road Residential treatment. DAY NURSERY SCHOOL—L.C.C. Old Church Road Open Monday s to Fridays. *Denotes that there is a doctor in at tendance 40 (I have to thank Dr. O'Shiel for the following report upon the work of the Maternity and Child Welfare Section. I may say that I am in absolute agreement with his observations). The year has been remarkable for the lowness of the figures recorded in Maternal Mortality and Infant Mortality. As has been mentioned elsewhere in this report both are phenomenally low, being 6 and 191 respectively compared with 18 and 288 in 1934, giving mortality rates of 1.9 for Maternal deaths compared with 5.45 for last year, and for Infant Mortality 63.0 compared with 87.2 last year. The high figures recorded last year were exceptional, and it appears to me that the low figures this year may be regarded in the same light, for I fear it is too much to hope that such excellent figures can be maintained. The Infantile Mortality figures for 1936 will almost certainly be affected by the measles epidemic. The work of the department has proceeded normally during the year. There were few changes on the staff. Two of our Health Visitors, Miss D. Blackmore and Miss A. Carty, attended a revision course for Health Visitors at the Annual Winter School for Health Visitors held at the Bedford College for Women under the auspices of the Women's Public Health Officers Organisation from 30th December, 1935, to 10th January, 1936. One new Borough Ante-Natal Clinic was opened during the year at Hughes Mansions, Vallance Road, on 13th August. This clinic undertakes much of the work previously done by St. Peter's Hospital where the Ante-Natal Department has closed down. Most of the cases in attendance at the Hughes Mansions Clinic are booked for delivery at Mile End Hospital and the establishment of this Ante-natal Clinic in Vallance Road has been a great boon to the mothers of Whitechapel, saving them from undertaking long journeys to Mile End Hospital. There is an excellent system of co-operation in practice between the Clinic and Mile End Hospital and one of our Health Visitors attends at Mile End Hospital Ante-natal Clinic weekly to receive and pass on reports of the doctors and to assist the Hospital almoner by her knowledge of the Whitechapel District and its mothers. This alliance has also proved most valuable in dealing with those mothers whose infants will eventually come under the Infant Life Protection Acts as foster-children. 41 During the year three schemes adopted by the Council commenced operation, viz., the compensation of midwives, the provision of trained midwives to act as maternity nurses to those expectant mothers who have engaged a general practitioner for their confinements at home and the provision of home helps in certain cases. The first scheme was adopted on the 29th May and the other two schemes on the 30th October. These schemes are set out in full in this report. The object of the first scheme is to compensate midwives for loss of fees in those cases where the patient having been sent by a midwife to a Borough ante-natal clinic for supervision has been advised on health grounds by the medical officer of the clinic to have her confinement in hospital. Such a scheme should encourage midwives to send cases to the ante-natal clinics and, when necessary, to hospital for confinement. By the scheme for the provision of Maternity Nurses it is hoped to decrease the number of " handy-women " who assist in doctors' cases. The third scheme providing Home Helps will enable harrassed mothers to have a sufficiently long period of rest following their confinement before resuming their household duties. This service will also be of great help to those cases where illnesses and abnormalities occur during the pregnancy whether the birth takes place at home or in hospital. Scheme I.—Compensation to Private Midwives for loss of confinement Compensafee consequent UPON midwife'S maternity case being transferred to Midwives. Hospital for confinement. The particular cases to which the scheme applies and the conditions laid down by the council are as follows:— (1) The case after engaging the midwife must have been referred by the midwife to one of the Borough ante-natal clinics for regular supervision or ante-natal care during pregnancy. (2) The case must be one where a private midwife has been definitely engaged for the confinement to take place at home. (3) As a result of the clinic Medical Officer's recommendation on health grounds the birth of the child must have taken place in hospital. (4) Before compensation is paid the midwife must return to the mother any booking fee received from her. 42 (5) In the above cases compensation of 10s. Od. will be paid by the Stepney Borough Council. Maternity Nursing. Scheme II—Trained Midwives as Maternity Nurses in Doctors' Cases. Method of Application, etc. (1) It will be necessary for an expectant mother desiring a midwife as a maternity nurse to apply to the Medical Officer of Health through her doctor who must be engaged for the case. (2) On the consent of his patient, any doctor who is engaged for the confinement, may certify in writing to the Medical Officer of Health that a midwife also is necessary or desirable to act as a maternity nurse, and that the patient does not appear to be able to pay for this service in full. (3) The expectant mother or her representative will attend at the Public Health Office with the above doctor's certificate and particulars of income will be taken. All particulars shall be entered by the clerk on a form or card which can later be presented to the Committee. (4) If the patient comes within the scale of necessity she will be eligible accordingly to have either half or all of the fee of the midwife paid for her by the Local Authority and notification of this in writing on an authorisation form will be either handed to her (or her representative) at the time, or posted to her later. (5) Where half the fee is to be paid by the patient, payment by weekly instalments can be arranged. (6) On receipt of this authorisation the patient can immediately proceed to engage any registered midwife whom she and the doctor desire. (7) To engage a midwife the patient must sign an authorisation form and hand it to the midwife. (8) The midwife on completion of her period of engagement obtains the signature of the doctor certifying satisfaction with the work and, having signed the form, she presents it to the Medical Officer of Health for payment. (9) The appropriate fee to which the midwife is entitled in a particular case is paid to the midwife by the Local Authority and, in cases where the patient has been assessed to pay half, this amount must be paid by the patient to the 43 Medical Officer of Health either at once or by weekly instalments (as arranged by the clerk at the time of interview for assessment). Any circumstances arising which will prevent an applicant completing payments within this time shall be considered by the Sub-Committee. Duties of the Midwife. When the Local Authority agrees to pay either the half or the whole fee of the midwife, the midwife in normal cases must attend at the confinement, and thereafter make morning and evening visits for the first three days of the puerperium, and at least one visit a day from the 4th to the 12th day of the puerperium. The midwife will only undertake those duties which entail the nursing and care of the mother and child, and these will not include ordinary household duties or the care of the other children. (In this connection it may sometimes be considered necessary to provide a Home Help in addition.) Rules and Conditions of Service. In normal cases in order to obtain the full fee the midwife must attend at the confinement and thereafter make morning and evening visits during the first three days of the puerperium, and at least one visit a day from the 4th to the 12th day of the puerperium. Scheme III.—Provision of Home Helps. Home Helps. Home Helps will be provided under the following circumstances. (a) During the confinement and puerperium of the housewife at home. (b) During the pregnancy of the housewife in whom there are malities which render it dangerous for her to continue her usual household duties. (c) During pregnancy when the housewife contracts a short illness (e.g., Influenza). (d) In order to enable expectant housewives to go to hospital either in the Ante Natal period or for her confinement. 44 It is hoped that Home Helps will be provided during confinement and puerperium only for those mothers whose homes are suitable for confinement, but it is realised that these Helps cannot be refused if the home conditions are unsatisfactory. In unsatisfactory conditions the Medical Officers will do all in their power to persuade the mothers to go to hospital. The Helps will be given in order to enable these mothers to go to hospital. Application for Home Helps. Application will be made to the Public Health Department by the expectant mother or her representatives. In the case of (a), a certificate from the doctor or midwife must be produced; in the case of (b), (c) and (d), a certificate from the doctor. A continuation certificate will be necessary in order to renew Home Helps after one month. The Health Visitor can assist in ascertaining this need if necessary and in (b) and (c) should report on whether the mother is carrying out her treatment conscientiously. In normal confinements Home Helps should be permitted in the first instance for two weeks only. Method of assessment and collection of contributions. The financial circumstances of the family will be investigated through the mother or her representative at the Public Health Office, and the scale of necessity will be the same as for the provision of a midwife as maternity nurse (i.e., the scale for the Milk Assistance Scheme, as amended by the Public Assistance Scale for family earnings). The Home Help shall be paid in full by the Borough Treasurer in the usual way, and the mother's contribution shall be paid in advance by the mother or her representative each week regularly into her Infant Welfare Centre, or the Public Health Office. Failure to pay her contribution on the date due, will be reported to the Medical Officer of Health for reference to the Chairman or the Committee if necessary. As evidence of good faith a mother, where possible, should pay an amount equal at least to two weekly contributions before the arrival of the Home Help, and this rule should be explained to her when engaging a Home Help. Note.—Except in emergency cases, the contribution should be paid in advance in instalments and all should be paid up before the date of engagement. Those on Public Assistance or Unemployment Benefit shall be granted free of cost. Where the mother pays half fee of the maternity nurse in doctors' cases, she will not be asked to pay for a Home Help. 45 Duties and remuneration of Home Helps. The hours of duty will be arranged so as to suit each individual mother, a day being a minimum of five hours. The duties of a Home Help will include:— Keeping the house clean. Bedmaking, etc. Purchasing and cooking of food. Bathing, dressing and feeding baby. (Bat not " Nursing duties "; e.g., dressing sores or attention to baby's eyes, etc.) Care of the other children. Washing of clothes, including washing of sheets, etc., used during labour, but not arrears of washing. Attention to the mother, exclusive of nursing duties. The Home Help must in no Way undertake the duties of the trained nurse. Supervision and Complaints. The Home Help shall work under the supervision of the Health Visitor who shall inspect the homes where they are in attendance, and all complaints shall be referred to the Medical Officer of Health. Food and Overalls. The Home Help must supply her own food which she can cook at the house. Overalls will be supplied and these overalls must be kept at the Public Health Offices and will be laundered free. The Council's Panel. This will be made up by applicants obtained in answer to advertisements in the local press, in the Maternity and Child Welfare Centres and by the Health Visitors. Infantile Mortality. During the year 191 infants died under the age of I year. The figures are remarkably lower than last year, the infant mortality rate being 63 per 1,000 births compared with 87.2 in 1934. 46 Measles.—Undoubtedly one of the chief causes of the improvement in the Infant Mortality figures was the absence of a measles epidemic, no deaths from this disease being recorded in any age group in 1935, as against 26 in children under one in 1934. It is most unlikely, therefore, that the low level of infant mortality can be maintained next year as the biennial measles epidemic will take its 'toll' not only in deaths from measles itself, but also from the many accompanying complications such as pneumonia and gastroenteritis. Pneumonia.— Deaths from pneumonia numbered 14, being 38 less than last year. This again is undoubtedly attributable to the absence of measles during the year. Diarrhoea.—Deaths from Infective Diarrhoea decreased by one-third, totalling 31 compared with 47 last year. These deaths were not more numerous in summer than at any other time of the year, the months of June, July and August being particularly free, whilst March, April, May and December showed the most deaths. Other Causes of Death.—Deaths from Congenital Malformations and Premature Births were 48 in 1935 compared with 59 in 1934. Infant Welfare Centres. The attendances at the Infant Welfare Centres continue to be good and there is no doubt the younger mothers are gradually putting into practice as a routine measure many principles of baby-craft which were only accepted with doubt and criticism by their mothers. More and more, the correct principles of infant feeding and management are being passed down from the younger grandmothers to their married daughters, so that we may hope that much of what is at present spade work in teaching will be absorbed automatically by the mothers of the future in their process of growing up. " Old Wives' tales" will disappear and correct principles will take their place. The grandmother and her influence will then cease to be looked upon as a danger. It will be many years, however, before knowledge becomes so general that individual teaching at Infant Welfare Centres can be dispensed with, for, unfortunately, there are still many mothers who rely for direction solely on their instincts of well-meant but ignorant kindness towards their babies. 47 Maternal Mortality. Each maternal death in the Borough whether occurring as a result of childbirth or merely in association with pregnancy is investigated and reports are received from the doctors and nurses concerned. From these reports it is possible to conjecture with some degree of accuracy how many maternal deaths were avoidable and how many were not. Only 6 maternal deaths occurred this year compared with 18 in 1934, the maternal mortality rate being 1.9 per 1,000 births compared with 5.45in 1934. Of the six maternal deaths in 1935, three were accompanied by sepsis. A. Sepsis following caesarian operation. B. „ „ a normal confinement. C. „ „ spontaneous non-criminal abortion. Three cases were non-septic. D. Chronic very advanced heart disease complicating pregnancy. E >> }> )> )) F. Ruptured womb. After considering all the available facts it can be said that two of the above six cases were probably avoidable. Three of the six cases were probably insufficiently physically fit for the strain of pregnancy, though two of these could have improved their chances had they not discontinued necessary treatment. It is possible that these latter two mothers were not to blame for their failure to continue treatment as such may have been due to domestic or other difficulties. It is not possible or fair to make the comments on these six deaths more definite as it is difficult to judge the cases on the necessarily insufficient evidence it is possible to obtain. There appear to have been no " deaths following suspected cases of criminal abortion " and on the whole the maternal mortality position in 1935 was very good. It is most gratifying to be able to record such a great improvement. Enquiry into Ante-Natal Supervision. In view of the recent attention drawn to maternal mortality and the concern felt that possibly many expectant mothers were not receiving adequate ante-natal supervision I considered it advisable to make a special investigation in the Borough in 1935. 48 For this purpose a questionnaire was prepared and the Health Visitors obtained the necessary information on their visits to the mothers concerned. It was not found possible to obtain answers from more than 2,737 of the 3,118 mothers who were confined during the year, but from the number questioned it has been possible to draw up interesting figures and percentages. The object of the questionnaire was to ascertain the degree of ante-natal supervision each mother had received during her pregnancy. It was thought the questionnaire might reveal a necessity to establish more ante-natal clinics in certain districts in the Borough. For purposes of the enquiry, therefore, the Borough was divided up into six compact districts as follows:— A. Spitalfields West, Spitalfields East, Mile End New Town, Whitechapel East and Whitechapel Middle. B. Whitechapel South, Mile End West and St. George's North. C. Tower Ward, St. George's in the East South and Shadwell. D. Mile End North, Mile End Central and Mile End South. (Note.—Mile End South is the most central part of the Borough.) E. Ratcliff, Limehouse North and Limehouse South. F. Mile End North East and Mile End South East. The answers to the questionnaire elicited the following information which has been set out in table form below. No. of Live and Still Births in 1935=3,118. No. of answers obtained and analysed below=2,737 or 87.7%. Attendances at Ante-natal Clinics. Individual Districts. All Districts. A. B. C. D. E. F. Number of cases investigated 353 447 228 763 577 369 2,737 Number who attended an antenatal clinic 333 427 219 731 522 323 2,555 Number who did not attend an ante-natal clinic 20 20 9 32 55 46 182 Percentage of attendances 94.33 95.51 96.05 95.84 90.46 87.53 93.35% Percentage of non-attendances 5.67 4.49 3.95 4.16 9.54 12.47 6.65% 49 In addition to those recorded in the tables above who attended either the Borough Ante-natal Clinics or the ante-natal clinic of the London County Council or Voluntary Hospitals, 64 received some ante-natal supervision from their private doctors and 74 from their private midwives. Taking these additional cases into account the number who received some form of antenatal supervision is increased by 138 to 2,693 or 93.39%, leaving only 44 or 1.6% who received no supervision whatever. The extent and regularity of attendance at the ante-natal clinics is indicated to some extent in the following table:— Number of Attendances at Ante-natal Clinics made by each Case. Number of cases who attended an ante-natal clinic. Once only. 2-3 attendances. 4-5 attendances. Over 5 attendances. 97 569 826 1,063 Total 2,555 Percentage 3.54 20.79 30.18 38.84 It is apparent from the figures shown in the previous two tables, that the ante-natal supervision in Stepney, both as regards the number of clinics provided for each district of the Borough and the degree to which they are patronised is highly satisfactory, and there is no cause to fear that the mothers of Stepney are not receiving reasonably full and careful supervision in the ante-natal period. Nature of Skilled Supervision at Birth. It was further thought advisable in 1935 to enquire into the nature of the skilled supervision each mother had available to her at child-birth, and there is therefore added below a table showing the qualification of the individual attendant who actually undertook the delivery of each birth. Total number of live and still births=3,l 18. Total number of cases investigated=2,737. Total number married=2,704. Total number single= 33. 50 No. delivered in a Hospital by a Doctor (or Medical Student) = 351 No. delivered in their own homes by a Doctor (or Medical Student) from a Hospital = 98 No. delivered in a Hospital by a Midwife (or pupil Midwife) = 1,657 No. delivered in their own homes by a Midwife (or Pupil Midwife) = 404 No. „ „ „ „ by a Private Doctor = 68 No. „ „ „ „ by a Private Midwife = 151 No. „ „ „ „ by a Handy Woman = 2 No. „ „ „ „ by a Relative = 4 No. „ „ „ „ unattended (i.e., B.B.A.) = 2 2,737 From the figures obtained as the result of these two enquiries it will be seen that the Metropolitan Borough of Stepney does not suffer from a lack of skilled supervision for its mothers either in the ante-natal period or at child-birth. F. R. O'SHIEL, Deputy Medical Officer of Health. III.—SANITARY CIRCUMSTANCES OF THE AREA. Scavenging. The Public Cleansing Officer has kindly supplied me with particulars of the activities of the Public Cleansing Department during the year:— There were no material improvements or alterations made in the Street Cleansing service during the year under review, but one or two reorganization schemes of a minor character were put into operation, to overcome certain difficulties which presented themselves, and, the whole system can be said to be working satisfactorily. As a result of the revision of the Collection of House and Trade Refuse, all premises now have at least a twice weekly collection, some have a thrice weekly, and from Hospitals, institutions and most main thoroughfares, refuse is collected daily. Shops Act, 1934. 1,317 inspections were carried out during the year. It was found necessary to serve 63 notices, i.e., 33 with respect to sanitary accommodation, 15 to ventilation, and 15 with respect to temperature. 51 11 applications were received for exemption under Section 10 (2) of the Act, 9 of which were granted. 155 observations were made by the Sanitary Inspectors for the detection of nuisances from smoke, which necessitated the serving of 8 Intimation notices for the abatement of the nuisance. Smoke Nuisances 3,404 written complaints were made to me during the year, which were duly investigated. Of these 92 were from H.M. Inspector of Factories relating to workshops, 203 from the London County Council respecting verminous school children, 29 from the London County Council respecting premises under the Shops Act, 1934 and 3,080 related to the condition of houses, etc. In addition inspections were made as a result of complaints made to the Sanitary Inspectors. Complaints. The Sanitary Inspectors supervise all drainage work. Full particulars as to the work done by them are given on pages 61 and 62. 3,817 drains were tested during the year. Of these, 456 were found to be defective. Drainage. During the year 751 complaints were received as to nuisances from rats or mice. As a consequence 838 drains were tested and in 215 instances they were found to be defective. 533 complaints were forwarded to the Borough Engineer and Surveyor, so that the Council's ratcatchers could call and assist the tenants concerned. Rats and Mice. I am indebted to the Borough Engineer and Surveyor for the following information as to work carried out during the year by his department. Record of Rat Destruction carried out by the Council's Ratcatchers from Is/ January to 31s/ December. No. of premises visited. 764 „ „ visits 17,021 „ „ dead rats found poisoned 32 * „ „ rats caught in our traps 1,581 „ „ premises cleared of rats as reported by the Occupiers 401 „ ,, new rat complaints during this period 609 *1,237 of these were actually brought into the Depot and destroyed. The poisons used were as follows:— Rodine 43,506 cubes Barium carbonate 35,296 „ Phosphor paste 30,828 ,, Extract of Squills 13,674 portions (2 oz.) 52 In addition to the National Rat Week in November, three extra Rat Weeks were held in February, May and August, in collaboration with the adjoining Boroughs of Bethnal Green, Shoreditch and Poplar, when poisoned bait was laid in the manholes and side entrances of the sewers in and adjoining the boundary roads of the respective Boroughs. The following is a record of the work done in Stepney during these extra Rat Weeks in 1935 :— Extra Rat Weeks. Dates (inc.) Poisoned baits laid in Baits laid Manholes. Side-entrances. Eaten. Uneaten. First 4th to 9th February 192 22 1,726 330 Second 13 th to 18 th May 219 25 1,849 173 Third 29th July to 3rd August 255 15 1,870 272 National Rat Week—Uh to 9th November. The Council adopted a similar procedure as in previous years. Notices, drawing the attention of the public to the matter, were inserted in four local newspapers. Communications were sent to 13 local cinemas, requesting that notices be displayed on the screen, drawing attention to National Rat Week. 75 chemists and oilmen within the Borough were supplied with copies of the Ministry of Agriculture's form No. 618/T.R., bulletin No. 30 the official pictorial bills and bills "Rat Poison Sold Here," and were requested to display the same in their shop windows. Rat poison, consisting of extract of squills, barium carbonate, phosphor paste and rodine, were placed in the sewer manholes and side entrances at 238 different positions throughout the Borough. A total of 1,887 portions of bait were laid, of which number 1,690 were eaten. The Council employ three men as ratcatchers, who give their whole time to rat destruction. Rent and Mortgage Interest Restrictions Acts. 54 applications were received during the year for Certificates that certain houses were not in a reasonable state of repair. 51 were granted, 3 were refused. In addition, 15 applications were received for Reports that the work mentioned on the Certificates have been satisfactorily executed. All were granted. post-mortem room refrigerating plant 53 Certificates were granted under the provisions of the Public Health (London) Act, 1891, as to dwelling houses having a proper and sufficient supply of water with respect to 9 houses and 154 tenements. Water Certificates, Annual certificates are granted respecting Hairdressers' Shops in the Borough, which come up to a certain standard of cleanliness. Six certificates were granted during the year. Hairdressers Shops. The number of bodies deposited in the Mortuary during the year was 259. 31 Jewish bodies were officially "watched." 161 inquests were held in the Coroner's Court, and 159 post mortem examinations were made. Mortuary and Shelter. The shelter is used for the accommodation of contacts of infectious disease while their homes are being disinfected. During the year there were 4 persons admitted to the shelter; 2 adults and 2 children. Modernisation of the Mortuary. Up to last year there were no proper and adequate means for the retention of dead bodies for more than a few days and owing to the spells of very hot weather during recent years it became necessary to provide such means. At the same time it was necessary to reorganise the post-mortem room which contained one old-fashioned slate table which was dilapidated. In October a new refrigerating plant was installed which consists of two chambers—one the chiller, accommodates 15 bodies at a temperature of 34°F. to 38°F., and the other—the freezer—accommodates 3 bodies at a temperature of 18°F. to 22°F. The Chambers are fitted with galvanized iron trays with handles and the bodies are arranged in 3 tiers and internal lighting is provided. The method of producing the refrigeration is by cold air circulation, created by means of the passage of methyl chloride (CH3Cl) through coils, the circulation of a fan and a compressor. A 2½ H.P. electric motor, which is automatic, is used for the purpose of producing the circulation. It is now possible to retain bodies if necessary for long periods. A new rack is also provided for the keeping of bodies to be viewed by friends and the Coroner when inquests are held. With reference to the post-mortem room, two new post-mortem tables were installed in place of the old one, additional sinks and gulleys were provided and the lighting and water arrangements improved. This is a great improvement and facilitates the work of the Mortuary Keeper and of the doctors conducting the post-mortems. 54 Report required by the L.C.C. Premises. No. in borough on 31st December, 1935. No. of Inspections. No. of Prosecutions. Common lodging houses 17 296 — Seamen's lodging houses 10 256 — Cowsheds (licensed) 19 128 3 Slaughterhouses (licensed) — — — Other offensive trades 53 261 — Milkshops 263 912 16 Restaurants and Eating houses 330 459 — Registered Foster mothers 22 299 1 Nurse children kept 24 294 — Smoke Nuisances. (1) No. of observations 155 (5) No. of legal proceedings - (2) No. of intimations served 8 (6) No. of convictions — (3) No. of complaints received 25 (7) Amount of penalty and costs (4) No. of Statutory notices served — imposed in each case — Cleansing and Disinfection. No. of adults cleansed 180 No. of premises cleansed (a) after infectious diseases 1,309 No. of children cleansed 2 cleansed (b) for vermin 1,210 (c) after Tuberculosis 123 Water Supply to Tenement Houses. No. of premises supplied 3 No. of prosecutions — Sanitary Officers. No. of Sanitary inspectors (whole-time)—Male 22 Female 1 ,, „ „ (part-time)—Male — Female — No. of health visitors (whole-time) 10 (part-time) — 55 Housing. 1. Total number of houses in the borough 37,766 2. Number of houses occupied by the working classes .31,717 Public Health Act. 3. No. of houses inspected on account of complaints 3,404 Illness 1,646 4. Number of statutory notices served 3,451 5. Number of houses repaired or nuisances remedied 11,852 Housing Acts (1925-35). 6. Number of houses inspected— house to house (Housing Consolidated Regs. 1925) 703 7. (a) Number of houses included in representations by the Borough Medical Officer under Sec. I of H.A. 1930 105 (b) Number of houses demolished following representation by Borough Medical Officer under Sec. I. of H.A. 1930 112 8. Number of houses repaired under Sections 17 and 18 of H.A. 1930 : (а) by owners — (b) by LA. in default of owners — 9. Number of houses demolished: (a) in pursuance of orders under Sec. 19 of the Housing Act, 1930 2 (b) Voluntarily 90 10. Number of houses (wholly or in part) the subject of Closing Orders (excluding underground rooms) 1 11. Number of Closing Orders determined (i.e., houses made fit) — 12. Number of houses in accepted schemes for redevelopment or reconditioning by owners under Part V of the H.A. 1935 — 13. Number of certificates of fitness issued under Sec. 55 H.A. 1935 — 14. Number of houses erected by the Borough Council for working classes during year 153 15. Houses Let in Lodgings. Number in Borough 3,276 Number of inspections 1,447 Number of prosecutions 1 Number of complaints remedied under the By-laws (not included under any other heading) 787 16. Underground. Rooms. Number occupied but unfit under Sec. 18 of H.A. 1925 as modified by Sec. 84 of Housing Act, 1935 6,159 Number closed or modified occupation approved under Section 84 H.A. 1935 8 17. Overcrowding (Housing Act, 1935) Number of houses inspected under Sec. I of H.A. 1935 35,199 Number of families found to be living in overcrowded conditions Sec.I of H.A.1935 7,612 Infectious diseases—cases notified under local orders (excluding cases coming to knowledge otherwise than by notification). Disease. Cases notified. Period. Measles (Children np to 5 years) 89 Commencing 1st November, 1935 German Measles — — Whooping Cough — — Rheumatic Fever (0.16) — — Chicken Pox — — Zymotic Enteritis - - 56 Canal Boats Acts 1877 and 1884. Pursuant to the Third Section of the Canal Boats Act, 1884, the Metropolitan Borough of Stepney, being the Registration Authority under the above Acts, has to report as follows with regard to the execution of such Acts and of the Regulations made thereunder, and as to the steps taken by them as such authority during the year 1935 to give effect to the provisions of the said Acts and Regulations, viz.: — (1) Canal Boats coming within the district are inspected by a Sanitary Inspector, who receives a sum of ,£10 per annum for the performance of this duty. His inspection is irrespective of the examination of Boats made by the Examining Officer prior to their registration. (2) The number of boats inspected was 14. Two children were found on the boats. There were no contraventions of the Acts and Regulations. No boats were registered during the year. [Home Office Form 572 Factories, Workshops and Workplaces I.—Inspections. Premises. Number of Inspections. Written Notices. Prosecutions. Factories (Including Factory Laundries) 1,004 215 — Workshops (Including Workshop Laundries) 1,468 416 - Workplaces (Other than. Outworkers' premises) 263 42 - Totals 2,735 673 — 57 2 —Defects found. Particulars. Number of Defects. Number of Prosecutions. Found. Remedied. Referred to H.M. Inspector. Nuisances under the Public Health A cts:— Want of cleanliness 216 216 — — Want of ventilation 8 8 — — Overcrowding 1 1 — — Want of drainage of floors - 1 1 — — Other nuisances - 264 264 — — Sanitary Accommodation insufficient 32 32 — — unsuitable or defective 225 225 — — not separate for sexes 15 15 — — Offences under the Factory and Workshop A ct:— Illegal occupation of underground bakehouse (s. 101) - - - - Other offences (Excluding offences relating to outwork which are included in Part 3 oi this report.) 1 1 - - Totals 763 763 — — 3.—Registered Workshops. Workshops on the Register (s. 131) at the end of the year 1935. Number Bakehouses 134 Boot, Shoe and Slipper Making 109 Cabinet Making 78 Furriers 179 Hat and Cap Manufacturers 30 Laundries 12 Rag Sorting, etc. 49 Wearing Apparel (Tailors, Milliners, Dressmakers, etc., etc.) 1,289 Miscellaneous 492 Total 2,372 58 4.—Other Matters. Class. Number. Matters notified to H.M. Inspector of Factories:— Failure to affix Abstract of the Factory and Workshop Act (s. 133), 1901 9 Action taken in matters referred by H.M. Inspector as remediable under the Public Health Acts, but not under the Factory and Workshop Act (s. 5). 1901 Notified by H.M. Inspector 92 Reports (of action taken) sent to H.M. Inspector 92 Other — Underground Bakehouses (s. 101):— Certificates granted during the year — In use at the end of the year 46 Outworkers. The net number of outworkers in the Borough engaged in is as follows:— various trades Making, cleaning, etc., of wearing apparel 2,209 Furriers 40 Umbrellas 18 Boots and shoes 43 Paper bags and cardboard boxes 12 Brushes 1 Flag making 2 Feather bedding 1 Christmas cards 1 Carnival hats 4 Artificial flowers 1 Braces 1 Handbags 4 Cigarette making 1 Pot scourers 10 Fancy jewellery 1 Christmas crackers 6 Baby Linen 1 Hat and Cap making 6 Art needlework 1 Leather goods 1 Ties 2 Toys 17 Upholstery 1 2,384 The number of inspections made to outworkers' premises was 726, and the number of premises where sanitary defects were found to exist was 336. Notifiable infectious disease occurred in 108 outworkers' premises. There are 98 firms in the Borough employing outworkers, and of these firms 85 sent in lists twice in the year and 13 once. These related to a net number of 1,416 outworkers, of which 702 were resident in the Borough and 714 were transferred to other Districts. 59 In addition, 631 lists relating to a net number of 1,682 outworkers were received from other Boroughs during the year. Outworkers premises where sanitary defects were found to exist :— Nature of work. Instances. Notices served. Wearing Apparel— Making, etc. 299 295 Cleaning and washing 2 2 Feather sorting 1 1 Furniture and upholstery 11 9 Furriers 4 4 Umbrellas 5 5 Paper, etc., boxes, paper bags 2 2 Cosaques, Christmas crackers, Christmas stockings, etc. 1 1 Boots and shoes 11 11 Total 336 330 25 inspections were made during the year to 7 premises subject to the provisions of the Rag Flock Acts. Rag Flock Acts. There are 19 cowsheds in the Borough. During the year 128 inspections were made to the cowsheds, and it was found necessary to serve 28 notices for minor matters. Cowsheds. 261 inspections were made during the year to the 53 offensive businesses carried on in the borough. 21 notices were served for minor matters and it was not found necessary to take legal proceedings. Offensive Businesses. 11 persons were duly licensed under the Slaughter of Animals Act, 1933, as Slaughtermen at a knackers yard in the Borough. There are 17 common lodging houses. 296 inspections were carried out during the year. 16 notices were served for various defects found to exist. Lodging Houses. The usual annual census of persons in Common Lodging Houses was taken on the night of Friday the 21st February. Of the 2,180 licensed beds for men 1,511 were occupied. ,, 541 ,, ,, women 339 were occupied. ,, 48 ,, ,, married couples 26 were occupied. In addition to the above, there are 10 Seamen's lodging houses. 256 inspections were made to them during the year, and 2 notices were served for minor nuisances. 60 Sanitary work. RETURN OF SANITARY WORK, 1935. W. E. Anstee. i G. Bottomley. C. F. Brockett. J. H. Brownlee. W Cue. R. W. G. Day T. W. Dee. E. J. Edwards. E. W. Flint. G. D. Freeland. H. J. Green. C. F. Guy. H. O. Harris. W H. Haworth W. H. Howard. S. Lowther. J. G. McCarthy. R. Roper. W. Shepherd. R. Simpson. W. F. Smith. S. H. V. Trimming. W. T. Twynham. R. H. Waterman. Totals. Animals kept so as to constitute a nuisance, removed - 1 — — 10 1 — 3 1 1 — 3 4 24 Bakehouses: No. of cleansings of — 2 11 1 — — — 3 — 6 1 13 7 1 ] 20 — — 15 — — 6 - 91 Cisterns cleansed, covered and repaired - 7 1 — — — — 7 — 3 8 5 — 1 — 4 — 3 — — 1 — 2 - 44 Dampness in premises remedied 2 51 90 38 3 131 20 76 105 80 l83 47 36 158 57 159 151 40 — Ill 3 126 8 239 85 2,078 Drains—Cleansed or repaired — 49 52 19 2 57 23 38 36 25 81 48 8 80 23 81 73 57 — 108 20 2 118 50 1,050 Constructed or reconstructed - 13 49 4 — 28 10 32 20 11 4 12 30 37 — 12 7 11 — 33 1 — 15 9 340 Dust receptacles provided 8 201 174 59 25 336 47 182 168 71 122 137 20 124 164 189 380 88 — 358 118 1 152 185 3,309 Number of dwelling rooms cleansed 13 352 299 144 45 1,006 127 206 463 179 601 371 41 314 419 549 790 287 — 785 437 2 473 931 8,834 Houses ventilated beneath the lower floor — 2 3 - - 7 - - 1 - - 2 - - - - 8 - - 2 4 - - 3 32 Improved light and ventilation provided to rooms — 3 10 - - 1 11 — 5 - 4 1 1 1 — 2 2 3 — 1 2 — 10 — 57 Manure receptacles provided or reconstructed - 1 - - - 2 - - - - - - - - -- - - 1 - - - - - - 4 Offensive accumulations removed - 9 29 11 - 31 10 23 17 19 89 5 4 34 4 31 21 25 — 18 37 — 102 13 532 Overcrowding in dwellings abated — 5 9 1 1 1 5 — 6 — — 2 - 1 2 2 4 2 — — 1 — 6 9 63 61 RETURN OF SANITARY WORK, 193f—Continued. W. E. Anstee. G. Bottomley. C. F. Brockett. J. H. Brownlee. W. Cue. R. W. G. Day T. W. Dee. E. J. Edwards. E. W. Flint. G. D. Freeland. H. J. Green. C. F. Guy. H. O. Harris. W. H. Haworth W. H. Howard. S. Lowther. J. G. McCarthy. R. Roper W.Shepherd. R. Simpson. W. F. Smith. S. H. V. Trimming. W. T. Twynham. R. H. Waterman. Totals. No. of gutters and rain-water pipes fixed or repaired — 42 35 12 6 83 19 101 57 13 158 39 14 64 114 103 90 52 - 275 94 3 124 104 1,602 No. of repairs to roofs 5 173 105 66 13 340 20 155 142 118 171 129 19 153 221 192 340 103 - 270 173 7 200 310 3,425 Sink, bath and lavatory pipes fixed or repaired 1 10 18 17 — 70 12 41 24 6 114 70 13 23 60 105 143 27 - 97 38 - 109 26 1,023 Smoke nuisances abated — 20 16 — 3 8 — 9 10 2 — — 7 7 — 1 — 2 - 7 — - - 8 100 Underground rooms — illegal occupation discontinued — — - - — 9 — - 8 4 5 - - 5 - 2 - - - - - - - - 33 Urinals fixed or repaired — 3 2 — — 9 8 — 5 — 4 6 3 — 1 3 — 1 - 14 2 - 7 1 69 Verminous rooms cleansed 2 17 65 6 1 24 10 14 25 22 48 33 2 70 40 9 3 26 - 23 41 - 11 30 522 Waterclosets—Cleansed or repaired 4 48 59 52 12 100 20 59 66 51 274 87 33 56 39 154 96 127 - 111 164 1 283 90 1,986 „ Light and ventilation provided - 23 25 3 — 14 8 1 8 8 9 10 — 6 — 5 6 10 _ 4 7 - 56 10 213 ,, Pans and traps fixed 2 45 68 8 1 45 24 72 9 22 8 43 21 33 9 52 104 9 - 142 38 - 72 30 857 „ Provision or repair of flushing apparatus 2 51 48 35 5 61 23 29 16 18 80 69 7 44 24 54 69 39 - 115 39 1 140 75 1,044 Water supply to houses reinstated or repaired — 3 9 — 3 5 3 5 13 2 12 7 14 7 16 5 - 15 7 1 9 11 147 Yards, areas and forecourts cleansed, paved, or paving repaired — 7 18 3 3 114 10 43 53 3 96 48 5 34 73 111 30 38 - 113 55 - 80 68 1,005 Floors, windows, staircases, fireplaces and coppers repaired 8 182 220 132 56 444 51 186 277 150 545 159 69 327 496 408 411 231 - 556 481 3 548 415 6,355 Miscellaneous 14 60 185 95 15 188 33 155 179 111 341 66 35 287 449 450 156 125 — 199 275 9 304 200 3,931 62 The following tables show the work of the District Sanitary Inspectors :— Sanitary Inspection, REPORT OF INSPECTIONS, ETC. BY THE DISTRICT SANITARY INSPECTORS—1935. W. E. Anstee. G. Bottomley. C. F. Brockett. J. H. Brownlee. W. Cue. R. W. G. Day T. W. Dee. E. J. Edwards. E. W. Flint. j G. D. Freeland. | H. J. Green. C. F. Guy. H. O. Harris. W. H. Haworth W. H. Howard. S. Lowther. J. G. McCarthy. R. Roper. W. Shepherd. R. Simpson. W. F. Smith. S. H. V. Trimming W. T. Twynham. R. H. Waterman. Miss H. A. Whitty. Totals Bakehouses 4 27 15 7 25 34 — 12 14 36 3 34 8 18 29 23 17 19 — 21 22 — 372 Common Lodging Houses 1 44 4 5 2 — — — — 15 53 7 — 11 — 15 — 30 — — 12 — 52 8 37 296 Complaints 30 75 625 483 60 1,259 97 698 421 514 1,095 502 107 740 791 1,009 1,235 244 — 424 805 982 260 — 12,456 Factories 2 67 15 32 1 24 — 63 20 28 124 98 22 71 — 46 10 34 — 36 79 150 82 — 1,004 Houses let in Lodgings — 165 15 54 3 43 32 73 20 35 161 173 1 41 56 41 113 121 — — 121 — 145 34 — 1,447 House to House — 131 — 22 — — 73 — 94 — 117 147 13 166 42 69 7 217 — 404 65 61 366 — 1,994 Infectious Disease 5 98 90 35 10 128 43 61 27 64 107 67 15 73 49 114 142 96 — 121 83 — 96 122 — 1,646 Offensive Trades — 4 7 26 — — 3 1 4 37 19 — 1 8 — 43 11 50 — 1 24 _ 14 8 — 261 Outworkers 5 6 17 29 — 10 1 45 29 11 86 93 4 27 — 39 9 158 — 49 36 _ 64 8 — 726 Restaurants and Eating Houses - 78 20 2 2 11 11 12 9 17 25 7 15 22 — 47 19 33 — 15 16 — 32 66 — 459 Markets (week-end) — 4 1 1 — 2 1 4 2 1 4 4 1 4 1 — 4 3 6 3 — 4 5 — 55 Seamen's Lodging Houses 1 205 6 — 22 - - - - - - - - - - - - 22 - - - - - - - 256 Workplaces — 16 9 1 1 8 — 9 6 17 8 8 5 34 1 13 — 99 - 21 3 - 2 2 — 263 Workshops 19 63 45 42 1 34 — 34 33 51 102 121 11 110 17 65 71 236 — 105 87 - 93 128 — 1,468 Shops Act 18 2 92 77 15 50 — 1 3 68 148 84 — 105 13 88 71 171 - 9 100 - 132 70 — 1,317 63 REPORT OF INSPECTIONS, ETC. BY THE DISTRICT SANITARY INSPECTORS—1935—Continued. W. E. Anstee. G. Bottomley. C. F. Brockett. J. H. Brovvnlee. W. Cue. R. W. G. Day T. W. Dee. E. J. Edwards. E. W. Flint. G. D. Freeland. H. J. Green. C. F. Guy. H. O. Harris. W. H. Haworth W. H. Howard. S. Lowther. J. G. McCarthy. R. Roper W. Shepherd. R. Simpson. W. F. Smith. S. H. V. Trimming. W. T. Twynham. R. H. Waterman. Miss H. A. Whitty. Totals. Rag Flock Acts - - 10 - - - - - - - - - - - - - - 10 - - - - - 5 - 25 Miscellaneous 97 2,266 732 600 35 1,068 587 658 753 569 591 1,215 283 1,371 527 819 918 1,447 - 1,169 1,184 - 1,000 1,227 - 19,106 Observations re Smoke Nuisance — — — 5 14 15 — 9 — 11 — — - — 4 9 - 11 - 11 3 - 4 59 - 155 Re-Visits 118 1,804 944 1,093 173 2,006 872 1,019 598 853 2,344 1,821 207 1,536 1,405 1,444 2,058 1,661 - 3,808 1,829 - 2,450 2,229 - 32,272 Intimations served 26 624 429 304 54 963 235 526 597 281 1,033 578 120 688 559 810 1,003 590 - 1,046 759 - 971 851 - 13,047 Statutory Notices served 13 95 104 63 6 392 54 138 142 66 353 199 26 202 102 203 182 116 - 258 285 - 298 154 - 3,451 No. of Summonses taken out — 2 - 1 1 - 1 8 - 20 1 1 2 - - - - - 2 3 - 4 — 1 47 64 Legal proceedings. Date. Matter of Information or Complaint. t. 1935. Public Health (London) Act, 1891. 3rd Jan. Failing to abate nuisances arising from defective flooring, front door, handrail, balusters and dust bin at 13, Tredegar Square. Ordered to do the work within 14 days and pay £2 8s. 0d. costs. 3rd Jan. Failing to abate nuisances arising from defective main and scullery roofs at 52, Perth Street. Ordered to do the work within 14 days and pay £2 8s. 0d. costs. 8th Jan. Failing to abate a nuisance arising from defective window at 49, Church Row. Ordered to do the work within 7 days and pay £2 8s. 0d. costs. 10th Jan. Failing to abate nuisances arising from defective rainpipe, yard paving, damp walls and no dust bin at 21, Burdett Road. The work having been completed at the time of hearing, the summons was withdrawn on payment of £2 5s. 0d. costs. 10th Jan. Failing to abate nuisances arising from defective flooring and windows at 64, Mile End Road. The work having been completed at the time of hearing, the summons was withdrawn on payment of £2 5s. 0d. costs. 22nd Jan. Failing to abate a nuisance arising from choked sink waste pipe, defective watercloset, etc., at 50, Great Prescot Street. Ordered to do the work within 7 days and pay £2 8s. 0d. costs. 25th Jan. Failing to abate nuisances arising from defective roofs, stove, flooring, dirty and defective walls and ceilings at 9, Tredegar Square. Ordered to do the work within 14 days and pay £2 8s. 0d. costs. 30th Jan. Exposing for sale 18 lbs. of unsound apples at 50, Old Montague Street, on 2nd January. Fined £5 0s. 0d.,with£5 5s. 0d. costs. 30th Jan. Exposing for sale 12 lbs. of unsound apples at 50, Old Montague Street, on 8th January, The offence was taken into consideration by the Magistrate when fining the Defendant for exposing unsound applies on 2nd instant, as above indicated. 1st Feb. Having deposited for the purpose of sale for food of man on 7th December, 1934, at 18, Plumbers Row, dried pears which were unwholesome and unfit for food. Fined £5 0s. 0d., with £3 3s. 0d. costs. 5th Feb. Failing to abate nuisances arising from defective main roof, etc., at 41, Plumbers Row. Ordered to do the work within 14 days and pay £2 8s. 0d. costs. 7th Feb. Failing to abate nuisances arising from defective roof and damp and dilapidated ceiling at 13, Doveton Street. Ordered to do the work within 7 days and pay £2 8s. 0d. costs. 11th Mar. Failing to abate nuisance arising from defective roof, etc., at 376, Commercial Road East. Ordered to do the work within 7 days and pay £2 8s. 0d. costs. 11th Mar. Failing to abate nuisance arising from defective roof, parapet gutter, etc., at 21, Burslem Street. Ordered to do the work within 7 days and pay £2 8s. 0d. costs. 65 Date Matter of information or complaint. Result. 11th Mar Failing to abate nuisances arising from defective drain, steps, window frames, etc., at 20, Frederick Place. The work having been completed at the time of the hearing, the summons was withdrawn on payment of £2 5s. 0d. costs. 11th Mar. Failing to abate nuisances arising from defective roof, steps, stairtreads, dirty and defective walls and ceilings at 11, Coborn Road. Ordered to do the work within 7 days and pay £2 8s. 0d. costs. 14th Mar. Failing to repair roof and remedy damp wall at 2, Floreston Street. The work having been completed at the time of the hearing, the summons was withdrawn on payment of £2 2s. 0d. costs. 14th Mar. Failing to repair defective drain at 33, Old Montague Street. The work having been completed at the time of the hearing, the summons was withdrawn on payment of £2 2s. 0d. costs. 25th Mar. Failing to remedy defective roof and gutters, also damp and dilapidated walls of rooms at 6, Frimley Street. The defendant proved that he had assigned his property to a firm of Chartered Accountants who were responsible for the repairs. The work had been done by the Agents who collect the rents and the summons was dismissed. 26th Mar. Failing to abate nuisance arising from a defective sink at 80, Lambeth Street The work having been completed at the time of the hearing, the summons was withdrawn on payment of £2 5s. Od. costs. 26th Mar. Failing to abate nuisance arising from absence of dustbin and accumulation of rubbish at 61, Mansell Street. Ordered to do the work within 7 days and pay £2 8s. 0d. costs. 26th Mar. Failing to abate nuisance arising from damp wall at 57, Lambeth Street. Ordered to do the work within 14 days. Fined £2 0s. 0d., with £2 8s. 0d. costs. 27th Mar. Exposing for sale on 5th March, at 9a, Leyden Street, mixed pudding fruit that was unfit and unwholesome. Fined £5 0s. 0d. with £2 0s. 0d. costs. 11th April Failing to abate nuisances arising from damp walls, defective paving, sink, rainpipe, drain, water-closet pan, etc., at 8, Frederick Place. Ordered to do the work within 14 days and pay £2 13s. 0d. costs. 17th April Failing to abate nuisance arising from choked gully in yard and damp walls in basement back room at 51, Fieldgate Street. Ordered to do the work within 14 days and pay £2 8s. 0d. costs. 7th May Failing to abate nuisances arising from defective brickwork of party wall, dirty walls and ceilings, and defective roof at 22, Clinton Road. Ordered to do the work within 6 weeks and pay £2 8s. 0d costs. 66 Date. Matter of information or complaint. Result. 28th May Depositing and exposing for sale 14 lbs. of dried mixed fruit, at 476, Commercial Road East, on 5th April, the said fruit being unsound, unwholesome and unfit for human consumption. Fined £1 with 10s. 6d. costs. 29th May Depositing for the purpose of sale a quantity of dried apple rings at 268, Oxford Street, on 11th March, the same being unsound, unwholesome and unfit for human consumption. Fined £1 with 10s. 6d. costs. 30 th May Failing to abate a nuisance arising from defective roof, dirty and dilapidated walls and ceiling of top landing at 14, Beccles Street. The work having been completed at the time of the hearing, the summons was withdrawn on payment of £2 8s. Od. costs. 4th June Failing to abate a nuisance arising from defective yard paving, etc., at 7, Yalford Street. The work having been completed at the time of the hearing, the summons was withdrawn on payment of £2 8s. costs. 5th June Depositing for the purpose of sale 30tins of Anchovy Fillets which were unsound, unwholesome and unfit for the food of man, at 50a, Princes Square, on 26th April. Fined £5 with £4 4s. costs 14th June Failing to abate nuisances arising from defective roof, stove, eavesgutter and dirty walls and ceilings at 15, Baggally Street. Ordered to do the work within 14 days and pay £2 8 costs. 24th June Failing to abate nuisances arising from defective pavement of yard, accumulation of refuse and choked drains of Pelham Yard. Ordered to do the work within 28 days and pay £2 8s. costs. 28th June Failing to repair defective roof of house and damp and defective ceiling at 27, Great Garden Street. Ordered to do the work within 7 days and pay £2 8s. costs. 2nd July Failing to abate nuisance caused by defective roof and damp walls at 37, Yalford Street. Ordered to do the work within 7 days and pay £2 8s. 0d. costs. 2nd July Failing to abate nuisance caused by defective roof at 41, Plumbers Row. Ordered to do the work within 7 days and pay £2 8s. 0d. costs. 27th Aug. Failing to abate nuisance arising from dilapidated walls and ceiling and defective flooring at 1, North Place. The work having been completed at the time of hearing, the summons was withdrawn on payment of £2 8s. Od. costs. 27th Aug. Failing to abate nuisance ari sing from dilapidated walls and ceilings and defective flooring at 2, North Place. The work having been com pleted at the time of hearing the summons was withdrawn on payment of £2 8s. Od. costs. 11th Sept. Failing to comply with a Magistrate's Order, made on 2nd July, to abate a nuisance at 41, Plumbers Row. Fined £2 0s. 0d., with £2 2s. Od. costs. 67 Date Matter of information or complaint. Result. 12th Sept. Exposing for sale 15¾ lbs. of unsound pickled meat at 8. Durham Row on 21st August. Defendant cautioned, case dismissed on payment of £2 2s. 0d. costs. 23rd Sept. Failing to abate nuisance caused by defective rainwater pipes, yard paving, etc., at 15, Artillery Passage. Ordered to do the work within within 21 days and pay £2 8s. 0d. costs. 29th Nov. Failing to abate nuisance caused by damp wall at 19, Philpot Street. The work having been completed at the time of the hearing, summons withdrawn on payment of £2 8s. 0d. costs. 29th Nov. Failing to abate nuisance caused by defective roof at 17, Philpot Street. Ordered to do the work within 14 days. Pay £2 8s. 0d. costs. . 9th Dec. Failing to abate nuisance consisting of defective front gutter at 13, Yalford Street. Ordered to do the work within 21 days and to pay £2 8s. 0d. costs. 9th Dec. Failing to abate nuisance consisting of walls and ceilings dirty and dilapidated at 29, Vallance Road. Houses-let-in-Lodgings Byelaws. Ordered to do the work within 14 days and to pay £2 8s. 0d. costs. 17th Jan. Absence of lighting of staircase one hour after sunset until 11 p.m. at 51, Oxford Street. *Dismissed because under a High Court Judgment stated by Defendant's Counsel there was a separate rating of each tenement which excluded it from being a House let in lodgings under the Bye-laws. * The premises have accordingly been removed from the Register of Houses-let-in-lodgings and treated as a tenement building. London County Council Drainage Byelaws. 26th April . Failing to give notice of the construction of a new portion of the drain at 6, Black Lion Yard. Fined £1 0s. 0d. with £1 1s. 0d. costs. 26th April Failing to deposit plans of a new portion of drain constructed at 6, Black Lion Yard. Fined £1 0s. 0d. with £1 1s. 0d. costs. 24th June Failing to give notice or deposit plans of drainage work to be executed at 28, Middlesex Street. Dismissed under the Probation of Offenders Act on payment of £4 4s. Od. costs. 26th Aug. Failing to deposit plans and drawings of drainage work executed at 126, Whitechapel Road. Fined £1 0s. 0d. with £2 2s. 0d. costs. Children and Young Persons Acts, 1908- 1932. 28th Mar Failing to give notice of her intention of taking a foster child at 2, Flower and Dean Street on 12th November, 1934. Bound over for 12 months in own recognizances in the sum of £2 0s. 0d. 68 Date. Matter of Information of Complaint. Result. Public Health (Preservatives in Food) Regulations. 26th April Manufacturing for sale Egg Substitute Powder that contained an excess of 625 parts per million sulphur dioxide, on 11th March (Sample C 148). Fined £5 0s. 0d. with £3 3s. 0d. costs. 26th April Selling Egg Substitute Powder containing an excess of 480 parts per million sulphur dioxide, between 14th January and 11th February (Sample B 102). Fined £5 0s. 0d. with £4 4s. 0d. costs. Metropolitan Borough of Stepney Bye-laws re Street Trading. 3rd June Failing to take reasonable steps to prevent contamination of food, i.e., Poultry, exposed for sale on his stall in Watney Street, on 28th April. Fined £3 with £2 2s. costs. 3rd June Failing to take reasonable steps to prevent contamination of food, i.e., Poultry, on the same stall as above, but he was the assistant in charge. Case not dealt with. Public Health (Meat) Regulations, 1924. 12th June Using a butcher stall at the corner of Martha Street and Watney Street, the same not being suitably screened at one side on 12th April. Fined £1 with £1 1s. costs. 23rd Oct. Having his meat stall improperly screened at the corner of Eastfield Street and White Horse Street, on 10th September. Fined 5s with £2 2s. 0d costs London County Council (General Powers) Act, 1908. 1st Feb. Failing to keep the shop at 18, Plumbers Row (food premises), in a clean condition, on 7th December, 1934. Fined £3 0s. Od. with £2 2s. 0d. costs. 17th July Dirty condition of milk saucepan used in the manufacture of ice-cream at 19, Hanbury Street, on 30th May. Fined £1 with 6s. 8d. costs. 17th July Dirty condition of ice-cream wafer-machine at 19, Hanbury Street, on 30th May. Fined £1 0s. 0d. with 6s. 8d. costs. 17th July Dirty condition of premises where ice-cream is manufactured at 1, Hanbury Street on 30th May. Fined £1 0s. 0d. with 10s. 0d. costs. 26th July Lock-up shop used for selling fruit occupied as a sleeping place at 16, Crellin Street on 18th July. Cautioned and case dismissed. 29th July Manufacturing ice-cream on 4th July at 21, Plumbers Row, the premises being in a dirty condition. Fined £1 0s. 0d. 2nd Aug. Failing on 15th July to observe due cleanliness at premises, 16, Stepney High Street, where ice-cream is manufactured. Fined 10s. 0d. with 10s. 6d. costs. 69 Date. Matter of information or complaint. Result. 18th Sept. Failing on 1st August to observe due cleanliness in shop at 18, Mulberry Street, wherein articles intended for the food of man are sold. Fined £1 0s. 0d. with £1 1s. 0d. costs. London County Council (General Powers) Act, 1932. 17th July. Manufacture and sale of ice-cream on 30th May, on unregistered premises, 19, Hanbury Street. Fined £1 0s. 0d. with 6s. 8d. costs. 17th July Manufacture and sale of ice-cream on 30th May, on unregistered premises 1, Hanbury Street. Fined £1 0s. 0d. with 10s. 0d. costs. 29th July Manufacture and sale of ice-cream on 4th July, on unregistered premises, 30, Plumbers Row. Fined £1 10s. 0d. with £3 3s. 0d. costs. 2nd Aug. Manufacture of ice-cream on unregistered premises, on 15th July, 16, Stepney High Street. Dismissed under the Probation of Offenders Act on payment of 10s. 6d. costs. Merchandise Marks Act, 1926. 25th Mar. Exposing for sale at 136a, White Horse Street on 28th February, frozen mutton which carried no " indication of origin." Fined £2 0s. 0d. with £2 2s. 0d costs. 25th Mar. Exposing for sale at 156, White Horse Street on 25th February frozen meat which carried no " indication of origin." Fined £2 0s. 0d. with £2 2s. 0d. costs. 12th June Exposing for sale at 71, Burdett Road, on 10th May, imported meat, the same not showing any " indication of origin." Fined £5 with £2 2s. costs. 12th June Exposing for sale at 58 Watney Street, Argentine liver, the same not showing any *' indication of origin." Fined £2 with £1 1s. costs. 12th June Exposing for sale Argentine liver, the same not showing any " indication of origin " on her butcher stall at corner of Martha Street and Watney Street Fined £2 with £1 Is. costs. 12th Sept. Exposing for sale at 171 Salmon Lane on 7th August, imported liver, the same not bearing any " indication of origin." Fined £3 0s. 0d. with £1 1s. 0d. costs. 14th Oct. Exposing for sale at 159, Salmon Lane imported liver and imported meat, neither having any " indication of origin." Found guilty without any penalties. Co-defendant with the above, for exposing for sale imported liver not bearing any "indication of origin." Fined £1 with £1 1s. 0d. costs. The same co-defendant as above for exposing for sale imported meat not bearing any " indication of origin." Fined £2 with £3 3s. 0d. costs. 70 Date. Matter of information or complaint. Result. Milk and Dairies Consolidation Act, 1915. 8th Mar. Not having his name and address conspicuously inscribed on milk barrow on 31st January. Fined £1 0s. 0d. with £2 2s. 0d. costs. 27th Mar. Failing to inscribe his name and address conspicuously on his milk barrow on 27th February. Dismissed under the Probation of Offenders Act on payment of £1 1s. 0d. costs. 18th Nov. Failing to have his name and address conspicuously inscribed upon his vehicle or receptacles when selling milk in the highway on 1st October, (Case adjourned from 11th November). Case was withdrawn. 18th Nov. Failing to have his name and address conspicuously inscribed on his vehicle or receptacles when selling milk in the highway on the 1st October. Fined £2 with £1 1s. 0d. costs. Milk and Dairies Order, 1926. 31st Jan. Failing to keep utensils used in connection with his business as a dairyman in a state of thorough cleanliness. Fined £2 0s 0d. with £2 2s. costs. 8th Mar Selling milk from a dirty vehicle in Aston Street on 30th January. Dismissed under the Probation of Offenders Act on payment of £3 3s. 0d. costs. 28th Mar. Selling loose cream at 632, Mile End Road, the premises not being registered as a dairy, on 27th February. There were 2 defendants and each was fined £2 with £1 1s. 0d. costs. 11th April Failing to keep utensils used in connection with his business as a dairyman in a state of thorough cleanliness on 19th March. Fined £3 0s. 0d. with £1 0s. 0d. costs. 3rd June Failing to keep utensils used in connection wi th his business as a dairyman in a state of thorough cleanliness on 10th April. Fined £3 with £1 1s. costs. 3rd June Failing to keep utensils used in connection with his business as a dairyman in a state of thorough cleanliness on 11th April. Fined £2 with £11s. 0d. costs 18th July Carrying on the business of dairyman on 12th June without being registered. Fined £2 0s. 0d. 22nd July Failing to keep a churn containing milk, which was delivered to the South Grove Institution on 14th May, in a thorough state of cleanliness. Fined £2 0s. 0d. with £4 4s.0d. costs. 24th July Failing on 18th May, to keep a cowshed reasonably sweet and clean. Fined £5 0s. 0d. with £4 4s. 0d. costs. 24th July Failing on 18th May, to keep milking stools used in a cowshed thoroughly clean. Fined £5 0s. 0d. 24th July Failing on 18th May, to cause the milk of each cow milked in the cowshed to be removed from the cowshed to a suitable milk room as soon as possible after milking. Fined £5 0s. 0d. 71 Date. Matter of information or complaint. Result. 25th July Carrying on the business of a dairy on 23rd June, on unregistered premises. Fined £1 0s. 0d. with £1 Is. 0d. costs. 29th July Carrying on the business of a dairy at 65, Vallance Road, E.l, on 10th July, the said premises not being registered as a dairy. Fined £5 0s. 0d. with £3 3s. 0d. costs. 29th July. (a) for filling dirty milk bottles with milk on 10th July; (6) failing to take all practicable precautions for preventing the contamination of milk, on the same date. Summonses withdrawn. 9th Sept Selling milk on 19th July, from a foul and rusted half-pint milk measure. Fined £1 0s.0d. with £1 1s. 0d. costs. 9th Sept. Maintaining the milk shop at 25, Heneage Street in a dirty and unwholesome condition on the 22nd July. Fined £1 0s. 0d. with £2 2s. 0d. costs. 21st Oct. Removing the disc from a closed bottle of milk and selling the milk on 2nd September on premises not registered. Fined £2. 29th Oct. Carrying on the business of Dairyman at 220, Bow Common Lane on 18th September without being registered. Fined £3 with £2 2s. 0d. costs. 18th Nov. Selling milk, on 1st October, without being registered. (Case adjourned from 11th November). Case was withdrawn. Milk Act, 1934. 7th Aug. Selling milk on 10th July, with a description " Pasteuris< d Milk" without being licensed to do so. Fined £1 0s. 0d. with £2 2s. Od. costs. Food and Drugs (Adulteration) Act, 1928. 14th Jan. Selling milk deficient in solids-not-fat to the extent of 6.2 per cent. on 5th December, 1934. (Sample X.66.) Fined £2 0s. 0d. with £2 2s. Od. costs. 1st Feb. Selling milk deficient in solids-not-fat to the extent of 6.6 per cent. (due to the presence of at least 9.2 per cent. added water) on 18th December, 1934 (Sample E.83). Dismissed under Probation of Offenders Act on payment of £2 2s. 0d. costs. 13th Feb Selling milk deficient in fat to the extent of 13.3 per cent. and solids-not-fat to the extent of 26.4 per cent. on 9th January. (Sample B.16.) Fined £5 0s. Od. with £1 0s. 0d. costs, or one month in default of distress. 13th Feb Selling milk deficient in solids-not-fat to the extent of 10.9 per cent. on 9th January. (Sample B.15.) Fined £3 0s. Od. with £1 0s. 0d. costs. 13th Feb Selling milk deficient in solids-not-fat to the extent of 35.6 per cent. and fat to the extent of 40.3 per cent. on 9th February. (Sample B.13.) Fined £3 0s. Cd. with £2 0s. 0d costs. 72 Date. Matter of information or complaint. Result. 13th Feb. Selling milk deficient in fat to the extent of 40 per cent. on 7th February. (Sample B.2.) Fined £3 0s. 0d. with £2 0s. 0d. costs. 14th Feb. Selling milk deficient in solids-not-fat to the extent of 31.8 per cent. and fat to the extent of 20.7 per cent. on 7th January. (Sample B.4.) Fined £3 0s. 0d. with £2 0s. 0d costs, or one month in default of distress. 14th Feb. Selling milk deficient in solids-not-fat to the extent of 28.4 per cent. and fat to the extent of 16.7 per cent. on 8th January. (Sample B.12) Fined £3 0s. 0d. with £2 0s. 0d costs or one month in default of distress. 1st Mar. Selling milk 25.0 per cent. deficient in fat. on 14th January. (Sample C 30.) Fined £ 1 0s. 0d. with £3 3s. 0d. costs. 1st Mar. Selling milk that was 8.0 per cent. deficient in solids-not-fat (equivalent to the addition of 11.1 per cent. of water) on 14th January. (Sample C.28.) Dismissed under the Probation of Offenders Act on payment of £2 2s. 0d. costs. 18th Mar. Selling whisky containing 15.4 per cent. excess water on 8th February. (Sample B.64.) Dismissed under the Probation of Offenders Act on payment of £5 5s. 0d. costs. 8th April Selling milk 11.0 per cent. deficient in fat on 5th March, (Sample B. 114.) Fined £2 0s. 0d. with £3 3s. 0d. costs. 24th April Selling milk 11.3 per cent. deficient in fat on 25th March. (Sample C. 175.) Fined £4 0s. 0d. with £2 2s. 0d. costs. 24th April Selling milk 5.7 per cent. deficient in fat on 11th March. (Sample C.142.) Fined £2 10s, 0d. with £2 2s. 0d. costs. 24th April Selling milk 10.3 per cent. deficient in fat on 12th March. (Sample C.152 ) Fined £2 0s. 0d. with £2 2s 0d. costs. 24th June Selling margarine containing 50 per cent. of fat derived from milk on 22nd May. (Sample B 289.) Fined £2 with £1 1s. costs. 24th June Exposing for sale by retail a parcel of Margarine not labelled "Margarine," on 22nd May. Fined £5 with £2 2s. costs. 24th June Selling milk 2.4 per cent. deficient in solidsnot-fat (4.9 per cent. added water), on 24th May. (Sample C 334.) Dismissed under the Probation of Offenders Act on payment of £4 4s. costs. 24th June Selling margarine containing 50 per cent. of fat derived from milk on 22nd May. (Sample B.289.) Fined £2 with £1 1s. costs. 24th June Exposing for sale by retail a parcel of Margarine not labelled "Margarine," on 22nd May. Fined £5 with £2 2s. 0d. costs. 73 Date. Matter of information or complaint. Result. 5th July Selling bread and butter on 17th May, the fat of which consisted of 100 per cent. margarine. (Sample B 286.) Dismissed under the Probation of Offenders Act on payment of £2 2s. 0d. costs 15th July Selling milk on 4th June 22 per cent. deficient in fat. (Sample C.350.) Case dismissed as summons was served on the defendant less than 14 days from the time of hearing 18th July Selling milk on 12th June, 50.7 per cent. deficient in fat. (Sample B 326.) Fined £3 0s. 0d. with £2 2s. 0d. costs. 18th July Selling milk on 7th June, 12 per cent. deficient in fat and 15.5 per cent. solidsnot-fat. (Sample C 364.) Fined £2 0s. 0d. with £3 3s. 0d. costs. 25th July Selling milk on 23rd June, 55 per cent. deficient in fat. (Sample C 405.) Fined £1 0s. 0d. with £1 1s. 0d. costs. 25th July Selling rolls and butter on 26th June, the fat of which consisted of 100 per cent. margarine. (Sample D 367.) Fined £2 0s. 0d. with £2 2s. 0d. costs. 9th Sept. Selling milk on 19th July, 19 per cent. deficient in fat. (Sample C 474.) Fined £1 0s. 0d. with £2 2s. 0d. costs. 9th Sept. Selling milk on 30th July, 15.6 per cent. deficient in solids-not-fat and 10.7 per cent. deficient in fat. (Sample C 483.) Dismissed under the Probation of Offenders Act. 9th Sept. Obstructing a Sampling Officer whilst purchasing milk on 30th July. (Sample C 483). Fined £5 0s. 0d. with £2 2s. 0d. costs. 26th Sept. Selling milk on 7th August, 16 per cent. deficient in fat. (Sample C 512.) Fined £5 0s. 0d. with £2 2s. 0d. costs. 26th Sept. Selling ½-lb. of minced meat containing 96 parts sulphur dioxide per million. (Sample A 8.) Fined £2 0s. 0d. with £2 2s. 0d. costs. 26th Sept. Selling ½-lb minced meat containing 1,860 parts sulphur dioxide per million. (Sample A 16.) Fined £10 0s. 0d. with £2 2s. 0d. costs. 10th Oct. Selling milk on 7th August deficient of 9 per cent of solids-not-fat and 3.7 per cent. of fat. (Sample C.513.) Case dismissed under Probation of Offenders Act on payment of £2 2s. 0d. costs. 21st Oct. Selling milk on 2nd September 26.3 per cent. deficient in fat. (Sample C.552.) Case dismissed under Probation of Offenders Act on payment of £2 2s. 0d. costs. 21st Oct. Selling ½ lb. minced meat on 30th August containing 500 parts of sulphur dioxide per million. (Sample A. 32.) Fined £3 0s. 0d with £2 2s. 0d. costs. 28th Oct. Selling rolls and butter on 12th September, which on analysis proved to be margarine. (Sample C 609.) The summonses were dismissed. 74 Date. Matter of information or complaint. Result. 11th Nov. Selling milk on 25th September deficient of 19.2 percent. solids-not-fat and 17 per cent. of fat. (Sample C.632.) Fined £2 0s. 0d. with £2 2s. 0d. costs. 11th Nov. Selling milk on 8th October deficient of 25 per cent. of fat. (Sample C.654.) Case dismissed on payment of £2 2s. 0d. costs. 18th Nov. Selling milk on 1st October deficient of fat to the extent of 26.3 per cent. (B 571). This was adjourned from 11th November, 1935. Case was withdrawn. 18th Nov. Selling milk on 1st October, deficient in fat to the extent of 26.3 per cent. (Sample B 571). Fined £10 0s. 0d. with £2 2s. 0d. costs. 28th Nov. Selling milk on 25th October, deficient of 15 per cent. of solids-not-fat. (Sample C 702). Case dismissed under Probation of Offenders Act on payment of £2 2s. 0d. costs. 28th Nov. Selling milk on 25th October, deficient of 7.3 percent. of fat. (Sample C 705). Fined £2 0s. 0d. with £2 2s. 0d. costs. 28th Nov. Selling milk on 17th October, deficient in fat to the extent of 22.3 per cent. (Sample B 620). Case dismissed under Probation of Offenders Act on payment of £3 3s. 0d. costs. 28th Nov. Selling milk on 15th October deficient in fat to the extent of 30 per cent. and solids-not-fat 20.8 per cent. (24.5 percent. added water — Hortvet). (Sample B 607). Fined £2 0s. 0d. with £2 2s. 0d. costs. 29th Nov. Selling milk on 21st October, deficient of 7.4 per cent. of solids-not-fat. (Sample C 677). The summons was adjourned sine die because defendant has gone to Italy. It will be proceeded with on his return. 29th Nov. Selling milk on 23rd October, deficient of 27.3 per cent. of fat and 1.9 per cent. of solids-not-fat. (Sample C 691). Summons was not served because defendant had entered a sanatorium. 29th Nov. Selling milk on 16th October, deficient in solids-not-fat to the extent of 9.2 per cent. (11.1 per cent. added water Hortvet) (Sample B 615). Case was dismissed under Probation of Offenders Act on payment of £3 3s. 0d. costs. 29th Nov. Selling milk on 16th October, deficient in solid-not-fat to the extent of 24.8 per cent. (27 per cent. added water—Hortvet). (Sample B 614). Case dismissed under Probation of Offenders Act on payment of £2 2s. 0d. costs. 2nd Dec. Selling milk on the 16th October deficient in fat to the extent of 26.3 per cent. (Sample B 617.) Fined £5 0s. 0d., and to pay £2 0s. 0d. costs 2nd Dec. Selling milk on the 16th October deficient in solids-not-fat to the extent of 42.9 per cent (44.5 per cent. added waterHortvet). (Sample B 618.) Fined £3 0s. 0d, and to pay £1 0s 0d. costs 75 Date. Matter of information or complaint. Result. 2nd Dec. Selling on the 21st October milk deficient of 18.6 per cent of solids-not-fat. (Sample C 678 ) Fined £2 0s 0d., and to pay £1 1s. 0d costs. 2nd Dec. Selling milk on 21st October which was deficient of 25.3 per cent. fat and 4.2 per cent, solids-not-fat (Sample C.679.) Fined £2 0s 0d and to pay £1 1s. 0d. costs. 5th Dec. Selling on 22nd October Grey powder deficient of 54.2 per cent. of mercury. (Sample C.683.) Case dismissed under Probation of Offenders Act on payment of £1 1s. 0d. costs. No. of Summonses. Fines. Costs. £ s. d. £ s. d. Public Health (London) Act, 1891 45 26 0 0 103 0 0 Houses-Let-in-Lodgings Bye-laws 1 — — London County Council Drainage Byelaws 4 3 0 0 8 8 0 Children and Young Persons Acts 19081932 1 - - Public Health (Preservatives in Food) Regulations 2 10 0 0 7 7 0 Stepney Borough Council Byelaws re Street Trading 2 3 0 0 2 2 0 Public Health (Meat) Regulations, 1924 2 1 5 0 3 3 0 London County Council (General Powers) Act, 1908 8 8 10 0 4 16 10 London County Council (General Powers) Act, 1932 4 3 10 0 4 10 2 Merchandise Marks Act, 1926 9 19 0 0 13 13 0 Milk and Dairies (Consolidation) Act, 1915 4 3 0 0 4 4 0 Milk and Dairies Order, 1926 20 46 0 0 27 12 0 Milk Act, 1934 1 1 0 0 2 2 0 Food and Drugs (Adulteration) Act, 1928 57 115 10 0 105 10 0 Total 160 239 15 0 286 8 0 76 Statistics IV.— HOUSING. I. —Inspection of dwelling houses during the year (1) (a) Total number of dwelling houses inspected for housing defects (under Public Health or Housing Acts) 21,637 (b) Number of inspections made for the purpose 26,507 (2) (a) Number of dwelling houses (included under sub-head (1) above) which were inspected and recorded under the Housing Consolidated Regulations, 1925 703 (b) Number of inspections made for the purpose 729 (3) Number of dwelling houses found to be in a state so dangerous or injurious to health as to be unfit for human habitatation 91 (4) Number of dwelling houses (exclusive of those referred to under the preceding sub-head) found not to be in all respects reasonably fit for human habitation 11,852 2.—Remedy of defects during the Year without service of formal notices :— Number of defective dwelling houses rendered fit in consequence of informal action by the Local Authority or their officers 8,614 3.—Action under Statutory Powers during the Year :— (a) Proceedings under sections 17, 18 and 33 of the Housing Act, 1930 :— (1) Number of dwelling houses in respect of which notices were served requiring repairs — (2) Number of dwelling houses which were rendered fit after service of formal notices (a) By owners — (b) By local authority in default of owners — (b) Proceedings under Public Health Acts :— (1) Number of dwelling houses in respect of which notices were served requiring defects to be remedied 3,238 (2) Number of dwelling houses in which defects were remedied after service of formal notices :— (a) By owners 3,238 (b) By local authority in default of owners — 77 (c) Proceedings under sections 19 and 21 of the Housing Act, 1930 :— (1) Number of dwelling houses in respect of which Demolition Orders were made 4 (2) Number of dwelling houses demolished in pursuance of Demolition Orders 2 (d) Proceedings under section 20 of the Housing Act, 1930 :— (1) Number of separate tenements or underground rooms in respect of which Closing Orders Were made 8 (2) Number of separate tenements or underground rooms in respect of which Closing Orders were determined, the tenement or room having been rendered fit — 489 families in the Borough took accommodation on the London County Council's housing estates as follows :— Estate. Number of families. Estate. Number of families. Andover 1 Honor Oak 2 Ann Street 4 Holland 4 Becontree 328 Mare Street 1 Bekesbourne Buildings 4 Northwold 14 Birchfield Street 1 Prestons Road 4 Brook Street 1 Prevost Street 5 Boundary Street 20 Roehampton 1 Bow Bridge 4 Shore 2 Bourne 2 St. Helier 11 Cable Street 4 Swan Lane 1 Collingwood 7 Stamford Hill 6 Clapham Park 2 Watling 1 Chancery Buildings 2 White Hart Lane 3 Downham 3 Wapping 4 East Hill 1 Westferry Road 38 Goldsmith Row 1 Whitmore 1 Haggerston 6 Housing Accommodation provided. 78 Overcrowding Full particulars of bad cases of overcrowding are forwarded to the Borough Treasurer for special consideration with a view to obtaining alternative accommodation. During the year, 42 fresh cases of overcrowding were found, which involved the serving of 40 intimations and 35 statutory notices. 63 cases of overcrowding were abated. House to House Inspection. List of streets in which all the houses have been inspected as a result of House to House inspection during the year 1935. (a) Limehouse. Mr. Bottomley. Amoy Place Batson Street Birchfield Street Church Row Gill Street Grenade Street Lance Street Limehouse Causeway Pads tow Place Phoebe Street Park Street Rich Street Robert Street Rugg Street Salter Street Three Colt Street Trinidad Street West India Dock Road Mr. Cue. Nil. Mr. McCarthy. Nil. Mr. Waterman. Barnardo Street Boulcott Street Bower Street Giles Place Glasshouse Fields Hilton Street Horndon Place Manor Court Medland Street Prittlewell Place Ratcliff Cross Street Sage Street Solander Street Steels Lane Stepney Causeway Thirza Street (b) Mile End. Mr. Day. Nil. Mr. Edwards. Nil. Mr. Flint. Antill Road Frederick Place Murdock Cottages Mr. Harris. Nil. Mr. Lowther. Cordelia Street Milward Street Mr. Simpson. Braintree Street Cambridge Mansions Devonshire Street Drivers Buildings Frimley Street May's Buildings Mile End Buildings Orson Place Williams Buildings Mr. Trimming. Nil. 79 (c) St. George's. Mr. Brockett. Nil. Mr. Dee. Church Court Coleman Street Drood Yard Sarah Street Woodside Mansions Mr. Freeland. Nil. Mr. Guy. Agra Buildings Agra Place Blakesley Street Cross Court Dunch Street Fenton Street Hungerford Street Mariner Street Star Place Whites Gardens Mr. Haworth. Batty Street Durer Place Helena Mansions Hogarth Houses, Blocks 11-31 Meredith Buildings Priestley Buildings Queens Place Wellington Buildings (d) Whitechapel. Mr. Green. Chamber Street Great Eastern Buildings Katherine Buildings Mr. Roper. Black Eagle Street Blossom Street Duke Street Duval Street Fleur-de-lis Buildings Rosetta Place Mr. Smith. Buxton Street Spring Gardens Mr. Twynham. Boundary Court Chicksand Place Flower and Dean Street Green Dragon Yard Ramar Place Spencer House Mr. Brownlee. Court Street Eele Street Lombard Street Nelson Place 80 Slum Clearance. Slum Clearance. During the year the Council made a Compulsory Purchase Order with reference to an area known as the Padstow Place Area. This area included 68 houses and the number of persons to be displaced is 365. Clearance Orders were also made as follows :— Houses. Persons to be displaced. Mary Place Area 10 52 Plough Alley Area 4 23 Williams Place No. 1 Area 2 4 ,, ,, ,, 2 ,, 3 7 Wellington Buildings Area 14 63 Half Moon Passage Area 6 30 Drum Yard Area 8 30 An enquiry was held by the Ministry of Health into each of the above areas and it is gratifying to be able to report that in every case as regards the colouring of the maps and the representation of the areas, the orders were confirmed without any modification. It is a matter for regret, however, that owing to unforeseen difficulties which have arisen in the provision of rehousing accommodation for the persons to be displaced, the Minister has had to defer the operation of the Orders. In my report for 1934, having in mind the building programme of the Council for 1935, I ventured to suggest that a real start had been made in slum clearance. It is, however, disappointing to find that, owing to the difficulties which the Council have experienced, blocks of flats which it was anticipated would by this time have been ready for occupation, or nearing completion, will not be available for some considerable time. It is apparent that it is impossible to deal with future areas until definite progress is made in the provision of rehousing accommodation. London County Council. During the year the London County Council have passed clearance order resolutions in respect of the following areas within the Borough :— Houses. Persons to be displaced. Shadwell Place Area 194 1,174 Pennington Street Areas 180 992 Chicksand Street Areas 193 780 Pedley Street Area (Portion in Stepney) 20 93 81 Overcrowding. The overcrowding survey which was commenced on 4th November was carried through successfully. The number of structurally separate dwellings surveyed was 35,199, the number of separate families being 49,317. (See appendix for tables of results.) Of this total number of families, 7,632 were found to be overcrowded or 15.42% of the whole. The next stage was to ascertain the number of new dwellings required to abate overcrowding on a basis of 1½ persons per room and also to estimate what proportion of the accommodation required will be provided by rehousing operations under the Housing Act 1930 (Slum Clearance Areas, &c.). Overcrowding Survey. As regards the latter requirement, as a result of consultations with the Medical Officer of Health of the London County Council a list of such areas was agreed, an examination of which shows that there are 2,268 overcrowded families to be included in this category. The following table shows at a glance:— (1) The total number of additional dwellings required on a basis of 1½ persons per room. (2) The number of such additional dwellings to be provided under the Housing Act, 1930. (3) The balance of dwellings to be provided under the Housing Act 1935. Additional dwellings required on the standard of l ½ persons a room under the above headings. 3 rooms 4 rooms 5 rooms 6 rooms 7 rooms 8 rooms 9 rooms 10 rooms Total (1) 1,293 707 791 176 139 31 11 2 3,150 (2) 388 212 237 53 42 8 4 1 945 (3) 905 495 554 123 97 23 7 1 2,205 Following upon the foregoing is the submission of proposals as to the provision of the new houses. As to this matter, the 1935 Act provides that the County Council shall be the authority, provided that if the Borough Council themselves propose to provide houses to abate overcrowding, they must submit their report thereon to the County Council. 82 It is here we come face to face with the real difficulties of the problem These additional houses cannot be provided within the Borough. Most of the overcrowding in the Borough is found to be due to poverty as well as to the necessity of people to live near their work. In the examination of the returns for slum areas, the percentage of overcrowding is found to be in some cases as high as 50%, whilst in the case of a large estate containing no slums, out of 1,560 houses containing 2,436 families, the percentage of overcrowding is 4.9%. Section 12 of the Housing Act, 1935, defines alternative accommodation as follows:—"(b) The Local Authority must certify the house to be suitable to the needs of the occupier and his family as respects security of tenure and proximity to place of work and otherwise and to be suitable in relation to his means." The position therefore appears to be as follows :— The required building sites are not available in Stepney and, even if they were, it is doubtful whether, owing to the cost of some of the sites it would be possible to provide accommodation for a large number of families at a rent within their means. To expect the majority of them to remove some distance away and to incur additional expenses in travelling is doomed to failure. Before any really effective work of slum clearance and of housing to abate overcrowding can be carried out, a substantially large area within easy reach of Stepney must be found for rehousing, otherwise the progress must necessarily be slow. The problem is a vast one and the Borough Council are doing their best to deal with a difficult situation. We can only hope that the County Council and the Government with their vast resources will use every endeavour to deal with the problem in no uncertain manner. One cannot even guess what the future has in store for us. London has grown to its present dimensions during the past century as a result of the industrial revolution known as the Steam Age. We are now on the threshold of the electrical age and it may be that industry will move out into the open country where it would be possible to build new composite towns on garden city lines in which people could live and work in healthy surroundings. Has this process of disintegration already set in ? The following figures may be of interest in this connection as regards the population of Stepney :— 83 In 1911 Census, the population was 280,366 „ 1921 „ „ „ 249,738 „ 1931 „ „ „ 225,800 „ 1934 estimate „ „ 214,990 (i.e., a steady reduction in 23 years of over 65,000 persons.) If this rate of reduction is continued or accelerated it will not be many years before it would be a practicable proposition to re-plan and rebuild Stepney and make it a place of which future citizens may well be proud. Why should not part, at least, of East London be a Garden City ? A long view and a broad view is necessary and we should make sure that our plans for the future are built on solid foundations, and that they will not be interfered with by any intermediate planning. V.—INSPECTION AND SUPERVISION OF FOOD. The new Food Section commenced its work on 1st January, 1935, and has already justified itself to the full. The year was a strenuous one. New methods of recording, compilation of new registers and amendments to existing registers, have all taken up a considerable time in addition to that devoted to the general work of Food Inspection and Sampling. Improvements have been brought about in the dairies, cowsheds, milkshops, ice-cream premises, preserved food premises, butcher's shops, greengrocers and the food premises generally, and the Merchandise Marks Act has been more rigidly enforced. This has been possible because the Food Inspectors have been able to concentrate upon those premises whereas previously supervision was carried out by the District Sanitary Inspectors, who were, with their multifarious and increasing duties, unable to give such attention to these premises as was necessary. Efforts have been made to raise the standards of the food premises. In this respect it is to be noted that the number of dairies is considerably less, whereas the number of persons selling milk in sealed containers has increased; the number of premises where ice-cream is manufactured has decreased with a corresponding increase in the number of premises where wrapped ice cream is sold. Sampling under the Food and Drugs (Adulteration) Act, 1928, has been more varied and has been carried out more systematically, with an increase in interesting legal points. 84 Special attention has been paid to milk sampling. There has been more extensive sampling of "graded" milks, school milks and hospital milks for analysis and bacteriological examination; more samples of milk have been submitted for T.B. examination by guinea-pig inoculation and samples of milk from cowsheds have been submitted for bacteriological examination. Strenuous efforts have been made to trace the various sources of adulteration, and samples have been taken in course of delivery by wholesalers where no warranty is in existence. The co-operation between the Sampling Officers and the Public Analyst continues to be most effective, producing very practical results this year. The number of prosecutions instituted has been a record. Unfortunately, it has been necessary to issue a considerable number of summonses under the Food and Drugs (Adulteration) Act, 1928, during the year. It is hoped that the strenuous efforts made by the Food Inspectors to stamp out adulteration of food will bear fruit during the coming years. The Section is still in its infancy. Difficulties have been met with and will continue to be met with, but the year has been a successful one. The compulsory marking of imported meat came into operation on the 7th January, 1935. In most cases tradesmen, after an explanation of the requirements of the Merchandise Marks Act, made endeavours to comply with the same, though it was found necessary to institute legal proceedings in 8 cases when fines and costs were imposed. There is now a marked improvement in the marking of imported meat. 85 The following is a summary of the inspections, etc., by the four special Inspectors engaged in the supervision and inspection of food :— No. of Inspections H. Abson A.C.Brown T. W. Dee S. Vogler Totals Butcher and Bacon shops 477 — — — 477 Butcher and Bacon Stalls 171 — — - 171 Butter and Margarine premises. — 25 — 33 58 Complaints 13 22 2 29 66 Cowsheds — 71 — 57 128 Fish shops — 10 1 7 18 Greengrocers and Fruiterers — — 285 — 285 Ice Cream Premises — 345 — 252 597 Markets (Daily) — 270 18 324 612 Milkshops — 423 2 487 912 Prepared food premises 14 211 14 229 468 Wharves 602 — 261 — 863 Wholesale Grocers 1 47 — 79 127 Bishopsgate Station 14 1 141 — 156 Spitalfields Market — — 223 — 223 Miscellaneous visits 95 — 326 160 581 London Fruit Exchange — — 37 — 37 Samples taken—Food and Drugs. 32 720 - 757 1509 ,, ,, Other 30 27 18 28 103 Revisits 5 198 — 432 635 No. of Summonses taken out 15 47 — 51 113 86 Milk Supply. No. on No. of No. of Register. inspections. notices served. Dairy premises 263 912 243 Purveyors bottled milk 367 — 3 Itinerant vendors 74 — 2 Cowsheds 19 128 28 9 samples of milk were submitted to the Bacteriologist for the detection of Tuberculosis (guinea pig inoculation). 2 of these were unsatisfactory and communications were sent to the Medical Officer of Health of the districts where the milk was produced informing them of the results of the examination. 76 samples of milk were taken in course of delivery to various schools in the borough. 44 of the samples were submitted for chemical analysis and 32 for bacteriological examination. Of these, 1 sample of Pasteurised milk examined bacteriologically proved to be unsatisfactory, and the Medical Officer of Health of the district where the vendor was registered was informed. 29 samples of milk were taken in course of delivery to various hospitals and institutions in the borough. 26 of the samples were submitted for chemical analysis and 3 for bacteriological examination. All were satisfactory. 43 samples of milk and 4 samples of ice cream were submitted for bacteriological examination. Of these, 2 samples of milk were unsatisfactory and the Medical Officer of Health of other districts were communicated with. 69 Licences were issued under the Milk (Special Designations) Order, 1923, being 4 more than in the previous year, as follows :— Dealer's Licences Dealer's Supplementary Licences. "Certified " 3 1 "Grade 'A' (T.T.)" 17 8 "Grade 'A' Pasteurised" 1 — "Grade 'A'" 5 — "Pasteruised" 23 11 Butchers' Shops and Stalls. 648 inspections were made during the year and 6 cautions were sent for minor infringements of the Meat Regulations. Ice Cream Premises. The number of premises on the register at the end of the year was 376. 597 inspections Were made and 87 notices served. 87  No. on Register. No. of Notices served. No. of Inspections. Butter and Margarine Factories 7 — 58 Wholesale Dealers in Margarine 46 8 Preserved Fish premises 91 104 468 Preserved Meat premises 71 47 Butter and Margarine. Factories. Preserved Food Premises. 285 visits were made to the various shops and stalls in the borough and the proprietors were advised concerning the requirements of the Merchandise Marks Act, particularly with regard to the marking of Apples and Tomatoes. Greengrocers and Fruiterers. 372 inspections were made to the bakehouses in the Borough. Bakehouses. 20 certificates have been issued respecting the export of consignments of food products prepared within the Borough :— 3 to Italy. 3 to Egypt. 1 to Syria. 3 to Argentine. 9 to the United States of America. 1 to Australia. Certification of Food Products for Export. 595 other certificates were issued in respect of unsound food destroyed. The following is a list and quantity of the Foodstuffs from the wharves destroyed during the year under the Public Health (Imported Food) Regulations, 1925. Wharves. Tons cwts. qrs. lbs. Fresh Meat and Poultry. 1,265 Ducks 2 8 0 0 1 carcase New Zealand Mutton — — 1 18 4 Ostend Rabbits — — — 8 Preserved Meat. 505 tins Beef 1 7 0 4 149 „ Pork — 9 2 26 343 „ Rabbit — 9 1 6 2,335 „ Tongues 2 5 2 24 Unsound food. 88 Fresh Fruit and Vegetables. Tons cwts. qrs. lbs. 3,863 packages Assorted Fruit and Vegetables 54 14 0 0 5 crates Apricots — — 3 16 51 „ Bananas —- 17 2 0 50 baskets Beans — 5 2 23 318 cases Grape Fruit 8 18 3 24 45 „ Melons 1 8 2 18 117 „ Onions 2 7 3 16 3 „ Oranges — 3 3 18 10 crates Pau Pau Fruit — 2 2 0 5 cases Peaches — — 3 16 1,583 packages Plums 15 3 1 19 1,259 bags Potatoes 54 16 0 0 4 baskets Potatoes — 4 0 0 8 „ Tomatoes — 1 0 16 Preserved Fruit and Vegetables. Assorted tinned Fruit and Vegetables 5 1 0 22 552 tins Cherries — 12 1 8 3 cases and 340 tins Fruit Pulp 2 8 2 18 1,728 tins Loganberries — 15 1 20 827 „ Oranges — 9 0 2 1,355 „ Pineapple 1 3 3 14 273 boxes Prunes 4 0 0 0 242 „ Raisins 3 0 2 0 457 tins Tomatoes — 10 2 26 Preserved Fish. 248 tins and 432 jars Crab — 6 4 22 6,150 „ Salmon 2 13 3 18 653 „ Pilchards — 6 3 9 231 packages Frozen Shrimps and Crayfish 3 5 0 0 Sundries. Assorted canned goods 5 19 2 26 960 tins Lobster Paste — 2 0 16 280 packages Macaroni — 1 2 0 48 tins Milk — — 1 14 26 bags Rice 1 2 0 0 550 tins Soup — 4 3 18 28 bags Spaghetti — — 1 0 178 11 1 9 89  Tons cwts. qrs. lbs. Spitalfields Market and London Fruit Exchange. 154 boxes Apples 2 17 0 0 74 bags Chestnuts 2 8 2 8 Grape Fruits 7 0 0 24 10 crates Leeks — 2 2 0 1 case Lemons — — 3 6 190 boxes Oranges 4 15 0 18 120 bags Parsnips 2 18 0 0 730 boxes Pears 5 2 1 17 24 „ Peas — 3 0 0 15 cases Melons — 16 3 14 196 boxes Plums 1 12 1 26 387 Pineapples — 17 0 20 132 bags Potatoes 6 12 0 0 1,648 boxes Tomatoes 8 12 3 0 43 18 3 21 Other Premises. Fruit and Vegetables. Assorted tinned Fruit and Vegetables 7 0 0 25½ Dried Apple Rings — — — 9½ Apples — — 1 11 Dried Apricots — 1 2 0 Artichokes — 6 0 0 Butter Beans — — 2 16 Chestnuts — — 1 26 Dates — 1 0 12 Dried Mixed Fruit — — — 14 Grapes — — — 17 Oranges — — — 5 Peaches — — — 8 Pears — 16 1 23 Peas — 6 0 0 Plums 4 7 1 8 Tomatoes 21 2 0 0 90 Fish. Tons cwts. qrs. lbs. Hungarian Carp (51) - 1 0 0 Dabs (1 box) - — 3 0 Assorted Fish — — — 14 Assorted Fish (tinned) — — 1 14 Herrings (1 barrel) — 1 2 0 Dutch Herrings — 1 0 0 Tinned Herrings — — — 16 Plaice — — — 18 Rollmops (29 jars) - — — 21½ Tinned Sild — — — 1½ Skate — — 1 14 Meat and Poultry. Assorted tinned Meats - 14 2 19 Bacon — 9 2 121 Corned Beef - 14 1 23 Beef and Pork Brawn — — 3 22 2 Fowls — — — 7 Tinned Ham — 4 3 18½ Assorted Meat — 1 0 2 Pickled Meat — — — 15¾ 1 carcase New Zealand Pork — — 2 25 70 New Zealand Rabbits - 1 0 0 Tinned Tongue — — — 24 Tinned Turtle Meat - 1 0 2 Tinned Veal — — 3 24 Miscellaneous. Almonds (63 bags) 3 0 3 20 Assorted tinned goods 4 9 0 24| Chocolates — 16 1 01 Cocoa Beans 4 19 3 14 Pickled Cucumbers — — — 20 Jam - — 1 20 Marmalade — — — 9 Mixed Pudding Fruit — — — 20 Sweets — - — 3 Tomato Puree — 4 0 0 50 9 0 11 91 170 Detention Notices and 184 Release Notices were issued during the year in respect to the undermentioned foodstuffs :— Article. Detention Notices. Release Notices. Quantity. No. of notices. Weight. Quantity. No. of Notices. Weight. T. c. q lbs. T. c. q. lbs. Tallow 3,769 casks 51 1,510 12 0 0 3,582 casks. 95 1,432 16 0 0 Mutton 29,425 carcases 87 — 29,424 carcases. 83 — Corned Pork 19 cases 1 1 0 0 — — - Pigs Tongues 26 cases 1 11 0 16 — — — Oxtongues 10 cases 2 4 2 0 — — — Tongues 377 tins 10 12 0 10 — — — Ducks 1,265 1 2 8 0 0 — — — Whole Pepper 350 bags 2 24 9 0 0 350 bags 4 24 9 0 0 Almonds 100 bags 2 6 10 0 22 — — — Macaroni 280 packages 1 1 3 0 — — — Mandarin Oranges 47 cases 1 — — — — Prunes 218 boxes 1 3 12 0 0 — — — Loganberries 36 cases 1 1 20 — — — Rice 9 bags 1 9 0 0 - — — Potatoes 800 bags 1 40 0 0 0 — — — Crab 15 cases 1 1 3 4 — — — Cocoa (in bean) 90 bags 1 — — — — Pork 108 tins 1 5 3 4 — — — Pears 285 tins 1 1 5 1 22 — — — Apples 2 boxes 1 1 0 0 — — — Bacon 4 bales 1 8 0 0 4 part bales 1 4 2 27 Raisins 242 boxes 1 3 0 2 0 242 boxes 1 3 0 2 0 92 Caseous Lymphadenitis.— There were 2,110 carcases of imported mutton examined by the cutting of lymphatic glands. Of these, 1 was found diseased. This is a further marked reduction of the percentage of diseased carcases. This shows .047 per cent. against .25 per cent, in 1934. This is undoubtedly brought about by the more careful examination at the time of slaughter. 80 tons, 4 cwts., 0 qrs., 22 lbs. of Tea Sweepings were removed from warehouses for chemical purposes. Damaged Tea.—8,728 chests and 7 bags of tea, water damaged during a large waterside fire were removed from one wharf to another in this borough for reconditioning. The damaged portion weighing 59½ tons was allowed to be used for purposes other than for human consumption. 1,904 similar chests were sent to a wharf in Bermondsey for similar processing. ZEEBRUGGE-HARWICH AND CALAIS-HARWICH TRAIN FERRY. 101 special midnight and early morning visits were made by the Food Inspectors. In addition, 55 inspections were made by day. At Bishopsgate Station. The total weight of fresh fruit and vegetables examined was 11,805 tons, 18 cwts. This consisted of :— Belgian Apples, Greengages, Pears, Plums and Vegetables. Bulgarian Grapes and Plums. French Dates and Red and Black Currants. Hungarian Peaches, Plums and Tomatoes. Italian Apples, Apricots, Cherries, Chestnuts, Grapes, Greengages, Lemons, Melons, Peaches, Pears, Plums, Raspberries, Strawberries and Vegetables. Jugo-Slavian Grapes, Melons and Plums. Spanish Grapes, Peaches, Plums and Vegetables. Belgian, Luxembourg and Jugo-Slavian Bacon, Hungarian and Bulgarian Poultry and Belgian Fish and Eggs were also examined. 93 The following foodstuffs were found to be unsound and destroyed :—- Tons. cwts. qrs. lbs. 3 packages Apricots — — 2 24 Fresh Water Carp 1 10 0 26 2 crates Cauliflowers — — 2 20 12 packages Grapes - 1 3 8 177 „ Greengages 1 2 0 4 294 crates Lettuce 1 11 2 0 155 packages Peaches 1 5 2 8 1 bag Pears — 1 0 0 1,622 packages Plums 14 16 2 4 2 bags Potatoes — 2 0 0 20 12 0 10 Owing to the operation of the Cherry Fly Order, all imports of Italian Cherries were prohibited on 23rd June, 1935. The condition of the Italian fruit generally has been good, due no doubt to the extensive use of iced insulating trucks. The amount of fruit imported during the month of August (5,072 tons) was probably a record for any one month and necessitated attendance at Durward Street Depot on 7 occasions. This depot was used as a relief station owing to the facilities at Bishopsgate Station being congested. A sample of bulked Italian Raspberries in barrels was taken and submitted for analysis and was found to be free from preservative. Consignments of fruit continued to arrive later than in previous years. This was due to the comparatively new trade in Bulgarian Grapes of which large quantities arrived in very good condition. Hungarian live carp were sent approximately each fortnight. 95 Borough Analyst's Annual Report. To the Mayor, Aldermen and Councillors of the Metropolitan Borough of Stepney. Ladies and Gentlemen, I have the honour to submit to you my twelfth Annual Report, dealing with the work carried out in the Borough Laboratory during the year 1935. During the year 1,739 samples were submitted to me for examination these samples were made up as under :— Foods 1,491 1,630 Drugs 139 Public Health Department 87 Borough Engineer 8 Public Cleansing Officer 4 Private 10 1,739 The 1,630 samples of foods and drugs were purchased or taken by Inspectors under the Food and Drugs (Adulteration) Act, and consisted of :—- Formal Samples 1 ,048 Informal Samples 582 1,630 Out of 1,048 formal samples 98 or 9.4 per cent. were adulterated and of 582 informal samples 41 or 7.0 per cent. were adulterated, making a total of 1,630 samples out of which 139 samples or 8.5 per cent. were adulterated. Table A shows the nature of the samples taken under the Food and Drugs (Adulteration) Act and gives the numbers and percentages found to be adulterated, and the number of samples found to contain preservative, 96 Table A. Nature. Number of Samples. Number Genuine. Number Adulterated Percentage Adulterated Preservative Found. Ale 3 3 - - 1 Almond Oil 3 3 — — — Ammoniated Tincture of Quinine 3 3 - — — Arrowroot 3 3 — — None Aspirin 1 1 - — — Baking Powder 6 6 - — 1 Blanc Mange 4 4 - — None Boracic Ointment 7 7 — — — Boracic Powder 3 3 - — — Borax 3 3 - — — Brawn 6 6 — — None Bread and Butter 23 18 5 21.7 — Butter 61 60 1 1.6 None Cake 6 6 — — None Calamine Ointment 1 1 — — — Calcium Lactate 3 3 — — — Calomel Ointment 5 1 4 80.0 — Camphorated Oil 3 3 — — — Caraway Seeds 3 3 — — — Castor Oil 3 3 — — — Cheese 2 2 — — None Cinnamon 6 6 — — — Citric Acid 3 3 — — — Cocoa 5 5 — — — Coconut 3 3 — — None Cod Liver Oil and Malt 6 6 — — — Coffee 2 2 — — — Coffee and Chicory 2 2 — — — Coffee Extract 2 2 — — None Condensed Milk 6 6 — — None Corn Flour 3 3 — — None Cream 5 5 — — None Cream Buns 9 1 8 88.9 — Cream Cheese 3 — 3 100 None Cream of Tartar 3 3 — — — Custard Powder 6 6 — — 2 Dried Fruit 13 13 — — 3 Dried Milk 3 3 — — None Dried Mint 1 1 — — — Dripping 3 3 — — — Egg Substitute Powder 19 15 4 211 5 Epsom Salts 6 6 — — — 97 Table A—Continued. Nature. Number of Samples. Number Genuine. Number Adulterated Percentage Adulterated Preservative Found Eucalyptus Oil 6 6 — — — Feen-a-Mint 1 1 — — — Fish Paste 4 4 — — None Flour 7 7 — — None Glauber's Salt 3 3 — — — Glycerine 7 7 — — — Glycerine, Honey& Lemon 3 3 — — — Grape Fruit Squash 4 1 3 75.0 4 Gravy Powder 2 2 — — None Grey Powder 7 1 6 85.7 — Ground Almonds 5 5 — — — Ground Ginger 6 6 — — None Honey 10 10 — — None Iodine Ointment 9 3 6 66.7 — Jam 9 9 — — 6 Jelly 13 12 1 7.7 11 Lard 9 9 — — None Lemonade Powder 9 9 — — None Margarine 47 46 1 2 1 None Marmalade 3 3 — — None Milk 965 891 74 7.7 None Milk Sugar 3 3 — — — Minced Meat 30 26 4 13.3 4 Mustard 4 4 — — — Oatmeal 6 6 — — None Olive Oil 7 7 — — — Pearl Barley 10 9 1 10.0 None Pepper 13 13 — — None Pickles 3 3 — — Nona Pickling Liquor 3 3 — — None Poloney Colour 1 1 — — None Potassium Chlorate 3 3 — — — Potato Crisps 3 3 — — None Potato Flour 1 1 — — None Rice 15 15 — — None Saffron 3 3 — — — Sago 3 — 3 100 — Salicylic Ointment 3 3 — — — Sal Volatile 5 3 2 40.0 — Sauce 5 5 — — None Sausage 9 5 4 44.4 6 Seidlitz Powder 3 3 — — — Sodium Bicarbonate 3 3 — — — 98 Table A.—Continued. Nature. Number of Samples Number Genuine. Number Adult' rated Perientages Adult' rated Preservatives Found Solution of Iodine 1 — 1 100 — Soup Powder 3 3 — — None Spice 3 3 — — — Spirit of Iodine 1 1 — — — Spirits 27 24 3 11.1 — Sponge Mixture 1 1 — — None Suet 10 10 — — — Sugar 9 9 — — None Sulphur Ointment 8 7 1 12-5 — Sweets 3 3 — — None Sweet Spirit of Nitre 6 2 4 66.7 — Tea 5 5 — — — Tinned Fish 3 3 — — None Tinned Fruit 3 3 — — None Tinned Peas 2 2 — — None Vinegar 9 9 — — None Yeast 3 3 — — — Zinc Ointment 7 7 — — — 1,630 1,491 139 8.5 43 Details of samples shown in the above table to contain preservative are given under the respective headings in those cases where an offence had been committed. Table B shows the number of samples taken under the Act with the percentage of adulteration and also the total number of samples examined during the nast ten years. Table B. Year. Samples taken under the Act. Number Adulterated. Percentage Adulterated. Bact. Examinations Miscellaneous Samples Total Samples 1926 1,341 37 2.8 — 41 1,382 1927 1,292 42 3.3 — 55 1,347 1928 1,528 68 4.5 — 29 1,557 1929 1,537 63 4.1 — 72 1,609 1930 1,518 35 2.3 1 83 1,602 1931 1,488 43 2.9 46 173 1,707 1932 1,546 48 3.1 38 185 1,769 1933 1,513 37 2.4 20 112 1,645 1934 1,614 74 4.6 — 111 1,725 1935 1,630 139 8.5 — 109 1,739 It will be seen that there has been a considerable increase in the percentage of adulteration. 99 Of the samples taken under the Act, 1,491 consisted of foods and of these 115 or 7.7 per cent. were adulterated ; of the remaining 139 samples consisting of drugs, 24 samples or 17.3 per cent. were adulterated. This is a great increase on previous years and this increase may be accounted for by the fact that full-time sampling officers have been appointed who can follow up all cases where adulteration is suspected or proved. Samples of milk and bread and butter have for the first time been taken from the restaurants. Very few of these samples of milk have been found to be genuine. Offences were committed in 162 cases. These were dealt with as shown below :— Legal Proceedings. Adulterated. Other offences. Total. Formal Proceedings Caution No action 61 14 75 36 3 39 1 1 2 Informal 41 5 46 139 23 162 100 Table D. Number. Deficient in | Fat per cent. Deficient in Solids-notfat per cent. Minimum added water per cent. Hortvet. Action : Result of Proceedings. C 12 6.0 1.4 4.2 Vendor cautioned. C 13 12.3 — — Vendor cautioned. C 25 18.7 — — Vendor cautioned. B 2 40.0 — — Vendor fined £3 with £2 costs. B 4 20.7 31.8 33.8 less than Vendor fined £3 with £2 costs. B 7 — 1.8 1.0 Vendor cautioned. B 9 — 2.7 3.2 Vendor cautioned. B 10 — 2.4 1.5 Vendor cautioned. B 12 16.7 28.4 30.8 Vendor fined £3 with £2 costs. B 13 40.3 35.6 38.1 Vendor fined £3 with £2 costs. B 15 — 10.9 10.6 Vendor fined £3 with £1 costs. B 16 13.3 26.4 27.9 Vendor fined £5 with £1 costs. B 19 13.7 — — Vendor cautioned. C 28 — 8.0 11.1 Discharged under the Probation of Offenders Act. Vendor paid £2 2s. costs. C 30 25.0 — Vendor fined £1 with £3 3s. costs. B 47 — 1.2 4.0 Vendor cautioned. C 116 — 2.0 4.2 Vendor cautioned. B 114 11.0 — — Vendor fined £2 with £3 3s. costs. C 142 5.7 — — Vendor fined £2 10s. with £2 2s. costs. C 152 10.3 — — Vendor fined £2 with £2 2s. costs. C 175 11.3 — — Vendor fined £4 with £2 2s. costs. C 93 — 2.4 4.9 Sample purchased informally. C 100 — 1.8 3.4 Sample purchased informally. B 72 — — 1.5 Sample purchased informally. B 79 — 1.2 2.3 Sample purchased informally. B 177 10.0 — — Vendor fined £2 with £2 2s. costs. B 178 8.3 — — Vendor fined £5 with £3 3s. costs. B 189 18.0 — — Vendor fined £2 with £2 2s. costs. C 216 — 1.1 3.2 Vendor cautioned. C 283 9.0 — — Vendor cautioned. C 334 — 2.4 4.9 Discharged under the Probation of Offenders Act. Vendor paid £4 4s. costs. C 350 22.0 — — Summons dismissed. C 364 12.0 15.5 19.1 Vendor fined £2 with £3 3s. costs. B 322 —- 2.9 4.3 Sample purchased informally. B 326 50.7 — — Vendor fined £3 with £2 2s. costs. B 342 — 1.4 3.6 Vendor cautioned. B 346 — 3.2 3.9 Sample purchased informally. C 405 55.0 — — Vendor fined £1 with £1 1s. costs. C 474 19.0 — — Vendor fined £1 with £2 2s. costs. C 483 10.7 15.6 18.1 Discharged under the Probation of Offenders Act. C 512 16.0 — — Vendor fined £5 with £2 2s. costs. 101 Table D—continued. Number. Deficient in Fat per cent. Deficient in Solids-not fat per cent. Minimum added water per cent. Hortvet. Action : Result of Proceedings. C 513 3.7 9.0 10.2 Discharged under the Probation of Offenders Act. Vendor paid £2 2s. costs. C 536 3.3 — — Sample purchased informally. C 541 — 2.9 2.6 Sample purchased informally. C 552 26.3 — — Discharged under the Probation of Offenders Act. Vendor paid £2 2s. costs. C 562 — 3.9 4.3 Vendor cautioned. C 632 17.0 19.2 22.1 Vendor fined £2 with £2 2s. costs. B 571 26.3 — — Vendor fined £10 with £2 2s. costs. B 576 — — 1.3 Vendor cautioned. C 654 25.0 — — Summons dismissed on payment of £2 2s. costs. B 607 30.0 20.8 24.5 Vendor fined £2 with £2 2s. costs. B 611 15.3 — — Vendor cautioned. B 614 — 24.8 27.0 Discharged under the Probation of Offenders Act. Vendor paid £2 2s. costs. B 615 — 9.2 11.1 Discharged under the Probation of Offenders Act. Vendor paid £3 3s. costs. B 617 28.3 — — Vendor fined £5 with £2 costs. B 618 — 42.9 44.5 Vendor fined £3 with £1 costs. B 620 22.3 — — Discharged under the Probation of Offenders Act. Vendor paid £3 3s. costs. C 677 — 7.4 9.1 Adjourned sine die. Defendant gone to Italy. C 678 — 18.6 22.5 Vendor fined £2 with £1 1s. costs. C 679 25.3 4.2 8.7 Vendor fined £2 with £1 1s. costs. C 691 27.3 1.9 3.8 Summons not served. Defendant in sanatorium. C 692 16.7 — — Vendor cautioned. C 702 — 15.1 16.4 Discharged under the Probation of Offenders Act. Vendor paid £2 2s. costs. C 705 7.3 — — Vendor fined £2 with £2 2s. costs. C 804 3.3 — — Vendor cautioned. C 805 12.3 — — Vendor cautioned. C 806 — 3.5 3.4 Sample purchased informally. B 651 — 4.0 5.3 Vendor fined £5 with £3 3s. costs. B 671 — — — Contained 2.6 percent added water. Vendor fined £5 with £3 3s costs. B 726 — 2.4 4.3 Discharged under the Probation of Offenders Act. Vendor paid £3 3s. costs. B 743 — 0.6 3.2 Case not dealt with. C 800 — 9.6 12.3 Vendor fined £1 with £2 2s. costs. C 803 — 12.1 — Contained 3.8 per cent of sugar. Vendor fined £1 with £2 2s. costs. B 18 — — — Contained 1.8 per cent, of sugar Vendor cautioned. 102 There has been a decided increase in the number of adulterated milk samples. Samples containing 10 per cent. of added water are now rarely met with but, during the year, out of samples taken from restaurants 17 have shown from 10.2 to 44.5 per cent. of added water, the average figure being 22.4 per cent. There are also signs that the old habit of trusting to the quality of the milk and adding one gallon of water to every churn of 17 gallons has not yet disappeared. Milk would require an original solids-notfat percentage of 9.0 and a freezing point of -0.561° C. to stand the addition of this amount of water which would reduce it to the limits of 8.5 per centsolids-not-fat and a freezing point of -0.530° C. Usually the resulting mixture was slightly below the minimum limits and was returned as a poor quality sample. Samples C 93, C 100, B 72 and B 79 in the Table are samples of this kind. They were purchased informally from the same vendor on successive days. Finally the Sampling Officer obtained a sample on delivery at the shop and later a sample was bought from the vendor. The first of these samples showed 8.78 per cent. solids-not-fat and a freezing point of -0.540° C. The second sample showed 8.53 per cent. solids-not-fat and a freezing point of -0.525° C. : 2.8 per cent. of water was therefore contained in the second sample. As this sample, however, contained more than the minimum requirement of solids-not-fat and the depression of the freezing point was only slightly less than the minimum, the sample was not condemned. (In a similar case described later, legal proceedings were taken and a conviction obtained.) Sample C 334. This sample contained 4.10 per cent. of fat and 8.30 per cent, of solids-not-fat, a deficiency of 2.4 per cent. of solids-not-fat. The freezing point was -0.504° C., which showed the presence of at least 4.9 per cent. of added water. The certificate of a Public Analyst, under the Food and Drugs Act, is sufficient evidence in law of the facts stated therein, but he must attend the Court if either side requires him to be present. It had been previously intimated to me at the Court that it was the intention when a suitable occasion arose to contest the results obtained by the freezing point method and this sample was selected for the purpose. It was contended that the milk, which contained a high percentage of fat, could not possibly have been watered as it had been taken direct from the cowshed, and it was stated that a number of witnesses were present who would say that the milk had not been tampered with. A chemist who gave evidence for the defence stated that the freezing point determination was unreliable, 103 and mentioned the names of other chemists who held the same opinion. The accuracy of the apparatus was also criticised. The Magistrate, however, accepted my evidence and decided that the milk had been watered, but as the case was rather a strange one, he discharged the defendant under the Probation of Offenders Act and imposed increased costs. There is, of course, more than one magistrate attending the Thames Police Court, but up to the present time the evidence of definite watering which the freezing point determination provides has always been accepted. The freezing point determination is not accurate when milk is sour, so that the vendor must have the " second part " which he holds analysed at once if he wishes to check the Public Analyst's figures. In order that the vendor may be aware of this necessity, the Medical Officer of Health has circularised all milk purveyors in the Borough to the effect that the Council may rely in milk prosecutions under the Food and Drugs (Adulteration) Act, 1928, upon the Hortvet freezing test, in addition to chemical analysis and advising them of the necessity of submitting their portions for examination by their analyst immediately after the samples are taken. Samples B 651, B 670, B 671. These samples were taken from the same vendor. B 651 showed the presence of at least 5.3 per cent. of added water by the Hortvet test. This was followed up by sample B 670, which was taken on delivery. Inspector Brown and his assistant then concealed themselves in a shed until the vendor arrived and took the churns into his premises. A little later sample B 671 was taken in the premises. As far as the analysis was concerned, both samples satisfied the requirements of the Regulations, but the difference in composition showed that water had been added. The vendor was summoned for adding water to milk and for selling milk containing added water. After giving the composition of the sample, my certificate stated : "As compared with sample B 670 (solids-not-fat 8.70 per cent. and freezing point -0.542° C.), the said sample, which has a freezing point of -0.528° C., contains 2.6 per cent. of added water." Evidence was given at the Court with regard to the freezing point determination. The vendor was fined £5 with £3 3s. Od. costs for adding water to milk, the other summons was " Not dealt with." 104 The average composition of all samples of milk analysed during the year is shown below. Table E. Month. Number examined. Fat per cent. Solids-not-fat per cent. Total Solids per cent. January 65 3.40 8.53 11.93 February 86 3.68 8.79 12.47 March 82 3.48 8.79 12.27 April 76 3.49 8.80 12.29 May 83 3.50 8.83 12.33 June 86 3.39 8.75 12.14 July 83 3.40 8.71 12.11 August 63 3.50 8.62 12.12 September 85 3.66 868 12.34 October 90 3.58 8.62 12.20 November 88 3.72 8.81 12.53 December 78 3.62 8.77 12.39 Whole Year 965 3.54 8.73 1 2.27 Legal Minimum 3.00 8.50 - The above table includes all adulterated samples. Usually the averages are little altered by their inclusion. During 1935, however, the large number of adulterated samples and the extent of adulteration (17 samples from cafes contained from 10 to 44.5 per cent. of added water) has considerably affected the averages, particularly in the months of January and October. In Table F is given the average composition of all samples of milk which were reported as genuine. Table F. Month. Number Examined. Fat per cent. Solids.not-fat per cent. Total Solids per cent. January 50 3.61 8.76 12.37 February 80 3.69 8.83 12.52 March 78 3.52 8.79 12.31 April 72 3.53 8.80 12.33 May 81 3.50 8.84 12.34 June 79 3.47 8.78 12.25 July 81 3.42 8.73 12.15 August 59 3.54 8.64 12.18 September 82 3.70 8.71 12.41 October 72 3.73 8.78 12.51 November 85 3.73 8.83 12.56 December 73 3.65 8.82 12.47 Whole Year 892 3.59 8.78 12.37 Legal Minimurn — 3.0 8.50 — 105 As is usual in Stepney, the best quality milk was supplied in November, the lowest figure being obtained in July and August. The yearly averages, including adulterated samples, are given in the following table :— Table G. Year. Fat per cent. Solids-not-fat per cent. Total Solids per cent. 1926 3.71 8.71 12.42 1927 3.68 8.67 12.35 1928 3.67 8.65 12.32 1929 3.62 8.65 12.27 1930 3.65 8.70 12.35 1931 3.69 8.69 12.38 1932 3.60 8.69 12.29 1933 3.63 8.74 12.37 1934 3.61 8.74 12.35 1935 3.54 8.73 12.27 In previous reports samples of milk which have been slightly below the legal standard of composition have been reported as " Genuine, poor quality, slightly deficient in solids-not-fat." During 1935, when possible, freezing point determinations were made on those samples of milk which contained slightly less than or more than the standard of 8.5 per cent. of solids-not-fat, with the result that it was possible to condemn a number of these samples, and the number of samples reported as adulterated has been slightly increased from this reason. There still remain during the year 8 samples of milk which were border-line samples both with regard to the percentage of solids-not-fat and the freezing point, and these samples were reported as being of suspicious character. Poor QualityMilk Samples 25 samples of milk were taken on delivery for chemical examination from five institutions in the Borough. The average composition of the milk was : Fat, 3.53 per cent., and solids-not-fat, 8.82 per cent. 43 samples of milk were taken on delivery at 38 schools in the Borough. All the samples were genuine. The average composition of the samples was : Fat, 3.47 per cent., and solids-not-fat, 8.78 per cent. Hospitals, etc., Samples School Samples. 23 samples consisting of either bread and butter or rolls and butter were examined. Of these, one sample of bread and butter and 4 samples of rolls and butter were adulterated. Bread and Butter. 106 B 286. Bread and butter. The fat in the sample consisted entirely of margarine. Discharged under the Probation of Offenders Act. Vendor paid £2 2s. Od. costs. B 367. Rolls and butter. The fat consisted entirely of margarine. Vendor fined £2 with £2 2s. Od. costs. C 609. Rolls and butter. The fat consisted entirely of margarine. Summons dismissed. B 758. Rolls and butter (Informal). The fat consisted entirely of margarine. B 776. Rolls and butter (same vendor as B 758). Discharged under the Probation of Offenders Act. Vendor paid £2 2s. Od costs. Butter. 61 samples of butter were examined, and of these, one sample was found to be adulterated. B 783 (Informal). Contained 10 per cent. of margarine. A further sample, taken formally, was genuine. All the samples were free from preservative and prohibited dyes. 6 samples of condensed milk and 3 samples of dried milk were genuine and free from preservative. These samples complied with the requirements of the Condensed Milk and Dried Milk Regulations respectively as regards percentage composition of milk fat and milk solids, and each tin contained sufficient condensed or dried milk to produce the number of pints of standard milk as stated on the lable. 9 samples of cream confectionery were examined. Only one of these samples was genuine. Cream Buns. C 253 (Informal), C 257 (Informal), C 272 (Formal), C 279 (Formal) and C 280 (Formal). In these samples the filling consisted of emulsified foreign fat. Cream Doughnuts. C 278 (Informal) and C 273 (Formal) contained emulsified foreign fat. Cream Horns. C 304 (Formal) contained emulsified foreign fat. No proceedings were taken in connection with the above cases, but a circular letter was sent by the Medical Officer of Health to all bakers and confectioners in the Borough. Condensed and Dried Milk. Cream Bans, etc. 107 At Battersea the Stipendiary Magistrate dismissed a summons with costs against the Council, as he held that " cream does not necessarily mean the product of the cow, as is shown in the names ' face cream,' ' cold cream,' etc." Convictions, however, have been obtained in other parts of the country. There is little doubt that a purchaser of a cream bun expects to get cream. Shoe cream, shaving cream, etc., are creams but not cream, no one expects to eat such creams. If confectioners called these buns by the true name, that is, coconut oil bun or pea-nut oil bun, etc., not many would be sold, and it is obvious that by the designation cream bun it is intended, in order to sell them, to convey to the purchaser the belief that the buns actually contain cream. 3 samples of cream cheese examined were unsatisfactory. C 254 (Informal). Consisted of soft cheese containing 11.0 per cent. of fat, made from partially skimmed milk. C 255 (Informal). Whole milk soft cheese containing 22.6 per cent. of fat. C 256 (Informal). Consisted of soft cheese containing 9.8 per cent. of fat, made from partially skimmed milk. No further samples were taken. In 1927 eleven samples were taken The percentage of fat in these samples ranged from 1.2 to 17.8 per cent, A soft cheese made from whole milk or even from partially skimmed milk should show a fat content of 20 per cent. and upward, the percentage depending on the amount of water left in the product. True cream cheese should be made from cream and should contain at least 35 per cent. of fat. There should be some distinction between true cream cheese and the article sold locally under the name of cream cheese. 19 samples of egg substitute powder were examined. Of these, 4 samples contained an excess of sulphur dioxide. B 90 (Informal). Contained 152 parts sulphur dioxide per million or 4.8 times the permitted quantity. B 101 (Informal, same vendor as B 90). Contained 208 parts. sulphur dioxide per million or 7.2 times the permitted quantity. B 102 (Same vendor). Contained 176 parts sulphur dioxide per million or 5.8 times the permitted quantity. Wholesaler fined £5 with £4 4s. Od. costs. Cream Cheese. Egg Substitute. 108 C 148 (Wholesaler). Contained 216 parts sulphur dioxide per million or 7.25 times the permitted quantity. Wholesaler fined £5 with £3 3s. Od. costs. The only constituent of the powders which may contain sulphur dioxide is starch, in which 100 parts per million are allowed. As the powders contained 30.3 and 29.8 per cent. of starch respectively the amount of sulphur dioxide found in the powders would represent 580 and 725 parts sulphur dioxide per million respectively in the starch. As these figures appeared unusually high for starch, by courtesy of the firms concerned, samples of all the ingredients used were obtained. These samples, under various fancy names, consisted of sodium phosphate and maize starch, sodium bicarbonate, acid calcium phosphate, rice starch, eggyellow dye and neutral calcium phosphate. All of these were examined for sulphur dioxide and sulphates and all were satisfactory, with the exception of the neutral calcium phosphate, which was labelled " dryer." This substance is an unusual constituent of baking powder or egg-substitute powder, and from its name is presumably used to keep the mixture dry. This powder contained 10,560 parts sulphur dioxide per million and some sulphate and was responsible for the sulphur dioxide in the egg substitute. Counsel for the defence stated that sulphur dioxide had been found in the " dryer " by their analyst, and that the firm supplying them on warranty with the " dryer " admitted that it had been examined for lead and arsenic but not for sulphur dioxide. The powders consisted of dyed baking powder, the dye being presumably the substitute for the egg. Grape Fruit Out of 4 samples of grape fruit squash examined, 3 were found to be Squash. adulterated. B 104 (Informal). Contained 110 parts sulphur dioxide per million and benzoic acid. (Sample too small to determine the quantity.) B 138 (Informal. Same vendor). Contained 210 parts sulphur dioxide per million and 230 parts benzoic acid per million. B 187 (Same vendor). Contained 195 parts sulphur dioxide per million and 245 parts benzoic acid per million. 109 Fruit juices may contain either 350 parts sulphur dioxide per million or 600 parts benzoic acid per million. The presence of more than one preservative is not permitted. The vendor was cautioned. As the grape fruit squash was imported from Palestine, the Port Authorities were notified of the adulteration by the Medical Officer of Health. One sample, out of 13 samples of jelly examined, was unsatisfactory. B 127 (Informal). Contained an excess of 10 parts of sulphur dioxide per million over the permitted amount. A further formal sample was found to be satisfactory. 47 samples of margarine were examined and of these one sample was adulterated. B 289. Contained 50 per cent. of butter fat. Vendor fined £2 with £1 Is. Od. costs. See also under " Other Offences." All the samples were free from preservative and prohibited dyes. Jelly Margarine. Out of 30 samples of minced meat, 4 samples contained preservative. Sulphur dioxide is prohibited in meat. B 206. Contained 220 parts sulphur dioxide per million. Two partners were each fined £2 and each paid £1 Is. Od. costs. A 8. Contained 96 parts sulphur dioxide per million. Vendor fined £2 with £2 2s. Od. costs. A 16. Contained 1,860 parts sulphur dioxide per million. Vendor fined £10 with £2 2s. Od. costs. A 32. Contained 500 parts sulphur dioxide per million. Vendor fined £3 with£2 2s. Od. costs. Minced Meat. 10 samples of pearl barley were examined and one of these was found to Pearl Barley, be adulterated. C 200 (Informal). Contained 0.25 per cent. of talc. 3 informal samples of sago consisted of pearl tapioca. No further samples Sago. were taken. In Sandys v. Rhodes (1903), a grocer was prosecuted for selling tapioca as sago. The High Court held that no offence had been committed. 110 Sausage. 9 samples of sausage were examined. Two samples contained 170 and 56 parts sulphur dioxide per million respectively, the presence of preservative being declared. 4 samples, containing preservative without declaration, were unsatisfactory. A 10. Beef Sausage. Contained 42 parts sulphur dioxide per million without notice or label. Vendor cautioned. C 258. Vienna Sausage. Contained 18 parts sulphur dioxide per million without declaration. Vendor cautioned. C 303. Vienna Sausage. Contained 13 parts sulphur dioxide per million without declaration. Vendor cautioned. A 1. Vienna Sausage. Contained 19 parts sulphur dioxide per million without declaration. Vendor cautioned. As the vendor of the samples of Vienna sausage maintained that no preservative was used, some of the ingredients were examined. Poloney colour and spice were free from sulphur dioxide ; potato flour contained traces and pepper contained 40 parts per million. These amounts were not sufficient to account for the proportion of sulphur dioxide in the finished article. 18 samples of whisky, 4 samples of brandy, 3 samples of gin, and 2 samples of rum were analysed. Of these, 2 samples of whisky and 1 of gin were adulterated. B 64. Whisky. Contained 15.4 per cent. excess water. Summons dismissed under the Probation of Offenders Act. Vendor paid £5 5s. Od. costs. B 140. Whisky (Informal). Contained 4.7 per cent. excess water. The vendor refused to make a sale when application was made for a formal sample. Further informal samples were genuine. C 757. Gin (Informal). Contained 3.5 per cent. excess water. A further formal sample was of poor quality. 13 samples examined were genuine. 3 of the samples contained. preservative in amount less than that permitted by the Regulations. 2 samples of mixed dried fruit contained 64 and 851 parts sulphur dioxide per million respectively. 1 sample of raisins contained 128 parts sulphur dioxide per million. Spirits. Dried Fruit. 111 5 samples of raisins, 4 samples of mixed peel and 1 sample of mixed dried fruit were free from preservative. 1 sample of mixed dried fruit, B 132 (Informal), was unsatisfactory, the apple portion being infested with insects. Of 139 drugs examined, 24, or 17.3 per cent., failed to comply with the Drugs. requirements of the British Pharmacopoeia or the Codex and were returned as adulterated. Calomel Ointment. C 401 (Informal). 50.0 per cent. deficient in mercurous chloride. The base consisted of benzoated lard. C 411 (Same vendor as C 401). 40.5 per cent. deficient in mercurous chloride. The base consisted of benzoated lard. Vendor cautioned. B 515 (Informal) and B 551 (Same vendor as B 515). Benzoated lard substituted for simple ointment. Vendor cautioned. Grey Powder. B 595 (Informal). 54.2 per cent. deficient in mercury. C 683 (Same vendor as B 595). 58.4 per cent. deficient in mercury. Dismissed under the Probation of Offenders Act. Vendor paid £1 1s. 0d. costs. B 596 (Informal). 38.1 per cent. deficient in mercury. C 682 (Same vendor as B 596). 29.0 per cent. deficient in mercury. Vendor cautioned. B 666. 29.0 per cent. deficient in mercury and contained 23.5 per cent. of lactose. Vendor cautioned. C 684 (Informal). 11.3 per cent. deficient in mercury. A further formal sample was of poor quality. Grey Powder should contain 31 to 35 per cent. of mercury, the remainder of the powder consisting of chalk. The informal samples of grey powder were supplied in packets, each of which contained one dose. It was found that although the powder was considerably below the required strength, sufficient was supplied to ensure that the required dose of mercury was taken, together with an extra amount of chalk. A dose of grey powder is a very small quantity, and it is supposed that the weak powder is more easily handled and less liable to be lost. In one case milk sugar was added in order to make the powder more palatable 112 The British Pharmacopoeia, 1914, required grey powder to contain 33 per cent. of mercury ; the new 1932 Pharmacopoeia still requires from 31 to 35 per cent. of mercury. Grey powder is prescribed especially for children, and the authorities responsible have seen no reason to alter the composition since 1914. In a letter to the Pharmaceutical Society, the Medical Officer of Health observed that " it is apparently a practice to add chalk or sugar of milk." In reply it was stated that " if the sampling officer asked for Grey Powder then there is no question but that he should have been supplied with the Pharmacopoeia article. On the other hand, if he asked for six grey powders for a child of three, there is the defence that the powders were mixed with sugar of milk in accordance with a general custom." It will be noted that reference is made to the addition of milk sugar only, not to the use of a larger amount of grey powder containing too small a percentage of mercury and too high a percentage of chalk. Some samples taken in previous years did not contain even the equivalent of half of the minimum dose, and when various ages of child were given there was no difference in the strength of the powder supplied. There can be no certainty that the required dose will be received when powders of indefinite composition are used. The British Pharmaceutical Codex, 1934, states that " grey powder is used especially for children ; it is administered in powders or cachets, usually mixed with an equal weight of milk sugar." It would therefore seem that according to the authorities grey powder, however asked for, should be grey powder of correct composition, whether sold by itself or mixed with milk sugar. Proceedings were taken in one case. The defendant, however, did not state that it was the general custom to use weak powder, but stated that he sold the powder in a packet in the same condition as it was supplied to him by the wholesale purveyor. Iodine Ointment. B 550 (Informal). B 563 (Same vendor as B 550). 85 per cent. deficient in iodine and 100 per cent. deficient in potassium iodide. No action taken. B 722 (Same vendor as B 550 and B 563). 85 per cent. deficient in iodine and 100 per cent. deficient in potassium iodide. Vendor fined £1 with £2 2s. 0d. costs. 113 B 597 (Informal) and B 723 (Same vendor as B 597). 93.5 per cent deficient in iodine and 100 per cent. deficient in potassium iodide. Vendor fined £1 with £2 2s. Od. costs. C 790 (Informal). 34.3 per cent. deficient in iodine. Iodine ointment must contain 4 per cent. of iodine and 4 per cent. of potassium iodide. Five of the above samples were quite worthless as they contained only traces of iodine in a paraffin base ; these samples were marked, " Ingredients guaranteed conforming to the standard of the British Pharmacopoeia." All were sold at 2d. per pot, though three of the samples were marked 1s. 3d. Sal Volatile. C 707 (Informal). 72.4 per cent. deficient in ammonia and 73.9 per cent. deficient in carbon dioxide. C 708 (Informal). 15.2 per cent. deficient in ammonia. A further formal sample from each vendor was satisfactory. Spiritous Iodine. B 564. Contained industrial methylated spirits which had been substituted for alcohol of the British Pharmacopoeia. Vendor cautioned. The sample was labelled " This solution is compounded of and S.V.I. Spirit to the formula as permitted by H.M. Customs and Excise." Sulphur Ointment. B 516 (Informal). Benzoated lard substituted for simple ointment. A further sample taken formally from the same vendor was satisfactory. Sweet Spirit of Nitre. B 83 (Informal). 33.6 per cent. deficient in ethyl nitrite. B 84 (Informal). 60.0 per cent. deficient in ethyl nitrite. B 86. 28.0 per cent. deficient in ethyl nitrite. B 88. 69.6 per cent. deficient in ethyl nitrite. The vendors were cautioned and advised to keep smaller quantities in stock. These include samples of inferior grade or of doubtful character and are poor Quality 29 in number. Samples. 114 8 of these consisted of milk. Other poor quality samples were : flour (4), self-raising flour (3), pearl barley (3), ale (2), fish paste, butter, margarine, gin, borax, boric ointment, glycerine, grey powder and sulphur ointment. Milk.— Proceedings were taken against 7 vendors who were not registered for the sale of milk. Three of the samples, B 326, C 405 and B 571, were adulterated. Convictions were obtained in each case, the fines and costs amounting to £24 7s. Od. Two vendors paid £1 fine with £2 2s. Od. costs and £1 1s. 0d. costs respectively for omitting the name and address on the can. One vendor (adulterated sample C 483) was fined £5 with £2 2s. Od. costs for obstruction. In 2 cases where pasteurised milk had been sold without a licence, one vendor was fined £1 with £2 2s. Od. costs, and in the other case no action was taken. Margarine.—In 6 cases the vendor had not complied with the requirements of the Act with regard to labelling. One vendor was cautioned and one vendor (adulterated sample B 289) was fined £5 with £2 2s. Od. costs. Cream.—For selling loose cream on unregistered premises, one vendor was cautioned and one vendor was fined £4 with £2 2s. Od. costs. Mixed Fruit.—One sample of mixed fruit (B 132, informal) was unfit for human consumption. The vendor was fined £5 with £2 2s. Od. costs. Shredded Suet.—In two cases of shredded suet a misleading label was printed on the carton. B 636 (Informal) and B 678 (Same vendor as B 636). The label stated : " One pound goes considerably further than one pound of raw suet." Raw suet contains on an average 97 per cent. of fat. As the samples contained only 86.4 per cent. of fat, the remainder being starch, the statement on the label was quite untrue. The vendor was cautioned. Public Health Department.—86 samples submitted by the Public Health Department comprised the following :— Preservatives— 53 samples were examined for the presence of preservative. Of these, 47 samples were satisfactory. Offences other than Adulteration Miscellaneous Samples. 115 Satisfactory samples were :— (a) Raisins (12), Sultanas (4), Muscatels (2), Tinned Chicken (2), Tinned Pig's Tongue, Preservative Powder, Tinned Cherries, Minced Meat and Bulked Raspberries. The above contained no preservative. (b) Sultanas (15), Raisins (5), Orange Squash and Lemon Squash. The above contained preservative in amount less than the permitted quantity. Unsatisfactory samples were :— Belgian Chocolate Wafers (3) (contained 3.7 grains boron compound per pound expressed as boric acid). Orange Squash (contained 800 parts benzoic acid per million), Pepper (contained 40 parts sulphur dioxide per million), and Danish Tinned Sealachs (contained 760 parts benzoic acid per million). Fit for Food— 16 samples examined with regard to their fitness for human consumption were :— Satisfactory samples : Peppercorns (3), Almonds (2), Shelled Walnuts, Condensed Milk and Sugar. Unsatisfactory samples : Shelled Walnuts (3), Prunes (4) and Raisins. The samples of prunes represented different treatments of unfit prunes with the object of making them fit for market. One treatment consisted in soaking the prunes in water glass which restored the shiny surface, This sample contained 0.75 per cent. of silica expressed as sodium silicate. Export. 4 samples of Olive Oil for export were satisfactory. Metals. 5 samples of tinned foods were examined for metallic contamination. Satisfactory samples : Tinned Gooseberries, Tinned Anchovies and Tinned Cherries, all examined for tin, and Tinned Sild, examined for tin and lead. 1 sample of Tinned Pineapple was unsatisfactory. 116 Water. 2 samples of bath water contained the required amount of chlorine, 1 sample of drainage water was free from sewage, and 1 sample was examined for the nature of the deposit. Other Samples. 2 samples of Formalin complied with the requirements of the specification; one sample of insecticide contained 2 per cent. soap and cresols. 5 per cent. turpentine and the remainder water ; one sample of insecticide contained petroleum and coal tar distillates with 5 per cent. cresylic acid and citronella oil. Rag Flock Act. According to the standard of cleanliness required by the Rag Flock Regulations, rag flock must not contain more than 30 parts of chlorine in 100,000 parts of the flock. One informal sample was satisfactory, the chlorine content being less than 10 parts per 100,000. Borough Engineer.—-8 samples comprised : Carbolic Powder 3 and Cold Bitumen 5. Public Cleansing Officer.—4 samples of Carbolic Powder examined were satisfactory. Private Samples.—10 samples consisted of : Jam-invert, Gravy Powder, Vegetable Extract, Wax Paper, White Powder, Palm Kernel Oil, Cottonseed Oil, Margarine and Fats (2). All these samples were free from animal fat. I wish again to express my appreciation of the able assistance given me in the laboratory by Mr. W. M. Paulley, B.A., F.I.C. I have the honour to be, Ladies and Gentlemen, Your obedient servant, DOUGLAS HENVILLE, Borough Analyst. Chemical Laboratory, 43, White Horse Street, E.1, May, 1936, 117 VI.—PREVALENCE OF, AND CONTROL OVER, DISEASE. A—Notifiable Diseases. 1,445 notifications (other than of tuberculosis) were received, or 305 less than in the previous year. The notification rate for the whole Borough was 6.4 per 1,000 of the population. 442 cases were notified during the year, or 372 less than in the previous year. 436 of these cases were removed to hospital. There were no deaths from Scarlet Fever during the year. 695 cases were notified during the year, or 29 more than in the previous year. 688 of these cases were removed to hospital. The death rate for the whole Borough was .07 per 1,000 of the population. There were 16 deaths of which 12 were in children from 1 to 5 years of age, and 4 in children between the ages of 5 and 14 ; the case mortality was 2.3 per cent. Last year the case mortality was 3.3 per cent. This serum is supplied on request to the general practioners of the Borough. During the year 48 tubes, each containing 4,000 units, were issued from the Public Health Office. There were 5 cases notified during the year. All were removed to hospital. There was one death. The death rate for the whole Borough was .004 per 1,000 of the population. There were no cases of small pox notified during the year and it was not found necessary for me to take action under the Public Health (Small Pox) Regulations, 1917. Notifications. Scarlet Fever. Diphtheria. Anti- Diphtheritic Serum. Typhoid fever. Small Pox 118 < p O O 5" p r+ o" p RETURN RESPECTING THE VACCINATION OF CHILDREN WHOSE BIRTHS WERE REGISTERED IN STEPNEY FROM JANUARY 1st TO DECEMBER 31st, 1934 INCLUSIVE. M.379 Registration Sub-Districts comprised in the Vaccination Officer's District. Number of Births returned in the " Birth List Sheets " as registered from 1st January to 31st December, 1934. Number of these Births duly entered by 31st January, 1936, in Columns I., II., IV. and V. of the " Vaccination Register " (Birth List Sheets), viz. : Col. I. Successfully Vaccinated. Col. II. Col. IV. Number in respect of whom Statutory Declarations of Conscientious Objection have been received. Col. V. Died unvaccinated. Insusceptible of Vaccination. Had Small Pox. (1) (2) (3) (4) (5) (6) (7) Limehouse 1,905 399 2 — 1,083 73 St. Georges, East 540 182 — — 226 22 Total 2,445* 581 2 — 1,309 95 Whitechapel 1,869 934 1 — 516 89 Mile End 950 240 — — 523 55 Total 2,819* 1,174 1 — 1,039 144 119 Registration Sub-Districts comprised in the Vaccination Officer's District. Number of these Births which on 31st January, 1936, remained unentered in the " Vaccination Register " on account (as shown by " Report Book") of Number of these Births remaining on 31st Jan., 1936, neither duly entered in the "Vaccination Register" (columns 3, 4, 5, 6 and 7 of this Return) nor temporarily accounted for in the " Report Book " (columns 8, 9 and 10 of this Return). Total number of Certificates of Successful primary Vaccination of Children under 14 received during the Calendar Year 1935. Number of Statutory Declarations of Conscientious Objection actually received by the Vaccination Officei irrespective of the dates of birth of the children t< which they relate, durin the Calendar Year 1935. Postponement by Medical Certificate. Removal to Districts the Vaccination Officers of which have been duly apprised. Removal to places unknown, or which cannot be reached ; and cases not having been found. (8) (9) (10) (11) (12) (13) Limehouse — 281 10 57 553 1,008 St Georges, East — 7 2 101 353 202 Total — 288 12 158 906 1,210 Whitechapel 3 258 24 44 1,064 531 Mile End 2 64 11 55 344 523 Total 5 322 35 99 1,408 1,054 120 SUMMARY OF PRIMARY VACCINATIONS DURING THE YEAR JANUARY TO DECEMBER, 1935 (Form N). No. of cases in birth lists received during the year. No of certificates of vaccination received. No. of certificates of postponement owing to No. of statutory declarations under section 1 of the Vaccination Act, 1907. No. of certificates ol insusceptibility or of having had smallpox. No. of cases No. of entries in lists sent to public vaccinator Health of child. Condition of house. Prevalence of infectious disease. Parents removed out of district. Otherwise not found. Whitechapel 1,716 1,064 177 — — 531 1 880 18 405 Mile End 993 344 73 — — 523 — 157 12 378 Other vaccinations 5 — — — — — — — — Limehouse 1,866 553 25 — — 1,008 1 1,031 53 189 St. Georges 503 353 22 — — 202 1 145 46 324 Other Vaccinations 12 — — — — — — — — Total 5,078 2,331 297 — — 2,264 3 2,213 129 1,296 121 Return showing the number of persons successfully vaccinated and re-vaccinated at the cost of the Rates by the Medical Officers of Institutions and the Public Vaccinators during the year ended 30th September, 1935. Name of Institution or Vaccination District. Name of Medical Officer or Public Vaccinator. Number of successful primary vaccinations of persons. Number of successful re-vaccinations. Under one year of age. One year and upwards. Total. Whitechapel District Dr. D. F, Kennard 312 80 392 15 Shadwell do. Dr. E. Lipman 138 23 161 33 Mile End do. Dr. S. Mikbail 243 44 287 1 Limehouse do. Dr. T. O'Keefe 67 21 88 11 St. George-in-the-East District Dr. B. Rygate 281 34 315 17 St. George-in-the East Hospital Dr. J. G. Leebody — — — 7 Mile End Hospital Dr. A. Randle 16 10 26 — Totals 1057 212 1269 84 122 AcutePoliomyelitis 2 cases of acute poliomyelitis were notified. Both children are receiving treatment at Queen Mary's Hospital, Carshalton. Encephalitis 1 case Was notified during the year, and there were 2 deaths. The death Lethargica. rate for the whole Borough was .009 per 1,000 of the popidation. The notified case referred to a man who died 2 weeks after admission into a local hospital. 11 patients were notified during the year, 6 of which died. The death Spinal rate for the whole Borough was .02 per 1,000 of the population. 4 cases Meningitis. recovered and 1 left the district and could not be traced. Again there has been a decrease in the number of notified cases, there Ophthalmia being 6 cases as against 13 in the previous year. All the cases were removed Neonatorum. to hospital. 11 cases of puerperal fever and 27 cases of puerperal pyrexia were notified FeverTnd during the year, there being 5 less cases than in the previous year. All these Puerperal cases were duly investigated and there were 2 deaths. All were removed to Pyrexia. hospital. 191 cases of Pneumonia, 23 of Dysentery and 2 of Malaria were notified Pneumonia under the Regulations during the year. There were 163 deaths from Malaria and Dysentery Pneumonia, or 72 less than in the previous year. 106 of these were in persons Regulations. , _ , over 45 years of age. 128 cases of infectious diseases removed to hospital were found not to Wrong be suffering from the disease stated on the certificate. Of these, 32 were cases of scarlet fever, 91 of Diphtheria, and 5 of Dysentery. 55 cases were notified by private practioners and 73 were from public institutions. NOTIFIABLE DISEASES (OTHER THAN TUBERCULOSIS) DURING THE YEAR, 1935. Disease. Total Cases Notified. Cases mitted to Hospital Total Deaths.  In Age Groups. Under 1 year. 1— 2— 3— 4— 3- 10— 15— 20— 35— 45— 65 and over Total Smallpox — — — — — — — — — — — — - — — Scarlet Fever 7 24 35 47 40 159 66 20 41 3 — — 442 436 — Diphtheria 24 40 66 94 84 255 69 21 32 7 3 — 695 688 16 Enteric Fever — — — — 1 — 1 — 1 1 1 — 5 5 1 Measles 16 26 14 23 10 - - - - - - - 89 63 — Puerperal Fever — — — — — — - — 10 1 — — 11 10 — Puerperal Pyrexia - - - - - - - 2 24 1 — — 27 27 2 Erysipelas 1 — 1 1 2 7 3 4 18 17 53 17 124 72 — Encephalitis Lethargica - - - - - - - - - - 1 — 1 1 2 Cerebro-spinal Fever 4 2 1 — 1 2 1 - - - - - 11 11 6 Ophthalmia Neonatorum 6 - - - - - - - - - - - 6 6 — Food Poisoning — 1 — 1 — 1 - 3 18 4 3 1 32 11 3 Polio-myelitis — — 1 1 - - - - - - - - 2 2 — Polio-encephalitis - - - - - - - - - - - - - - - Totals 58 93 118 167 138 424 140 50 144 34 61 18 1,445 1,332 30 123 124 Food Poisoning.— 32 cases were notified, most of them being attributed to eating meat or fish. The following cases were of interest : 9 of the cases referred to a party of male students from a hospital in the Borough who ate oysters whilst on a visit to Burnham on Crouch. They were taken ill with diarrhoea and vomiting, they all recovered. One case was that of a man who had eaten some meat pie bought in Croydon. Bacillus aertrycke having been isolated in his stools. He was unable to state the vendors of the pies. He recovered. Another case was that of a man aged 68 who was admitted to a local hospital on the 7th September. He was moribund on admission and had extreme vomiting and diarrhoea; he died 3 days afterwards. At the inquest it was stated that the post-mortem examination revealed inflamed condition of lower intestine and after bacteriological examination, the hospital physician was able to isolate Bacillus aertrycke—a bacillus of the salmonella group, and in his opinion the invasion of the bacillus could only be through the mouth by ingestion. Death was due to toxaemia and dehydration as a result of the invasion of the specfic bacillus. The bacillus may have been introduced into the household by the presence of a rat found and destroyed on the premises a week earlier. The coroner stated in the absence of the body of the rat the death could not be definitely attributed to this cause. He recorded a verdict of "Death by misadventure," the cause of death being toxaemia and dehydration due to the invasion of Bacillus aertrycke. For the past 25 years the patient had attacks of vomiting and diarrhoea once or twice a year. He had dysentery for many years whilst in H.M. Forces in South Africa. 4 Cases occurred in another family— the husband and wife died, though no particular food Was suspected. On the 12th August the husband and wife had an attack of diarrhoea and sickness, and their two children were sick during the night. They were attended by a doctor and on the following day the 13th August the wife and the 2 children were admitted to hospital. The next day the 14th August the woman died and a post-mortem was held. The only food in the house were portions of batter pudding, meat and dripping; these and portions of the organs were examined. On the examination of the organs the pathologist isolated Bacillus aertrycke, but with regard to the food no bacteria were found that could be the cause of food poisoning or other bacteriological disease. An inquest was held on the 16th August and was adjourned. 125 On the 30th August the adjourned inquest was held, the verdict being accidental death from Food Poisoning caused by Bacillus aertrycke. The husband on the 12th August after having a meal ofmeat,etc. was taken ill with abdominal pains and vomiting and he was admitted to hospital on the 14th August. On the 24th August he died, the cause of death stated to be toxaemia and intestinal infection with Bacillus aertrycke. On the 26th August a post mortem was held, the organs were sent away for examination and B. aertrycke isolated. The inquest was held on the 28th and it was adjourned to the 30th August when the inquest on the wife was to be held. The cause of death was the same as that of the wife. Their two children recovered. The first information I received was on the 14th August from the Coroner's Office : inquiries were made the same day at the house but the husband was unable to say where the meat was bought as his wife had no fixed shops from which she procured her food. She bought her food at various places and as the wife was dead I was unable to obtain any information about these shops. The condition of the house was clean and satisfactory and apparently reasonable care was taken in preparing the food. 3 cases occurred in a family who were taken ill— alleged to be due to eating cabbage. They all recovered. 4 cases occurred in a family and it was alleged that their illness was due to eating fish. They all recovered. 126 Ministry of Health. Form T.137 1935. PART I — Summary of Notifications during the period from the 1st January, 1935, to the 31st December, 1935, in the area of the Metropolitan Borough of STEPNEY. Public Health (Tuberculosis) Regulations, 1930 Formal Notifications. Number of Primary Notifications of new cases of Tuberculosis Age periods 0— 1— 5— 10— 15— 20— 25— 35— 45— 55— 65— Total (all ages) Total Notifications. Pulmonary Males 1 3 4 6 21 20 49 46 49 30 16 245 249 Females — 3 4 2 16 22 27 12 11 18 9 124 125 Non-pulmonary Males - 9 5 5 4 3 4 4 1 5 3 45 46 „ „ Females 2 6 10 5 3 4 3 - - 2 1 36 36 SUPPLEMENTAL RETURN. PART IT.— New cases of Tuberculosis coming to the knowledge of the Medical Officer of Health during the above-mentioned period, otherwise than by formal notification. Age periods 0— 1- 5— 10— 15— 20— 26- 35— 45— 55— 65— Total Pulmonary Males - - - - - 2 5 3 3 - 2 15 Females — — — 1 — 4 2 1 — - 1 9 Non-pulmonary Males — — 1 — 1 — 3 - - - 1 6 „ „ Females - - 1 - 1 - 2 - 1 - - 5 The source or sources from which information as to the above-mentioned cases was obtained is stated below:— Source of Information. No. of Cases. Pulmonary NonPulmonary. Death Returns from local Registrars 4 1 transferable deaths from Registrar General 3 3 Posthumous notifications - — "Transfers" from other areas (other than transferable deaths) 17 7 Other Sources - — PART III. NOTIFICATION REGISTER. Number of cases of Tuberculosis remaining at the 31st December, 1935, on the Registers of Notifications kept by the Medical Officer of Health. Pulmonary Non-pulmonary Total Cases Males Females Total Males Females Total 1015 609 1624 294 205 499 2,123 Number of cases removed from the Register(s) during the year by reason inter alia of:— 1. Withdrawal of notification 2 3 5 - 2 2 7 2. Recovery from disease 5 9 14 4 1 5 19 3. Deaths 100 50 150 11 12 23 173* *3 of these refer to old cases, ascertained during the revision of the Register. 127 Particulars of new cases of tuberculosis and of all deaths from the disease in Stepney during 1935. Age Periods. New Cases. Deaths. Pulmonary. Non-Pulmonary Pulmonary. Non-Pulmonary M. F. M. F. M. F. M. F. 0 1 - - 2 - - 2 1 1 3 3 9 6 — — - 2 5 4 4 5 10 1 1 — •2 10 6 2 5 5 — 4 1 1 15 21 16 4 3 2 4 — 1 20 20 22 3 4 11 13 3 3 25 49 27 6 3 11 11 1 2 35 46 12 4 — 13 4 — 1 45 49 11 1 — 23 4 — 1 55 30 18 5 25 2 1 — 65 and upwards 16 9 3 1 13 5 1 — Totals 245 124 45 36 99 48 9 14 New Cases of Tuberculosis and Mortality, Of the 170 deaths, 11 of them had not been notified to the Medical Officer of Health of this Borough as cases of Tuberculosis. The death rate for the whole Borough was "8 for 1,000 of the population. These regulations provide that persons suffering from Tuberculosis of the Respiratory tract shall not be employed in the handling of milk or milk receptacles. Power is given to the Council to cause such persons to discontinue their employment. Public Health (Prevention of Tuberculosis) Regulations. 1925. 128 Incidence of Tuberculosis in various occupations. It was not found necessary to take action under the regulations during the year. Occupation. New Cases Notified. Deaths Occupation. New Cases Notified. Deaths Acetylene welder 1 - Lampshade maker 1 - Advertising Agent — 1 Lay Missioner — 1 Baker 1 — Leather-worker 1 — Barman 1 1 Licensed Victualler 1 - Biscuit worker 1 — Lighterman 2 1 Book-keeper 1 — Machinist 8 1 Bookmaker 1 — Market Porter 1 — Bootmaker 1 3 Messenger 2 — Bottle-washer 1 1 Milkman 1 — „ capper 1 — Motor-driver 2 4 Box-maker 1 — Musician — 1 Brass moulder — 1 Milk Foreman - 1 Brewer 1 1 News vender 1 — Builder 1 — No occupation 28 29 Butcher — 1 Nurse 2 — Canvaser 1 — Occupation unknown 45 — Carman 1 2 Office boy 1 — Carpenter 1 — Painter 1 - Cabinet Maker 1 — Pedlar 1 2 Caretaker 1 — Pensioner 4 - Chicken Dealer 1 - Perfume Packer 1 1 Cigar-maker - 1 Packer 4 — Cigarette Packer 1 — Plumber — 2 Charwoman — I Porter 1 4 Clerk — 4 Printers - 2 Coal Porter 2 - Presser 6 — Coat-hanger maker 1 1 Professional Singer 1 — Commissionaire — 1 Saw-worker 1 — Commercial Traveller 4 1 Sales Lady 1 — Compositor 1 — Salesman 1 — Cooper — 1 Scavenger — 1 Drayman — 1 Scholar 46 — Drapers Assistant — ] Seamen 21 3 Decorator 1 2 Ships steward 1 — Dock Labourer 1 9 „ fireman 1 1 Domestic Servant 5 2 „ Bosun 1 1 Dressmaker 6 2 Sheet Metal Worker 1 — Drivers mate 1 - Skin Dresser — 1 Electrician 2 1 Shop Assistant 4 2 Engineer—Mercantile Marine — 1 Silk Merchant — 1 Factory Hand 1 — Shorthand-Typist 2 1 Fish Fryer 1 — Street Trader 2 1 Fish Porter - 1 Stableman - 1 French Polisher 1 — Mason — 1 Fur Dyer 1 - Stoker 2 — Furrier 1 — Student — 1 Gas Fitter 1 — Tailoring 38 20 General Dealer 1 — Tea Packer 1 — General Labourer 36 10 Teacher 1 — Gum Sampler — 1 Tobacconist 1 — Hairdresser 2 1 Under 5 years 39 4 ,, Assistant — 1 Upholsterer 1 1 Hawker 9 5 Waiter 3 — Hebrew Teacher - 1 Watchmaker 1 1 Housewife 58 18 Warehousman 3 — Insurance Agent — 1 Wireman G.P.O. — 1 Jeweller 1 — Wool tracker 1 — J ournalist 1 - Kitchen hand 1 1 450 170 129 The number of deaths was 6, or 14 less than in the previous year. All Whooping of these, occurred in children under 5 years of age (4 of them under 1 year). Cough- The death rate was .02 per 1,000 of the population. There were 54 deaths, 15 less than in the previous year. 42 of these deaths, Diarrhoea, or 77 per cent., were in children under 1 year of age. The death rate was .25 per 1,000 of the population. The total deaths from diseases of a Zymotic character was 77, or 127 less ZymoticDiseases than in the previous year. They include all deaths from Small Pox, Scarlet Fever, Diphtheria, Typhoid Fever, Measles, Whooping Cough and Diarrhoea. The decrease was entirely due to Measles. The death rate was .36 per 1,000 of the population. The number of deaths was 14, or 1 more than in the previous year. As influenza, usual these occurred in elderly persons. The death-rate for the whole Borough was .06 per 1,000 of the population. The number of deaths from cancer was 333, or 12 more than in the previous Canceryear. The death-rate for the whole Borough was 1.5 per 1,000 of the population. 22 were under 45 years of age—12 males and 10 females. 157 Were between 45 and 65 years of age—80 males and 77 females. 105 were between 65 and 75 years of age—60 males and 45 females. 49 Were 75 years of age and over—25 males and 24 females. The organs and parts of the body affected were as follows:— Male. Female. Mouth, Throat and alimentary canal 55 24 Other abdominal organs 51 49 Generative organs 3 9 Breast — 30 Skin 1 — Lung and Pleura 22 6 Bones 1 — Other specified Organs 40 36 Other undefined 4 2 Totals 177 156 There were 704 deaths from Heart disease (337 males and 367 females) or 71 more than in the previous year. The death-rate for the whole Borough was 3.3 per 1,000 of the population. Heart Disease. Diseases of the Respiratory Organs. Scabies. Cleansing and Disinfection. Bug eradication 130 The number of deaths from diseases of the Respiratory Organs (excluding Tuberculosis) was 261 of 77 less than in the previous year. The death-rate for the Whole Borough was 1.2 per 1,000 of the population. The arrangements with Bethnal Green for the treatment of adults and with the London County Council for the treatment of children under school leaving age were continued. During this year 54 adults were sent to Bethnal Green and 14 children to the L.C.C. Bathing station. 182 persons were cleansed during the year and had their clothing disinfected—180 adults and 2 children. 178 were cleansed because of vermin and 4 because of infectious disease. 2,642 rooms were fumigated and the bedding, etc., removed and disinfected by steam. Of these, 1,309 rooms were fumigated because of infectious disease, 123 as a result of pulmonary tuberculosis, and 1,210 because they were verminous. In addition to these, scabies occurred in 350 families and the bedding was taken away and disinfected by steam. The disinfection of second-hand clothing, prior to export to South Africa and the supervision of the packing of the goods was carried out as in previous years. The number of such articles dealt with this year reached 72,320. The total number of articles disinfected for all purposes was 104,423. Arising from a report I submitted on the need for a scheme of Bug Eradication, A Sub-Committee was appointed to consider the matter. Visits were paid to Hackney and Kensington to inspect the plant installed for fumigation with Hydrogen Cyanide and it was decided to adopt the method used in Hackney. On May 29th Mr. Edwards was appointed to supervise the disinfestation and draw up a scheme. We were fortunate in securing a suitable site belonging to the Council, 42, Narrow Street, and the Chamber is now in course of erection. The chamber is specially constructed to make it gas tight, the furniture van containing the household effects is drawn into it, the chamber closed and the gas applied. After 2 hours exposure, the gas is extracted and when quite free the van in driven to the new flat and the furniture is delivered. In view of the urgency of the problem and as flats were becoming ready for occupation before our scheme could operate, it was felt necessary to place a contract with a firm of fumigators. The furniture vans were driven to 131 shire Street Depot and the gas applied in the vans. The furniture and effects of 105 families were treated in this way during the year. Bedding is taken separately by this Department and treated at the Steam Disinfector. AH persons rehoused are visited and notified that the fumigation of their effects must be carried out before they can take possession of their new flats. I am pleased to be able to report that there has been no difficulty in persuading the tenants to co-operate in the scheme. They appreciate the efforts that are being made on their behalf and are quick to respond to it. Incidentally this service is one of the most useful and effectual means of inculcating "Bugmindedness " in the people. The closest co-operation with the Housing Department exists and all vacant flats are notified to this Department and suitable action taken regarding disinfestation before they are re-occupied. 41 cases were dealt with during the year. The arrangement whereby the Housing Manager notifies all redecorative work has been of undoubted value. The flats in question are inspected and any disinfestation work required is done before re-decoration. The Special Gas Chamber is well on its way to completion and should be in operation by August and next year I hope to give a full acccount of the scheme in its entirety. Inspections to Councils' Flats re Vermin. Primary General inspection for vermin 670 Revisits re vermin 571 No. of flats found to be verminous 446 Suspicious cases 18 Miscellaneous 472 No. of flats fumigated 27 No. of flats sprayed 18 No. of Rooms fumigated 136 No. of Rooms sprayed 152 132 VII.— STATISTICS PROVIDED BY THE REGISTRAR- GENERAL. Memorandum for the Medical Officer of Health. S.D.51. 1936. In accordance with paragraph 4 and Appendix II of Circular 1492 dated the 18th October, 1935, sent to Local Authorities from the Ministry of Health, forms S.D.52, and S.D.24 are enclosed herewith setting out the statistics of population, live births, stillbirths, notifiable infectious diseases and deaths of the year 1935 in respect of your area. A table S.D.55 is also enclosed providing a summary of the vital statistics for England and Wales as a whole and for certain groups of towns. s.d. 52. Metropolitan Borough of Stepney. (1) Estimated Mid-Year Resident Population 211,500. (2) Live Births Live Births registered (excluding reregistrations). Inward Transfers. Outward Transfers, Live births allocated to the Borough. Total Live Births (Legitimate and Illegitimate) Males 2,602 74 1,118 1,558 Females 2,462 93 1,086 1,469 Illegitimate Live Births Males 57 9 13 53 Females 58 12 16 54 (3) Still-Births Stillbirths registered. Inward Transfers. Outward Transfers. Stillbirths allocated to the Borough. Total Still-Births (Legitimate and Illegitimate) Males 94 8 45 52 Females 62 2 25 39 Illegitimate Still-Births Males 1 — — 1 Females 4 — — 4 (4) Notifiable Infectious Diseases:—number of cases notified during the 52 weeks ended 28th December, 1935. Small-pox. Scarlet Fever. Diphtheria. Enteric Fever. Pneumonia. Puerperal Puerperal Fever. Pyrexia. Erysipelas. — 471 793 5 188 11 28 127 (5) Comparability Factor. As explained in the memorandum accompanying this sheet the Comparability Factor indicated last year should be regarded as applicable to the crude rate of the current year unless revised figures are shewn in the following lines :— Revised Comparability Factor for 1935 Revised Comparability Factor for 1936 and subsequent years. TOTAL DEATHS BY CAUSE AND AGE IN THE METROPOLITAN BOROUGH OF STEPNEY, 1935. S.D.24 ESTIMATED RESIDENT POPULATION (MID. 1935). SEE S.D.52 CAUSES OF DEATH. Sex. All Ages. 0— 1— 2— 5— 15— 25— 35— 45— 55— 65— 75— ALL CAUSES M. 1,290 119 11 15 14 47 51 64 143 288 317 221 F. 1,103 67 20 10 36 40 41 51 95 201 290 252 1. Typhoid and paratyphoid fevers M. ... ... ... ... ... ... ... ... ... ... ... ... F. 1 ... ... ... ... ... ... 1 ... ... ... ... 2. Measles M. ... ... ... ... ... ... ... ... ... ... ... ... F. ... ... ... ... ... ... ... ... ... ... ... ... 3. Scarlet Fever M. ... ... ... ... ... ... ... ... ... ... ... ... F. ... ... ... ... ... ... ... ... ... ... ... ... 4. Whooping cough M. 3 3 ... ... ... ... ... ... ... ... ... ... F. 3 1 2 ... ... ... ... ... ... ... ... ... 5. Diphtheria M. 6 1 1 3 1 ... ... ... ... ... ... ... F. 10 1 1 5 3 ... ... ... ... ... ... ... 6. Influenza M. 5 1 ... ... ... ... ... ... ... 2 2 ... F. 9 ... ... ... ... ... ... ... ... ... 4 5 7. Encephalitis lethargica M. 1 ... ... ... ... ... ... ... ... 1 ... ... F. 1 ... ... ... ... ... ... ... ... 1 ... ... 8. Cerebro-spinal fever M. 4 2 ... ... ... ... ... ... ... ... 1 ... F. 2 ... ... ... 1 ... ... ... ... ... ... ... 9. Tuberculosis of respiratorysystem. M. 99 ... ... ... 1 13 12 12 22 26 12 1 F. 48 ... ... ... 4 17 9 5 4 2 4 3 10. Other tuberculous diseases M. 8 2 ... ... 1 3 ... ... ... 1 1 ... F. 15 1 ... ... 5 4 2 ... 1 ... ... • • • 11. Syphilis M. 8 1 ... ... ... ... ... ... 5 1 1 ... F. 3 ... ... ... ... ... ... ... 1 1 1 ... 12. General paralysis of the insane, tabes dorsalis. M. 17 ... ... ... ... ... 1 2 4 5 3 2 F. 2 ... ... ... ... ... ... ... 2 ... ... ... 13. Cancer, malignant disease M. 177 ... ... ... ... ... 4 8 27 53 60 25 F. 156 ... ... ... 1 ... 3 6 31 46 45 24 14. Diabetes M. 23 ... ... ... ... ... 1 ... ... 12 9 1 F. 38 ... ... ... ... ... 1 1 4 14 16 2 15. Cerebral haemorrhage, etc. M. 28 ... ... ... ... ... ... 1 2 7 11 8 F. 31 ... ... ... ... ... ... 1 2 7 16 5 16. Heart disease M. 337 ... ... ... 2 3 9 10 25 77 109 102 F. 367 ... ... ... 4 6 10 12 21 60 121 133 17. Aneurysm M. 11 ... ... ... ... ... 1 2 2 3 2 1 F. 5 ... ... ... 1 ... ... ... ... 1 2 1 18 Other circulatory diseases M. 51 ... ... ... ... ... ... ... 3 7 24 1 7 F. 45 ... ... ... ... ... ... ... 3 11 18 13 19. Bronchitis M. 54 5 ... ... 1 ... 1 2 9 14 12 10 F. 24 3 ... ... ... 1 ... 2 3 7 2 6 133 TOTAL DEATHS BY CAUSE AND AGE IN THE METROPOLITAN BOROUGH OF STEPNEY, 1935—{continued). CAUSES OF DEATH. Sex. All Ages. 0— 1— 2— 5— 15— 25— 35— 45— 55— 65— 75— 20. Pneumonia (all forms) M. 87 14 4 2 1 1 1 7 17 18 11 11 F. 76 17 7 1 ... 2 1 14 18 16 21. Other respiratory diseases M. 12 1 1 2 1 1 ... 2 2 2 F. 8 2 1 1 ... 1 2 1 22. Peptic ulcer M. 21 ... ... ... ... ... l 5 3 9 3 F. 8 ... ... ... ... ... l ... 1 2 3 1 23. Diarrhoea, etc. M. 37 32 ... ... ... 3 ... • • • 1 ... 1 F. 17 10 ... ... ... 3 ... 1 1 ... ... 1 24. Appendicitis M. 10 ... ... ... ... 2 1 3 1 ... 1 F. 5 ... ... ... 1 ... 1 1 1 ... 1 ... 26. Cirrhosis of liver M. 2 ... ... ... ... ... ... ... 1 ... 1 ... F. 2 ... ... ... ... ... ... ... 1 1 ... ... 26. Other diseases of liver, etc. M. 6 1 2 1 2 F. 8 ... ... ... ... ... ... ... 1 2 2 3 27. Other digestive diseases M. 25 3 ... ... ... 2 2 ... 1 8 5 4 F. 19 1 ... ... 1 ... 2 3 ... 4 4 2 28. Acute and chronic nephritis M. 40 1 ... ... l 2 1 1 4 7 11 12 F. 43 ... ... ... ... 1 3 12 15 11 29. Puerperal sepsis F. 2 ... ... ... ... ... 2 ... ... ... ... ... 30. Other puerperal causes F. 3 ... ... ... ... ... 1 2 ... ... ... 81. Congenital debility, premature birth, malformations, etc. M. 47 46 ... ... ... ... ... ... ... ... ... ... F. 29 28 ... ... ... ... ... ... ... ... ... ... 32. Senility M. 1 ... ... ... ... ... ... ... ... ... ... 1 F. 7 ... ... ... ... ... ... ... ... ... ... 7 33. Suicide M. 15 ... ... ... ... 1 4 1 3 3 3 F. 8 ... ... ... ... ... 1 5 2 ... ... ... 34. Other violence M. 51 2 1 2 1 9 3 4 6 7 6 10 F. 31 ... ... 2 2 1 2 2 ... 6 8 8 35. Other defined diseases M. 103 5 3 3 4 7 9 5 6 23 25 13 F. 77 5 2 ... 13 7 4 6 12 9 8 11 36. Causes ill-defined, or unknown M. 1 ... ... ... ... ... ... ... ... ... ... 1 F. ... ... ... ... ... ... ... ... ... ... ... ... Deaths under 1 year of age: Legitimate Illegitimate M. 111 8 F. 62 5 134 135 S.D.55 Birthrates, Death rates, Analysis of Mortality England and Wales, London, Maternal Death-rates, and Case-rates for 121 Great Towns and 140 certain Infectious Diseases in the year 1935. Smaller Towns. (Provisional Figures based on Weekly and Quarterly Returns.) England and Wales. 121 County Boroughs and Great Towns including London. 140 Smaller Towns (Resident Population 25,000 to 50,000 at 1931 census). London Administrative County. Rates per 1,000 population. Births:— Live 14.7 14.8 14.8 13.3 Still 0.62 0.68 0.64 0.52 Deaths:— All causes 11.7 11.8 11.2 11.4 Typhoid and Paratyphoid Fever 0.00 0.00 0.00 0.00 Small-pox — — — — Measles 0.03 0.04 0.03 0.00 Scarlet Fever 0.01 0.01 0.01 0.01 Whooping Cough 0.04 0.04 0.03 0.04 Diphtheria 0.08 0.09 0.07 0.06 Influenza 0.18 0.16 0.17 0.11 Violence 0.52 0.45 0.41 0.51 Notifications:— Small-pox — — — — Scarlet Fever 2.96 3.19 2.75 2.64 Diphtheria 1.60 1.96 1.34 2.25 Enteric Fever 0.04 0.04 0.06 0.05 Erysipelas 0.42 0.48 0.37 0.45 Pneumonia 1.15 1.36 0.91 0.89 Rates per 1,000 Live Births. Deaths under 1 year of age 57 62 55 58 Deaths from Diarrhoea and Enteritis under 2 years of age 5.7 7.9 3.8 11.2 Maternal Mortality:— Puerperal S epsis 1.68 Not available. Others 2.42 Total 4.10 Rates per 1,000 Total Births (i.e. Live and Still.) Maternal Mortality :— Puerperal Sepsis 1.61 Not available. Others 2.32 Total 3.93 Notifications:— Puerperal Fever 3.60 4.55 2.76 4.32 Puerperal Pyrexia 9.44 11.14 8.25 11.89 136 APPENDIX I. RESULTS OF THE OVERCROWDING SURVEY— November 4th to December 13th, 1935. Table I. Stepney as a whole. (a) Structurally separate dwellings surveyed (Forms A) 35,199 (b) ,, ,, ,, measured (Forms B) 9,565 (c) Separate families in (A) 49,317 (id) ,, ,, found to be overcrowded 7,612 (e) Percentage of overcrowded families 15.42 Table II. Results in Estates of Local Authorities. Authority. , __ No. of families. No. overcrowded. Percentage. Borough Council 744 195 26.21 London County Council 864 192 22.27 City Corporation 109 18 16.51 Table III. Results in each of the 16 Sanitary Districts. District No. No. of houses surveyed [form a). No. of houses surveyed (form b). No. of families. No. of families overcrowded . Percentage. Approx. identification of district. 1 1,992 492 2,609 401 15.36 Mile End W and part W'plE 2 3,208 636 4,482 351 7.82 Mile End S. 3 2,414 720 3,667 674 18.38 Mile End Central. 4 2,292 607 4,199 368 8.76 Mile End S.E. & small part of Limehouse S. 5 2,192 503 3,657 328 8.96 Mile End N.E. 6 2,545 555 3,767 336 8.91 Mile End N. 7 2,088 604 2,274 397 17.45 Mile End New Town & part of Whitechapel E. 8 2,266 631 2,482 522 21.03 Spitalfields E. & partW'chpl Middle. 9 1,484 488 1,833 387 21.03 Spitalfields W. & part W'chpl. Middle. 10 1,342 371 1,772 362 20.44 W'chpl. S. & part St. Georges N. 11 1,675 445 2,207 420 19.03 Parts of St. Georges N. & St. Georges S. 12 1,773 551 2,661 533 20.03 St. Georges N. 13 2,638 851 3,100 698 22.51 St. Georges S. & Tower. 14 2,482 700 3,047 634 20.81 Shadwell and S. part of Ratcliff. 15 2,825 815 4,315 720 16.68 Limehouse N. & N. part of Ratcliff. 16 1,982 596 3,245 481 14.82 Limehouse S. Totals 35,199 9,565 49,317 7,612 15.42 137 It should be understood that for purposes of this survey, " number of persons in a family" means the "equivalent number," calculated as follows : Child under 1 year of age =0 ,, 10years,, ,, =£ Person 10 years and over (i.e. adult)=l Thus in the case of a family consisting of : Husband = 1 Wife = 1 Child aged 17 years = 1 ,, ,, 15 ,, = 1 9 = A 4 — ½ ,, ,, ,, =½ 2 =½ ,, ,, 6 months = 0 i.e. 8 individuals = 5½ Table IV. This table should be read as follows :— of (b) number of families consisting of (a) number of persons, (c) number are overcrowded. (a) (b) (c) Equivalent number of persons in family. Total number of such families, Number of such families which are overcrowded. 1 6,542 18 1½ 120 1 2 10,429 196 2½ 3,754 379 3 7,992 368 3½ 2,432 952 4 5,718 1,318 4½ 1,493 423 5 3,938 721 5½ 1,095 540 6 2,260 900 6½ 694 372 7 1178 464 7½ 380 182 8 599 343 8½ 197 122 9 224 114 9½ 80 66 10 101 66 10½ 38 26 11 23 17 11½ 8 7 12 9 7 12½ 5 2 13 8 8 138 Other Details. After careful scrutiny of the 9,565 Forms B (i.e. in the case of the 9,565 structurally separate houses which were measured) the following additional results were obtained. A. In addition to the number of families given as overcrowded in Table I, there are 83 families which are overcrowded by reason only of their having insufficient accommodation in which to separate properly the sexes. (N.B.— Except in the case of husband and wife, no person of one sex over the age of 10 years is permitted to sleep in the same room as a person of the other sex over the age of 10 years.) B. There are also 424 families which will be overcrowded within the next two years by reason of the children in those families attaining to ages of 1 or 10 years— provided of course that there are no deaths or other removals from the families. 139 APPENDIX II. COMPARATIVE INFANT MORTALITY IN THE LONDON BOROUGHS. I am indebted to Dr. W. Allan Young, the Medical Officer of Health for Poplar, for kindly supplying me with the following interesting and informative table. Borough. Estd. Res. Population (mid. 1935). Live Births rate per 1,000 population Death' rate per 1,000 population. Infantile Mortality rate per 1,000 live births. crude adjusted WEST DISTRICTS. Paddington 138,600 14.17 12.08 11.95 71 Kensington 178,300 12.4 12.1 11.3 79 Hammersmith 128,100 14.7 11.9 12.3 70 Fulham 143,600 13.8 11.6 11.7 51 Chelsea 57,320 10.2 12.6 10.7 59.6 Westminster 124,400 8.3 11.5 11.8 72 NORTH DISTRICTS. St. Marylebone 92,200 9.72 11.8 11.7 56 Hampstead 90,600 11.02 11.2 10.5 49 St. Pancras 185,300 13.3 11.97 12.2 62.8 Islington 308,170 14.85 — 10.99 52 Stoke Newington 50,210 13.9 11.1 10.6 51 Hackney 210,600 14.0 10.6 11.1 47.6 CENTRAL DISTRICTS. Holborn 35,400 7.65 11.9 12.7 89 Finsbury 63.100 14.7 12.6 13.7 59 City of London 9,360 7.6 11.0 12.2 113 EAST DISTRICTS. Shoreditch 88,400 14.6 11.3 12.4 52 Bethnal Green 99,910 14.4 10.3 11.6 51 Stepney 211,500 14.3 11.3 12.8 63 Poplar 143,700 15.4 11.0 12.3 46 SOUTH DISTRICTS. Southwark 156,100 14.8 — 12.4 66 Bermondsey 102,700 14.5 11.7 13.3 69 Lambeth 279,900 13.65 12.15 12.02 59 Battersea 148,200 14.2 12.0 11.9 65.11 Wandsworth 343,300 11.03 11.00 10.23 55 Camberwell 234,400 13.4 11.8 11.8 60 Deptford 99,500 14.4 11.1 11.5 52 Greenwich [96,600 13.87 10.83 11.04 59 Lewisham 223,000 12.5 9.9 10.0 43 Woolwich 146,400 14.0 10.2 10.8 44 140 INDEX. PAGE. I. Statistics and Social Conditions of the Area 7 II. General Provision of Health Services 10 III. Sanitary Circumstances of the Area 50 IV. Housing 77 V. Inspection and Supervision of Food 84 VI. Prevalence of, and Control over Infectious and other Diseases 117 VII. Statistics provided by the Registrar-General 132 After care, Tuberculosis 13 Analyst's Report 95-116 Ante-Natal Clinics 28, 89, 48 Ante-Natal and Post-Natal Services 29 Ante-Natal Supervision, Inquiry into 47 Area of Borough 7 Bacteriological Examinations 12 Bakehouses 88 Births 7, 8 Births Act, Notification of 8, 27 Bishopsgate Goods Station 93 Bug Eradication 10, 130 Butcher Shops and Stalls 87 Butter Factories 88 Canal Boats Acts 57 Cancer 129 Cerebro-Spinal Fever 122 Cleansing of persons 55, 130 Committees, List of Members 2 Complaints of nuisances 51 Convalescent Treatment 29, 33 Cowsheds 55, 60 Creches, List of 39 Dairies and Milkshops 87 Day Nurseries 30, 39 Deafness, prevention of 33 Deaths 9 Dental Clinic 26 Diarrhoea 129 Diphtheria 117 141 PAGE. Diphtheritic Serum 117 Disinfection 55, 130 Drainage 51 Dysentery 122 Eating Houses 55 Encephalitis Lethargica 122 Enteric Fever 117 Extra Nourishment, Supply of 16 Factory and Workshops 57-60 Fines and Costs 76 Finsen Light 16 Food and Drugs Acts 95-116 „ Inspection 84-94 „ Poisoning 124 ,, Premises 86-88 „ Products, Certification of 88 „ Regulations (Imported) - 88-94 „ Section, Formation of 84 „ Zeebrugge-Harwich Ferry 93 „ Calais-Harwich Ferry 93 Foster Mothers 31; 34, 55 Greengrocers and Fruiterers 88 Hairdressers' Shops 53 Handicraft Class 15 Health Visitors, work of 27, 35, 36 Health Week 23 Heart Disease 129 Home Helps 43 Home nursing 30 Home Office, report to 57-60 Hospital facilities 12 Houses-let-in-Lodgings 56 House to House Inspection 79-80 Housing:—Statistics 56, 77-78 „ Slum Clearance 81 „ Accommodation 78 „ Overcrowding Survey 82, 84, 136-188 Ice Cream Premises 87 Infant Life Protection 31, 34, 55 Infant Welfare Centres, List of 38, 39 ERRATA, All figures in the index between 55-94, inclusive, to be read back one figure, and Ministry of Health Returns will be found on pages 17-22. 142 PAGE. Infant Welfare Centres, Work at 27, 36 Infantile Mortality 37, 40, 45 ,, „ in London Boroughs 139 Infants, Feeding of 32 Infectious Diseases 117-123 „ „ Summary of, 123 Influenza 129 Laboratory facilities 12 Legal Proceedings 65-76 Lodging houses, Common and Seamen's - 55, 60 London County Council, Report to 55-56 Malaria 122 Marriages y Margarine premises 38 Maternal Mortality 31, 40, 47 Maternity Nursing 42, 43 Maternity and Child Welfare Centres, etc. 38, 39 „ „ Services 27-32, 40-50 „ Centres, Work at 27, 36 „ Outfits 32 Measles 30, 56,123 Merchandise Marks Act 70, 85 Midvvives 12, 31 „ Compensation to 41 „ Payments for 42 Milk—(Special Designations) Order 37 „ Analysis of 87, 99 Milk and Dairies Order 71, 72 „ and Meals, Provision of 28,33 Milkshops 55, 87 Ministry of Health, Returns to 27-32, 118-121, 126-127 Mortuary 53 Notifiable diseases 117 Nursing in the Home 12 Offensive Businesses 55,60 Ophthalmia Neonatorum 30, J 22 Outworkers 59, 60 Overcrowding 79, 82 „ Survey 82-84, 13(5-138 Pneumo-Thorax refills 16 143 PAGE. Pneumonia 122 Polio-Myelitis 122 Population7 Public Cleansing 50 Puerperal Fever and Pyrexia 122 Rag Flock Acts 60 Rats and Mice Destruction 51,52 Refrigeration Plant at the Mortuary 53 Rent and Mortgage Interest, etc., Act 52 Respiratory Diseases 130 Restaurants and Eating Houses 55 Sanitary Inspectors:—Inspections 63,64 „ „ Notices served 64 „ „ Return of sanitary work 61, 62 „ ,, Samples taken 86, 95 Sanocrysin Treatment 16 Scabies 130 Scarlet Fever 117 Scavenging 50 Shelter 53 Shops Act 50 Slaughter of Animals Act, 1933 60 Slum Clearance 81 Small-pox 117 Smoke Nuisances 51, 55 Social Conditions 9 Special Treatment (Tuberculosis) 16 Staff 3, 10, 11 Statistics, Summary of 7 Tuberculosis: Dental clinic 26 „ Dispensaries, List of 13 „ „ Return of work (Forms T 145 & T 145a) 17-22 „ Incidence of and Mortality from occupations - 128 „ Notifications, Summary of (Form T137 Rev.) - 126 „ Regulations, 1930 126 1925 127 „ Deaths 127 Twins 8 Underground Rooms 56, 78 Unsound Food 88-94 144 PAGE, Vaccination 118-121 „ by Public Vaccinators J 21 „ Officers, Returns by 118-120 Verminous persons and premises 55, 130 Water Certificates 53 Whooping Cough 129 Workshops and Workplaces 57-60 Wrong Diagnosis of Infectious Diseases 122 Zymotic Diseases 129+