STE 41 Metropolitan Borough of Stepney ANNUAL REPORT For the Year 1936 BY F. R. O'SHIEL, L.R.C.P.I., L.M., D.P.H., Medical Officer of Health AND Administrative Tuberculosis Officer TOGETHER WITH THE REPORT OF THE PUBLIC ANALYST. Vail & Co., ltd., Printers to the Council, 170, Farringdon Road, E.C.1 2 PUBLIC HEALTH COMMITTEE (November, 1935, to October, 1936.) Ex.Officio: Her Worship The Mayor (Councillor (Mrs.) H. Roberts., J.P.) Chairman: Councillor (Dr.) M. L. Barst. Vice.Chairman: Alderman H. F. Kober.' Alderman (Miss) M. Moses, J.P. Councillor (Mrs.) C. Aylward Councillor (Mrs.) K. O'Connor „ (Mrs.) A. Barnes ,, B. G. Purdy „ D. J. Berry „ (Mrs.) H. Rampling „ (Mrs.) A. P. Bunn „ J. Sambrook „ (Mrs.) R. V. Dubury „ L. Schaverin „ J. L. Fine, J.P. „ F. J. Shirley „ (Mrs.) L. Frankel „ (Mrs.) S. Spicer „ I. J. Kudish „ L. Tanaman „ (Mrs.) H. Long MATERNITY AND CHILD WELFARE COMMITTEE. (November, 1935, to October, 1936.) Chairman: Councillor (Mrs.) L. Frankel. Vice.Chairman: Councillor (Mrs.) R. V. Dubury. The Members of the Public Health Committee. 3 STAFF OF THE PUBLIC HEALTH DEPARTMENT on the 31st December, 1936. Medical Officer of Health and Chief Administrative Tuberculosis Officer: A. Ferguson, m.b., b.s. (lond.), m.r.c.s., l.r.c.p., d.p.h., deceased 14th September F. Roantree O'Shiel, l.r.c.p.i., l.m., d.p.h. (Liverpool). Deputy Medical Officer of Health : (Vacant) 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) S. S. Lowtheh. (3, 4) J.H. Brownlee. (1, 3, 4) y G. F. Guy. (2) J.G. McCarthy. (3) W. Cue. (1, 3) W. H. Haworth. (3) Roper. (3, 4) R. W. G. Day. ( 3) W. H. Howard. (1, 3) W. F. Smith. (2, 4) G. D. Freeland. (1, 3, 4) J. Keniry. (3) W.T.wynham. (2) R.H. Waterman. (1, 2, 4) 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. †Miss H. A. Whitty. Disinfestation and Female Common (3, 4, 5, 6, 8) Lodging Houses. Clerical Staff : W. F. Lellow, Chief Clerk (2) R. Bach. S. Embleton. J. McMullon. Miss G. Boulton. (m. & c.w.) Miss M. Fitzgerald, (m. & c.w.) M. Pliskin. Miss G.A.Carthy. (m.&c.w.) Mrs. H. Hiles. (m. & c.w.) Miss P. Romaine. J. J. Coveney. W. P. Howard. (m. & c.w.) T. W. Dawson. Miss M. W. Hunt. (m. & c.w.) E. P. Simpson. W.J. Dixon. c. H. Lowry. E. P. Webber. Vaccination Officers: E. Price. (3) E. J. Robertson. Medical Officers for Maternity and Child Welfare (Part Time): Norah Cotter, m.b., b.Ch. Margaret Emslie, m.b., Ch.B. Doris M. Pullen, m.b., ch.b. Margaret Ward, m.b., Ch.b., d.p.h. tHealth Visitors : Miss M. Bailey. (5,6,7) Miss E. Clements. (5, 6) Miss A. E. Gibbs. (5, 6) „ D. E. Blackmore. (5, 6, 7) „ A. Clifford. (5, 6, 7) „ M. F. E. Styles. W. Brazier. (6, 7) „ A. M. Cordwell. (1, 6,8) (5,6,7) A. Carty, (5, 6, 7) „ S. Foucar. (2, 5, 6, 7) Senior Tuberculosis Officer: E. Harley Stevens, m.b., m.r.c.p., ch.m., d.p.h. Assistant Tuberculosis Officer: (Vacant) Tuberculosis Visitors: Miss M. C. Hurley. (5, 6, 7) Miss M. Prickman. (5, 6, 7) „ E. Lindsley. (7) „ M. F. Weatherilt. (5, 6, 7) Nurse Dispensers: Miss M. Coulman. (5, 6, 7, 9), Miss A. O. Jones. (7, 8, 9) Clerk and Secretary to Care Committee: Miss M. Grant. Clerk: Miss 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. Anesthetist (part.time): J. P. Reidy, b.a., m.r.c.s., l.r.c.p. Diphtheria Immunisation: W. W. King.Brown, m.b., b.s. (lon ) Part time Medical Officer. Guy Bousfield, m.d., b.s. (lon.) Hon. Advisory Expert. 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. Exam. 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.l. 20th May, 1937. 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 the annual report upon the health and sanitary conditions of the Borough of Stepney for the year 1936. This report is, for the most part, presented by me on behalf of the late Medical Officer of Health, Dr. Archibald Ferguson, whose lamented and untimely death it is my sad duty to record, occurred during the year, on 14th September. Dr. Ferguson who was absent on sick leave from February only returned to duty for a brief period of two weeks in May. It was my privilege to work with Dr. Ferguson, firstly in the Tuberculosis Department in 1931, and for the last three years as his Deputy during his Medical Officership of Health. I know I am voicing, not only my own feelings, but those of all the staff when I say that no kinder, no more conscientious or more likeable colleague could one possibly have hoped to work for. Dr. Ferguson, as Medical Officer of Health, carried out the administration of the department with zest and earnestness that few could equal, and the remarkable number of reforms in the department and new public health schemes introduced into the Borough during his short three years of office are a lasting tribute to his industry and enthusiasm. Not a few of the many services provided by the Borough Council, the activities of which are recorded herein, came into being during his period of office. I need only refer to the following, viz.: The reorganization of the food section and housing section; the disinfestation section, with its staff and special hydrocyanic disinfesting chamber; the new model tuberculosis dispensary and the reorganising of the tuberculosis service; the diphtheria immunisation clinic; the home.help service and the maternity nursing service. All these were the fruit of Dr. Ferguson's effort and organising initiative. Full of enthusiasm for the future and devoted to his duty, the tragic unexpectedness of his end is brought home to us by the final words of his last annual report, "I end this report in a spirit of definite optimism, for the department can now look forward to many years of uninterrupted routine." * * * * The year, in many ways, was not an easy one for the department, there being considerable temporary depletion of staff arising from various causes. It was inevitable that the unfortunate illness of the late medical officer necessitating his prolonged absence from duty, should be reflected in some interruption of the year's programme, arresting the progress of matters awaiting his return, although much was accomplished during the year and many new schemes commenced to function, 5 The Senior Clinical Tuberculosis Officer, Dr. Ethard Goss, left the service of the Council on 31st July, after 15 years' service, and many years previously associated with the voluntary tuberculosis service in the Borough, and it is with deep regret that I record here his subsequent demise in May of this present year. During the illness of Dr. Ferguson, I myself deputised for him in the capacity of Acting Medical Officer of Health, and on 23rd December you appointed me to be your Medical Officer of Health and Chief Administrative Tuberculosis Officer, an honour which I most deeply appreciate. Dr. Harley Stevens, the Tuberculosis Officer, was promoted by you, on the resignation of Dr. Goss, to the position of Senior Tuberculosis Officer, on 1st August. The vacancy for Assistant Tuberculosis Officer, created by this promotion, has not yet been filled. Mr. H. T. Kightley, a senior clerk in the department, retired on a well. earned pension on 29th February, after 44 years' service. Dr. Cecily Phelps, part.time medical officer in the Maternity and Child Welfare Department, resigned in January, and Dr. Margaret Emslie was appointed in her place. Owing to my acting for the Medical Officer of Health, the Maternity and Child Welfare Department did not, this year, have the full services of a Deputy Medical Officer of Health. In this present year, however, a Deputy will be appointed. * * * * New activities commencing to operate during the year included the hydrocyanic acid gas fumigation chamber for bug disinfestation, under the charge of a sanitary inspector and three disinfectors (a photograph of the station appears in this report); the diphtheria immunisation clinic, which opened on 5th June, under Dr. King.Brown, and which has been largely attended; the home.helps and the maternity nurses services. The vaccination districts were amended during the year. Important legislation which came into operation and affected the work of the department, were the Public Health (London) Act, 1936, on 1st October, the Pharmacy and Poisons Act, 1933, on 1st May, new food bye.laws formulated by the London County Council and the Milk (Special Designations) Order, 1936. The Pharmacy and Poisons Act involved the inauguration of a new system of records by the clerical staff, and a series of special visits by the sanitary inspectors. * * * * Housing activities during the year were much to the fore. Ministry of Health inquiries were held on three London County Council areas and two Borough Council areas, the latter being confirmed by the Ministry without modification. Closing Orders were made in respect of ten underground rooms and 15 further were satisfactorily altered to comply. 255 cases of overcrowding were abated, although the "appointed day," as laid down by the Act, has not yet been fixed in this Borough. The food section has had a busy and successful year, and reports an all round improvement in conditions of food production and in the compliance of the Merchandise Marks Act. 6 The activities of the newly opened bug disinfesting station have resulted in 100 per cent, vermin free admissions of tenants into the new Borough Council flats, and great interest both in and outside the Borough has been aroused by the ingenious system of wholesale disinfestation of furniture in vans, followed by forced ventilation. * * * * It is most satisfactory to record that the maternal mortality rate of the Borough continues to decline, being only 1.56 per 1,000 births. As anticipated in the annual report of last year (pp. 40 and 46), the infant mortality rate for the present year is, unfortunately, high, 100.09 per 1,000 live births, to some extent accounted for by the severe epidemic of measles and concurrent broncho.pneumonia. 1,294 more cases of measles were notified this year with 52 deaths, 15 deaths being of infants under one year of age. Broncho.pneumonia showed 56 deaths of infants compared with 34 last year. The population of the Borough has decreased by 3,700. Births have increased by 40, with a birth rate of 14.7. Deaths from all causes increased by 227 to a total of 2,620. Pulmonary tuberculosis deaths were 4 less and non.pulmonary 10 less than last year. Zymotic disease deaths totalled 192, compared with last year's unusually low figure of 77. Notifications of infectious diseases were 1,096 more than last year, but excluding measles, were 198 less than last year. There were 54 more cases of scarlet fever and 224 less of diphtheria—a very large decrease. There were no cases of small.pox. Food poisoning cases notified numbered 8, or 24 less than last year. * * * * In presenting this, the annual report for the year 1936, may I express my sincere thanks to the chairmen and members of the several committees associated with the work of this Department for the very great help and consideration I have received from them at all times and, to the staff of the department, may I pay a warm tribute for the keen interest they have taken in their work and for their ever.willing co.operation. With every prospect of a full and complete staff, I am hopeful that still further progress will be shown in the year 1937. I have the honour to be, Your Worship, Ladies and Gentlemen, Your obedient servant, F. R. O'Shiel, Medical Officer of Health. 7 SUMMARY OF STATISTICS, 1936. Area of Borough (in acres) 1902 766 Population (1936) (Registrar.General's estimate) 207,800 Number of inhabited houses (end of 1936) according to Rate Books 37,237 Rateable value 31st December, 1936 £1,737,804 Sum represented by a penny rate £6,896 Total. Male. Female. Legitimate 2,950 1,519 1,431 Birth Rate per Live Births Illegitimate 117 59 58 1,000 of the mated resident 3,067 1,578 1,489 population 147 Still Births 112 71 41 Rate per 1,000 total (live and still) births 35.2 Total Births 3,179 1,649 1,530 Deaths 2,620 1,445 1,175 Death rate per 1,000 of the estimated resident population 12.6 Deaths from puerperal causes (Headings 29 and 30 of the Registrar.General's Short List):— Deaths Rate per 1,000 total (live and still) births. No. 29 Puerperal sepsis 3 0.94 No. 30 Other puerperal causes 2 0.62 Total 5 1.56 Death rate of Infants under one year of age: All infants per 1,000 live births 100.09 Legitimate infants per 1,000 legitimate live births 99.3 Illegitimate infants per 1,000 illegitimate live births 136.7 Deaths from Cancer (all ages) 304 „ „ Measles (all ages) 52 „ „ Whooping Cough (all ages) 22 „ „ Diarrhœa (under 2 years of age) 100 I.—STATISTICS AND SOCIAL CONDITIONS OF THE AREA. The estimate of the Registrar.General to the mid.year 1936 is 207,800. The total number of live births of Stepney residents during the year was 3,067—1,578 males and 1,489 females—or 40 more than in the previous year. The birth.rate was 14.7 per 1,000 of the population. Population. Births. 4,319 births occurred in Public Institutions in the Borough, of which 2,035 belonged to Stepney and 2,284 belonged to other Boroughs. 1,452 births occurred in the East End Maternity Hospital:— 386 belonged to Stepney, and 1066 to outlying Districts. 906 births occurred in the London Hospital:— 381 belonged to Stepney, and 525 to outlying Districts. Births in Public Institutions in the Borough. 8 Births in Outlying Districts. Twins. 331 births occurred in the St. George.in.the.East Hospital:— 292 belonged to Stepney, and 39 to outlying Districts. 930 births occurred in the Mile End Hospital:— 713 belonged to Stepney, and 217 to outlying Districts. 699 births occurred at 24, Underwood Street:— 263 belonged to Stepney, and 436 to outlying Districts. 1 birth occurred in the London Jewish Hospital which belonged to an outlying District. 166 births occurred outside the Borough, the parents being residents of Stepney. 41 sets of twins were born in the Borough during the year: 37 sets were live births. 2 „ „ still.born. 2 „ „ 1 live birth and 1 still birth in each case. 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 2252 88 (b) At home: — Notified by doctors 75 7 „ private midwives 140 1 ,, doctors and midwives from Institutions 610 12 3,077 108 Marriages. The total number of marriages which took place during the year was 2,272, or 8 more than in the previous year. Deaths. The proportion of persons married was 2T8 per 1,000 of the population. 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 2,620—1,445 males and 1,175 females—or 227 more than in the previous year. Deaths in Public Institutions in the Borough. The death.rate for the whole Borough was 12.6 per 1,000 of the population. 2,308 deaths occurred in Public Institutions in the Borough, of which 1,507 belonged to Stepney and 801 belonged to other Boroughs. Belonging to Stepney. Belonging to other Boroughs. East End Maternity Hospital, Commercial Road 17 12 Princess Elizabeth of York Hospital for Children Shadwell 30 75 London Hospital, Whitechapel Road 160 475 London Jewish Hospital, Stepney Green 54 32 Mile End Hospital, Bancroft Road 535 61 St. George's Hospital, Raine Street 365 61 St. Peter's Hospital, Vallance Road 330 77 Sick Room Help Society, 24, Underwood Street 7 5 Stepney Institution, South Grove 9 3 9 There were 483 deaths of persons belonging to the Borough in various Institutions outside the Borough: — Mental Hospitals 97 Hospitals for Infectious Diseases 87 Hospitals and Institutions 299 In addition there were 21 deaths of Stepney residents in private houses outside the Borough. Deaths in Outlying Districts. 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:— 1936. Men. Women. Children. Total. 4th January 1,980 2,840 2,751 7,571 26th December 1,595 2,394 1,793 5,782 1935. 5th January 2,255 3,140 3,720 9,115 28th December 1,865 2,721 2,539 7,125 (b) Number of registered unemployed:— Total. 26th October, 1936 5,461 males 703 females and 231 juveniles 6,395 December, 1935 7,833 „ 1,320 „ „ — „ 9,153 Public Assistance and Unemployment. II.—GENERAL PROVISION OF HEALTH SERVICES. As already referred to in my preface to this report, Dr. Archibald Ferguson, the Medical Officer of Health, passed away on 14th September, after a long illness, having been absent from duty on sick leave from 27th February, except for a short period from 27th May to 11th June. During Dr. Ferguson's absence I was deputed Acting Medical Officer of Health, and subsequently you appointed me on 23rd December to be your Medical Officer of Health and Chief Administrative Tuberculosis Officer. Dr. W. E. Goss, the Senior Clinical Tuberculosis Officer, left the service of the Council on 31st July, and on 1st August, Dr. Harley Stevens, the Assistant Tuberculosis Officer, was promoted to the position of Senior Tuberculosis Officer. The vacancies for Assistant Tuberculosis Officer and for Deputy Medical Officer of Health, created by Dr. Harley Stevens' and my appointments, were not filled by the end of the year. Pending the appointment of the Assistant Tuberculosis Officer, Dr. Crowe was appointed in a temporary capacity and commenced duty on 7 th December. Dr. Cecily Phelps, part.time Maternity and Child Welfare Medical Officer at the Council's Burdett Road Infant Welfare Centre, resigned in January and Dr. Margaret Emslie was appointed on 25th March. Mr. C. F. Brockett, a Sanitary Inspector, resigned to take up a new appointment on 14th November. Mr. J. Keniry, a clerk in the Public Health Department, was appointed a Sanitary Inspector on 23rd December. Mr. H. T. Kightley, a Senior Clerk, retired on superannuation on 29th February, having reached the age of 64, after 44 years service in the Public Health Department. Dr. King.Brown was appointed as part.time Medical Officer in charge of the new diphtheria immunisation clinic at 35, Stepney Green, on 26th February, and Dr. Guy Bousfield as Honorary Advisory Expert. Changes in Staff. 10 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 Is. 3d. per visit to such cases and 1588 visits were made by them during the year, i e., 1464 Measles, 101 Ophthalmia Neonatorum and 23 Pemphigus Neonatorum. Midwives. There are 11 Midwives practising in the Borough, and in addition there are 33 employed by the voluntary associations. Laboratory facilities. The midwives are under the supervision of the London County Council. The number of bacteriological examinations made at the Mile End Hospital on behalf of the Public Health Department during the year was 2,643. These consisted of:— No. No. Positive. Negative. Totals Swabs (for Diphtheria bacilli) 211 2,426 2,637 Blood (for Typhoid bacilli) — 6 6 There were 915 specimens of sputum examined at the Tuberculosis Dispensaries. 188 of these were found to be positive. Hospital facilities 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 357 14,364 101,093 General and Maternity. Voluntary. Female 408 Children 84 Mile End Hospital, Bancroft Road. Male 166 7,264 11,650 General and Maternity. L.C.C. Female 237 Ante.natal 1,028 Children 139 Post.natal 239 Cots 46 St. George.in.the.East Hospital, Raine Street. Male 157 4,951 10,115 General. and Maternity. L.C.C. Female 253 St. Peter's Hospital, Vallance Road. Male 203 3,626 1,809 General. L.C.C. Female 171 Children 30 South Grove Institution, South Grove. 649 — — Public Assistance. L.C.C. London Jewish Hospital, Stepney Green. Male 41 1,498 13,374 General. Voluntary. Female 51 Children 12 Other 5 Princess Elizabeth of York Hospital for Children, Glamis Road. Children 135 1,849 50,350 General. Voluntary. last End Maternity Hospital, Commercial Road. 59 1,494 306 Maternity Voluntary. Jewish Maternity Hospital, Underwood Street. Maternity beds 34 681 40 midwifery cases. Maternity. Voluntary. 11 The two dispensaries at Steel's Lane and Stepney Green continue to function, and in the light of experience the time.table of sessions has been altered but not reduced. The present time.table for new patients is as follows:— Main. Branch, m. t. w. th. f. s. m. t. w. th. f. s. Morning Men School Children Men Afternoon Women and Children Men Women and Children Women and Children Evening Workers Workers Tuberculosis Dispensaries. Eight meetings of the Tuberculosis Care Committee were held during 1936. All cases are now discussed by the full Committee, which meets once a month at the new main dispensary, instead of the three sub.Committees meeting at each dispensary as before. The three sub.Committees became one full Committee on the closing of the Whitechapel and St. George.in.the.East dispensaries in November, 1935, and the Stepney Green cases are discussed at the meetings at the main dispensary. Two meetings of the Standing Conference of the Metropolitan Borough Tuberculosis Care Committees were held at the County Hall, and matters concerning the welfare of tuberculosis patients were discussed and recommendations sent to the London County Council. There were no matters of outstanding urgency, so at the Spring meeting the Medical Superintendent of Colindale Hospital gave an address on the After.Care of patients, and at the meeting held in November, Dr. Somerville Hastings, of the London County Council, attended, and answered questions put to him by various members of the Care Committees. 420 cases, including new and old patients, came before the Care Committee during the year, and of these 156 needed advice or assistance of some kind, so that it will be seen that a good deal of care and after.care work is necessary. The Jewish Board of Guardians assisted 78 patients or their families; a deserving case of tuberculosis referred to them is rarely refused help, and their willing co.operation makes the handling of necessitous Jewish patients a comparatively easy matter. The voluntary charitable societies have again given valuable help in many cases. These societies send representatives to the Care Committee, who are often able, after hearing the details of a case, to take it back to their own committee and obtain the kind of help we cannot at present give ourselves. The Charity Organisation Society gave timely assistance in several cases. They sent four people away for a badly needed change of air, and paid for spectacles for another patient. Tuberculosis After Care. 12 The Invalid Kitchens provided dinners and nourishments for three needy patients who were not eligible for this through the Borough Council grant. The British Legion, in conjunction with the Red Cross Society, provided pocket money, paid removal expenses, and gave a grant for trading to ex. service men during the year. Individual members of the Care Committee have also helped, providing pocket money for destitute patients in sanatorium, the loan of a bath chair for a crippled woman, and one, a representative of one of the hospitals, sending us medical appliances which are very useful for advanced cases of tuberculosis being nursed at home. To commemorate the late Medical Officer of Health, Dr. Archibald Ferguson, and the great and personal interest which he took in the welfare of the patients of the tuberculosis dispensaries during his long association with the dispensaries as Tuberculosis Officer, her Worship the Mayor, Councillor (Mrs.) Roberts, J.P., very kindly opened a fund, "The Dr. Ferguson Memorial Fund," to which generous donors subscribed. This fund was placed at the disposal of the Care Committee to augment their resources for the benefit of patients requiring small necessities and comforts, not provided for from official sources. Pocket money was sent to patients who were in sanatorium without even the means to buy themselves a stamp; the railway fare was paid for a girl who was sent for a free holiday through the Church Army, and the wives of two very poor patients were given the fare to visit them at sanatorium. The London County Council provided clothing for 38 patients going to sanatorium who were unable to obtain suitable clothing for themselves. Eight beds were supplied on loan by the Borough Council for patients who were advised to sleep alone and could not provide themselves with a separate bed. Handicraft Class. The Handicraft Class has had another successful year. 46 classes were again held, with an average attendance of 14, and several new members joined during the year. Our students joined in the combined Sale of Work, held at the Carpenter's Hall in June, and although this sale was not so successful generally, as some of the former ones, the results of our stall compared very favourably with those of other Boroughs. The work of the ex.servicemen again went to the Imperial Institute, and practically everything was sold. With these two sales to work for, no local sale of work was held, but it is hoped that during 1937 we may be able to hold one of our own in Stepney. Geere House Open Air School. The Senior Tuberculosis Officer, Dr. Harley Stevens, as Medical Officer to the Geere House open.air school for tuberculous children, kindly supplies me with the following interesting report of the school for the year. The school is under the jurisdiction of the London County Council and is situated at the rear of the Council's tuberculosis dispensary at 35, Stepney Green. "During the year 1936, the roll was full, and with the policy of admitting suitable contacts I anticipate no falling off in admissions for 1937. "There has been a considerable turnover, a number of arrested cases over twelve years of age being discharged to elementary schools after three or more years at Geere House. A number also attained school.leaving age. 13 "It speaks well for the teaching staff and the popularity of the school that in every case discharged to elementary school the parents have either sought an interview or written to request that the children might be retained. "I must add a word of appreciation for the co.operation and interest of the head.mistress, Miss O'Brien, and the assistant mistress, Miss Jacka. The school has also been greatly helped by the untiring efforts of Mrs. Tritton who, for many years has undertaken the home visiting, financial assessments and following.up for the School Care Committee. "The atmosphere of the school is at all times a most happy one. "The activities of the children have been extended during the year with regular swimming classes, manual work for the boys and needlework for the girls. The swimming has continued popular through the winter and unless there is otitis media, chronic rhinitis, a cutaneous tuberculide or non.arrested pulmonary disease, I have encouraged the children over nine years of age to take part. "With reference to the Annual School Sports in which the children competed, there was some disappointment because they were not permitted to enter for the jumping contests. I can see no medical grounds for such a veto. "There are as yet no data of value regarding the school breakfasts, of which all the children partake. When they were introduced the parents were circularised, explaining the object of the breakfasts and asking them to continue the usual morning meal before the children left home. I believe this is done in nearly all cases, so that the breakfast is in fact an addition to the daily diet. "It is difficult with the sum available to provide proteins and fats except as a rare treat, so that the meal is mainly a carbohydrate one. When the effect of the breakfasts is reviewed, the absence of proteins should be taken into consideration. "I suggest that Geere House, where all the children are receiving breakfasts and which serves a very poor area, might be selected for an experiment in which the children could be provided with a high protein meal. "It is observed in nearly all cases that the rate of growth of the younger children is much less than that of children over eleven years of age. With the average age reduced during the year, there will be many weight charts showing relatively disappointing results. So far as Geere House is concerned the Medical Officer must be blamed, for the policy of admitting young contacts and discharging the older children, rather than condemn the breakfasts as of no value. "I consider the reason for this slow development in the young children is due in some part to the overcrowded conditions in the houses of the East End. There is no separate room in which the children can be put to bed early and remain undisturbed. More improvement in general physical condition and rate of growth is obtained by giving these children additional rest periods at school. For that purpose there is unfortunately no secluded corner available at Geere House. "The school time.table is a full one and it is difficult to provide a daily drill period. A number of minor postural defects might be corrected by class exercises. Occasionally children who have had a pleural effusion tend to develop a scoliosis for which exercises would be beneficial. 14 "It should be noted that the average gain in weight during the first and last terms of the year exceeds the gain during April to September inclusive. "The School Journey proved very popular. The older children gained an average of 0.6 kilos in two weeks, and the younger group 0.3 kilos. "I am pleased that the Stepney Borough Council are arranging to make available a portion of the grounds of 35, Stepney Green for the use of the school as a garden." Boarded.out Contacts. 10 Children who were contacts of infectious cases of pulmonary tuberculosis were boarded out during the year. Special Treatment for Tuberculosis Patients. The Council have 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 7 98 Pneumo.Thorax Refills at Brompton ,, 1 28 „ „ „ London Chest „ 28 355 „ „ „ City Road Chest Hospita 1 6 „ „ „ Colindale „ 3 16 „ „ „ Grove Park „ 2 14 „ „ Margaret Street „ 1 6 Solganol or Sanocrysin treatment at Victoria Park Hospita 3 47 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 Pasteurised or Tuberculin Tested Milk per day, seven eggs per week, and a half pound of butter per week. During the year 424 grants were made to 152 persons, the total cost being approximately £360 8s. 0d. 15 Memo. 37/T (Revised). Ministry of Health Form T. 145. A. Return showing the work of the Dispensaries for the year 1936: — 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 144 62 3 6 16 8 9 9 160 70 12 15 593 *(b) Diagnosis not completed . . . . . . . . 9 5 5 1 (c Non.tuberculous . . . . . . . . 122 131 30 33 t5 —Contacts examined during the year— (a) Definitely tuberculous — 2 — 1 — — 1 — 2 — 2 641 *(b) Diagnosis not completed . . . . . . . . . 2 — — (c) Non.tuberculous . . . . . . . . 101 174 180 180 C.—Cases written off the Dispensary Register as:— (a) Recovered ., 19 21 7 4 2 3 14 15 21 24 21 19 1179 (b) Non.tuberculous (including any such cases previously diagnosed and entered on the Dispensary Register as tuberculous) . . . . . . . . 259 342 246 247 D.—Number of Cases on Dispensary Register on December 31st :— (a) Definitely tuberculous 760 417 81 73 72 54 125 94 832 471 206 167 1,698 (b) Diagnosis not completed . . . . . . . . 9 7 5 1 1. Number of cases on Dispensary Register on January 1st 1,868 2. Number of cases transferred from other areas and cases returned after discharge under Head 3 in previous years 69 3. Number of cases transferred to other areas, cases not desiring further assistance under the scheme, and cases "lost sight of " 148 4. Cases written off during the year as Dead (all causes) 146 5. Number of attendances at the Dispensary (including Contacts) 5,293 6. Number of Insured Persons under Domiciliary Treatment on the 31st December 486 7. Number of consultations with medical practitioners:— (a) Personal 224 (b) Other 378 8. Number of visits by Tuberculosis Officers to homes (including personal consultations) 458 9. Number of visits by Nurses or Health Visitors to homes for Dispensary purposes 5,545 10. Number of:— (а) Specimens of sputum, etc., examined 915 (b) X.ray examinations made in connection with Dispensary work 468 11. Number of "Recovered" cases restored to Dispensary Register, and included in A(a) and A(b) above 1 12. Number of "T.B. plus " cases on Dispensary Register on December 31st 763 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 — *i.e., remaining undiagnosed on 3lst December. 17 Form T145a. (a) PULMONARY TUBERCULOSIS. Supplementary Annual Return showing in summary form (a) the condition at the end of 1936 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 1930 Class T. B. minim 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, pius 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. 16 9 12 — 21 2 1 — — 1 1 — — — — 3 2 6 — 8 4 3 2 1 6 4 3 5 — 8 F. 8 8 9 — 17 — 1 2 — 3 1 — 2 — 2 2 3 — — 3 3 4 — — 4 3 3 — — 3 Children 3 2 — — 2 2 — — — — 3 3 — — 3 4 — — — — 6 — — — — 4 1 — — 1 Disease not Arrested Adults M. 2 12 10 2 24 1 1 4 — 5 — 5 4 — 9 3 — 1 — 1 6 4 10 1 14 4 7 5 2 14 F. 2 6 3 1 10 — — 5 — 5 1 1 2 — 3 — 3 2 — 5 — 3 1 — 4 4 5 6 — 11 Children — — — — — — — — — — — — — — — 1 — — — — 2 — 1 — 1 1 — — — — Condition not ascertained during the year 19 16 15 — 31 7 2 4 — 6 12 2 1 — 3 18 5 4 — 9 14 5 3 — 8 14 9 5 1 15 Total on Dispensary Register at 31st December 50 53 49 3 105 12 5 15 — 20 18 11 9 — 20 31 13 13 — 26 35 19 17 1 37 34 28 21 3 52 (b) Not now on Dispensary Register and reasons for removal therefrom. Discharged as Recovered Adults M. 21 11 7 — 18 7 5 — — 5 11 4 — — 4 8 1 2 — 3 10 4 — — 6 3 2 — — 2 F. 21 23 5 — 28 3 6 — — 6 12 3 1 — 4 5 6 2 — 8 13 3 — — 3 4 5 1 — 6 Children 7 2 — — 2 4 — — — — 6 2 — — 2 5 5 — — 5 3 — — — — 6 1 — — 1 Lost sight of, or otherwise removedfromDispensary Register 77 53 35 1 89 7 12 8 — 20 12 12 14 1 27 13 17 11 2 30 23 11 16 1 28 21 12 18 3 33 Dead. Adults M. 9 8 24 7 39 5 4 5 2 11 7 4 9 2 15 4 2 8 3 13 12 4 9 2 15 5 9 13 4 26 F. 9 6 11 1 18 — — 3 3 6 2 4 4 — 8 4 3 3 1 7 6 6 9 2 17 7 3 6 5 14 Children 1 . . . . 1 . . . . . . . . . . . . . . . . 1 . 1 . 2 . . 2 Total written off Dispensary Register. 145 103 82 9 194 27 27 16 5 48 50 29 28 3 60 39 34 26 6 66 67 28 37 5 70 45 34 38 12 84 Grand Totals 195 156 131 12 299 39 32 31 5 68 68 40 37 3 80 70 47 39 6 92 102 47 54 6 107 79 62 59 16 136 18 PULMONARY TUBERCULOSIS—continued. Condition at the time of the last record made during the year to which the return relates 1931 1932 1933 1934 1935 1936 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 Grhup 2 Group 3 Total (class T.B. plus) (a) Remaining on Dispensary Register on 31st December. Disease Arrested. Adults M. 6 3 4 — 7 6 6 13 1 20 17 4 1 4 — 8 7 — 1 — 1 — — _ — — — — — — — F. 10 6 4 — 10 4 3 2 — 5 6 2 1 1 4 4 1 . . 1 . . . . . . . . . . Children 7 1 — — 1 7 1 — — 1 7 . . . . . . . . . . . . . . . . . . . Disease not Arrested. Adults M. 2 6 13 1 20 4 6 15 2 23 6 11 26 4 41 20 20 22 1 43 30 15 43 1 59 35 16 52 6 74 F. — 5 5 — 10 2 11 9 1 21 10 10 8 — 18 10 7 11 1 19 16 12 16 — 28 20 7 18 — 25 Children 2 — 1 — 1 5 — — — — 4 — — — — 7 2 3 — 5 14 3 2 — 5 10 1 — — 1 Condition not ascertained during the year 25 4 6 — 10 32 9 7 — 16 22 4 4 — 8 23 13 — 1 14 2 3 1 1 5 . . . . . Total on Dispensary Register at 31st December 52 25 33 1 59 60 36 46 4 86 72 31 43 5 79 76 43 37 3 83 62 33 62 2 97 65 24 70 6 100 (b) Not now on Dispensary register and reasons for removal therefrom. Discharged as Recovered Adults M. 4 1 2 — 3 . . . . . . . . . . . . . . . . . . . . . . . . . F. 2 2 1 . 3 . . . . . . . . . . . . . . . . . . . . . . . . . Children 1 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Lost sight of, or otherwise removed from Dispensary Register 36 21 28 1 50 48 16 27 1 44 43 29 21 2 52 27 10 18 2 30 8 6 10 1 17 4 — 5 1 6 Dead Adults M 8 4 18 10 32 9 11 21 11 43 8 12 23 17 52 7 10 19 27 56 10 3 21 11 35 2 2 12 16 30 F. 7 8 12 4 24 2 7 7 6 20 1 3 14 12 29 3 4 10 7 21 7 — 5 3 8 1 — 10 5 15 Children — — — — — 1 1 — — 1 1 1 — 2 3 1 — 1 — 1 — — 1 1 — — — — — Total written off Dispensary Register 57 33 61 15 112 60 35 55 18 108 53 45 58 33 136 38 24 48 36 108 25 9 36 16 61 7 2 27 22 51 Grand Totals 109 61 94 16 171 120 71 101 22 194 125 76 101 38 215 114 67 85 39 191 87 42 98 18 158 72 26 97 28 151 19 (b) NON-PULMONARY TUBERCULOSIS. Supplementary Annual Return showing in summary form (a) the condition at the end of 1936 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 1930 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 OtherOrgans Peripheral Glands Total Bones and Joints Abdominal Other Organs Peripheral Glands Total (a) Remaining on Dispensary Register on 31st December. Disease Arrested Adults M. 1 — 2 - 3 1 — 1 — 2 — — — — — 2 — — — 2 — — — — — 1 — 2 — 3 F. — — — — — 2 — — — 2 1 — — — 1 1 — 1 — 2 — — — — — 1 — — 1 2 Children 8 — 2 — 10 — — 1 1 2 4 1 1 3 9 5 — 2 2 8 1 3 1 2 7 4 3 5 6 18 Disease not Arrested Adults M. - - - - - 1 - - - 1 - - - - - - - - - - - - - 1 1 1 — — — 1 F. 1 - 2 - 3 - - 1 - 1 - - - - - - - - - - - - - - - - - - - - Children — — — 1 1 — — — — — — — — — — — — — 1 1 3 — — 1 4 2 — — — 2 Condition not ascertained during the year 3 — 2 4 9 1 1 — — 2 1 — 1 — 2 2 — — 3 5 4 1 4 2 11 3 — 3 4 10 Total on Dispensary Register at 31st December 13 — 8 5 26 5 1 3 1 10 6 1 2 3 12 10 — 3 6 19 8 4 5 6 23 12 3 10 11 36 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 — 1 3 2 — — 2 4 F. — — — 2 2 — — 1 1 2 — — — 1 1 — — — — — — — 1 2 3 - - - - - Children 4 1 2 5 12 5 1 — 3 9 2 3 — 5 10 1 1 1 14 17 4 — — 7 11 2 1 — 7 10 Lost sight of, or otherwise removed from Dispensary Register 12 3 4 15 34 2 2 — 6 10 3 1 2 6 12 4 1 3 2 10 7 2 2 3 14 2 2 2 5 11 Dead Adults M. - - - 1 1 - - - - - 1 - - - 1 - - 1 - 1 - - 1 - 1 - - 1 2 3 F. - - - - - - - 2 - 2 - - - - - - - - - - - - - - - - - - - - Children — 1 — 1 2 — — — — — 1 — — 1 2 — — — — — — — — — — — — — 1 1 Total written off Dispensary Register 16 5 7 27 55 7 5 3 12 27 8 4 2 13 27 6 2 5 18 31 12 3 4 13 32 6 3 3 17 29 Grand Totals of (a) and (b) excluding those transferred to Pulmonary). 29 5 15 32 81 12 6 6 13 37 14 5 4 16 39 16 2 8 24 50 20 7 9 19 55 18 6 13 28 65 20 NON.PULMONARY TUBERCULOSIS—continued. Condition at the time of the last record made during the year to which the return relates. 1931 1932 1933 1934 1935 1936 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 J oints Abdominal Other Organs Peripheral Glands Total Bones and Joints Abdominal Other Organs Peripheral Glands Total Bonus and Joints Abdominal Other Organs Peripheral Glands Total (a) Remaining on Dispensary Register on 31st December. Disease Arrested Adults M. 1 1 1 — 3 1 1 1 — 3 2 1 2 3 8 - - - - - - - - - - - - - - - F. 1 — — — 1 — 1 1 — 2 1 1 — 1 3 - - - - - - - - - - - - - - - Children 4 1 4 12 21 4 2 2 10 18 2 1 1 8 12 — 2 2 4 8 — — — 2 2 — — - - - Disease not Arrested Adults M. 1 - - - - - - - - - - - 1 1 2 3 — — — 3 4 1 3 — 8 6 1 8 2 16 F. — — — — — 1 — — 1 2 1 — 1 1 3 — 2 1 2 5 — — — 1 1 1 2 — 3 6 Children — — — 2 2 2 — — 3 5 6 — — 3 9 5 — 2 5 12 5 — 3 8 16 6 — 1 7 14 Condition not ascertained during the year 4 — 2 3 9 3 — 1 3 7 — — 3 5 8 3 1 2 3 9 - - - - - - - - - - Total on Dispensary Register at 31st December 11 2 7 17 37 11 4 5 17 37 12 3 8 22 45 11 5 7 14 37 9 1 6 11 27 12 3 9 12 36 Transferred to Pulmonary - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - (b) Not now on Dispensary Re-gister and reasons for removal therefrom. Discharged as Recovered Adults M. — — — 1 1 — 1 - - - - - - - - - - - - - - - - - - - - - - F. 1 — — — 1 — — — 1 1 — — — 2 2 - - - - - - - - - - - - - - - Children 2 3 — 3 8 1 — — 1 2 — — 1 1 2 - - - - - - - - - - - - - - - Lost sight of, or otherwise removed from Dispensary Register 7 2 5 7 21 7 3 — 11 21 2 2 1 11 16 — — 1 5 6 3 — — 2 5 — — — 2 2 Dead Adults M. — 1 1 — 2 — — — — — — — 1 1 2 1 1 1 — 3 - 3 — — 3 — — — — — F. — — — — — — — — — — — — — — — — — — — — — — 1 — 1 2 — 1 — 3 Children — — — 1 1 1 — 3 1 5 — — 1 1 2 1 1 2 — 4 — — 3 — 3 — — 3 - 3 Total written off Dispensary Register 10 6 6 12 34 9 4 3 14 30 2 2 4 16 24 2 2 4 5 13 3 3 4 2 12 2 — 4 2 8 Grand Totals of (a) and (6) (excluding those transferred to Pulmonary) 21 8 13 29 71 20 8 8 31 67 14 5 12 38 69 13 7 11 19 50 12 4 10 13 39 14 3 13 14 44 21 SUMMARY OF WORK DONE AX 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 113 7 — 3 . 4 15 72 9 8 1 2 2 24 67 11 Children . . . . . . . . . . . . . . . . Men 59 — — — . . 5 16 3 3 — — . 14 40 5 Total 172 7 — 3 — 4 20 88 12 11 1 2 2 38 107 16 No. of Ordinary sessions held 13 No. of Gas „ „ 13 (b) MATERNITY. Women 569 7 — 25 — 5 117 739 52 48 3 6 7 94 281 62 Children 232 1 6 — 10 — 2 77 398 17 15 2 — — 44 94 38 Total 801 13 — 35 . 7 194 1137 69 63 5 6 7 138 375 100 No. of Ordinary sessions held 24 No. of gas 26 22 Maternity and Child Welfare. The Maternity and Child Welfare Section was much hindered early in the year by the very severe measles epidemic totalling 2,682 cases. These cases had to be visited by the Health Visitors and Voluntary Health Visitors, and at times the urgency of visiting was such that routine revisiting of the ordinary infant welfare children had to take second place. These biennial epidemics always throw a great strain on the visiting resources of the staff, and the consequent pneumonia cases and infantile diarrhoea cases arising out of, or concurrent with, a measles epidemic entails much visiting which is reflected in the figures for the year's work. Two of the Borough Health Visitors staff, Miss Gibbs and Miss Clifford, attended the annual revision course for health visitors at the winter school for health visitors, held at Bedford College for Women, under the auspices of the Women's Public Health Officers' Association, from 30th December, 1935, to 7th January, 1936. These classes are much appreciated by the health visitors and serve to imbue them with a new interest in their work. Ante.natal Clinics. The system of co.operation between the two Council ante.natal clinics and the maternity department of the Mile End London County Council hospital was continued during the year, with excellent results. Our health visitor visits the Mile End Hospital ante.natal clinic weekly and acts as a liaison officer between the ante. and post.natal clinics of the Borough Council and the lying.in wards of the Mile End Hospital. As pointed out in last year's report, this is invaluable for keeping in touch with the unmarried mother when she leaves the hospital with her baby. The total attendances at the Borough ante.natal Clinics have increased from 363 to 585 and a number of mothers delivered in Mile End Hospital from the Whitechapel district attend the Borough ante.natal Clinic at Hughes Mansions. Vallance Road. Infantile Mortality. Unfortunately, as anticipated in the annual report of the late Medical Officer of Health last year, the deaths of infants under 1 year showed an increase in 1936. The biennial measles epidemic and its concurrent bronchopneumonia and diarrhoea epidemics have taken their toll. The total infantile mortality was 307, compared with 191 last year. A mortality rate of 100.09 compared with 63.00. It is noticeable, however, that an increase in the infant mortality figure occurred in more than half of the London Boroughs this year (see page 33). The mortality figures in infants under 1 for the three diseases mentioned are as follows: Measles: In 1936, 15 deaths occurred; in 1935 there were no deaths. Pneumonia and broncho.pneumonia: 56 deaths in 1936; 34 in 1935. Diarrhoea: 71 in 1936, and 31 in 1935. The deaths from diarrhoea occurred, practically all, during the early months of the year, from January to June, concurrently with the measles epidemic, which reached its apex in April. Diarrhoea, in recent years, has lost its summer incidence. Previously referred to as "summer diarrhoea of infants," it now takes its toll chiefly in the autumn and early spring. It was noticeable that the summer months, June to September, appeared to be completely free from the disease. This, no doubt, is largely due to the suppression of the house fly and through cleaner streets and better facilities for the removal of garbage inhibiting the breeding of the pest. The better protection of milk and foodstuffs from contamination by the house fly is a similarly potent factor in reducing the incidence of this disease in the summer months. Maternal Mortality. It is gratifying to record that the maternal mortality figure for the year, 1.56, is the lowest recorded in the Borough for ten years. There were only five deaths of mothers in 3,179 births. Each maternal death occurring in the Borough is investigated and reports are received from the doctors and nurses concerned. From the data received 23 an effort is made to ascertain, so far as it is possible, whether any of the deaths could have been avoided. The deaths this year were attributable to the following causes:—. Three associated with septic conditions: (a) Ruptured womb and kidney trouble. (b) Septic infection following a miscarriage. (c) Septic infection following the birth of the child. Two cases were non.septic: (d) Chronic rheumatic heart disease. (e) Acute heart failure and collapse of lungs. Of the above five deaths, in two cases the patients failed to send for medical assistance early enough. Had earlier medical attention been obtained these deaths might possibly have been averted. Two deaths were unavoidable. One death was doubtfully avoidable but the general condition of the patient was poor. None of the deaths appear definitely to have been associated with criminal abortion. MATERNAL MORTALITY IN LONDON BOROUGHS, 1936. Rate per 1,000 live births. Rate per 1,000 live and still births. Puerperal sepsis. Other causes. Total. Puerperal sepsis. Other Causes Total. West Districts. Paddington 2.60 2.60 5.20 2.50 2.50 5.00 Kensington 0.4 0.4 0.8 0.4 0.4 0.8 Hammersmith 0.52 1.04 1.56 0.50 1.01 1.51 Fulham 0.95 0.95 1.89 0.92 0.92 1.85 Chelsea 0.00 31 3.1 0.00 3.0 3.0 Westminster 0.00 0.9 0.9 0.00 0.9 0.9 North Districts. St. Marylebone 0.00 2.21 2.21 0.00 2.15 2.15 Hampstead 2.00 1.00 3.00 1.8 0.91 2.7 St. Pancras 2.1 0.8 2.9 2.0 0.8 2.8 Islington 0.63 1.06 1.69 0.62 1.03 1.65 Stoke Newington 0.00 5.8 5.8 6.50 5.5 5.5 Hackney 0.33 0.99 1.32 0.32 0.96 1.28 Central Districts Holborn 0.00 0.00 0.00 0.00 0.00 0.00 Finsbury 1.19 2.38 3.57 115 2.30 3.45 City of London 0.00 0.00 0.00 0.00 0.00 0.00 East Districts. Shoreditch 0.00 0.00 0.00 0.00 0.00 0.00 Bethnal Green 1.52 0.76 2.28 1.46 0.73 2.19 Stepney 0.97 0.65 1.6 0.94 0.62 1.56 Poplar 0.47 0.00 0.47 0.46 0.00 0.46 South Districts. Southwark 0.44 1.33 1.77 0.43 1.29 1.7 Bermondsey 1.28 4.49 5.77 1.26 4.40 5.66 Lambeth 0.256 0.516 0.77 0.25 0.50 0.75 Battersea 1 .41 0.94 2.35 1.371 0.914 2.285 Wandsworth 0.25 1.52 1.77 0.24 1.48 1.72 Camberwell 0.31 1.88 2.19 0.30 1.82 2.12 Deptford 0.00 0.6 0.6 0.00 0.6 0.6 Greenwich 0.00 0.75 0.75 0.00 0.73 0.73 Lewisham 0.34 1.70 2.04 0.32 1.64 1.97 Woolwich 0.99 1.48 2.47 0.96 1.44 2.40 24 Maternity and Child Welfare Service*. (Form M.C.W. 96 revised) Return (1) showing the arrangements made for maternity and child welfare by the Council and by Voluntary Associations providing maternity and child welfare services in respect of which the Council pay contributions under Section 101 of the Local Government Act, 1929, or otherwise; and (2) giving particulars of the work done during the year 1936. 1.—Population of the area served by the Council:—207,800. 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, 3,077. (b) Still births, 108. (c) Total, 3,185. (d) By midwives, 2,886. (e) By doctors and parents, 299. 3.—Health Visiting. (a) Number of officers employed for health visiting at the end of the year: (i) by the Council 10. (ii) by Voluntary Associations, 15. (b) Equivalent of whole.time services devoted by the whole staff to health visiting (including attendance at infant welfare centres):— (i) in the case of Health Visitors employed by the Council, 10. (ii) in the case of Health Visitors employed by Voluntary Associations, 14.5. (c) Number of visits paid during the year by all Health Visitors :— (i) to expectant mothers:—First visits, 1,414. Total visits, 3,244. (ii) to children under 1 year of age:—First visits, 2,791. Total visits, 20,659. (iii) to children between the ages of 1 and 5 years:—Total visits, 36,901. 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, 29,526. (ii) by children between the ages of 1 and 5 years, 22,466. (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, 2,332. (ii) between the ages of 1 and 5 years, 349. (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, 2,326. (ii) over 1 year of age, 4,181. (f) Percentage of notified live births represented by the number in (d) (i), 75.78. 5.—Ante.natal and Post.natal Services. (a) Ante.natal and Post.natal Clinics (whether held at Infant Welfare Centres or at other premises):— 25 Ante-natal. Post-natal. (i) Number of Clinics provided and maintained by the Council 2 2 (ii) Number of Clinics provided and maintained by Voluntary Associations 3 3 (iii) Total number of attendances at all Clinics during the year 24,022 2,216 (iv) Total number of women who attended at the Clinics during the year* 5,277 1,208 (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. (a) Arrangements made for this service:— 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 (b) Total quantify of milk supplied during the year to expectant and nursing mothers and young children:— (i) By the Council—Dried milk 8120£ packets. Liquid milk 32562 3/8 gallons. (ii) by Voluntary Associations operating in the area of the Council (supplied through the Borough Council's scheme (i) above). 7.—Maternity Homes and Hospitals. 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 grant of £100 per annum to the East Eud 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 26 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. 26 I. Separate Institutions provided by the Council for these cases Institutions (wiih accommodation for these cases) transferred to the Council under Part I of the Local Governmeni 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 tbese 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, 81. (d) Total number of such cases sent by the Council during the year to other convalescent institutions, 158. Total number sent to convalescent institutions through the Voluntary Association including (c), 342. 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 (e) Total number of such cases sent by the Council during the year to other homes for mothers and babies nil 27 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 198 (c) Total number of attendances of children at these nurseries during the year, 33,257. 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 *12 12 4 8 (2) Pemphigus Neonatorum Not notifiable - - - (3) Puerperal fever 2 2 - 2 (4) Puerperal pyrexia 36 36 — 34 (5) Measles and German measles (in children under 5 years of age) 1383 2682 116 242 (6) Whooping Cough (do.) Not notifiable — — — (7) Epidemic Diarrhœa (do.) Not notifiable — — — (8) Poliomyelitis (do.) Nil. — - — *Number of cases in which vision was unimpaired 11, impaired —, or lost — „ „ „ the patient died 1, removed from district —, or was still under treatment at the end of the year ... — ,, ,, 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 ... ... 2 (part time maternity nurses) (ii) by Voluntary Associations 2 (whole time ditto ) (b) Total number of cases attended during the year by these nurses, 640. 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 ... 1 28 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) 15 (Council) 16.—Midwives. I. (a) Number practising in the area served by the Council for maternity and child welfare at the end of the year 11 (b) Number (i) employed by the Council nil (ii) directly subsidised by the Council nil (iii) employed by Voluntary Associations 33 (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 3 (ii) from other causes 2 (b) Number of these cases which died:— (i) at home nil (ii) in institutions 5 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 24 (b) Number of children on the Register:— (i) at the end of the year 26 (ii) who died during the year nil (iii) on whom inquests were held during the year nil (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, nil — (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 1 (ii) from a single Justice 1 29 Feeding ol Infants. Maternity Outfits. Health Visitintr Prevention of Deafness. Convalescent Treatment. Provision of Milk and Meals to Expectant and Nursing Mothers and to Children. Home Helps Artificial Sunlight Treatment. Breast fed at birth 94.5% Artificially fed at birth 5.5% „ „ at six months 66.9% „ „ at six months 33.1% No of Infants breast fed at birth 2636 „ „ artificially fed at birth 155 No. of infants dead before the visit of Health Visitor 99 removed before the visit of the Health Visitor 131 „ Untraced 19 No sterilized maternity outfits were supplied through the Municipal Ante-natal Clinic during the year. 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 30 and 31. One case received treatment under the arrangements with the London County Council for the treatment of children, suffering from ear defects. During the year, mothers and children were sent away to the homes mentioned below:— Home. Mothers. Children. St. Mary's, Dover 48 64 All Saints' Convalescent Home, Eastbourne 6 36 Roseneath, Broadstairs 2 2 56 102 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 9,161 32,0947/8 gals. 3,286 18 6 Half-Price 161 567½ „ 28 11 30¾ Dried— Free 1,838 7,768½ packets. 615 4 5 Half-Price 81 352 „ 14 3 7 Virol, etc.— Free 3,280 3,272½lbs. 223 0 0½ Half-Price 65 65 „ 2 12 6 Total 14,586 32,6623/8| gals. £4,170 10 4¼ 8,120½ packets 3.337½ lbs. Ihe 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 2,135, at a cost to the Council of £69 3s. 6d. Home helps were provided in 15 instances during the year—12 being supplied free of cost to the patient and 3 at half-price. During the year arrangements were made with the London County Council to provide artificial sunlight treatment at St. Peter's Hospital for children attending the local municipal centre. Three cases received such treatment free of cost. 30 Visits by Health Visitors. Infant Life Protection. Maternity Nursing. Maternity Nurses were supplied in two instances in doctors' cases under the Council's Scheme free of cost to the patients. Total visits of the eleven Infant Protection Visitors to homes of foster mothers 273 Total visits of the eleven Infant Protection Visitors to foster children 174 Other visits made by these visitors 219 HEALTH VISITORS' REPORT. DISTRICT Wapping Shad well, S.W. 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. Whitechapel, S. St. George's, W. Tower. Mile End, S.E. Mile End, N.E., part N. part S. Mile End, C. Limehouse, N.W. Limehouse, N. Ratcliffe, N. Mile End, part S. NAME Miss Bailey Miss Blackmore Miss Brazier Miss Carty Miss Clements Miss Clifford Miss Cordwell Miss Foucar Miss Gibbs Miss Styles Total Visits:— Primary 143 347 307 216 251 290 218 388 253 378 2,791 Revisits:— To infants under 1 year 297 275 547 516 287 433 469 441 599 501 4,365 To children between 1-5 years 897 765 1022 1,187 845 1,012 688 977 882 1,322 9,597 Ante-natal:— Primary 14 57 26 12 40 62 94 87 29 45 466 Subsequent 3 9 5 6 — 37 10 — — 4 74 Ophthalmia Neonatorum — 2 2 4 — 1 — 1 1 1 12 Puerperal Fever — 1 — — — — — 1 — — 2 „ Pyrexia 1 2 6 — 3 5 3 8 4 4 36 Measles 137 149 76 116 199 135 170 232 176 193 1,583 „ Revisits 10 24 13 12 46 5 44 4 23 18 199 Miscellaneous 578 689 890 615 358 1,153 689 458 369 794 6,593 Infant Life Protection Visits to homes of foster mothers 41 23 - - 1 1 17 - - 83 Visits to foster children — 54 27 16 — 6 7 15 7 7 139 Other visits - 21 - - - - - 1 - - 22 Totals 2,080 2,436 2,944 2,700 2,029 3,140 2,393 2,630 2,343 3,267 25,962 CENTRES ATTENDED:— Municipal 219 217 152 194 201 159 223 126 27 179 1,697 Voluntary 11 — 10 — — 15 — 103 141 13 293 Totals 1 230 217 162 194 201 174 223 229 168 192 1,990 31 Municipal Infant Welfare and Ante-Natal Centres. Details of the work at the Municipal Infant Welfare and Ante-Natal Centres will be seen in the following table. MUNICIPAL INFANT WELFARE AND ANTE-NATAL 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 Infant Welfare Sessions (total) 49 63 - 53 53 51 47 51 53 52 48 52 562 „ Attendances of Infants 1,317 1,394 — 1,457 1,791 1,550 972 644 1,476 1,185 148 903 12,837 „ „ Children 1 to 5 849 976 - 1,171 863 1,198 780 527 1,523 990 157 1,029 10,063 „ Infants on Registers at end of the year 194 — 68 101 152 131 123 85 854 „ Children on Registers at end of the year 344 — 101 953 209 300 154 87 1,248 „ Ante-Natal Sessions — — 52 — — — — 51 — — — - 103 „ „ New Cases — — 112 — — — — 94 — — — — 206 „ „ Subsequent Attendances - - 304 - — — — 281 — — — — 585 „ Doctors' Consultations 49 83 52 53 53 51 47 51 53 51 — 52 565 32 The deaths from stated causes at various ages under one year of age are shown in the table below:— Cause ok 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 50 8 7 4 69 39 32 31 19 190 F 21 6 5 1 33 22 23 20 19 117 Small-pox m. ... ... ... ... ... ... ... ... ... ... F. ... ... ... ... ... ... ... ... ... ... Chicken-pox m. ... ... ... ... ... ... ... ... ... ... F. ... ... ... ... ... ... ... ... ... ... 2 Measles m. ... ... ... ... ... ... ... 2 4 6 F. ... ... ... ... ... ... ... 4 5 9 3 Scarlet Fever m. ... ... ... ... ... ... ... 3 ... 3 F. ... ... ... ... ... ... ... ... 2 2 4 Whooping Cough m. ... ... ... ... ... 1 ... 3 ... 4 F. ... ... ... ... ... ... 1 2 ... 3 5 Diphtheria and Croup m. ... ... ... ... ... ... l ... ... 1 F. ... ... ... ... ... ... ... 2 ... 2 10 Tuberculous Meningitis M. ... ... ... ... ... ... ... ... ... ... F. ... ... ... ... ... ... ... ... ... ... 10 Abdominal Tuberculosis M. ... ... ... ... ... ... ... ... ... ... F. ... ... ... ... ... ... ... ... ... ... 10 Other Tuberculous Diseases M. ... ... ... ... ... ... ... 1 ... 1 11 Syphilis F. ... ... ... ... ... 1 ... ... ... 1 M. ... ... ... ... ... ... ... ... ... ... 19 Bronchitis F. ... ... ... ... ... ... ... ... ... ... m. ... ... 1 ... 1 l 3 ... ... 5 F. ... ... 1 ... 1 ... ... ... ... 1 20 Pneumonia (all forms) M. ... 3 1 ... 4 8 6 7 7 32 F. 1 2 1 1 5 5 6 3 5 24 23 Diarrhoea m. ... ... 2 1 3 15 15 6 7 46 F. ... ... ... ... ... 8 8 5 4 25 23 Enteritis m. ... ... ... ... ... 4 4 6 ... 14 F. ... ... ... ... ... 2 1 1 3 7 27 Gastritis ... ... ..._ r m. ... ... F. ... ... 1 ... 1 31 Congenital Malformations r m. 7 i ... 2 10 4 14 F. 3 l ... ... 4 4 31 Premature Birth ... r M. 24 2 ... 26 2 i 29 F. 10 ... 10 2 i 13 31 Atrophy, Debility & Marasmus r m. 3 2 1 6 3 ... 1 10 31 Atelectasis F. 1 2 ... 3 3 ... 8 r m. 6 ... 6 1 ... 7 31 Injury at Birth ... 1 F. 3 ... 3 1 4 f M. 5 ... 5 5 31 Convulsions 1 F. 2 1 3 4 f M. ... ... 34 Suffocation, overlying F. ... f m. ... F. ... 35 Rickets r m. ... ... 1 F. 35 Meningitis (not tuberculous) r m. ... i "i 1 F. ... l l 35 Laryngitis r m. ... ... 1 F. ... ... ... ... 35 Erysipelas . m. ... ... ... F. ... ... 35 Other causes f m. 5 2 1 8 3 l 12 F. 2 1 4 3 I 8 36 111 defined m. ... ... ... ... ... ... ... ... ... ... F: ... ... ... ... ... ... ... ... ... ... Totals 71 14 12 5 102 61 55 51 38 307 33 INFANTILE MORTALITY, Etc., IN LONDON BOROUGHS, 1936. Borough. Estd. Res. population (mid. 1936). Live births rate per 1,000 populat ion Death rate per 1,000 population. Infantile Mortality rate per 1,000 live births. Crude. Adjusted. West districts. Paddington 139,200 13.8 12.98 12.81 72 Kensington 176,100 12.7 12.5 11.7 73 Hammersmith 127,700 15.1 12.5 12.9 60 Fulham 141,300 14.9 12.6 12.7 64 Chelsea 56,500 11.3 13.7 11.6 53 Westminster 124,100 8.5 11.1 11.4 65.8 North districts. St. Marylebone 92,400 9.8 12.6 12.5 75 Hampstead 90,700 10.4 10.2 9.6 65.8 St. Pancras 183,900 13.0 13.5 13.8 79 Islington 304,100 15.24 12.44 12.56 61 Stoke Newington 50,350 13.7 11.4 10.9 44.6 Hackney 209,100 14.4 12.0 12.6 62.9 Central districts. Holborn 34,850 8.29 11.99 12.83 62 Finsbury 60,800 13.8 14.0 15.3 81 City of London 9,100 7.5 11.4 12.65 147 East districts. Shoreditch 85,400 14.9 12.8 14.1 75 Bethnal Green 96,900 13.5 12.7 14.3 98 Stepney 207,800 14.7 12.6 14.7 100.09 Poplar 140,300 15.0 12.5 13.8 72 South districts. Southwark 152,200 14.8 13.1 - 59 Bermondsey 100,400 15.4 12.8 14.6 60 Lambeth 277,500 13.9 12.5 12.4 59 Battersea 145,500 14.63 13.06 12.93 59.21 Wandsworth 343,000 11.46 11.79 10.96 58 Camberwell 229,300 13.93 12.64 12.64 58.86 Deptford 98,900 15.7 12.2 12.6 50 Greenwich 95,900 13.82 11.36 11.58 49 Lewisham 224,000 13.0 10.8 10.9 55 Woolwich 146,500 13.8 11.2 11.8 59 34 LIST OF MATERNITY AND CHILD WELFARE CENTRES, ETC., IN THE METROPOLITAN BOROUGH OF STEPNEY. CENTRES. MONDAY. TUESDAY. WEDNESDAY. THURSDAY. FRIDAY. REMARKS: morning. afternoon. morning. afternoon. morning. afternoon. morning. afternoon. morning. afternoon. (a) Municipal: Iyimehouse Town Hall, Commercial Road ... 2 to 5* ... ... ... 2 to 5* ... ... ... ... Advice to mothers, health talks and knitting classes are held in connection with these Municipal 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* ... ... ib) 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 4.15 (sewing) 10.30 (dental) 2.30 (lectures on 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, Shadwell ... ... ... 2 to 4* ... 2 to 4* ... home nursing and infant care) 2.30 to 4 (sewing) ... ... Dame Colet House— 29, Duckett Street 9.15 to 11 2* 9.15 to 11 2* 9.15 to 11 2.30 9.15 to 11 ... 9.15 to 11 also (minor dressings) (minor dressings) (minor dressings) (sewing and health talk) (minor dressings) (minor dressings) Sunlight with the doctor by arrangement. 10, Duckett Street ... 3 (sunlight) ... ... ... 2.30 (sunlight) ... ... ... 2.30 (sunlight) 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 1 dinners daily, 2. Jewish Infant Welfare Centre, Bernard Baron Settlement, Berner Street ... 2 to 5* ... 2 to 4 ... 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) (sewing) 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, L,eman Street ... ... ... ... ... ... .... 1.30 to 2.30 (dental) ... ... * Denotes that there is a Doctor in attendance. 35 LIST OF MATERNITY AND CHILD WELFARE CENTRES, ETC., IN THE BOROUGH—continued. CENTRES. MONDAY. TUESDAY. WEDNESDAY. THURSDAY. FRIDAY. REMARKS: morning. afternoon. morning. 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,Constitutional Hall, Redman's Road 10 to 12.30 2 to 4* ... ... 10 to 12.30 ... ... ... ... ANTE-NATAI, CLINICS. (a) Municipal : Limehouse Town Hall, Commercial Road ... ... ... ... ... ... 10 to1* ... ... ... 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. {e) 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 ... ... Tb is is an open air one and it is open from May to Octob er. ... ... 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. 36 Scavenging. Shops Act, 1934. Pharmacy and Poisons Act, 1933. Smoke Nuisances. Complaints. Drainage. Rats and Mice. III.—SANITARY CIRCUMSTANCES OF THE AREA. The Public Cleansing Officer has kindly supplied me with particulars as to the revisions in the Public Cleansing service during the year :— Market Cleansing.—Refuse from Street Markets is now collected by the movable container system. Containers of lj cubic yards capacity are left in each market and during trading hours are filled by scavengers engaged exclusively in market cleansing. The container, when full, is removed by a specially constructed vehicle, an empty clean container being left in its place. The great advantage in this system is that the refuse remains in the covered container from the time it is loaded by the scavengers until it is unloaded at the disposal centre, and therefore obviates the unpleasantness of refuse being exposed when being loaded from bin to lorry. Collection of Refuse from Hospitals, Tenement Dwellings, etc. —The system outlined above is being adopted as far as possible for refuse collection from premises where conditions permit its introduction, and without doubt is a vast improvement on the old method of collection with the use of dust baskets. In fact, so many applications have been received for conversion to the system that it has been found necessary to purchase additional containers and vehicles to cope with the demand. 2,818 inspections were carried out during the year. It was found necessary to serve 76 notices, i.e., 29 with respect to sanitary accommodation, 19 to ventilation, and 28 with respect to temperature. 12 applications were received for exemption under Section 10(2) of the Act, 11 of which were granted. This Act came into force on the 1st May. 84 persons were entered in the List of Persons entitled to sell Poisons included in part II of the Poisons List. 2 were removed from the list : one at his own request as the business was given up and in the other case the premises closed. 614 inspections and visits were made by the sanitary inspectors during the year. 491 observations were made by the Sanitary Inspectors for the detection of nuisances from smoke, which necessitated the serving of 36 Intimation notices for the abatement of the nuisance. 2,875 written complaints were made to me during the year, which were duly investigated. Of these 91 were from H.M. Inspector of Factories relating to workshops, 145 from the London County Council respecting verminous school children, 2 from the London County Council respecting premises under the Shops Act, 1934 and 2,637 related to the condition of houses, etc. In addition inspections were made as a result of complaints made to the Sanitary Inspectors. The Sanitary Inspectors supervise all drainage work. Full particulars as to the work done by them are given on pages 45 and 46. 2,606 drains were tested during the year. Of these, 307 were found to be defective. During the year 1,073 complaints were received as to nuisances from rats or mice. As a consequence 1,175 drains were tested and in 484 instances they were found to be defective. 595 complaints were forwarded to the Borough Engineer and Surveyor, so that the Council's ratcatchers could call and assist the tenants concerned. I am indebted to the Borough Engineer and Surveyor for the following information as to work carried out during the year by his department. 37 Rent and Mortgage Interest Restrictions Acts, Record of Rat Destruction carried out by the Council's Ratcatchers from lst January to 31 st December. No. of premises visited 725 „ „ visits 17,485 „ „ dead rats found poisoned 67 * „ „ rats caught in our traps 1,643 „ „ premises cleared of rats as reported by the Occupiers 376 „ „ new rat complaints during this period 556 *1,263 of these were actually brought into tlu Depot and destroyed. The poisons used were as follows:— Rodine 37,922 cubes Barium carbonate 36,510 „ Phosphor paste 34,491 „ Extract of Squills 16,696 portions (2 oz.) 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 1936:— Extra Rat Weeks. Dates (inc.) Poisoned baits laid in Baits laid Manholes. Side-entrances. Eaten. Uneaten. First 3rd to 8th February 327 34 2,229 225 Second 4th to 9th May 292 36 2,415 388 Third 27th July to 1st August 176 19 1,404 56 National Rat Week—2nd to 1th 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 14 local cinemas, requesting that notices be displayed on the screen, drawing attention to National Rat Week. 78 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 221 different positions throughout the Borough. A total of 1,040 portions of bait were laid, of which number 676 were eaten. The Council employ three men as ratcatchers, who give their whole time to rat destruction. 42 certificates were issued as to houses not being in a reasonable state of repair. 5 applications for such certificates were refused. 19 applications were received for reports that the work mentioned on certificates have been satisfactorily executed 14 were granted and 5 were refused. 38 Water Certificates. Hairdressers' Shops. Mortuary and Shelter. Report required by the L.C.C. 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 23 houses and 376 tenements. Annual certificates are granted respecting Hairdressers' Shops in the Borough, which come up to a certain standard of cleanliness. Three certificates were granted during the year. The number of bodies deposited in the Mortuary during the year was 311. 28 Jewish bodies were officially " watched." 198 inquests were held in the Coroner's Court, and 221 post mortem examinations were made. The shelter is used for the accommodation of contacts of infectious disease while their homes are being disinfected. During the year there were 2 persons admitted to the shelter; 1 adult and 1 child. Premises. No. in borough on 31st December, 1936. No. of Inspections. No. of Prosecutions. Common lodging houses 18 316 — Seamen's lodging houses 10 107 — Cowsheds (licensed) 19 130 — Slaughterhouses (licensed) — - — Other offensive trades 48 592 — Milkshops :— Dairy premises . Purveyors bottled milk 228 399 1,556 6 Ice cream premises 368 526 4 Registered foster mothers 24 273 — Nurse children kept 26 174 — Restaurants and eating houses 342 465 — bmoke Nuisances. (1) No. of observations. 491 (5) No. of legal proceedings (2) No. of intimations served 36 (6) No. of convictions (3) No. of complaints received 36 (7) Amount of penalty and costs (4) No. of Statutory notices served 3 imposed in each case Cleansing and Disinfection. No. of adults cleansed 211 No. of (a) after infectious premises diseases 1,798 No. of children cleansed 1 cleansed (b) for vermin 1,683 . (e) after Tuberculosis 321 Water Supply to Tenement Houses. No. of premises supplied 4 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) — 39 Canal Boats Acts, 1877 and 1884. Housing. 1. Total number of houses in the borough 37,237 2. Number of houses occupied by the working classes 35,199 Public Health Act. 3. No. of houses inspected on account of complaints 2,637 Illness 1,239 4. Number of statutory notices served 3,596 5. Number of houses repaired or nuisances remedied 12,243 Housing Acts (1925-35). 6. Number of houses inspected— house to house (Housing Consolidated Regs. 1925) 207 7. (a)Number of houses included in representations by the BoroughMedical Officer under Sec. I of H.A. 1930 22 (b) Number of houses demolished following representation by Borough Medical Officer under Sec. I. of H.A. 1930 (c) Under the H.A. 1925 49 8. Number of houses repaired under Sections 17 and 18 of H.A. 1930: (а) by owners (б)by L.A. 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 10. Number of houses (wholly or in part) the subject of Closing Orders (excluding underground rooms) 11. Number of Closing Orders determined i.e., houses made fit) 12. Number of houses erected by the Borough Council for working classes during year 154 13. Houses Let in Lodgings. Number in Borough 3,427 Number of inspections 2,096 Number of prosecutions 1 Number of complaints remedied under the By-laws (not included under any other heading) 94 14. Underground Rooms. Number occupied but unfit under Sec. 18 of H.A. 1925 as modified by Sec. 84 of Housing Act, 1935 6,134 Number closed or modified occupation approved under Section 84 H.A. 1935 10 15. Overcrowding (Housing Act, 1935) Number of houses inspected under Sec. I of H.A. 1935 848 Number of families found to be living in overcrowded conditions Sec.I of H.A. 1935 674 Number of overcrowded families who have obtained alternative accommodation 255 infectious diseases—cases notified under local orders (excluding cases coming to knowledge otherwise than by notification). Disease. Cases notified. Period. Measles (Children up to 5 years) 1,383 1st January to 31st December, 1936 German Measles Whooping Cough Rheumatic Fever (0-16) Chicken Pox Zymotic Enteritis Pursuant to ihe Third Section of the Canal Boats Act, 1884, the Metropolitan Borough ol Stepney, being the Registration Authority under the Canal Boats 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 taktn by them as such authority during the year 1936 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. 40 Factories, Workshops and Workplaces. (2) The number of boats inspected was 13. 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 1.—Inspections. Premises. Number of Inspections Writen Notice Prosecutions. Factories 1,560 254 - (Including Factory Laundries) Workshops 1,338 237 1 (Including Workshop Laundries) Workplaces (Other than Outworkers' premises) 452 30 — Totals 3,350 521 1 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 280 280 — 1 Want of ventilation 10 10 — — Overcrowding 3 3 — — Want of drainage of floors 1 1 — — Other nuisances 276 276 — — Sanitary insufficient 26 25 - — Accom unsuitable or defective 173 173 - - modation not separate for sexes 41 41 - - Offences under the Factory and shop Act:— Illegal occupation of underground bakehouse (s. 101) - - - - Other offences (Excluding offences relating to outwork which are included in Part 3 of this report.) - - - - Totals 810 809 — 1 41 Outworker 3.—Registered Workshops. Workshops on the Register (s. 131) at the end of the year 1936. Number. Bakehouses 78 Boot, Shoe and Slipper Making 76 Cabinet Making 78 Furriers 133 Hat and Cap Manufacturers 51 Laundries 13 Rag Sorting, etc. 45 Wearing Appreal (Tailors Milliners, Dress- makes, etc.,etc) 911 Miscellaneous 431 Total 1,816 4.—Other Matters. Class. Number Matters notified to H.M. Inspector of Factories:— Failure to affix Abstract of the Factory and shop Act (s. 133), 1901 26 Action taken in matters referred by H.M. Inspectoras remediable under the Public Health Acts, but not under the Factory and Workshop Act (s. 5), 1901 Notified by H.M. Inspector 91 Reports (of action taken) sent to H.M. Inspector 91 Other 9 Underground Bakehouses (s. 101):— Certificates granted during the year — In use at the end of the year 38 The net number of outworkers in the Borough engaged in various trades is as follows:— Making, cleaning, etc., of wearing apparel 2,329 Furriers 41 Umbrellas 19 Boots and shoes 38 Boxes 15 Flag making 1 Christmas cards 1 Carnival novelties 3 Artificial flowers 2 Handbags; 4 Cigarette making 1 Pot scourers 4 Christmas crackers 12 Hat and Cap making 5 Art needlework 2 Leather goods 1 Ties 3 Toys 6 Games 8 Ladies' belts 1 Paper hats 1 2,497 42 Rag Flock Acts. Cowsheds. Offensive Businesses. Lodging Houses. 9 inspections were made during the year to 3 premises subject to the provisions of the Rag Flock Acts. There are 19 cowsheds in the Borough. During the year 130 inspections were made to the cowsheds, and it was found necessary to serve 19 notices for minor matters. 592 inspections were made during the year to the 48 offensive businesses carried on in the borough. 32 notices were served for minor matters and it was not found necessary to take legal proceedings. 10 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. 316 inspections were carried out during the year and 13 notices were served for various defects found to exist. The usual annual census of persons in Common Lodging Houses was taken on the night of Friday the 21st February and the following information ascertained:— Licensed Number of beds. Beds occupied. Number known to be in receipt of public assistance. Number of beds paid for by charitable organisations Men Women Married Couples Men Women Children Married Couples Men Women Children Men Women Children 2180 541 48 1 11 339 6 ?6 46 13 — 43 18 3 In addition to the above, there are 10 Seamen's Lodging Houses. 107 inspections were made of them during the year, 8 notices were served for minor nuisances. The number of inspections made to outworkers' premises was 879, and the number of premises where sanitary defects were found to exist was 412. Notifiable infectious disease occurred in 83 outworkers' premises. There are 92 firms in the Borough employing outworkers, and of these firms 69 sent in lists twice in the year and 21 once. These related to a net number of 1,712 outworkers, of which 1,017 were resident in the Borough and 695 were transferred to other Districts. In addition, 582 lists relating to a net number of 1,480 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 393 393 Furniture and upholstery 10 8 Umbrellas 4 4 Paper, etc., boxes, paper bags 2 2 Household linen 2 2 Fur pulling 1 1 Total 412 410 43 Sanitary Inspection. The following tables show the work of the District Sanitary Inspectors:— REPORT OF INSPECTIONS, Etc. BY THE DISTRICT SANITARY INSPECTORS—1936. W. E. Anstee. C. F. Brockett. J. H. Brownlee. W. Cue. R. W. G. Day G. D. Freeland. H. J. Green. C. F. Guy. W. H. Haworth W. H. Howard. S. Lowther. J. G. McCarthy. R. Roper. W. F. Smith. W. T. Twynham. R. H. Waterman. Totals Bakehouses 32 — 38 10 20 36 14 19 26 8 22 16 17 37 21 16 332 Common Lodging Houses 33 6 13 19 — 24 13 — 24 — — — 75 — 50 15 272* Complaints 522 503 832 499 1,241 877 1,055 900 714 1,218 1,075 1,188 729 849 786 184 13,172 Factories 114 66 79 108 61 107 102 107 154 13 64 45 157 118 177 88 1,560 Houses let in Lodgings 230 307 79 10 69 232 110 175 192 44 27 57 214 153 174 23 2,096 House to House 108 130 68 22 58 32 49 110 82 39 55 56 210 106 218 583 1,926 Infectious Disease 65 85 88 74 108 48 90 72 57 66 106 111 67 83 51 78 1,239 Offensive Trades — 22 31 2 — 84 6 — 8 — 64 20 65 — 4 16 322 Outworkers 118 55 35 10 33 96 51 37 117 6 15 21 104 86 88 7 879 Restaurants and Eating Houses 21 84 41 34 5 4 13 14 34 4 49 - 63 15 52 32 465 Markets (week-end) 2 2 3 2 2 2 3 2 2 2 2 2 3 3 3 2 37 Seamen's Lodging Houses 6 21 - 80 - - - - - - - - - - - - 107 Workplaces 37 149 15 2 6 22 20 20 38 4 9 — 91 17 15 7 452 Workshops 166 167 79 15 51 116 70 56 138 32 34 43 135 84 59 93 1,338 i- hops Act 211 288 195 154 117 260 157 137 217 56 203 165 231 227 118 82 2,818 * In addition, 44 inspections to Women's Common I/xiging Houses were made by Miss Whitty. 44 REPORT OF INSPECTIONS, ETC. BY THE DISTRICT SANITARY INSPECTORS—1936—Continued. W. E. Anstee. C. F. Brockett. J. H. Brownlee. W. Cue. R. W. G. Day G. D. Freeland. H. J. Green. C. F. Guy. W. H. Haworth W. H. Howard. S. Lowther. J. G. McCarthy. R. Roper W. F. Smith. W. T. Twynham. R. H. Waterman. Totals Pharmacy & Poisons Act 42 38 46 79 35 59 3 12 46 17 4 89 21 29 59 35 614 Rag Flock Acts - - - 2 - - - - - - - - 2 - 5 9 Miscellaneous 1,590 666 1,067 744 1,210 843 529 901 1,835 437 968 692 1,953 1,325 1,147 1,233 17,140 Observations re Smoke Nuisance 2 - 13 186 51 7 1 8 20 3 7 - - 7 - 186 491 Re-Visits 1,459 1,930 2,421 2,398 2,421 1,841 2,507 2,038 1,302 2,592 1,780 2,680 1,918 1,661 2,405 2,143 33,496 Intimations served 496 429 575 476 1,009 649 1,085 808 612 1,000 661 983 474 717 984 808 11,766 Statutory Notices served 139 168 229 98 379 220 359 324 149 358 228 198 76 246 274 152 3,596 No. of Summonses taken out — — 4 4 2 — 23 3 1 1 — — 2 10 2 - 52 45 Sanitary work. RETURN OF SANITARY WORK, 1936. W. E. Anstee. C. F. Brockett. J. H. Brownlee. W. Cue. R. W. G. Day G. D. Freeland. H. J. Green. C. F. Guy. W H. Haworth W. H. Howard. S. Lowther. J. G. McCarthy. R. Roper. W. F. Smith. W. T. Twynham. R. H. Waterman. Totals. Animals kept so as to constitute a nuisance, removed 1 - 2 - - - 1 - 1 2 - - 2 - 5 1 15 Bakehouses: No.of cleansings of 12 18 4 10 20 11 1 16 7 5 11 16 1 31 8 10 181 Cisterns cleansed, covered and repaired — — - 1 — — 1 2 — 26 — — 1 3 1 — 35 Dampness in premises remedied 74 30 84 85 139 99 153 289 133 209 154 180 57 256 239 103 2,294 Drains—Cleansed or repaired 41 44 48 39 81 68 93 109 39 159 64 55 60 95 117 58 1,170 Constructed or reconstructed 43 37 2 17 30 31 3 31 59 3 10 17 22 55 23 25 408 Dust receptacles provided 104 94 76 88 220 110 105 166 75 424 158 339 33 119 112 118 2,341 Number of dwelling rooms cleansed 273 195 326 846 1,040 319 563 688 281 447 496 822 234 631 367 998 8,526 Houses ventilated beneath the lower floor — — — 11 — — — 5 — — 2 — - 3 — 2 23 Improved light and ventilation provided to rooms — 6 — - 3 3 — 7 — 8 4 2 1 8 4 — 46 Manure receptacles provided or reconstructed - - - - - - — 3 - - - - - - - - 3 Offensive accumulations removed 1 27 34 16 46 52 73 18 26 42 24 26 21 15 93 15 529 46 RETURN OP SANITARY WORK, 1936—Continued. W. E. Anstee. C. F. Brockett. J. H. Brownlee. W. Cue. R. W. G. Day G. D. Freeland. H. J. Green. C. F. Guy. W. H. Haworth W. H. Howard. S. Lowther. J. G. McCarthy. R. Roper W. F. Smith. W. T. Twynham. R. H. Waterman. Totals. No. of gutters and rain-water pipes fixed or repaired 54 42 48 114 82 34 144 294 65 124 63 100 32 245 88 Ill 1,640 No. of repairs to roofs 175 100 161 263 304 214 132 423 178 245 128 301 58 364 226 275 3,547 Sink, bath and lavatory pipes fixed or repaired 9 34 44 112 110 31 108 111 26 165 101 85 300 188 126 365 1,915 Smoke nuisances abated — — — 21 1 — 1 4 — 9 1 1 — — — 4 42 Urinals fixed or repaired 3 — 2 12 5 2 3 1 — — — 5 8 2 9 6 58 Verminous rooms cleansed 27 37 19 37 12 69 25 34 84 63 25 6 28 49 18 26 559 Waterclosets—Cleansed or repaired 19 53 124 208 J36 52 267 84 42 128 93 146 224 59 219 273 2,127 „ Light and ventilation provided — 6 1 37 29 6 6 10 12 4 3 64 105 3 57 186 529 „ Pans and traps fixed 9 29 14 45 95 29 10 139 43 29 39 73 141 65 68 212 1,040 „ Provision or repair of flushing apparatus 69 37 46 113 116 68 93 103 55 33 50 154 104 90 137 265 1,533 Water supply to houses reinstated or repaired 6 9 — 16 17 2 3 7 4 8 5 28 4 5 5 92 211 Yards, areas and forecourts cleansed, paved, or paving repaired 17 9 11 66 97 94 66 132 30 114 107 41 27 125 64 51 1,051 Floors, windows, staircases, fireplaces and coppers repaired 196 194 307 752 475 492 427 586 317 460 256 465 182 597 548 386 6,640 Miscellaneous 110 301 242 188 107 450 384 644 315 215 465 84 207 667 355 127 4,861 47 Legal Proceedings. Date. Matter of Information or Complaint. Result. Food and Drugs (Adulteration) Act, 1928. 17th Jan. Selling iodine ointment on 27th November, 1935, deficient in potassium iodide to the extent of 100 per cent, and iodine to the extent of 93.5 per cent. (B.723.) Fined £1 0s. 0d., with £2 2s. Od. costs. 17th Jan. Selling iodine ointment on 27th November, 1935, deficient in potassium iodide to the extent of 100 per cent. and iodine to the extent of 85 per cent. (B.722.) Fined £1 0s. 0d., with £2 2s. Od. costs. 21st Jan. Selling rolls and butter on 13th December, 1935, the fat of which consisted of 100 per cent, margarine. (B.776.) Case dismissed under Probation of Offenders Act, with £2 L's. Od. costs. 27th Jan. Selling milk on 28th November, 1935, deficient in solids-not-fat to the extent of 2.4 per cent. (4.3 per cent. added water Hortvet). (B.726.) Case dismissed under Probation of Offenders Act, with £3 3s. Od. costs. 27th Jan. Selling milk on 28th November, 1935, deficient in solids-not-fat to the extent of 0.6 per cent. (3.2 per cent. added water Hortvet). (B.743.) Magistrate decided that the case be not heard. 29th Jan. Selling milk on 30th October, 1935, deficient in solids-not-fat to the extent of 4 per cent. (5.3 per cent. added water Hortvet). (B.651.) Fined £5 0s. Od, with £3 3s. Od. costs. 4th Feb. Selling milk on 17th December, 1935, deficient of 9.6 per cent. of solids-not-fat (C.800). Fined £1 0s. Od. with £2 2s. Od. costs. 4th Feb. Selling milk on 17th December, 1935, deficient of 12.1 per cent. of solids-not-fat (C.803). Fined £1 0s. 0d. with £2 2s. Od. costs. 27th Mar. ... Selling milk on 13th February, 1936, which was deficient of 26.7 per cent. of fat. (C.95.) Case dismissed under the Probation of OSenders Act on payment of £2 2s. Od. costs. 27th Mar. ... Selling milk on 13th February, 1936, which was deficient of 11.9 per cent. of solidsnot-fat (14 per cent.added water Hortvet) and 17.7 per cent, of fat. (C.99.) Fined £1 0s. Od. with £2 2s. Od. costs. 3rd April Selling milk on 28th February, 1936, 19 per cent, deficient in fat and 16.6 per cent, solids-not-fat, equivalent to the addition of at least 18.5 per cent. of water (Hortvet). (C.138.) Fined £2 0s. Od. with £2 2s. Od costs. 16th April ... Selling milk on 3rd March, 1936, 4 per cent, deficient in fat. (B.140.) Case dismissed under the Probation of OSenders Act on payment of £2 2s. Od. costs. 16th April Selling milk on 3rd March, 1936, 4.7 per cent, deficient in fat. (B.141.) Case dismissed under the Probation of Offenders Act on payment of £3 3s. costs. 16th April Selling milk on 3rd March, 1936, 10 per cent, deficient in solids-not-fat (at least 10.9 per cent, added water Hortvet). (B.137.) Case dismissed under the Probation of Offenders Act on payment of £2 2s. Od. costs. 48 Date. Matter of information or complaint. Result. 24th April Selling milk on 10th March, 1936, 6 per cent, deficient of solids- not-fat (equivalent to 6.8 per cent. of added water. Hortvet). (C.154.) Case dismissed under the Probation of Offenders Act on payment of £3 3s. costs. (Summons under the Milk and Dairies (Amendment) Act, 1922, against the Company for selling milk containing added water, was withdrawn by consent.) 30th April Selling liniment of turpentine on 6th March, 1936, which was 100 per cent. deficient in camphor and in turpentine. (B. 160) Case dismissed, the Magistrate being of opinion that the sale was not to the prejudice of the purchaser. 30th April Selling milk on 18th March, 1936, 1.8 per cent, deficient in solids-not-fat. (At least 3 per cent. added water, Hortvet.) (B. 179.) Fined £2 0s. Od. with £3 3s. costs. Hth May Selling milk on 25th March, 1936, 18.7 per cent, deficient in fat and 7.6 per cent, deficient in solids-not-fat (equivalent to the addition of 5.8 per cent, of water, Hortvet.) (C.186.) Fined £1 0s. Od. with £2 2s.costs. 20th May Selling on 29th February, 1936, milk 33.5 per cent. deficient in solids-not-fat (32.8 per cent. added water, Hortvet) and 37 percent, deficient in fat. (C.139.) Case dismissed under the Probation of Offenders Act. Defendant without means. 20th May Selling on 29th February, 1936, rolls and butter containing 100 per cent, margarine instead of butter. (Sample C. 140.) Case dismissed under the Probation of Offenders Act. Defendant without means. 4th June Selling milk on 17th April, 1936, 8.3% deficient in fat and 30.6% deficient in solids-not-fat (at least 34% added water Hortvet). (B.253). Fined £1, with £2 2s. Od. costs. 4th June Selling milk on 17th April, 1936, 4.1% deficient in solids-not-fat (at least 5.1% added water Hortvet). (B.251). Fined £1, with £2 2s. Od. costs. 4th June Selling milk on 1st April, 1936, 5.1% deficient in solids-not-fat (at least 3.4% added water Hortvet). (B.212). Fined £1, with £2 2s. Od. costs. 5th June Selling on 30th April, 1936, £-lb. minced meat containing 1,250 parts of sulphur dioxide per million. (A.36). Fined £2. 18th June Selling milk on 16th April, 1936, 5.3% deficient in solids-not-fat (at least 7.2% added water Hortvet). (B.244). Fined £2. 18th June Selling milk on 30th April, 1936, 2.8% deficient in solids-not-fat (at least 3.4% added water Hortvet). (C.261). Fined £3, with £5 5s. Od. costs. 22nd June Selling milk on 6th May, 1936, 21% deficient of the minimum amount of fat. (C.281). Fined £1, with £2 2s. Od. costs. 22nd June Selling milk on 6th May, 1936, 9% deficient of the minimum amount of fat. (C.278). Fined £2, with £3 3s. Od. costs. 49 Date. Matter of information or complaint. Result. 29th June Selling milk on 4th May, 1936, 13.7% deficient of fat. (C.264). Summons dismissed. Theevidenc given by the defendant satis fied the Court that the mill was as given by the cow. 29th June Selling milk on 4th May, 1936, which was 10% deficient of fat (Sample C.266). Summons dismissed. Theevidenc given by the defendant satis fied the Court that the mil was as given by the cow. 2nd July Selling milk on 21st October, 1935, which was deficient of 7.4% of solids-notfat (9.1% added water at least by Hortvet test). (C 677). Fined £\, with £2 2s. Od. costs 27th July Selling milk on 3rd June, 1936, which was 19% deficient of the minimum amount of fat. (C 336). Fined £5, with £2 2s. Od. costs 27th July Selling rrilk on 3rd June, 1936, which was 16% deficient of the minimum amount of fat. (C 339). Fined £5, with £2 2s. Od. costs 27th July Selling milk on 4th June, 1936, which was 37% deficient of the minimum amount of fat. (C 345). Case dismissed under the Proba tion of Offenders Act on pay ment of 10s. costs. 28th July Selling milk on 16th June, 1936, which was 16.4% deficient of solids-not-fat (at least 18.9% of added water. Hortvet) (C 367) Case withdrawn on the advic( of the Council's solicitor with £5 5s. Od. costs. 28th July Selling milk on 8th June, 1936, which was 19.3% deficient in fat and 2.7% deficient in solids-not-fat (at least 6.6% added water. Hortvet) (B 357). Fined £2, with £2 2s. Od. costs 17th Sept. Selling milk on 9th July, 1936, deficient in solids-not-fat to the extent of 2.4% (at least 5.1% added water. Hortvet) (B 435). Case dismissed under the Proba tion of Offenders Act on pay ment of £5 5s costs. 1st October Selling Milk on 30th June, 1936, which was 14%deficient of minimum amount of fat. (C. 402). Fined £5, with £3 3s. Od. costs. 1st October Selling milk on 30th June, 1936, which was 14% deficient of minimum amount of fat. (C.403). Summons not dealt with. See preceding case. 7th October Selling half lb. minced meat which contained 375 parts per million of sulphur dioxide, on 25th August, 1936. (A.45). Fined £5, with £2 2s. Od. costs. 7th October Selling quarter lb. minced meat which contained 290 parts per million of sulphur dioxide on 26th August, 1936. (A.51). Fined £5, with £2 2s. Od. cost. 8th October Selling milk on 27th May, 1936, which was 93.3% deficient in fat. (B.336). Fined £2, with £3 3s. Od. costs. 14th October Selling milk on 10th September, 1936, which was 6.3% deficient in fat. (B.545). Fined £3, with £2 2s. Od. costs. 50 Date Matter of information or complaint. Result. 14th October Selling milk on 10th September 1936, which was 12.7% deficient in solids-not-fats. (At least 15.7% added water. Hortvet). (B.542) Fined £3, with £2 2s. Od. costs. 20th November Selling on 6th October, 1936, 6 rolN and butter, the fat of which consisted of 100% margarine. (B.589). Fined £2, with £2 2s. Od. costs. 20th November Selling on 6th October, 1936, 6 rolls and butter, the fat of which consisted of 100% margarine. (B.588). Milk and Dairies Order, 1926. Fined £:', with £2 2s. Od. costs. 3rd Jan Failing to keep the utensils used in connection with the business as a dairyman in a state of thorough cleanliness. Fined £2 0s. 0d., with £2 2s. Od. costs. 3rd Jan Failing on the 17th October, 1935, to keep the utensils used in the business of a dairyman in a state of thorough cleanliness. Fined £3 0s. Od. with £2 2s. Od. costs. 29th Jan For selling milk on the 20th November, 1935, when he was not registered as a dairyman. Case adjourned sine die, providing Mr. Miller applies for registration as a dairyman for all his shops. 11th May Carrying on (13th February, 1936), the business of a dairyman at 106, Stepney Green, without being registered. Fined £5, with £2 2s. Od. costs. 2nd April Carrying on the business of a dairyman without being registered. Fined £2 0s. Od. with £1 Is. Od. costs. 22nd June Filling and sealing bottles of milk other than on registered premises (in the street) and delivering same on 19th May, 1936. Fined £2, with £1 Is. Od. costs. 2nd Sept. Filling four bottles with milk and sealing them otherwise than on registered premises, i.e., in Willow Street on 17th July, 1936. Fined £2 with £1 Is. Od. costs. 2nd Sept Filling four bottles with milk in Willow Street on 17th July, such bottles not having been previously cleansed with boiling water or steam. Fined £2 with £1 Is. Od. costs. 11th Sept Failing to keep clean the floor of the milkshop at 189, St. George Street on Tuesday, 28th July, 1936. Fined £2, with £1 Is. Od. costs. 11th Sept Failing to keep clean the lid of the milkpail used in the business of a dairy at 189, St. George Street, on Tuesday, 28th July, 1933 Fined £], with £1 Is. Od. costs. 8th Oct Failing to observe due cleanliness with regard to a milk measure used in connection with his business as a dairyman on 27th May, 1936. Fined £1. 20th Oct Failing to keep clean a dairy at 96, Oxford Street, on 7th August, 1936. Fined £1, with £3 3s. Od. costs. 51 Date Matter of information or complaint. Result. 1st May Milk (Special Designations) Order, 1923. Failing to label a churn of pasteurised milk delivered to St. Peter's Hospital, E.l, on 12th March, 1936, with the designation "Pasteurised." Case dismissed under the Probation of Offenders Act on payment of £3 3s. 0d. costs. 2nd Sept. Milk (Special Designations) Order, 1936. Unlawfully applying the description "Tuberculin Tested Milk" to a pint bottle of milk purchased on 25th June, 1936. Fined £3 with £2 2s. 0d. costs. 29th Jan. Milk and Dairies (Amendment) Act, 1922. Adding water to milk intended for sale on 3rd November, 1935. (B.671) Fined £5 0s. 0d., with £3 3s. 0d. costs. Magistrate decided that the case be not heard. 29th Jan. Selling milk on the 3rd November, 1935, to which water had been added. (B.671.) 17th April Selling milk on the 16th March, 1936, to which water had been added. (At least 1.5 per cent. Hortvet). (B.167.) Summons dismissed under the Probation of Offenders Act, on payment of £2 2s. costs. 4th Dec. Selling milk on 27th October, 1936, containing at least 4.5 per cent. of added water (Hortvet). (Sample C.699.) Pay £1 1s. 0d. costs. 20th Mar. Merchandise Marks Act, 1926. Exposing for sale imported mutton not bearing any "indication of origin" Case dismissed under the Probation of Offenders Act on payment of £2 2s. 0d. costs. 15th April Exposing for sale imported mutton the same not bearing any "indication of origin." Date of offence 8th February, 1936. Fined £2 with £1 1s. 0d. costs. 30th April Milk and Dairies (Consolidation) Act, 1915. Obstructing the inspector in the course of his duties on 20th March, 1936. Case dismissed under the Probation of Offenders Act on payment of £1 1s. 0d. costs. 22nd June Failing to inscribe his name and address on his milk barrow used in the business of dairyman on the 15th May, 1936. Fined 10/-. 11th Aug. Failing to have his name and address conspicuously inscribed upon a vehicle from which milk was being sold on 25th June, 1936. Fined £1 with £1 1s 0d. costs. 7th Jan. London County Council (General Powers) Act, 1908. Keeping the premises at 30, Cable Street, where sweets are manufactured, in a dirty condition on the 4th December, 1935. Fined £1 0s. 0d., with £1 1s. 0d. costs. 17th June Dirty condition of ice-cream wafer machine on 15th May, 1936. Fined 10/-, with 10,'6 costs. 1st July Failing to observe due cleanliness upon premises where food is prepared, i.e., bakehouse, 84, White Horse Lane on 20th April, 1936. Fined £1 with £2 2s. 0d. costs, or one month in default of distress. 1st July Failing to observe due cleanliness in connection with utensils used at the bakehouse, 84, White Horse Lane on 20th April, 1936. Fined £1 with £1 1s. 0d. costs, or 21 days in default of distress. 52 Date. Matter of information or complaint. Result. 15th July Failing to keep an ice-cream wafer machine in a cleanly state on 25th May, 1936. Fined 10s., with 10s. 6d. costs. 15th July Selling ice-cream on 25th May, 1936, without being registered. Fined 10s., with 10s. 6d. costs. 11th Aug. Failing to keep ice-cream wafer machines in a cleanly state on 30th June, 1936. Fined 10s., with £1 1s. 0d. costs. 11th Aug. Failing to keep an ice-cream wafer machine in a cleanly state on 25th June, 1936. Fined 5s., with £1 1s. 0d. costs. 11th Sept. Failing to observe due cleanliness upon premises where food is prepared, i.e., 87, Old Montague Street, a bakehouse, on 21st July, 1936. Fined £1, with £2 2s. 0d. costs. 20th Oct. Failing to keep clean the grocery premises at 129, New Road on 17th August, 1936. Fined £1, with £3 3s. 0d. costs. 16th April London County Council (General Powers) Failing to provide adequate lighting on staircase at 51, Oxford Street. Act, 1927. The work having been done at the time of hearing, the case was withdrawn. 9th Jan. Metropolis Management Act, 1855. Failing to deposit plans before executing drainage work, i.e., fixing a sink at 40, Fieldgate Street on 5th November, 1935. Fined £1, with 10s. 6d. costs. 9th Jan. Failing to give notice prior to executing drainage work at 40, Fieldgate Street. Fined £1,, with 10s. 6d. costs. 3rd Dec. Failing to give notice before executing drainage work at 7, Newark Street. Dismissed under Probation of Offenders Act. Pay 5s. 0d. costs. 4th Dec. Failing to give notice before executing drainage work at 117, New Road. Fined 10s. 0d. 1st Dec. Public Health (London) Act, 1936. Failing to abate nuisance at 83, Varden Street caused by defective roof, yard paving etc. Ordered to do the work within 7 days. Pay £2 8s. 0d. costs. 1st Dec. Failing to abate nuisance caused by dirty condition of workshop and accumulation of rubbish at 33, Plumbers Row. Ordered to do the work within 7 days. Pay £2 8s. 0d. costs. 1st Dec. Failing to abate nuisance caused by foul condition of yard at 65, Plumbers Row. Ordered to do the work within 7 days. Pay £2 8s. 0d. costs. 3rd Dec. Exposing for sale on 28th September, 1936, upon a stall outside 78, Watney Street a quantity of pears which were unsound, unwholesome and unfit for the food of man. Fined £1 0s. Od. Pay £2 2s. 0d. costs. 4th Dec. Failing to provide an ashpit at 55, Plumbers Row. Fined £1 0s. Od. Pay 10s. 6d. costs. 4th Dec. Failing to abate nuisance caused by defective roof, gutters, windows, etc., at 12, Clark Street. Work completed at time of hearing. Pay £2 5s. 0d. costs. 53 Date. Matter of information or complaint. Result. 11th Dec. Failing to abate nuisance arising from dilapidated walls and ceilings, defective windows, etc., at 24, Clark Street. Work completed at time of hearing. Pay £2 5s. 0d. costs. 16th Dec. Failing to abate nuisance caused by choked gully at Pelham Yard (entry), Pelham Street. Work completed at time of hearing. Pay £2 8s. 0d. costs. 29th Dec. Failing to abate nuisance at 40, Diggon Street, arising from defective roof, damp walls and ceilings. Work completed. Case withdrawn on payment of £2 5s. 0d. costs. 29th Dec. Failing to abate nuisance at 54, Diggon Street, arising from defective roof, damp dilapidated walls and ceiling. Work completed. Case withdrawn on payment of £2 5s. 0d. costs. 27th Jan. London County Council Bye-laws. Failing to provide a dust receptacle at 10. Lee Street. Receptacle having been provided at the time of the hearing, the summons was dismissed under the Probation of Offenders Act on payment of 10s. 6d. costs. 3rd Dec. London County Council Drainage Bye-laws. Executing drainage work contrary to byelaws. Case not dealt with. 7th Jan. Public Health (London) Act, 1891. Exposing and depositing for sale on the 5th November, 1935, a number of cans of unsound fruit at 49a, Chicksand Street. Fined £7 0s. 0d., with £3 3s. 0d. costs. 8th Jan. Failing to abate a nuisance at 22, Greenfield Street caused by defective gutter, etc. Ordered to do the work within 7 days and to pay £2 8s. 0d. costs. 27th Jan. Failing to remedy dilapidated and dirty walls and ceilings and the insufficient flush of water to water closet pan at 10, Lee Street. Ordered to do the work within 7 days and fined £2 0s. 0d., with £2 8s. 0d. costs. 7th Feb. Failing to abate a nuisance at 49, Russell Street arising from damp walls of passage and ground floor back room. Ordered to do the work within 14 days and to pay £2 8s. 0d. costs. 7th Feb. Failing to abate a nuisance at 209, Jubilee Street arising from defective water closet apparatus and damp walls of ground floor back addition room. Ordered to do the work within 14 days and to pay £2 8s. 0d. costs. 7th Feb. Failing to abate a nuisance at Flat 16-131, Jubilee Street arising from defective roof. Case adjourned sine die. 11th Feb. Failing to abate a nuisance at 20, Settles Street caused by sinkwaste pipe discharging into gutter. Ordered to do the work within 7 days and to pay £2 8s. 0d costs. 11th Feb. Defective rainwater pipe at 45, Plumbers Row. Nuisance abated. Case withdrawn on payment of £2 5s. 0d. costs. 11th Feb. Defective scullery roof rainwater pipe, and top floor ceiling damp at 81, Varden Street. Nuisance abated. Case with drawn on payment of £2 5s. 0d. costs. 28th Feb. Defective roof over staircase to first floor at 16, Great Alie Street. Ordered to do the work within 7 days and pay £2 0s. 0d. fine with £2 8s. 0d. costs. 54 Date. Matter of information or complaint. Result. 10th Mar. Failing to abate a nuisance caused by damp walls at 1, Bulwer House, Pelham Street. Ordered to do the work within 7 days and to pay £2 8s. 0d costs. 20th Mar. Failing to abate a nuisance caused by foul water closets at 123, New Road. The work having been done at the time of hearing, the case was withdrawn on payment of £2 5s. 0d. costs. 26th Mar. Failing to abate a nuisance caused by defective gutters and damp walls at 10, Cobb Street. Ordered to do the work within 14 days and to pay £2 8s. 0d. costs. 26th Mar. Failing to abate a nuisance arising from defective roof, etc., at 83, Bancroft Road. Ordered to do the work within 14 days and to pay £2 8s. 0d. costs. 24th Mar. Failing to abate a nuisance caused by defective gutter at 13, Adler Street. The work having been done at the time of hearing, the case was withdrawn on payment of £1 2s. 6d. costs. 6th April Failing to remedy damp walls and defective rainwater pipe at 23, Spelman Street. The work having been done at the time of hearing, the case was withdrawn on payment of £2 5s. 0d. costs. 6th April Failing to abate a nuisance at 67, Varden Street, caused by defective gutter, rainwater pipe, etc. Order to do the within 14 days and to pay £2 8s. 0d. costs. 15th April Failing to repair defective roof of house No. 12, Hanbury Street. Ordered to do the work within 7 days and to pay £2 8s. 0d. costs. 21st April Failing to abate nuisance due to defective roof and dirty walls and ceilings at 2, Duval Street. Ordered to do the work within 14 days; to pay £5 fine and £2 8s. 0d. costs. 1st May Failing to abate a nuisance at 22, Fordham Street, caused by choked gulley and sinkwaste pipe, etc. Ordered to do the work within 14 days and to pay £2 8s. 0d. costs. 10th June Failing to abate a nuisance caused by keeping poultry at Turner House. Ordered to abate the nuisance within 14 days. Fined £5 with £4 4s. 0d. costs. 25th June Failing to abate a nuisance arising from defective roof, etc., at 145, Bancroft Road. Fined £3, with £2 8s. 0d. costs. 10th July Failing to abate nuisance at 21, Spring Gardens arising from defective scullery and main roofs; top floor room walls and ceiling dirty. The work having been completed at the time of hearing, the case was dismissed on payment of £2 8s. 0d. costs. 16th July Failing to abate nuisance caused by a choked sink waste pipe at 14, Turner House. The work having been completed at the time of hearing, the case was dismissed on payment of £2 8s. 0d. costs. 5th Aug. Failing to abate nuisance arising from damp walls, etc., at 10, Beaumont Square, An order was made to do the work in 14 days on payment of £2 8s. 0d. costs. 7th Aug. Failing to abate nuisance arising from a defective roof at 101, Devonshire Street. Ordered to do the work within 7 days and pay £2 8s. 0d. costs. 55 Date. Matter of information or complaint. Result. 15th Sept. Failing to abate nuisance arising from defective rain water pipes and gutters at 2, Fordham Street. The work having been done at the time of hearing, the defendant was fined 10s. with £2 8s. 0d. costs. 14th Sept. Failing to abate nuisance due to defective roof at 23, Dalgleish Street. Work completed at time of hearing. Fined £2, with £2 8s. 0d. costs. 25th Sept. Exposing for sale on 14th July, 1936, a quantity of butter which was unwholesome, unsound and unfit for the food of man. Fined £5, with £5 5s. 0d costs. 25th Sept. For depositing for the purpose of sale on 14th July, 1936, a quantity of butter which was unwholesome, unsound and unfit for the food of man. Fined £2 0s. 0d. 5th October Failing to abate nuisance arising from defective roof, etc., at 26, Clemence Street. Defendant ordered to do the work within 14 days and to pay £2 8s. 0d. costs. 5th October Failing to abate nuisance due to defective roof at 46, Clemence Street. Defendant ordered to do the work within 14 days and to pay £2 8s. 0d. costs. 5th Nov. Damp walls of ground floor room and defective main roof at 85, Underwood Street. Fined £5, with £2 8s. 0d. costs, and ordered to complete the work in 7 days. 6th Nov. Failing to abate nuisance arising from defective roof, etc., at 12, Dalgleish Place. Fined £1, with £2 8s. 0d. costs, and ordered to complete the work within 7 days. 13th Nov. Failing to abate nuisance arising from dangerously defective flooring at Flat 10, 131, Jubilee Street. Work done at time of hearing. Fined £2, with £2 8s. 0d costs. 13th Nov. Failing to abate nuisance arising from common yard, passage, staircases and landings not being kept in a cleanly state, and walls in an unwholesome condition at 135, Jubilee Street (a house-let-in lodgings). Fined £2, with £2 8s. 0d. costs, and ordered to abate nuisance in 14 days. 25th Nov. Failing to abate nuisance arising from defective roof at 18, Ford Square. Work having been done at time of hearing, case was dismissed on payment of £2 6s. 0d. costs. 30th Nov. Failing to abate nuisance caused by defective gutter of garage at 58/62, Plumbers Row. Work done at time of hearing. The case was withdrawn on payment of £2 5s. Od. costs. 30th Nov. Failing to abate nuisance caused by foul water-closet at No. 6a, Coke Street. Work done at time of hearing. The case was withdrawn on payment of £2 5s. 0d. costs. 56  No. of Summonses. Fines. Costs. £ s. d. £ s. d. Public Health (London) Act, 1891 38 39 0 0 89 10 6 ,, ,, ,, 1936 10 2 0 0 21 4 6 Houses-Let-in-Lodgings Bye-laws 1 2 0 0 2 8 0 London County Council Byelaws 1 — 10 6 „ ,, Drainage Byelaws 1 — — London County Council (General Powers) Act, 1908 10 7 5 0 13 2 6 London County Council (General Powers) Act, 1927 1 - - Metropolis Management Act. 4 2 10 0 1 6 0 Merchandise Marks Act, 1926 2 2 0 0 3 3 0 Milk and Dairies (Consolidation) Act, 1915 4 1 10 0 2 2 0 „ (Amendment) Act 1922 5 5 0 0 6 6 0 „ Order, 1926 11 23 0 0 15 15 0 Milk Special Designation Order, 1923 1 — 3 3 0 „ „ 1936 1 3 0 0 2 2 0 Food and Drugs (Adulteration) Act, 1928 46 68 0 0 93 19 0 Total 135 155 5 0 254 12 0 Slum Clearance. IV.—HOUSING. During the year the Council made compulsory purchase orders as follows: Houses. Persons to be displaced. Beccles Street Area No. 2 18 122 Beccles Street Area No. 3 5 52 An inquiry was held by the Ministry of Health and both orders were confirmed without modification. The London County Council also passed Clearance Order resolutions in respect of the following areas within the Borough:— Houses. Persons to be displaced. Waley Street No. 2 Area 8 49 James Street Area (part in Stepney) 4 20 Malay Street Area 128 918 Owing to the difficulties and unavoidable delays which the Council experienced in providing rehousing accommodation, it was not possible to represent further areas. It must also be appreciated that the activities of the London County Council have been restricted from the same cause. Although the rate of slum clearance in the Borough must necessarily be slow, having regard to the many difficulties which the problem presents, it is evident, having regard to the rebuilding schemes in hand and contemplated, that the progress will be considerably accelerated in the near future, 57 At the beginning of the year there were 6,159 underground rooms which did not comply with the requirements of the Housing Act and the regulations made thereunder. During the year Closing Orders were made in respect of 10 underground rooms and 15 were altered and made to comply with the regulations, thus leaving 6,134 still to be dealt with. Underground Rooms. The overcrowding survey revealed the fact that there were 7,632 families living in overcrowded conditions. During the year, 848 applications for housing accommodation were investigated; 674 of these were found to be overcrowded and were referred to the London County Council. During the year, 255 cases of overcrowding were abated as follows:—110 by the London County Council as a result of orange forms, 64 by Slum Clearance, 47 cases where persons themselves found other accommodation, and 37 cases where owners were able to transfer their overcrowded tenants. Overcrowding The overcrowding survey also revealed the fact that there were 424 families which would be overcrowded within 2 years by reason of children attaining the age of 1 or 10 years respectively. It will be seen from the above that the position is practically unchanged. The chief difficulty in dealing with overcrowding is the necessity of people to reside locally. The solution to the whole housing problem—slum clearance, overcrowding and underground rooms—is dependent on the ability of the responsible authorities to provide alternative accommodation as defined by the Housing Act: "A house suitable to the needs of the Occupier and his family as regards proximity to place of work and otherwise and suitable in relation to his means." I can only repeat the words of my predecessor, Dr. Ferguson: "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 London County Council and the Government with their vast resources will use every endeavour to deal with the problem in no uncertain manner." I fully realise the necessity of rehousing the people in blocks of flats. Whilst the people generally are pleased to move into the new flats, they do miss the back yard or garden where the husband can have a little hobby or do a little handicraft, but the mother misses it, particularly as a place where she could put her baby in the open air in safety while she does her housework. We must not forget that we are building for a generation almost and I hope that it will be impressed upon Architects in designing the new flats to make them homes in the strict sense of the word. Where possible, handicraft rooms should be provided for the men in connection with every estate and I feel sure that small special separate balconies for babies could be provided for each flat at very little extra expense. The decided benefit of sleep in the open air to the health of the babies has been proven time and again and this, together with the convenience and happiness of the mother would amply justify the provision of the extra amenity. I earnestly hope that it may be found possible to provide this most practical and inexpensive measure towards improving infant health in the Borough. The lack of sunlight and sleep in the open air is the East End infant's greatest handicap. With the modern tendency to house workingclass families in tall blocks of flats, the likelihood of the infants' being taken out into the open air in a pram becomes less and less. 154 dwellings were erected by the Council and occupied during the year. 191 dwellings were erected by and occupied by private enterprise. 58 HOUSING ACT, 1935.—OVERCROWDING SURVEY. (November 4th to December 13th, 1935). Distribution of working-class families in relation to size of family and size of dwelling occupied. Metropolitan Borough of STEPNEY Size of family ("equivalent number" of persons) Size of dwelling occupied, in terms of the maximum " equivalent number " of persons permitted to occupy it without causing it to be overcrowded. Totals of Families. *0 *½ 1 1½ 2 2½ 3 3½ 4 4½ 5 5½ 6 6½ 7 7½ 8 8½ 9 9½ 10 10½ 11 11½ 12 12½ 13 & OVER Overcrowded. Not Overcrowded. Total. 1 3 15 122 3,426 744 1,224 231 5 507 19 58 1 136 2 4 3 18 - - 16 2 - 3 - - - 3 18 6,524 6,542 1½ - - 1 5 34 45 17 - 6 - 4 - 2 1 - 1 3 - - 1 - - - - - - - 1 119 120 2 - 1 43 152 †952 3,652 1,169 19 2,470 133 358 25 919 23 27 40 232 1 6 162 4 - 26 1 - - 14 †216 10,213 10,429 2½ - - 4 244 131 76 1,637 16 987 34 151 7 312 7 11 19 72 2 1 38 1 - 2 - 1 - 1 379 3,375 3,754 3 - 4 170 111 83 1,928 12 2,295 131 424 20 1,538 41 74 89 567 13 11 382 7 3 56 1 2 - 30 368 7,624 7,992 3½ - - - 49 36 663 204 5 597 40 171 2 379 13 18 27 123 1 1 79 4 1 12 - 1 - 6 952 1,480 2,432 4 - - - 32 24 960 274 28 88 203 1,072 34 1,467 67 77 117 611 14 17 465 28 4 77 2 4 - 53 1,318 4,400 5,718 4½ - - 1 16 8 267 83 12 36 60 292 9 329 16 15 39 171 4 6 91 4 1 15 1 1 - 16 423 1,070 1,493 5 - - - 13 6 416 97 11 54 124 639 19 982 63 63 93 594 14 14 550 19 3 94 2 4 - 64 721 3,217 3,938 5½ - - - 1 3 139 40 - 290 15 52 8 261 18 18 23 102 5 5 86 4 1 12 1 3 - 8 540 555 1,095 6 - - - 6 - 192 39 5 460 39 125 34 77 78 109 164 391 24 14 374 10 3 66 2 3 - 45 900 1,360 2,260 6½ - - - 2 1 71 18 1 193 13 34 14 25 30 34 50 88 7 4 80 5 - 14 1 - - 9 372 322 694 7 - - - 1 - 86 16 - 207 18 30 20 39 47 55 72 234 16 11 229 11 5 41 3 3 - 34 464 714 1,178 7½ - - - - 1 29 6 1 71 7 19 7 15 13 13 29 76 8 7 56 2 - 9 - 1 1 9 182 198 380 8 - - - - - 26 4 - 77 7 9 - 168 9 16 27 18 13 21 143 14 1 18 2 6 - 20 343 256 599 8½ - - - 1 1 7 2 - 28 2 5 2 46 2 9 10 7 10 7 34 7 1 8 2 1 - 5 122 75 197 9 - - - - - 2 - - 24 1 5 1 48 2 6 10 7 8 10 59 9 1 13 - 3 - 15 114 110 224 9½ - - - - - 3 - - 16 - 1 - 24 - 4 5 4 3 6 2 2 2 5 - 1 - 2 66 14 80 10 - - - - - 3 - - 11 - 3 - 17 3 1 2 7 6 7 6 7 3 15 - 1 - 9 66 35 101 10½ - - - - - - - - - - - - - - - 1 4 1 1 3 - 2 4 3 1 - 2 26 12 38 11 - - - - - - - - 2 - 1 - 3 - 1 6 1 - 1 1 1 1 - 2 - 3 17 6 23 11½ - - - - - - - - - - - - 4 - - - - - - - - - - - - - 1 7 1 8 12 - - - - - - - - - - - - 3 - - 1 2 - - - - - - - - - 2 7 2 9 12½ - - - - - - - - - - - - - - - - - - - 1 1 - - - - 1 2 2 3 5 13 & over. - - - - - - - - - - - - - - - 1 1 - - 3 - - 1 - 1 - - 8 - 8 TOTALS OF OWELLINGS OVER- CROWDED 3 16 53 687 †342 2,947 783 58 1,474 227 284 78 404 76 49 58 41 19 14 14 2 1 1 - 1 - - †7,632 NOT OVER CROWDED - - 122 3,431 1,710 4,997 4,982 57 6,950 620 3,169 125 6,402 359 505 766 3,300 132 135 2,847 140 31 491 21 38 2 353 41,686 TOTAL 3 16 175 4,118 2,052 7,944 5,765 115 8,424 847 3,453 203 6,806 435 554 824 3,341 151 149 2,861 142 32 492 21 39 2 353 49,317 *0 = a dwelling of 1 room under 50 square feet: ½ = a dwelling of 1 room between 50 and 70 square feet †Including 20 families with insufficient accommodation to secure proper sex separation and for that reason overcrowded. 59 I.—Inspection of dwelling houses during the year:— Statistics. (1) (a) Total number of dwelling houses inspected for housing defects (under Public Health or Housing Acts) 25,038 (b) Number of inspections made for the purpose 30,203 (2) (a) Number of dwelling houses (included under sub-head (1) above) which were inspected and recorded under the Housing Consolidated Regulations, 1925 207 (b) Number of inspections made for the purpose 207 (3) Number of dwelling houses found to be in a state so dangerous or injurious to health as to be unfit for human habitatation - (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 12,243 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 8,676 3.—Action under Statutory Powers during the Year:— (a) Proceedings under sections 17, 18 and 23 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 3,284 (2) Number of dwelling houses in which defects were remedied after service of formal notices:— (a) By owners 3,284 (b) By local authority in default of owners - (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 1 (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 10 (2) Number of separate tenements or underground rooms in respect of which Closing Orders were determined, the tenement or room having been rendered fit — (Note—There were 15 underground rooms rendered fit on service of formal notice). 60 Housing Accomodation provided. 798 families in the Borough took accommodation on the London County Council's housing estates as follows:— Estate. Number of families Estate. Number of families. Amhurst Park 10 Hughes Fields 2 Ann Street 1 Kenneday Road 1 Bakers Alley 2 Kennington Park 1 Banbury Road 10 Kingshold 2 Becontree 375 Medland Street 20 Bekesbourne Buildings 6 Millbank 2 Bellinger 1 More Street 1 Bellingham 1 Mottingham 13 Boundary Street 19 Narrow Street 3 Bourne 3 Northwold 5 Bow Bridge 5 Old Castle Street 47 Brightlingsea Buildings 2 Oliver Goldsmith 1 Cable Street 15 Prestons Road 9 Clapham Park 3 Ranwell Street 16 Collingwood 6 Roehampton 1 Deptford Park 1 St. Helier 16 Dickens 5 St. Leonards Road 3 Dinmont 3 St. Leonards Street 12 Downham 19 Stamford Hill 19 Downs 4 Streatham Hill 3 Drysdale 3 Vassall Road 1 East Dulwich 4 Vauxhall Gardens 1 Ellen Street 65 Wapping 38 Haggerston Road 1 Watling 2 Holland 4 White Hart Lane 1 Hollybush Gardens 6 Wormholt 1 Honor Oak 3 4.—Housing Act, 1935—Overcrowding:— (a) (i) Number of dwellings overcrowded at the end of the year 7,377 (ii) Number of families dwelling therein 7,377 (iii) Number of persons dwelling therein 43,091 (b) Number of new cases of overcrowding reported during the year - (c) (i) Number of cases of overcrowding relieved during the year 255 (ii) Number of persons concerned in such cases 1,492 (d) Particulars of any cases in which dwelling-houses have again become overcrowded after the Local Authority have taken steps for the abatement of overcrowding - (e) Any other particulars with respect to overcrowding conditions upon which the Medical Officer of Health may consider it desirable to report - 61 Number of families overcrowded at the end of 1935 as per Survey 7,632 Number of cases abated during the year 255 In addition to the above, the overcrowding survey revealed the fact that there were 424 families which would be overcrowded within 2 years by reason of children attaining the age of 1 or 10 years respectively. List of streets in which all the houses have been inspected as a result of House to House inspection during the year 1936. House to House Inspection. (a) Limehouse. Mr. Anstee. Martineau Street Star Place White's Gardens Mr. Cue. Dod Street Mr. McCarthy. Cayley Street Dakin Street Railway Place Mr. Waterman. Boulcott Street Charles Place Cranford Cottages Devonport Street Drewton Street Dunstan's Buildings Elbow Lane Buildings Elm Row Glasshouse Fields Heckford Street Hilton Street Lake Street Manor Court Medland Street Ratcliff Cross Street Ronald Street Sage Street Schoolhouse Lane Buildings Solander Street Warton Place West Garden Buildings (b) Mile End. Mr. Day. Hall Street Kirks Place Salisbury Street Mr. Guy. Alderney Place Bude Place Coburgh Place Cornwall Place Faith Street Ferriers Court Frimley Street Goveys Place Key Street Mays Cottages Mile End Buildings Mr. Lowther. Arbery Road Maplin Place Murdock Cottages Salmen Street Treby Street Mr. Howard. Paragon Mansions. Mr. Smith. Baker Street Baker's Court Claremont Place Flats, 1-6, Bedford Street (c) St. George's. Mr. Brockett. Grace's Alley Pell Street (West Side) Royal Albert Buildings Royal Victoria Buildings Ship Alley Mr. Freeland. Wicker Terrace 62 Mr. Haworth. Chamber Street Felix Houses (1-36 Block) Hogarth Houses Rupert Street Mansions (d) Whitechapel. Mr. Green. Commercial Mansions Settles House Union Mansions Mr. Roper. Artillery Lane Artillery Passage Blossom Street Drum Yard Duval Street Elder Street Fleur de Lis Street Fleur de Lis Buildings Great Pearl Street Hanbury Street Little Pearl Street Peabody Buildings Rosetta Place Sandys Row Wilkes Street Mr. Twynham. Easington Buildings Godfrey House Green Dragon Yard Heneage Street Montague Houses Newmans Buildings Perry's Avenue Winifred House Mr. Brownlee. Buttress Street Charlotte Court Clinton House Deal Street Durward Street Hunton Place Osborn House Pelham House V.—INSPECTION AND SUPERVISION OF FOOD. The year 1936 has been one of consolidation for the Food Section. The good work commenced during 1935, the first year of its inception, has been carried on. Improvements continue to be brought about in dairies, cowsheds, milk shops, ice cream premises, preserved food premises, butchers' shops, greengrocers and food premises generally. The rigid enforcement of the Merchandise Marks Act with regard to the marking of fruit, meat and butter during 1935, has had good effect, and the year 1936 showed a marked improvement in this direction. Samples of dates, doughnuts, biscuits and cheese cakes exposed for sale in the Borough markets were purchased and submitted for bacteriological examination, the bacteriologist being asked to examine particularly for pathogenic organisms. All the samples were satisfactory. One pasteuriser's licence was granted during the year, and although the business was carried on for a few months only, the milk produced was in every respect satisfactory. The Sampling Officers continued to pay special attention to the sampling of milk delivered to schools and hospitals in the Borough, and it is pleasing to note that all the samples were satisfactory. The number of prosecutions under the Food and Drugs (Adulteration) Act, 1928, the Merchandise Marks Act and the Milk and Dairies Order, 1926, has decreased as compared with the year 1935. In 1935, there were 20 prosecutions under the Milk and Dairies Order, 1926, as compared with 2 63 during the year 1936. The big decrease is almost entirely due to the fact that the dairymen are keeping their premises and the utensils used in connection with the business in better conditions. The year 1936 has been a successful one—difficulties have been met with and will continue to be met with, but there is every hope for a good year during 1937. 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 606 - 2 - 608 Butcher and Bacon Stalls 172 — — — 172 Butter and Margarine premises. — 31 - 32 63 Complaints 12 37 8 13 70 Cowsheds — 59 — 71 130 Fish shops — 9 — 6 15 Greengrocers and Fruiterers — — 715 — 715 Ice Cream Premises — 269 — 257 526 Markets (Daily) 14 416 22 349 801 „ (Week end) 3 3 3 3 12 Milkshops — 828 — 728 1556 Prepared food premises 181 125 — 176 482 Wharves 741 — 629 — 1370 Wholesale Grocers — 67 — 117 184 Bishopsgate Station 10 — 174 — 184 Spitalfields Market — 1 369 370 Miscellaneous visits 270 118 63 192 643 London Fruit Exchange — — 284 — 284 Samples taken—Food and Drugs. 20 786 5 806 1617 „ „ Other 64 41 26 97 228 Revisits 109 287 159 610 1165 No. of Summonses taken out 5 44 — 35 84 No. on register. No. of inspections. No. of notices served. Dairy premises 228 Purvevors bottled milk 399 1,556 157 84 Itinerant vendors 86 - 6 Cowsheds 19 130 19 Milk Supply. 14 samples of milk were submitted to the Bacteriologist for the detection of Tuberculosis (guinea pig inoculation). In one case the two animals inoculated both died of septic infection, probably due to organisms present in the milk. The experiment was, therefore', nullified. Further samples were taken from the same source and proved to be satisfactory. The remainder of the samples were satisfactory. 64 74 samples of milk were taken in course of delivery to various schools in the Borough. 40 of the samples were submitted for chemical analysis, 29 for bacteriological examination, and 5 for the detection of Tuberculosis (guinea pig inoculation). All the samples proved to be satisfactory. 22 samples of milk were taken in course of delivery to various hospitals and institutions in the Borough. 17 were submitted for chemical analysis, 4 for bacteriological examination, and 1 for the detection of Tuberculosis (guinea pig inoculation). All the samples were satisfactory. 7 "appeal to the cow" samples were taken, 6 of which, on analysis, were found to be deficient in fat. Advice was given to the cowkeeper regarding the interval between the times of milking. A subsequent bulk sample of the milk from the 7 cows was satisfactory. The following samples were submitted for bacteriological examination:— Nature of sample. No. of samples. Number unsatisfactory and action taken. Milk (Pasteurised) 47 - Milk (Grade 'A' (T.T.) 2 1. M.O.H. of Borough concerned communicated with. Milk (undesignated) 5 3. In two cases the M.O.H.'s of the boroughs concerned were communicated with, and in the other case improvements in the methods of production were brought about. Dates 1 - Icecream 2 - Sterile milk bottles 2 - Doughnuts 1 - Biscuits 1 - Cheese cakes 1 - Gherkins in brine 4 - Cucumbers in brine 2 - 85 licences were issued under the Milk (Special Designations) Order, 1923, being 16 more than in the previous year, as follows:— Dealer's Licences Dealer's Supplementary Licences. "Certified'' 4 1 "Grade 'A' (T.T.)" 24 8 "Grade 'A' Pasteurised" 1 - "Grade ' A'" 3 - "Pasteurised" 31 12 Pasteuriser's Licence 1 Butchers' Shops and Stalls. 780 inspections were made during the year and 4 notices were served for minor infringements of the Meat Regulations. 65 The number of premises on the register at the end of the year was 368. 526 inspections were made and 73 notices served. Ice Cream Premises. No. on Register. No. of Notices served No. of Inspections. Butter and Margarine Factories 7 - Wholesale Dealers in Margarine 45 6 63 Butter and Margarine Factories. Preserved Fish premises 108 81 Preserved Meat premises 130 22 482 Preserved Food Premises. 715 visits were made to greengrocers and fruiterers shops and stalls and 269 notices were served for infringements of the Act with regard to the marking of Apples and Tomatoes. Merchandise Marks Act. Occupiers of dairies and milkshops were advised concerning the requirements of the Act particularly with regard to Butter and Dried Fruits and in this respect it was found necessary to serve 175 notices. There was a general improvement in the marking of imported meat although it was found necessary to institute legal proceedings in two cases. 184 visits were made during the year and 6 notices were served on Wholesale Grocers, 33 other notices were served in respect of miscellaneous food premises. Grocers, etc. 332 inspections were made to the bakehouses in the Borough. Bakehouses. 19 certificates have been issued respecting the export of consignments of food products prepared within the Borough:— 2 to Italy. 5 to Argentine. 3 to Syria. 1 to France. 3 to the United States of America. 1 to Switzerland. 2 to Sweden. 2 to Canada. Certification of Food Products for Export. 713 other certificates were issued in respect of unsound food destroyed. 1,370 inspections were made at the various wharves in the Borough. 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:— Unsound food. Wharves. Tons cwts. qrs. lbs. Fresh Meat and Poultry. 24 Hares — 2 0 12 2 carcases Mutton — — 3 11 Preserved Meat. 1,068 tins Assorted Meats 3 3 2 14 Bacon — 3 1 11 648 tins Tongues — 7 2 22 8 ,, Veal — — 1 11 Fresh Fruit and Vegetables. 1,525 crates Apricots 13 0 2 12 820 ,, Bananas 18 10 2 0 17 bundles Beans — 5 1 0 1 package fresh Figs — — — 17 8 boxes Grape Fruit — 5 2 6 66 Fresh Fruit and Vegetables. Tons cwts. qrts. lbs. 2 cases Lemons — 2 0 16 14 crates Lettuce — 3 2 0 68 cases Melons 3 8 0 0 13 boxes Oranges — 11 0 4 6 crates Plums — 1 0 8 1,129 bags Potatoes 54 12 0 0 3 baskets Tomatoes — — 1 26 Preserved Fruit and Vegetables. 327 tins Apricots — 7 3 22 3,545 ,, Assorted Fruits 2 6 3 2 244 ,, Apricot Pulp 1 19 3 6 1 cask and 256 tins Assorted Fruit Pulp 1 4 2 20 4 cases and 412 tins Black Currant Pulp 2 3 1 8 1,492 tins Grape Fruit — 14 0 0 145 ,, bitter Orange Pulp — 11 0 27 38 cases canned Oranges — 13 2 8 47 cases and 180 tins Pears 1 2 0 8 2,746 tins Pineapple 3 3 1 1 2 ,, Plum Pulp — — — 22 33 boxes and 5,474 tins Prunes 3 12 2 5 91 cases and 1,383 tins Tomatoes 3 18 3 21 4 boxes Sultanas — 1 0 0 Preserved Fish. 1,115 tins Assorted Fish — 10 1 9 293 ,, Crab 1 18 1 3 84 ,, Crayfish — — 1 14 1,090 „ Lobster — 3 1 26 458 ,, Salmon — 5 0 2 Sundries. Assorted canned goods 5 4 0 12 21 boxes Butter — 5 1 0 10 cases Chocolate 1 0 0 0 5 packages Confectionery — 1 1 15 16 bags Ground Nuts — 10 0 0 1 casks Orange juice — — 3 27 63 packages Quaker Oats 1 0 2 20 43 packets Sugar 2 9 3 0 70 tins Tomato Paste — 6 3 14 35 cases Shelled Walnuts — 17 2 0 131 11 2 14 Spitalfields Market and London Fruit Exchange. 77 crates Apricots — 11 3 16 450 boxes Apples 9 9 2 18 32 crates Bananas 1 1 3 14 23 boats Brussel Sprouts — 4 0 0 46 „ Cabbage 2 4 0 0 17  Tons cwts. qrts. lbs. Spitalsfields Market and London Fruit Exchange. 19 bags Red Cabbage — 14 0 0 235 ,, Chestnuts 4 4 3 0 20 boxes Cranberries — 3 0 0 17 baskets Gooseberries — 4 1 0 40 trays Grapes — 5 0 0 28½ boxes Grape Fruit 1 1 3 20 44 ,, Lemons 1 13 0 0 32 ,, Limes — 7 0 0 1,096 trays Melons 13 13 2 0 1 box Onions — — 2 0 463 boxes Oranges 18 4 2 11 406 „ Pears 6 14 2 14 543 packages Plums 6 7 3 0 38 bags Potatoes 1 18 0 0 1,070 boats Tomatoes 8 7 1 4 106 bags Turnips 1 10 0 0 34½ packages Walnuts — 10 0 0 79 10 2 13 Other premises. 26 packages Apples — 12 1 14 370 crates Apricots 2 6 1 0 1,141 tins Assorted Fruits 1 2 0 0 688 ,, Pickled Cucumbers 5 17 1 0 64 crates Lettuce — 10 0 0 Pears — — — 14 65 boxes Peaches — 4 3 8 4 packages Potatoes — 3 0 4 Fish. 7 tins Anchovies — — 1 3½ Assorted canned Fish — 1 0 0 65 cases and 1938 tins Crab 1 15 0 0 21 boxes Kippers — 5 3 3 Salmon (tinned) — 11 1 0 ,, (smoked) 7 17 0 0 654 tins Sardines — 3 0 0 976 ,, Seelachs — 6 0 0 12 cases and 2,354 tins Sild — 10 0 0 1 box Lemon Soles — — 3 6 1 ,, Sprats — 3 0 0 Meat and Poultry. 420 tins Assorted Meats — 13 3 10 Bacon 1 2 0 15 449 tins Beef — 16 2 10 Ham (tinned) — 4 2 17 1 carcase Lamb — — — 25 20 Pigs Heads — 2 0 22 1 box and 38 Pigs' Tongues — 1 1 24 68 Meat and Poultry. Tons cwts. qrs. lbs. 4 tins Sausage — — — 27 10 „ Tongues — — 2 10 2 „ Veal — — — 12 Sundries. Assorted canned goods 2 2 0 5 Butter — — 1 151 6 cases Confectionery — 10 1 7 Eggs — 1 0 0 Peel (candied) — 2 4 16 28 7 3 16 Caseous Lymphadenitis.—There were 1,000 carcases of imported mutton examined by the cutting of the lymphatic glands. Of these, 2 were found diseased, showing .002 as against .0004 in 1935. 135 tons 3 cwt. of Tea Sweepings were removed from warehouses for chemical purposes. 89 cases, each containing 24 tins of Prunes, were detained, and, after analyses of 12 of the tins had been made, it was found that the "tin" contents varied from 1.21 to 2.10 grains per lb. The whole parcel was eventually surrendered by the owners and destroyed. 1 case of 360 eggs was surrendered and destroyed as unfit for human consumption. The eggs were purchased from a farmer in Yorkshire, and were advertised as "New Laid Eggs." Most of them were marked with pencil indicating the breed of bird that had laid them. Judging by their condition, the eggs appeared to have spent some time in an incubator. The facts were forwarded to the Medical Officer of Health for the district in which the farm is situated. A quantity of pears was seized in one of the Borough markets. They were exposed for sale upon a stall. When questioned, the owner said the pears were for sale but that she sold them to children only. The pears were condemned and the owner fined £1 0s. 0d., with £2 2s. 0d. costs. A quantity of rancid butter was seized in a provision shop situated in one of the Borough markets. Some was exposed for sale in the shop and some deposited for sale in a refrigerator at the rear of the premises. The butter was condemned by the Magistrate at the Thames Police Court. The shopkeeper stated that the butter, sold at 10d. per lb., was for cake making only, although a notice in the shop described it as "Pure Butter, 10d. per lb." He was fined a total of £7 0s. 0d., with £5 5s. 0d. costs. Sodium Fluoride in Wine.—In February, the Food Inspector was approached by a wholesale manufacturing chemist in the Borough, who informed the Inspector that he was in the habit of supplying sulphur dioxide preservative to a large firm of wine merchants in Stepney, used for preserving wine. (The Public Health (Preservatives in Food) Regulations permits the presence of 450 parts per million of sulphur dioxide preservative in wine.) Unfortunately on this occasion, the chemist's foreman had supplied sodium fluoride by mistake and the fluoride had been added to about 1,200 gallons of wine by the merchant. Unless the sodium fluoride could be removed, the loss sustained by the chemist would amount to about £1,000, 69 The Public Analyst was able to advise the chemist on the steps to be taken to precipitate and remove the sodium fluoride. The wine was put under stop by the Food Inspector, samples were analysed and 100 to 250 parts of sodium fluoride per million were found. Samples were then analysed after treatment of the wine for the removal of the sodium fluoride, and were found to be satisfactory. The wine was then released for sale. Tin in Sugar.—In May, a letter was received from the Medical Officer of Health, Hampstead, stating that a sample of Barbadoes Soft Raw Sugar showed, on analysis, the presence of 2.1 grains of tin per pound, and 140 parts of sulphur dioxide preservative per million parts of the sample. (The Public Health (Preservatives in Food) Regulations limit the amount of S02 preservative in sugar to 70 parts per million.) The sugar camplained of came from a warehouse in the Borough. 9 samples of sugar were taken from the warehouse for analysis. 1 sample contained 104 parts of S02 per million, and 1 contained 1.87 grains of tin per pound. After considerable correspondence and action on the part of the Food Inspector, all the affected sugars were recalled and refined of tin and preservative before being released for sale. A letter was also received from Dr. Seymour, of the Ministry of Health, requesting that he be given information relating to the analyses of sugar samples and the action taken by this Department. The use of tin as a mordant for the colouring matter in the preparation of brown sugar is not very generally known. The Annual Report of the Chief Medical Officer of the Ministry of Health for the year 1929 states:- "Recent enquiries show that practically all the sugar sold in this country as Demerara or West Indian crystallized, contains tin. The amount is not large, ranging from 0.33 to 1.33 grains per pound. At the same time it is questionable whether a manufacturer is justified in adding tin salts to a food supply solely for the purpose of colouring it. Such an addition would appear to be quite unnecessary. It cannot be said categorically that a grain of tin per pound of sugar is prejudicial to health, but on general principles, the amount of tin, and of heavy metals generally, in food should be kept down to the lowest possible limits." As a result of the action taken in this matter, all existing parcels of sugar coming forward are now being analysed for the presence of tin and sulphur dioxide in excess, and where these are found, the parcels of sugar are being refined before sale. The trade has also discontinued the sale of bright-coloured soft sugars as these were found most liable to contain tin in excess, and grey sugars are being substituted. In addition to the usual guarantee being given to dealers, "First-hand" importers are further guaranteeing that the sugar has been analysed for tin and S02 in excess. 860 five-kilo tins of black currant pulp, landed at a wharf in the Borough from France, were detained for the reason that a considerable proportion showed indication of having been re-soldered. On a full examination being made, 511 tins were sound and satisfactory, 253 tins resoldered and unsatisfactory, and 96 tins unsound. A request was made for the release of the 253 resoldered tins for re-export to Paris. This was refused and the resoldered tins were surrendered and destroyed, together with the unsound tins. 70 167 Detention Notices and 234 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. Mutton 19,273 carcases 75 - 19,271 carcases 75 - Tallow 3,683 casks 55 1,454 0 0 0 6,248 casks 149 2,459 2 0 0 Potatoes 544 bags 7 25 0 0 0 - — — Shelled Walnuts 38 cases 3 19 0 0 - — — Pears 62 boxes 2 1 6 0 0 - — — Mandarin Oranges 400 cases 2 5 17 3 12 356 cases 2 5 9 1 20 Black Currant Pulp 90 cases & 4 tins 2 4 1 1 8 46 cases 1 2 6 0 0 Apricot Pulp 450 tins 2 2 3 3 8 204 tins 1 1 0 0 4 Tea 578 cases 1 32 2 0 0 — — - Sultanas 199 boxes 1 2 8 2 0 — — — Chocolate 10 cases 1 1 0 0 0 — - — Crayfish 84 tins 1 1 14 — — — Bacon 4 bales 1 8 0 0 4 part bales 1 5 3 16 Beef (tinned) 84 cases 1 3 3 2 14 — - — Orange Pulp 48 tins 1 1 2 24 — - — Butter 21 boxes 1 5 1 0 — — — Hares 2 crates 1 2 0 12 — — — Tomato Paste 7 cases 1 6 3 14 — - — Fruit Pulp 1 cask 1 1 1 5 — — - Dressed Crab 151 cases 1 1 5 0 0 — — — Tongues 11 cases 1 4 2 24 — — — Ground Nuts 37 bags 1 3 1 0 0 24 bags 1 2 8 0 0 Prunes 89 cases 1 1 18 2 26 — — — Orange Juice 1 cask 1 3 27 — — — Soft Sugar 215 bags & 2 9 pockets 1 22 15 3 16 115 bags & 29 pockets 3 12 15 3 16 Tomato Puree 78 cases 1 2 5 3 22 — — — Tomatoes (tinned) 900 cases' 1 28 17 0 0 900 cases 1 28 17 0 0 71 ZEEBRUGGE-HARWICH AND CALAIS-HARWICH TRAIN FERRY. 60 special midnight and early morning visits were made by the Food Inspectors. In addition, 125 inspections were made by day. At Bishopsgate Station. The total weight of fresh fruit and vegetables examined was 6,604 tons 13 cwts. This consisted of:— Belgian Carrots, Cauliflowers, Grapes, Peaches and Pears. Bulgarian Grapes and Peaches. Greek Grapes. Hungarian Apples, Apricots, Beans, Bilberries, Cherries, Currants, Grapes, Gooseberries, Melons, Peaches, Pears, Peas, Plums and Tomatoes. Italian Chestnuts, Grapes, Lemons, Peaches, Pears, Plums and Melons. Spanish Oranges and Plums. Yugo-Slavian Grapes. Belgian Bacon and Shrimps, Bulgarian Shelled Walnuts, Dutch Shrimps, Hungarian Live Carp and Poultry, Italian Cheese and Poultry and Yugoslavian Bacon and Poultry were also examined. The following foodstuffs were found to be unsound and destroyed:— Tons cwts. qrs. lbs. 222 packages Apricots 1 15 1 10 112 Carp — 3 0 15 3 crates Cauliflowers — — 3 18 1,620 bags Chestnuts 28 18 2 0 482 packages Grapes 3 4 3 23 372 Melons 1 9 3 5 300 packages Peaches 2 1 1 12 41 ,, Pears — 7 2 21 70 „ Plums — 6 2 14 29 crates Tomatoes — 6 0 0 38 14 1 6 ex. Dutch steamer, via Harwich. 98 bags Potatoes 4 18 0 0 8 trucks of Peaches and 1 of Plums, entered as produce of the "State of San Marino" were detained by H.M. Customs for evidence of origin, it being suspected that these were from Italy. The whole were subsequently seized and sold on behalf of the Crown. There was a very large increase in the imports of Italian fruit after the raising of "Sanctions" on 15th July, 1936. 72 Congestion of traffic at Bishopsgate Station during July and August necessitated attendance at Durward Street Goods Station on 7 occasions. This depct was used as a relief station. During December, large consignments of Yugo-Slavian and Hungarian Poultry, chiefly Turkeys, arrived. These were found to be in a sound and wholesome condition, the consignments being fairly rapidly cleared as they arrived. 3 trucks of Italian Chestnuts, in consequence of being on hand about a month, were in a heated and mouldy condition and therefore unfit for human food. These were surrendered by the importers and destroyed. 73 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 thirteenth Annual Report, dealing with the work carried out in the Borough Laboratory during the year 1936. During the year, 1,816 samples were submitted to me for examination These samples were made up as under:— Foods 1,448 1,575 Drugs 127 Public Health Department 216 Borough Engineer 7 Public Cleansing Officer 1 Private 5 Cowshed Samples 7 Borough of Hackney 5 1,816 The 1,575 samples of foods and drugs were purchased or taken by Inspectors under the Food and Drugs (Adulteration) Act, and consisted of:— Formal Samples 1,025 Informal Samples 550 1,575 Out of 1,025 formal samples 97, or 9.5 per cent., were adulterated, and of 550 informal samples 28, or 5.1 per cent., were adulterated, making a total of 1,575 samples, out of which 125, or 7.9 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. Table A. Nature. Number of Samples. Number Genuine Number Adulterated Percentage Adulterated Preservative Found. Almond Oil 3 3 - - - Ammoniated Tablets Quinine 5 4 1 20.0 — Ammoniated and Cinnamon Quinine 2 — 2 100 — Tablets Ammoniated of Quinine Tincture 7 7 - - - 74 Table A—Continued. Nature. Number of Samples. Number Genuine. Number Adulterated Percentage Adulterated Preservative Found Arrowroot 3 3 - - None Backache Pills 1 1 — — — Baking Powder 9 9 — — None Blanc Mange 3 3 — — None Boracic Powder 6 6 — — — Borax 6 6 — — — Boric Ointment 4 4 — — — Bread 1 1 — — — Bread and Butter 43 37 6 14.0 — Butter 63 63 — — None Caraway Seeds 2 2 — — — Carbolic Ointment 1 — 1 100 — Castor Oil 6 6 — — — Cheese 6 6 — — None Chocolate Cakes 6 3 3 50.0 None Chocolate Wafers 1 1 — — None Cinnamon 3 3 — — — Cocoa 6 6 — — — Cod Liver Oil and Malt 3 3 — — — Coffee 6 6 — — — Condensed Milk 4 4 — — None Cooked Meats 4 4 — — None Cream 14 14 — — None Cream Cheese 9 4 5 55.6 None Curry Powder 2 2 — — None Custard Powder 6 6 — — 3 Dried Fruit 6 6 — — 4 Dried Milk 3 3 — — None Dripping 3 3 — — — Egg Substitute Powder 12 12 — — 1 Epsom Salts 3 3 — — — Eucalyptus Oil 3 3 — — — Fish Paste 5 5 — — None Flour 3 3 — — None Fruit Wine 1 1 — — 1 Glauber's Salt 3 3 — — — Glycerine 3 3 — — — Gregory Powder 3 3 — — — Ground Ginger 6 6 — — None Honey 5 5 — — None Ice Cream 5 5 — — None Iodine Ointment 6 6 — — — Jam 6 4 2 33.3 2 Jelly 10 10 — — 4 Lard 10 9 1 10.0 — Lard Substitute 1 1 — — — Lemonade Powder 6 6 — — None 75 Table A.—Continued. Nature. Number of Samples Number Genuine. Number Adult' rated Percentages Adult' rated Preservatives Found Liniment of Turpentine 8 5 3 37.5 - Linseed Meal 1 1 — — — Liquid Paraffin 1 1 — — — Lysol 1 1 — — — Magnesia 2 — 2 100 — Margarine 49 49 — — None Meat Paste 1 1 — — None Mercury Ointment 3 3 — — — Milk 984 899 85 8.6 None Minced Meat 19 16 3 15.8 3 Mustard 6 6 — - — Oatmeal 3 3 - - None Olive Oil 3 3 — - — Parrish's Food 3 3 — - — Pearl Barley 9 9 — - None Pepper 12 12 — - None Potassium Citrate 2 2 — - — Rice 15 15 — - None Sago 6 2 4 - None Salicylic Ointment 3 3 — - - Sauce 7 7 — - None Seidlitz Powder 6 6 — - — Semolina 3 3 — - None Separated Milk 1 1 — - None Shredded Suet 3 3 — - — Soda Water 3 2 1 - — Sodium Bicarbonate 4 4 — - — Sodium Citrate 1 1 — - — Soft Cheese 2 2 — - None Soup Powder 3 3 — - None Spirits 22 19 3 13.6 — Suet 3 3 — — — Sugar 3 3 — — None Sulphur Ointment 5 5 — — — Sweets 10 10 — — 4 Syrup of Figs 3 3 — — — Tartaric Acid 3 3 — — — Tincture of Iodine 6 6 — — — Tincture of Rhubarb 3 3 — — — Tinned Meat Roll 1 1 — — None Vinegar 7 4 3 42.9 None Zinc Ointment 7 7 — — — 1,575 1,450 125 7.9 22 76 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 past ten years. Table B. Year. Samples taken under the Act. Number Adulterated. Percentage Adulterated. Bact. Examinations Miscellaneous Samples Total Samples 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 1936 1,575 125 7.9 — 241 1,816 There has been a slight decrease in the percentage of adulteration. Of the samples taken under the Act, 1,448 consisted of foods and of these 116, or 8 per cent., were adulterated; of the remaining 127 samples consisting of drugs 9, or 7.1 per cent., were adulterated.. The increase in the number of miscellaneous samples is very considerable. Of these samples, 96 were examined for metallic contamination, involving the use of lengthy processes. Legal Proceedings. Offences were committed in 162 cases. These were dealt with as shown below :— Adulterated. Other offences. Total. Formal Proceedings *53 17 70 Caution 33 — 33 No action 12 — 12 Informal 28 — 28 *126 17 143 Fines and costs totalled £219. * Including one case from the year 1935. Milk. 984 samples of milk were analysed. Of these 85, or 8.6 per cent., were adulterated. In addition, 7 "Appeal to cow" samples and 5 samples, taken in the Borough of Hackney at the request of the Borough of Stepney, were analysed. Table C shows the number of samples of milk examined and the percentages of adulteration during the last ten years, 77 Table C. 1927. 1928. 1929. 1930. 1931. 1932. 1933. 1934. 1935. 1936. Number of samples. 854 923 923 900 881 974 928 1005 965 984 Percentage of adulteration. 1-4 4-1 3'9 22 3'0 26 22 4-6 7.7 8-6 The last three years have shown a great increase in the adulteration of milk. Table D shows the extent of the adulteration and the action taken in each case. 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 27 - 0.9 2.5 No action. C 29 - 1.2 3.2 No action. C 31 — 1.2 3.4 No action. C 45 — — 1.9 No action. B 45 — ' — 1.5 No action. B 46 — — 1.5 No action. B 47 — — 1.3 No action. B 80 — — 2.1 Vendor cautioned. C 95 26.7 Discharged under the Probation of Offenders Act. Vfendor paid £2 2s. costs. C 99 17.7 11.9 14.0 Vendor fined £1 with £2 2s. costs. C 100 4.7 7.2 11.1 Vendor cautioned. B 106 8.0 — — No action. Cowshed sample. C 138 19.0 16.6 18.5 Vendor fined £1 with £2 2s. costs. C 139 37.0 33.5 32.8 Discharged under the Probation of Offenders Act. B 137 — 10.0 10.9 Discharged under the Probation of Offenders Act. Vendor paid £2 2s. costs. B 140 4.0 - - Discharged under the Probation of Offenders Act. Vendor paid £2 2s. costs. B 141 4.7 - - Discharged under the Probation of Offenders Act. Vendor paid £3 3s. costs. B 157 — — 1.5 Vendor cautioned. C 154 6.0 6.8 Discharged under the Probation of Offenders Act. Vendor paid £3 3s. costs. B 167 - - 1.5 Discharged under the Probation of Offenders Act. Vendor paid £2 2s. costs. 78 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. B 179 - 1.8 3.0 Vendor fined £2 with £3 3s. costs. C 186 — 7.6 5.8 Vendor fined £1 with £2 2s. costs. C 187 23.3 — — Vendor cautioned. B 211 8.7 — — Vendor cautioned. B 212 — 5.1 3.4 Vendor fined £1 with £2 2s. costs. B 244 — 5.3 7.2 Vendor fined £2. B 251 — 4.1 5.1 Vendor fined £1 with £2 2s. costs B 253 8.5 30.6 34.0 Vendor fined £1 with £2 2s. costs. C 247 4.0 — — Vendor cautioned. B 268 — 2.0 3.6 Sample purchased informally. C 261 — 2.8 3.4 Vendor fined £3 with £5 5s. costs. B 281 33.0 — - Vendor cautioned. C 264 13.7 — — Summons dismissed. C 266 10.0 — — Summons dismissed. C 267 3.7 — — No action. C 268 3.3 — — No action. C 278 9.0 — — Vendor fined £2 with £3 3s. costs. C 281 21.0 — — Vendorfined£l with £2 2s. costs. B 294 8.0 .— — Vendor cautioned. C 306 8.0 — — Vendor cautioned. C 325 — — 1.1 Summons withdrawn. B 336 93.3 — — Vendor fined £2 with £3 3s. costs. C 336 19.0 - - Vendor fined £5 with £2 2s. costs. C 339 16.0 — — Vendor fined £5 with £2 2s. costs. C 345 37.0 Discharged under the Probation of Offenders Act. Vendor paid 10s. costs. f 347 3.0 — - Vendor cautioned. B 357 19.3 2.7 6.6 Vendor fined £2 with £2 2s. costs. B 369 — — 1.3 Vendor cautioned. C 364 — 1.2 4.2 Summons withdrawn. C 367 — 16.4 18.9 Summons withdrawn. Vendor paid £5 5s. costs. C 402 14.0 — - Vendor fined £5 with £3 3s costs. C 403 14.0 — - Not dealt with. B 435 - 2.4 5.1 Discharged under the Probation of Offenders Act. Vendor paid £5 5s. costs. B438 — — 2.1 Vendor cautioned. B 439 — — 2.5 Vendor cautioned. B 440 — — 1.9 Vendor cautioned. B 458 — 1.2 — Sample purchased informally. C 449 13.7 — — Vendor cautioned. C 489 — — 1.3 Vendor cautioned. C 566 8.0 — — Vendor cautioned. C 568 10.7 — — Vendor cautioned. C 571 — — 1.5 Vendor cautioned. B 541 — — 3.2 Vendor cautioned. B 542 — 12.7 15.7 Vendor fined £3 with £2 2s. costs. B 545 6.3 — — Vendor fined £3 with £2 2s. costs. 79 Number. Deficient in Fat per cent. Deficient in Solids-notfat per cent. Minimum added water per cent. Hortvet. Action : Result of Proceedings. C 603 - - 2.1 Vendor cautioned. B 599 — — 1.9 Vendor cautioned. C 699 4.5 Discharged under the Probation of Offenders Act. Vendor paid £1 Is. costs. C 733 — 6.2 — Sample purchased informally. C 776 — — 3.2 No action. C 781 — 2.4 6.4 Vendor fined £2 with £5 5s. costs. C 782 — — 1.9 Vendor fined £1 with £3 3s. costs. C 794 2.5 Vendor fined £3 with £3 3s. costs and removed from register for all time. C 795 — — 4.3 Not separately dealt with. C 797 — — 3.4 No action. B 714 6.3 — 1.5 Summons dismissed. Vendor paid £2 2s. costs. B 717 — — 1.5 Vendor fined £2 with £2 2s. costs. C 807 — — 2.8 Vendor fined 15/-. C 808 — — 2.6 Vendor fined 15/-. C 809 — — 2.3 Vendor fined 15/-. C 811 — — 1.9 Summons dismissed. C 824 — — 1.3 Vendor cautioned. B 758 3.7 — — Vendor cautioned. B 787 — — 1.7 Vendor cautioned. B 790 23.0 Discharged under the Probation of Offenders Act. Vendor paid £2 2s. costs. Also one case (Sample C. 677) in which legal proceedings had been adjourned in 1935 owing to the absence of the vendor in Italy, resulted in a fine of £1 with £2 2s. costs. Notes on Table D. Sample B 106. This sample was 8.0 per cent, deficient in fat. A request was made for "Appeal to cow" samples to be taken. 7 samples were taken at the cowshed, and the following results were obtained :— Number. Fat per cent. Solids-not-fat per cent. Deficiency Fat per cent. Solids-not-fat deficiency per cent. Freezing point Hortvet. B 123 2.85 9.00 5.0 - - B 124 3.95 9.67 — — 0.553°C B 125 2.95 9.00 1.7 — — B 126 3.40 8.05 — 5.3 0.538°C B 127 2.40 8.88 20.0 — — B 128 2.75 8.85 8.3 — — B 129 2.40 8.50 20.0 — 0.566°C 80 As only one of the above samples complied with the Sale of Milk Regulations, no action was taken against the vendor. Sample B 126, which was 5.3 per cent, deficient in solids-not-fat, gave a freezing point within the range shown by genuine milk, confirming the fact that the deficiency of solids-notfat was due to natural causes. Sample B 129 shows an unusual combination of figures, the solids-not-fat being the legal minimum and the freezing point "being at the extreme end of the range. About 6 per cent, of water could be added to such a sample and though this would cause a deficiency in solids-notfat, the freezing point would still be within the range shown by genuine milk. Samples C 264 and C 266. Both these samples were cowshed samples, deficient in fat and the summonses were dismissed, as it was proved that the milk had not been touched after leaving the cowshed. In three cases comprising 12 samples, legal proceedings were taken on the result of the freezing point determination, though the percentage of solids-not-fat satisfied the requirements of the Regulations. The cases were heard by three different magistrates and in each case the magistrate accepted my evidence with regard to the freezing point. One case was dismissed. The cases were :— (1) B 167. At least 1.5 per cent, of added water (Hortvet). A conviction was obtained. (2) C 811. At least 1.9 per cent, of added water (Hortvet). Summons dismissed as it was stated that the amount of added water was trivial. (3) This case was concerned with 10 samples taken from four vendors. It was agreed that all the summonses should be dealt with as one and sample C 782, containing at least 1.9 per cent, of added water (Hortvet), was chosen to decide all the cases. This vendor was convicted. The other summonses were then dealt with as follows :— C 325, C 364, C 794 and C 795. These samples contained at least 1.1, 4.2, 2.5 and 4.3 per cent, of added water (Hortvet) respectively. C 325 and C 364 were withdrawn, C 795 was not separately dealt with, and in connection with C 794 the vendor was fined and removed from the register. C 781, C 807, C 80S, C S09. These samples contained at least 6.4, 2.8, 2.6 and 2.3 per cent, of added water (Hortvet) respectively. The vendor was fined in each case. C 781 was also deficient in solids-notfat to the extend of 2.4 per cent., and the defence forwarded the third part to the Government chemist, who confirmed my analysis, the certificate showing a deficiency of 3.0 per cent. Sample B 717 contained at least 1.5 per cent, of added water (Hortvet). The vendor was fined. Sample 72 N, not included in Table D, taken in the Borough of Hackney, contained at least 0.9 per cent, added water (Hortvet). Ordinarily this sample would have been reported as suspicious but as the sample was taken in connection with a retailer in this Borough, it was reported as "containing a small percentage of added water, possibly as little as 0.9 per cent." The vendor was cautioned. 81 As a considerable amount of time has been spent in giving evidence in the Courts with regard to the Hortvet method, a short account of the method and of the points raised by the defence in a number of cases is appended. The Value of the Hortvet Determination. The Sale of Milk Regulations presume that when the percentage of solidsnot-fat in a milk is less than 8.5 the sample contains added water and the defendant is required to prove the contrary in order to avoid conviction. According to this standard 8.5 parts of solids-not-fat represent 100 parts of milk. If a sample contained half the quantity, that is, 4.25 parts of solidsnot-fat, that would represent half the sample, or 50 parts of milk, the remaining 50 parts being added water. On this principle by means of a simple formula the content of added water is calculated. The same figure represents the deficiency in solids-not-fat. Prior to the introduction of the Hortvet such a sample would have been reported as 50 per cent, deficient in solids-not-fat, representing the presence of at least 50 per cent, of added water. Milk may, for various reasons, be naturally deficient in solids-not-fat, so that it is necessary for the analyst to be able to differentiate between naturally abnormal milk and milk to which water has been added. The milk of a single cow and occasionally the mixed milk of a herd may fall below the standard. In Stepney the great proportion of the milk sold is previously balked and pasteurised, so that it is extremely unlikely that the composition of the milk would be below the minimum owing to natural causes. A very usual defence in the past has been the production of figures showing or purporting to show considerable deficiencies in solids-not-fat in the milk of herds of cows under natural conditions. There was then only one method which was really helpful in confirming the presence of added water as suspected by the deficiency of solids-not-fat. This method depends on the fact that the constituents of the milk solids, lactose, proteins and ash (mineral compounds after ignition) are present in certain proportions in normal milk. It was found that in the case of milk naturally deficient in solids-not-fat the ratio did not hold good owing usually to a deficiency of lactose, but in watered milk the constituents remained in the usual proportions. This method was used here in addition to the ordinary analysis in cases where the deficiencies of solidsnot-fat were small. Owing to the difficulty in distinguishing between a milk naturally deficient in solids-not-fat and one to which water has been added, samples showing a percentage of from 8.25 to 8.50 solids-not-fat were reported as " Poor quality slightly deficient in solids-not-fat." Others showing a greater deficiency, i.e., over 3 per cent, were reported as adulterated. As the minimum of 8.5 per cent, solids-not-fat is a lenient one it follows that many of these " poor quality " milks actually contained 5 or 6 per cent, of added water. The introduction of the freezing point method, which has been used in this laboratory since 1931, has cleared the position considerably. Cryoscopy, or the study of freezing points, was developed largely by the French scientist Raoult. In 1892, Dreser found that the freezing point of milk was practically the same as that of cow's blood and later Beckmann and Jordis suggested the freezing point determination as a method of detecting added water in milk. The method is based on the fact that the freezing point of milk depends on the osmotic pressure, and as the osmotic pressure is for biological reasons practically constant, the freezing point of genuine milk, whatever its chemical composition, varies only within a limited range. 82 In 1914, Monier-Williams (L.G.B. Food Reports, No. 22) described an apparatus of his own design which he used in determining the freezing point of milk and later, in 1934, devised another form of apparatus on the lines of the Hortvet, for the same purpose. The earlier form of apparatus was too complicated for use in a working laboratory. An apparatus was, therefore, produced in 1921, by an American, Julius Hortvet, working with a number of collaborators; this apparatus is simple and efficient, but there is no attempt by corrections, etc., to obtain the true freezing point. The figure obtained is the freezing point as determined in the Hortvet apparatus. This has been official in America for many years. The freezing point method for the determination of added water in milk is used officially or semi-officially in many other countries. The Council of the Society of Public Analysts state that investigations in this country and abroad have fully established that the freezing point of genuine milk varies only within narrow limits and have approved the freezing point determination as a means of detecting and determining added water in milk and that for administrative purposes the freezing point should be determined by the Hortvet exactly as described by the Association of Official Agricultural Chemists, U.S.A. The range of variation of the freezing point. According to Hortvet and Bailey, the freezing point of genuine milk using the Hortvet apparatus varies between —0.530° C. and —0.566° C., with an average of — 0.545° C. Stubbs and Elsdon (Analyst 1934, 59, 146) examined 1,000 milks in the Hortvet apparatus. Of these 330 samples were " Appeal to cow " samples and the remainder were presumed genuine. The figures obtained ranged from —0.529° C. to —0.563° C., with an average of —0.544° C. Different figures quoted for defence purposes in Court have been obtained by using other types of apparatus or using the Hortvet apparatus with a variety of corrections and different methods of working. These figures are not comparable with the figures obtained above with the standard apparatus. The use of the word depression. When speaking about a higher or lower freezing point some confusion might arise as to whether the figure itself or its position on the thermometer is referred to. It is usual, therefore, to state the amount by which milk has lowered the freezing point of water as the depression. In the case of genuine milk therefore, the minimum depression is .530° C. and the maximum depression .565° C. Relation to the solidsnot-fat. The percentage of solids-not-fat is independent of the freezing point depression. If a sample is deficient in solids-not-fat and the freezing point depression falls within the range found for genuine milk then the deficiency is probably a natural one. If the depression found is less than the minimum depression for genuine milk then the milk contains added water whatever its chemical composition may be. Any milk which is naturally deficient in fat or solids-not-fat is genuine milk. There is no law to enforce a minimum standard of quality in genuine milk. Method of calculation of added water from the freezing opint. Supposing that a sample gives a freezing point of —0.477° C., the minimum depression of .530° C. has been lessened by .530—.477, or .053, i.e., 53 in 530, or 10 per cent. The sample, therefore, contains a minimum of 10 per cent, of water, which is definitely added water. 83 An alternative method of calculation has been suggested by Elsdon and Stubbs (Analyst 1936, 61, 382). For many years in my Annual Reports I have pointed out that the composition of the milk supplied in the Borough of Stepney compares unfavourably with that of the milk supplied in other parts of the country. This, in my opinion, is due in part to the purchase by wholesalers of cheap milk containing added water. The minimum standard of 8.5 per cent, of solids-not-fat is a lenient one and usually a certain percentage of added water can safely be added to milk without reducing it greatly below this minimum. In those cases one is not prepared to condemn the sample as adulterated. It must be remembered that the greater part of the Stepney milk is bulked milk and one cannot therefore take checking or " Appeal to cow " samples at the farm concerned as is done in other parts of the countiy. Amount of water which may be present. The Hortvet method helps very considerably, as it proves that when the depression is less than .530° C. water has definitely been added. Unfortunately the Hortvet ranges from —0.530° C. to —0.565° C. This means that a sample having an original freezing point of —0.565° C. can be watered down from .565° to .530° without detection. In the examination of 1,000 milks previously referred to it was shown that the extreme ranges rarely occur, the minimum depression only occurring 6 times in 1,000 samples. As in England the added water is calculated on 0.530, it follows that the added water is considerably under-estimated. Further, samples found in this laboratory to show freezing points between —0.525° C. and —0.530° C. are reported as suspicious; only those samples which show over a minimum figure of 1 per cent, being certified as adulterated. Actually such samples will contain in most cases 3 or 4 per cent, of added water. If legal proceedings are not taken in such cases, the milk purveyor can add small percentages of water with impunity. A milk dealer selling say 1,000 gallons daily is selling 30 or 40 gallons of water per day when 3 or 4 per cent, of added water is present. A sample of such milk would probably show a minimum of about 1 per cent, by the Hortvet, and the solids-not-fat would not be reduced or only slightly reduced below the minimum of 8.5 per cent. In America the added water is officially calculated on an average depression of 0.55° C. and a tolerance of 3 per cent, is allowed. This is the same as taking a limit figure of 0.533° C. This tolerance figure is not deducted from results showing added water in excess of 3 per cent. In this way the figure obtained approximates more nearly to the amount actually present. In Stepney the solids-not-fat range from 9.1 per cent, at the most to the legal minimum of 8.5 per cent., so that a sample of milk containing 9.1 per cent, of solids-not-fat could be watered down to 8.5 per cent, and would satisfy the legal minimum ; a sample so treated would contain 6.6. per cent, of added water. Similarly in the case of the freezing-point a sample diluted from —0.565° C. to —0.530° C. would contain 6.2 per cent, added water, so that it would at first appear that both methods give similar results for Stepney milk. This is not entirely so, however, as there is no relation between the solids-not-fat and the freezing-point. It would in fact be possible to obtain the following conditions, which will show that it is to some extent a matter of chance as to whether either method will indicate the presence of appreciable amounts of added water. Amount of water not detected under certain conditions. 84 In order to show the significance of the Hortvet figure, combinations of the extreme variations of the solids-not-fat in Stepney milk have been related to the extreme variations of the freezing-point. Table G. Original Milk. After dilution. Solidsnot-fat per cent. Freezing Point. Solidsnot-fat per cent. Minimum added water per cent. from S.-n.-F. Freezing Point. Minimum added water per cent. Hortvet. Actual water content per cent. 1 8.50 —0.565°C. 7.97 6.2 —0.530°C. None. 6.2 2 8.50 —0.530°C. 7.97 6.2 —0.497°C. 6.2 6.2 3 9.10 —0.565°C. 8.54 None. —0.530°C. None. 6.2 4 9.10 —0.530°C. 8.50 None. —0.495°C. 6.6 6.6 In the first case the solids-not-fat shows the presence of at least 6.2 per cent, added water, while the freezing point shows none and points to the possibility of the deficiency being due to natural causes. In the second case the maximum of added water is obtained in both methods of calculation. In the third case no added water is indicated by either test, although 6.2 per cent, is actually present. In the fourth case the solids-not-fat figure satisfies the Regulations though 6.6 per cent, added water is shown to be present by the freezing point. The last example shows the necessity of carrying out freezing point determinations although the sample is apparently satisfactory from the chemical analysis. Effect of sourness. I have often been questioned as to the time that had elapsed before the freezing point determination was made and as to whether the acidity had been determined, etc. Sourness actually increases the depression of the freezing point and any added water which might have been present would be either under-estimated or missed entirely. This would be to the advantage of the vendor. (Determinations are not in any case carried out on sour samples.) Sterilised and pasteurised milk. Elsdon and Stubbs (Analyst 1933, 58, 7) examined a number of samples before and after pasteurisation and sterilization and concluded that there is a slight tendency for the freezing point depression to be decreased when milk is heated but that the amount of change, when it takes place is too small to interfere with the value of the test. Heated milk from cafes, etc. Many of the samples of milk are taken from cafes in the Borough, and a high proportion of these samples are adulterated. Williams (Analyst 1936, 61, 246) has shown that the freezing point is unchanged except where evaporation has taken place. The depression is then increased and added water would be under-estimated. 85 It has been stated by the defence that it is a very terrible thing to condemn a sample of milk owing to a difference of one hundredth of a degree (equal to 1.9 per cent, of added water). This would be true if an ordinary household thermometer were used. The actual thermometer used is about 2 feet in length and there are only three degrees on the scale, one above zero and two below zero. Each degree is approximately 4 inches in length and is further sub-divided into tenths and hundredths. A tenth of a degree is about three-eighths of an inch in length, and one-hundredth of a degree is about equal to one degree on an ordinary thermometer. One hundredth of a degree can, therefore, be read easily by any one with the naked eye. Using a magnifier attached to the thermometer, the thermometer can be read accurately to one-thousandth of a degree (.001° C.) each way, i.e., .527 might be .526 or .528. This difference of .001 would represent 0.2 per cent, of added water. The apparatus is, therefore, accurate to 0.2 per cent, of added water. Accuracy of thermometer readings. Owing to the delicacy of the thermometer it is necessary to check any inequality of the thread or graduations. This is carried out by means of sugar solutions of known concentration. The extremes —0.422° C. and —0.621° C. are first checked. Obviously a slight inaccuracy is not important where the sample is heavily watered or in the case of genuine samples. The range is therefore shortened so as to ensure accurate results in cases where the amount of added water is small and determinations are made at a number of points within the range —0.487° C. to —0.537° C. Also, before a sample of milk is tested the zero point is always checked by determining the freezing point of boiled distilled water. Standardisation of the thermometer. Many questions are asked with regard to the rate of stirring, tapping the thermometer, super cooling, etc. It should surely be conceded that a trained chemist is capable of carrying out the test correctly according to the directions laid down. The Hortvet technique. Objections were raised by the defence because the determination of the freezing point had not been carried out by the public analyst himself. This involved the appearance of both my assistant and myself to give evidence. It is obvious that in a busy laboratory it is impossible for the public Analyst to carry out determinations on all samples which may or may not be genuine. In Bakewell v. Davis, 1894, where the analysis had been carried out by an assistant under the supervision of the Public Analyst, the judges were of opinion that the Public Analyst had analysed the sample within the meaning of the Act. Determination of Hortvet figure by assistant. When samples do not comply with the Sale of Milk Regulations proceedings are taken under Section 2 (1) of the Food and Drugs (Adulteration) Act, 1928, which states that "No person shall sell to the prejudice of the purchaser any article of food or any drug which is not of the nature or not of the substance or not of the quality of the article demanded by the purchaser." With the advent of the Hortvet test proceedings are taken also under Section 4 (1) of the Milk and Dairies (Amendment) Act, 1922, which states that "No person shall add any colouring matter or water to milk intended for sale and no person shall . . . sell, or offer or expose for sale any milk to which any such addition has been made." Legal procedure. 86 It is pleaded that the latter section is unfair as the defendant may not produce a warranty, neither has he the right to have the third part analysed by the Government Chemist, nor is he entitled to a copy of the certificate. With regard to these points, the Government Chemist could not possibly check the Hortvet as the milk would be sour ; a copy of the certificate is always sent to the defendant. It seems plain that the section was intended to be used when the prosecution was not depending on an analysis of the milk but had other means of proving that water had been added. (The freezing point method was not in use in this country at the time of this Act.) All milk purveyors in Stepney have, however, been circularised by the Medical Officer of Health to the effect that the Council may rely in milk prosecutions 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. [Lockwood (Analyst 1932, 57, 698) describes a preservative solution of a particular concentration which can be used to keep a sample for several days. It is stated that no other borough takes legal proceedings on the Hortvet only, when the sample otherwise satisfies the Regulations. I am unaware of the action taken by other boroughs, but similar cases are taken in the provinces. That the amount of added water is trivial. As previously explained, the certificate states the minimum amount of added water which is definitely present. In most cases the actual figure will be 2 or 3 per cent, higher than this. It is not a question, as has been put to me, of the amount of added water that would be present in a cup of milk, but a question of possibly a thousand or more gallons of milk involving the sale of tens of gallons of water daily. That the Hortvet method is not described as an official method by any Re lation. Under the Food and Drugs Act the analyst is free to use any method in order to detect adulteration. There are no official methods of analysis which he is bound to follow. (Official methods are laid down in the Fertilisers and Feeding Stuffs Act, the bacteriological examination of graded milks, etc.) It is also pointed out that since the Monier Williams report on the freezing point of milk to the Local Government Board in 1914, the method has not been taken up by the Ministry of Health. Cost of the Hortvet test. It is objected that the milkman has to pay a higher fee to the analyst for carrying out the Hortvet test. I understand that unqualified chemists charge Is. 6d. for a mechanical analysis of a sample and 10s. 6d. for the Hortvet test, the fee being reduced for a number of tests made at the same time. Other determinations. Elsdon (Analyst 1934, 59, 665) examined samples of colostrum obtained by milking cows following parturition and obtained a range of —0.541° C. to -0.590 °C. Page (Annual Report, Portsmouth, 1933) examined 22 samples of human milk and obtained a range of —0.532° C. to —0.566° C. He also obtained a range of —0.553° C. to —0.571° C. on four samples of goats' milk. A large number of determinations of the freezing point of cows' milk have been made, and a depression of 0.530° C. is generally accepted as a basis for calculating the minimum amount of added water in milk. 87 Addendum.—The above article outlined the position with regard to the Hortvet figure for the year 1936. Recently analysts have obtained depressions of less than 0.530° C. in the case of single cows, and such figures have been quoted in Court. It will probably be necessary therefore to use the Hortvet as a confirmatory test only until the matter has been investigated. The average composition of the samples of milk, genuine and adulterated, received during the year is shown below. The seven " appeal to cow" samples and five samples from the Borough of Hackney, are not included. Table E. Month. Number examined. Fat per cent. Solids-not-fat per cent. Total Solids per cent. January 80 3.61 8.76 12.37 February 74 3.41 8.70 12.11 March 92 3.38 8.70 12.08 April 68 3.40 8.67 12.07 May 86 3.27 8.76 12.03 Tune 84 3.30 8.76 12.06 July 83 3.56 8.71 12.27 August 81 3.62 8.70 12.32 September 81 3.54 8.71 12.25 October 92 3.69 8.83 12.52 November 75 3.71 8.79 12.50 December 88 3.56 8.74 12.30 Whole Yean 984 3.50 8.74 12.24 Legal Minimum - 3.00 8.50 - It will be seen that the best quality milk was supplied, as is usually the case, in the months of October and November. Although the percentage composition of the milk is not as high as it should be, it must be remembered that 85 adulterated samples are included in the above table. Also the Sampling Officers follow up poor or suspicious milk supplies so that many samples of poor quality obtained in this way will also have some effect in lowering the average composition. The yearly averages including adulterated samples are given in the following table :— Table F. Year. Fat per cent. Solids-not-fat per cent. Total Solids per cent. 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 1936 3.50 8.74 12.24 88 Poor quality milk samples. Where possible, freezing point determinations are carried out on all samples of milk in which the percentage of solids-not-fat, though satisfying the Regulations, appears to be suspiciously low. All samples containing a minimum of 1 per cent, or over of added water are reported as adulterated. Other samples which are outside the Hortvet range, but contain less than a minimum of 1 per cent., are reported as being of suspicious character. During the year, 19 samples of this type were examined. Hospitals, etc., samples. 17 samples of milk were taken on delivery for chemical examination from six institutions in the Borough. The average composition of the milk was : Fat, 3.41 per cent., and solids-not-fat, 8.80 per cent. School samples. 40 samples of milk were taken on delivery at 38 schools in the Borough. The average composition of the samples was : Fat, 3.48 per cent., and solidsnot-fat, 8.79 per cent. Bread and butter 43 samples, consisting of either bread and butter or rolls and butter, were examined. Of these, 2 samples of bread and butter and 4 samples of rolls and butter were adulterated. C 140. Rolls and butter. The fat consisted entirely of margarine. Discharged under the Probation of Offenders' Act. B 288. Bread and butter (Informal). The fat consisted entirely of margarine. B 535. Bread and butter (Informal). The fat consisted of margarine. B 539. Rolls and butter (Informal). The fat consisted of margarine. B 588. Rolls and butter. The fat consisted of margarine. Vendor fined £2, with £2 2s. Od. costs. B 589. Rolls and butter. The fat consisted of margarine. Vendor fined £2, with £2 2s. Od. costs. Cream. 14 samples of cream examined were genuine. In 7 of these samples the fat ranged from 39.4 per cent, to 54.4 per cent., with an average of 49.8 per cent. In the remaining 7 samples the fat ranged from 20.0 per cent, to 25.9 per cent., with an average of 23.fi per cent. 3 of the latter samples consisted of tinned cream, and 4 were sold loose as half-price cream. Condensed and dried milk. 4 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 label. Cream Cheese. 9 samples of cream cheese were examined, and of these 5 samples were unsatisfactory. B 570 (Informal). Consisted of soft cheese containing 10.8 per cent, of fat, made from partially skimmed milk. B 571 (Informal). Whole milk soft cheese containing 19.6 per cent, of fat. B 590. Soft cheese containing 8.4 per cent, of fat, made from partially skimmed milk. Vendor cautioned. 89 B 591. Soft cheese containing 0.5 per cent, of fat, made from separated milk. Vendor cautioned. B 710 (Informal). Whole milk soft cheese containing 19.4 per cent of fat. With regard to the above samples the Public Health Committee authorised the Medical Officer of Health to circularise all purveyors of cream cheese in the Borough. The circular stated that cream cheese should contain not less than 35 per cent, of fat and that it was a contravention of the provisions of the Food and Drugs (Adulteration) Act, 1928, to sell soft cheese containing a less amount of fat as cream cheese. Since this notice was circulated many vendors have stated when cream cheese was asked for, either that they had none or that they only supplied soft cheese. The standard given is arrived at in the following way. According to a leaflet published by the Ministry of Agriculture and Fisheries there are two varieties of cream cheese manufactured. Double Cream Cheese, made from cream containing about 50 per cent, of fat, and Single Cream Cheese made from cream containing 25 to 30 per cent, of fat. One gallon of cream containing 50 per cent, of fat makes 32 one-quarter pound double cream cheeses. One gallon of cream containing 25 to 30 per cent, of fat makes 24 one-quarter pound single cream cheeses. From these figures the percentage of fat in the final product can be calculated from the weight of cheese obtained from the weight of one gallon of each kind of cream. On this basis the percentage of fat in double cream cheese made from cream containing 50 per cent, of fat should be 61 per cent., and the percentage of fat in single cream cheese made from cream containing 30 to 25 per cent, of fat should be 50 and 42 per cent, respectively. I have, therefore, adopted a minimum standard of 35 per cent, of fat in cream cheese in Stepney and consider this figure to be a reasonable one. Out of 6 samples of chocolate cakes examined 3 samples were returned as adulterated. C 174 (Informal). Contained 1.1 per cent, of dry fat-free cocoa material. C 175 (Informal). Contained 0.5 per cent, of dry fat-free cocoa material. C 176 (Informal). Contained doubtful traces of cocoa material. Chocolate Cakes. Further samples of the same kind of cakes were not obtainable. To have a reasonable taste of chocolate, cakes should contain 4 per cent, of dry fat-free cocoa material. 5 samples of ice cream were examined. Two of these described as cream ice were free from starch and contained 19.3 and 19.7 per cent, of milk fat respectively. The remaining samples sold as ice cream contained starch and 2.4 2.5 and 3.5 per cent, of milk fat respectively. There is no legal standard controlling the composition of ice cream but it is however generally agreed that a milk fat standard of about 7 per cent, would be a reasonable one. Ice Cream. 2 samples of jam out of 6 examined were unsatisfactory. Jam. 90 B 644. Black currant jam (Informal). Contained 24 parts per million sulphur dioxide in excess or 1.6 times the permitted quantity. B 671. Black currant jam (same vendor as B 644). Contained 16 parts per million sulphur dioxide in excess or 1.4 times the permitted quantity. Vendor cautioned. Lard. Out of 10 samples of lard analysed one sample was adulterated. C 619 (Informal). Contained 8.5 per cent, of water. A further formal sample was genuine. Minced Meat. Out of 19 samples of minced meat 3 samples contained preservative. Sulphur dioxide is prohibited in meat. A 36. Contained 1,250 parts sulphur dioxide per million. Vendor fined £2. A 45. Contained 375 parts sulphur dioxide per million. Vendor fined £5, with £2 2s. Od. costs. A 51. Contained 290 parts sulphur dioxide per million. Vendor fined £5, with £2 2s. Od. costs. Sago. 4 out of 6 informal samples of sago consisted of a mixture of sago and tapioca. No further samples 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. Soda Water. 3 samples of soda water were analysed. 2 of these contained 7.3 and 8.1 grains of sodium bicarbonate per pint respectively ; the remaining sample consisted of aerated tap water. There is no definite standard for sodium bicarbonate in soda water. It is generally admitted that a reasonable standard is 10 grains sodium bicarbonate (the cost of which is slight) per pint of soda water, and many mineral water manufacturers conform fairly closely to that standard, the sodium bicarbonate varying from 5 to 10 grains per pint. The soda free article is usually cheap and probably satisfies many purchasers, but it should be labelled "Aerated water," or the absence of sodium bicarbonate declared. Spirits. 11 samples of whisky, 6 samples of gin, 3 samples of brandy and 2 samples of rum were analysed. Of these, 1 sample of whisky and 2 samples of gin were adulterated. B 332. Whisky. Contained 1.8 per cent, excess water. Vendor cautioned. B 449. Gin (Informal). Contained 1.5 per cent, excess water. B 500. Gin (Informal). Contained 2.8 per cent, excess water. Further formal samples taken from the vendors of these samples were of poor quality, containing 1.0 and 0.8 per cent, excess water respectively. Sweets. 10 samples of various kinds were genuine. 4 of these samples contained sulphur dioxide in amount less than the permitted quantity. In 2 of these cases—"Clear Mints"—the sweets were hard and had been made from cane sugar and glucose, and contained 190 parts of sulphur dioxide per million. Cane sugar and solid glucose may contain 70 parts sulphur dioxide per million and liquid glucose may contain 450 parts per million. Although the sweets 91 were hard it was clear from the optical activity that liquid glucose must have been used and therefore the sweets complied with the Regulations. It was afterwards found that certain proportions of cane sugar and liquid glucose had been taken and the mixture heated down to a certain weight. 3 samples out of 7 samples of vinegar examined were adulterated. Onlj 1 of the samples was a fermentation product, the remaining samples consistec of dilute acetic acid coloured with caramel. B 27. 29.5 per cent, deficient in acetic acid. Vendor cautioned. C 748 (Informal). 6.3 per cent, deficient in acetic acid. C 762 (same vendor as C 748). 6.8 per cent, deficient in acetic acid Vendor cautioned. Vinegar. Of 127 drugs analysed, 9 or 7.1 per cent, failed to comply with the requirements of the British Pharmacopoeia or the Codex, and were returned as adulterated. Drugs. Liniment of Turpentine. B 117 (Informal). 50 per cent, deficient in turpentine and 100 per cent, deficient in camphor. B 119 (Informal). 61.5 per cent, deficient in turpentine and 100 per cent, deficient in camphor. B 160. 61.5 per cent, deficient in turpentine and 100 per cent, deficient in camphor. Summons dismissed. It was stated for the defence that the sample had been sold as White Liniment and not as Liniment of Turpentine, and this statement was accepted. Ammoniated Quinine Tablets. B 516 (Informal). 91.0 per cent, deficient in ammonia. Ammoniated Quinine and Cinnamon Tablets. B 518 (Informal). 91.6 per cent, deficient in ammonium carbonate. B 534 (same vendor as B 518). 91.6 per cent, deficient in ammonium carbonate. Vendor cautioned. Each tablet was stated to be equivalent to 1 drachm of ammoniated tincture of quinine and to contain 1.10 grains of quinine sulphate and 0.24 grain of ammonium carbonate. The tablets actually contained 0.02 grain of ammonium carbonate. To be comparable with ammoniated quinine each tablet should contain 1.7 grains of ammonium carbonate. The content of quinine sulphate was found to be as stated. Magnesia. C 497. Light Magnesia (Informal). Consisted entirely of magnesium carbonate. C 727 (same vendor as C 497). Consisted entirely of magnesium carbonate. Vendor cautioned. Carbolic Ointment. B 451 (Informal). 29.2 per cent, deficient in phenol. No further sample was taken. The above deficiency was obtained after allowing a loss of 0.5 per cent. phenol during manufacture. 92 (In 3 cases at the West London Police Court in which the deficiencies, after making the same allowance, were 38, 21 and 25 per cent, respectively, the summonses were dismissed and 2 guineas costs awarded in each case.) Poor quality Samples. These comprise samples of inferior grade or of doubtful character and are 30 in number. 19 of these consisted of milk. Other poor quality samples were : Flour (3), butter (3), gin (2), rice (2) and lard. Offences other than Adulteration. Milk.—-Proceedings were taken against 4 vendors who were not registered for the sale of milk. Convictions were obtained in each case, the fines totalling £9, and the costs £5 5s. Od. For the omission of the name and address on the can, etc., two vendors were fined 10s. and £1, with £1 Is. Od. costs respectively. For filling or tampering with the caps of bottles in the street 5 vendors paid a total of £1 in fines, and £5 5s. Od. costs. For labelling ordinary milk " Tuberculin Tested," one vendor was fined £3, with £2 2s. Od. costs. For selling pasteurised milk without labelling the churn, one vendor paid £3 3s. Od. costs. For obstructing the Sampling Officer, one vendor paid £1 Is. Od. costs. Ice Cream.—One vendor who was not registered was fined 10s., with 10s. 6d. costs. Miscellaneous Samples. 241 samples were submitted for analysis. Included amongst these samples are 7 "Appeal to cow" samples, and 5 samples of milk from the Borough of Hackney. These have been referred to previously. Of the remaining 229 samples, 207 were foods, and of these, 58 or 28.0 per cent, were unsatisfactory. Public Health Department.—216 samples submitted by the Public Health Department comprised the following :— Metallic Contamination— 79 samples were examined, and of these 22 were unsatisfactory. Satisfactory samples were : Canned Crab (1), examined for aluminium ; Glace Cherries (4), examined for copper ; Tomato Puree (6), examined for tin and copper ; Tinned Sild (2), Tinned Sardines (3), Tinned Brisling (1) and Tinned Herrings (1), examined for lead ; Tinned Sild (24), Tinned Prunes (9), Tinned Crab (3), Tinned Brisling (2) and Tinned Oranges (1), examined for tin. Unsatisfactory samples were: Tinned Norwegian Sild (12) (contained 2.3, 2.5, 2.8, 2.3, 2.5, 3.1, 3.1, 3.6, 3.8, 3.3, 3.1 and 3.4 grains tin per lb. respectively), Tinned Australian Prunes (3) (each contained 2.1 grains tin per lb.) and Tinned Portuguese Sardines (7) (contained 30, 35, 30, 45, 30, 40 and 30 parts lead per million). Preservatives— 67 samples were examined, and of these 12 were unsatisfactory. Satisfactory samples were : 93 (a) Wine (11), Sultanas (6), Danish Mustar (5), Muscatels (1), Vegetable Extract (1) and Tinned Peas (1). The above contained no preservative. The samples of Danish Mustard were stated to contain 150 parts sulphur dioxide per million. During the analysis it was found that appreciable amounts of sulphuretted hydrogen were evolved but no trace of sulphur dioxide was detected. (b) Sultanas (19), Raspberry Pulp (6) and Raisins (5). The above contained preservative in amount less than the permitted quantity. Unsatisfactory samples were: Wine (7) (contained from 100 to 250 parts sodium fluoride per million. This had been added in mistake for potassium metabisulphite), and Tinned Danish Sea Salmon (5) (contained 54, 64, 59, 56 and 64 parts benzoic acid per million respectively). Fit for Food— 23 samples examined with regard to their fitness for human consumption were :— Satisfactory samples: Wood Vinegar, Malt Vinegar, Bread and Tinned Crayfish. Unsatisfactory samples: Shelled Walnuts (8), Butter (5) (very rancid), Dressed Crab (2), Soft Sugar (1) (contained 0.17 per cent, yellow ochre), Tinned Crab (1), Sugar (1) (contained 13.2 per cent, paraffin wax) and Chocolate Jellies (1). (In the case of the rancid butter, fines of £5 and £2, with £5 5s. Od. costs were imposed.) Metallic Contamination and Preservative— 2 samples of Tinned Peas examined for copper and preservative were satisfactory. Satisfactory samples examined for tin and preservative were : Soft Sugar (8), Demerara Sugar (3), Black Currant Pulp (1), and Apricot Pulp (1). Unsatisfactory samples were: Barbadoes Soft Sugar (2) (one containing 104 parts sulphur dioxide per million and the other 138 parts sulphur dioxide per million and 2.5 grains tin per pound. Export— 8 samples of Olive Oil for export were genuine. Cause of Illness— 7 samples, said to have caused illness, consisted of: Lemonade Powders (3), Gherkins, Jam, Lemonade and Condensed Milk. All were free from harmful ingredients or impurities. Other Samples— 3 samples of formalin complied with the requirements of the specification ; one sample of drainage water was free from sewage; one sewer deposit was free from harmful matter and one sample of condensed milk was incorrectly labelled. 94 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. 2 formal and 4 informal samples complied with the Regulations. Pharmacy and Poisons Act— Two samples of Pine Disinfectant and one sample of "Nonpoisonous Fluid " were satisfactory. Borough Engineer.—7 samples comprised: Carbolic Powder 4, and Cold Bitumen 3. Public Cleansing Officer.—1 sample of Carbolic Powder was examined. Private Samples.—5 samples consisted of: Mineral Water (smell of petrol), Tinned Sealachs (free from benzoic acid), Milk (3.3 per cent, deficient in fat), Jam and Kaola (free from deleterious substances). I wish to express my appreciation of the able assistance given me throughout a year's record work 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.8. June, 1937. 95 VI.—PREVALENCE OF, AND CONTROL OVER, INFECTIOUS AND OTHER DISEASES. 2,541 notifications (other than of tuberculosis) were received, or 1,096 more than in the previous year; of these, 1,383 referred to cases of measles. The notification rate for the whole Borough was 12.2 per 1,000 of the population. Notifications. 496 cases were notified daring the year, or 54 more than in the previous year. 485 of these cases were removed to hospital. There was one death from scarlet fever during the year. The death rate for the whole Borough was .004 per 1,000 of the population. Scarlet Fever. 471 cases were notified during the year, or 224 less than in the previous year. 466 of these cases were removed to hospital. The death rate for the whole Borough was .05 per 1,000 of the population. There were 11 deaths of which 10 were of children from 1 to 5 years of age, and 1 child over 5 years of age; the case mortality was 2.3 per cent., the same as in the previous year. Diphtheria. This serum is supplied on request to the general practitioners of the Borough. During the year 29 tubes, each containing 4,000 units, were issued from the Public Health Office. Anti- Diphtheritic Serum. A clinic for the active immunisation against diphtheria was opened on 5th June, at 35, Stepney Green, under the personal clinical supervision of Dr. King-Brown. The figures below show that in its first half-year the clinic has fully justified its establishment and has been well patronised. The method of immunisation adopted by Dr. King-Brown and approved by Dr. Guy Bousfield, the Honorary Advisory Expert to the clinic, is as follows: A preliminary visit when the Schick test for susceptibility to diphtheria is performed, and a visit after one week to read the result of the test. If the reading shows that the subject is naturally immune to diphtheria he is given a certificate to that effect and no further action is taken. If susceptible, three minute inoculations of toxoid-antitoxin mixture (T.A.M.) are given at intervals of one week. Six weeks later a final Schick test is performed and read a week later to ascertain if successful immunity has been established. If so, a certificate of immunity is presented to the individual concerned. If still susceptible, a second course of immunising inoculations may be required, but it is only very rarely that this is found necessary. The method of immunisation described is well established and has been proved to be entirely harmless, and moreover causes no discomfort or inconvenience. In connection with the clinic, a series of accurate records of cases are being kept by the clerk at the clinic, and these will be checked with the weekly notifications of diphtheria. The immunisation established is known to last for many years and it can be said that those immunised very rarely contract diphtheria and should they do so, they are most certainly protected against death from the disease. Cases attending the clinic are followed up by the Borough Health Visitors in order to ensure that they complete the course. Those who leave the Borough before the completion of their course can, in many cases, be referred for continuation treatment to the public health department concerned. All immunisation at the clinic is now given free. The clinic is held every Friday at 2 p.m. Diphtheria Immunisation. 96 As occasion arises, facilities are provided by which the medical officer visits the various day nurseries in the Borough to immunise children on the desire of the parents being so expressed. (a) Total number of clinics held 23 (J) Total number of all attendances of children at same (either for Schick or Immunisation) 339 (c) Number of Primary Schick tests 127 (d) Number of Final Schick tests 16 (e) Number of Immunisation Inoculations given 230 (/) Number of Immunisation Certificates given 14 (,g) Number of individual children on the register of the clinic during the year 120 (h) Number aged 12 months and under when they made first attendance 13 (») Number aged 1 year to 6 years inclusive when they made first attendance 85 (j) Number aged 6 years to 14 years inclusive when they made first attendance 22 (k) Number of adults, viz., from 15th birthday upwards who attended Nil (I) Number who failed to return for reading of first Schick ... 6 (m) Number who began but failed to complete their immunisation doses 6 (n) Number who failed to come for final Schick (or for reading of final Schick) 6 (o) Number found immune after first Schick and not therefore inoculated 24 (p) Number found to be still susceptible after one complete course Nil (q) Number of latter given a second course Nil (r) Number of (q) found immune after second course Nil (s) Number still in course of treatment at end of year and not yet completed 54 (it) Number of cases of diphtheria occurring in the Borough during the year who were found to have been supposedly immunised at the Borough clinic at any time Nil Typhoid Fever. There were 4 cases notified during the year. All were removed to hospital. There were no deaths. Small Pox. No cases of small pox were notified during the year and it was not found necessary for me to take action under the Public Health (Small Pox) Regulations, 1917. Acute Poliomyelitis No cases of acute poliomyelitis were notified. Encephalitis Lethargica. No cases were notified during the year. Cerebrospinal Meningitis. 5 patients were notified during the year, of which 3 died. The death rate for the whole Borough was .01 per 1,000 of the population. 97 There were 12 cases notified as against 6 in the previous year. 8 cases were removed to hospital. Ophthalmia Neonatorum. 2 cases of puerperal fever and 36 cases of puerperal pyrexia were notified during the year, the same number of cases as in the previous year. All these cases were duly investigated and there were 2 deaths. 36 cases were removed to hospital. Puerperal Fever and Puerperal Pyrexia. 201 cases of Pneumonia, and 17 of Dysentery were notified under the Regulations during the year. There were 181 deaths from Pneumonia, or 18 more than in the previous year. 88 of these were in persons over 45 years of age. No cases of Malaria were notified. Pneumonia Malaria and Dysentery Regulations. 71 cases of infectious diseases removed to hospital were found not to be suffering from the disease stated on the certificate. Of these, 20 were cases of scarlet fever, 48 of Diphtheria, 2 of Dysentery, and 1 of Enteric Fever. 23 cases were notified by private practitioners and 48 were from public institutions. Wrong Diagnosis. 8 cases were notified. Food Poisoning. 98 NOTIFIABLE DISEASES (OTHER THAN TUBERCULOSIS) DURING THE YEAR, 1936. Disease. Total Cases Notified. In .4Gk Groups. Cases admitted to Hospital Total Deaths. Under 1 year. 1— 2— 3— 4— 5— 10— 16— 20— 35— 45— 65 and over Total Smallpox — - — — — — — — - - — — - — — Scarlet Fever 5 28 57 49 58 176 57 17 44 3 2 — 496 485 1 Diphtheria 18 31 40 53 48 186 54 13 24 — 3 1 471 466 11 Enteric Fever — 1 — 1 — — 1 — — — — 1 4 4 — Measles 95 255 216 359 458 - - - - - - - 1,383 242 52 Puerperal Fever — — — — — — — 1 1 — — — 2 2 2 Puerperal Pyrexia - - - - - - - 2 23 11 — — 36 34 — Erysipelas 2 — 1 1 1 2 8 5 19 19 42 19 119 70 2 Encephalitis Lethargica — — — — — — — — 1 — — — 1 1 4 Cerebrospinal Fever - - - - - 1 — 1 3 — — — 5 5 3 Ophthalmia Neonatorum 12 - - - - - - - - - - - 12 8 — Food Poisoning - 1 — — — 1 1 1 3 1 — — 8 1 — Polio-myelitis - - - - - - - - - - - - - - - Polio-encephalitis - - - - - - - - - - - - - - - Membranous Croup — 1 — 3 — — — — — — — — 4 4 — Dysentry 2 4 3 1 2 3 — — 2 — — — 17 17 2 Malaria — — — — — — — — — — — — — — — Pneumonia 9 IS 17 11 12 25 12 12 22 19 33 H 201 59 181 Totals 143 339 334 481 679 394 133 62 142 63 80 29 2,769 1,398 258 99 The number of deaths was 22, or 16 more than in the previous year. 21 of these occurred in children under 5 years of age (12 of them under 1 year). The death rate was .10 per 1,000 of the population. Whooping Cough. There were 106 deaths, 52 more than in the previous year. 96 of these deaths, or 90.5 per cent., were in children under 1 year of age. Diarrhoea. I he death rate Was .51 per 1,000 of the population. The total deaths from diseases of a Zymotic character was 192, or 115 more than in the previous year. They include all deaths from Small Pox, Scarlet Fever, Diphtheria, Typhoid Fever, Measles, Whooping Cough and Diarrhoea. The increase being due to Measles and Diarrhoea. Zymotic Diseases. The death rate was .92 per 1,000 of the population. The number of deaths was 16, or 2 more than in the previous year. As usual these occurred in elderly persons. The death-rate for the whole Borough was .07 per 1,000 of the population. Influenza. The number of deaths from cancer was 304, or 29 less than in the previous year. The death-rate for the whole Borough was 1.4 per 1,000 of the population. 29 were under 45 years of age—14 males and 15 females. 123 were between 45 and 65 years of age—67 males and 56 females. 102 were between 65 and 75 years of age—56 males and 46 females. 50 were 75 vears of age and over—19 males and 31 females. Cancer. The organs and parts of the body affected were as follows :— Male. Female. Mouth, Throat and alimentary canal.. 32 14 Other abdominal organs 61 56 Generative organs 2 5 Breast — 20 Skin 1 — Lung and Pleura 18 9 Bones — 2 Other specified Organs 39 40 Other undefined 3 2 Totals 156 148 There were 786 deaths from Heart disease (412 males and 374 females) or 82 more than in the previous year. The death-rate for the whole Borough was 3.7 per 1,000 of the population. Heart Disease. The number of deaths from diseases of the Respiratory Organs (excluding Tuberculosis) was 268 or 7 more than in the previous year. The death-rate for the whole Borough was 1.2 per 1,000 of the population. Diseases of the Respiratory Organs. 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 133 adults were sent to Bethnal Green and 111 children to the L.C.C. Bathing station. Scabies. 212 persons were cleansed during the year and had their clothing disinfected—211 adults and 1 child. 210 were cleansed because of vermin and 2 because of infectious disease. Cleansing and Disinfection. 3,802 rooms were fumigated and the bedding, etc., removed and disinfected by steam. Of these, 1,798 rooms were fumigated because of infectious disease, 321 as a result of pulmonary tuberculosis, and 1,683 because they were verminous. In addition to these, scabies occurred in 791 families and the bedding was taken away and disinfected by steam. 100 I he 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 34,473. The total number of articles disinfected for all Durnoses was 62.540. Bug Eradication. The building of the special chamber at 42, Narrow Street, for the use of hydrogen cyanide gas was completed during the year and came into operation on the 23rd October, 1936. Thfe furniture and effects of 90 families were treated there before being re-housed. In addition, 28 families were similarly treated by fumigation contractors before the chamber was ready for use. The construction of the chamber entailed much work of a detailed and experimental nature and was carried oat by the Building Works Department, and tribute must be paid to the Borough Engineer and Surveyor and his staff who, by their keenness and co-operation did much to ensure its success. Briefly the scheme operates as follows:— The Housing Manager notifies this Department that certain families are to be rehoused in flats allotted to them and that he has made arrangements for their removal with the Council's furniture removal contractor. They are then visited a few days previously by the Sanitary Inspector, who explains the scheme and what is required of them to secure its successful operation. The furniture vans are loaded (usually 3 families to a van) under supervision and driven to the chamber where each van is under gas for 3 hours, and after the van has been freed of gas, driven off to the new home. Bedding is dealt with separately through the steam disinfector. In addition to families that are rehoused from Slum Clearance Areas, all persons transferred in Council flats are now treated similarly. Two Disinfectors and one Relief Disinfector were appointed from the existing staff and transferred to operate the scheme under the supervision of the Specialist Sanitary Inspector in charge of Disinfestation. It is pleasing to be able to report how willing the public are to assist the Health Department in its efforts to eradicate vermin, and up to date there have been no failures or re-infestations. The initiation of this scheme has aroused considerable interest in Public Health circles and Health Officials from places as far as Bombay, Irak, and Port Sudan, have visited the chamber. (1) The number of :— (a) Council houses— (i) found to be infested, 783 ; (ii) disinfested, 783. (ib) Other houses— (i) found to be infested, 417. (ii) disinfested, 414. (2) The methods employed for freeing infested houses from bed bugs— (a) Stripping of woodwork, where necessary, and application of blow lamp to same, and fumigation with sulphur dioxide. (b) Spraying with insecticides. (3) The methods employed for ensuring that the belongings of tenants are free from vermin before removal to Council houses :—• All furniture and effects fumigated with H.C.N. Bedding dealt with separately by steam disinfection. (4) Whether the work of disinfestation is carried out by the local authority or by a contractor : Local authority. interior of bug disinfestation chamber showing inspection window and tin opener facing same. the tin opening apparatus is worked from the exterior of the chamber, the tin containing zyklon fumigating material. the large pipe is inserted in the furniture van for extracting gas after fumigation. BUG DISINFESTATION CHAMBER FOR HYDRO-CYANIC FUMIGATION SHOWING EXTRACTION KAN AND AIR DUCTS. THE CHAMBER ACCOMMODATES FURNITURE vAN COMPLETE WITH FURNITURE AND IS FITTED WITH A. GAS-TIGHT DOOR AND INSPECTION WINDOWS. 101 Ministry of Health. Form T.157 1936. PART I —Summary of Notifications during the period from the 1st January, 1936, to the 31st December, 1936, in the area of the Metropolitan Borough of STEPNEY. Age periods Formal Notifications. Number of Primary Notifications of new cases of Tuberculosis Total Notifications. 0— 1— 5— 10— 15— 20— 25— 35— 45— 55— 65— Total (all ages) Pulmonary Males 1 - 2 4 13 22 42 37 28 29 17 195 222 „ Females — 2 3 2 15 20 27 8 4 5 2 88 102 Non-pulmonary Males — 4 3 3 3 6 6 1 2 4 — 32 34 „ „ Females 1 6 5 3 1 5 5 - 2 - 1 29 29 Public Health (Tuberculosis) Regulations, 1930. SUPPLEMENTAL RETURN. PART II.—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- 25- 35— 45— 55— 65— Total Pulmonary Males 1 - — — — 2 8 5 3 3 1 23 „ Females — - — — 1 1 9 2 1 — 1 15 Non-pulmonary Males — 2 1 2 2 1 - - - - - 8 „ „ Females 1 - 1 - 1 - 1 - 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 1 - transferable deaths from Registrar General — — Posthumous notifications 12 4 "Transfers" from other areas (other than transferable deaths) 25 9 Other Sources ~~ - PART III. NOTIFICATION REGISTER. Number of cases of Tuberculosis remaining at the 31st December, 1936, on the Registers of Notifications kept by the Medical Officer of Health. Pulmonary Non-pulmonary Total Cases Males Females Total Males Females Total 1032 590 1622 301 213 514 2,136 Number of cases removed from the Register(s) during the year by reason inter alia of:— 1. Withdrawal of notification 7 3 10 1 - 1 11 2. Recovery from disease 14 14 28 10 7 17 45 3. Deaths 94 49 143 6 7 13 156 T.B. Patients who died from other diseases 13 4 17 1 1 2 19 102 New Cases of Tuberculosis and Mortality. Particulars of new cases of tuberculosis and of all deaths from the disease in Stepney during 1936. Age Periods. New Cases. Deaths. Pulmonary. Non-Pulmonary Pulmonary. Non-Pulmonary M. F. M. F. M. F. M. F. 0 1 - - 1 - - 1 1 1 — 2 4 6 — — 2 2 5 2 3 2 5 — — — — 10 4 2 3 3 — — — 2 15 13 15 3 1 3 7 — — 20 22 20 6 5 10 11 1 — 25 42 27 6 5 16 9 — 1 35 37 8 2 — 16 7 — — 45 28 4 2 - 16 4 — 1 55 29 5 4 - 21 6 — — 65 and upwards 17 2 — 1 12 5 2 Totals 195 88 32 29 94 49 6 7 Public Health (Prevention of Tuberculosis) Regulations, 1925. The death rate for the while Borough was .75 per 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. Incidence of Tuberculosis in various occupations. Power is given to the Council to cause such persons to discontinue their employment. It was not found necessary to take action under the regulations during the year. Occupation. New Cases Notified. Deaths Occupation. New Cases Notified. Deaths Artist 2 1 Brewery Worker 2 2 Art Student 1 — Bricklayer 1 — Bandsman 1 — Brushmaker 1 — Barmaid 2 — Butcher — 2 Barman 2 1 Buttonmaker 1 — Biscuit Packer — 1 Cabinboy 1 — Blacksmith 1 — Cabinet Maker — 1 Boiler Maker — 1 Caneworker 1 — Bookkeeper 1 — Canvasser 2 — Bookmaker's Clerk 1 — Caretaker 1 — Bootmaker 3 — Carman 2 2 Boot Polisher — 1 Casemaker 1 — Bottlewasher 1 — Chairmaker 1 — Boxmaker 3 — Chauffeur — 1 103 Occupation. New Cases Notified. Deaths Occupation. New Cases Notified. Deaths Checker 2 — Housekeeper 1 — Children under 5 years 11 4 Housewife 31 18 Cinema Attendant 1 2 Ice Cream Vendor 1 — Clerk 6 1 Kitchen Porter — 1 Coach Painter 2 1 Labourer 25 11 Coalman 2 — Ladies' Tailor — 2 Commercial Traveller — 1 Laundress 1 — Compositor 1 1 Leather Trunk Maker — 1 Confectioner's Assistant — 1 Lighterman 1 — Cook 1 — Lorry Driver 3 — Cooper — 1 Machinist 5 — Cooper's Assistant — Malingerer 1 — Crackermaker 1 — Margarine Factory Worker 1 - Cutter 1 — Dairy Porter 1 — Market Porter 4 — Decorator 1 — Metal Merchant's Labourer - 2 Department Manager 1 — Dock Labourer — 12 Miller 1 — Domestic Servant 9 1 Milliner 2 — Dressmaker 5 3 Motor Driver 1 — Dyer's Presser — 1 Musician 2 1 Electrician 2 — Newsagent — 1 Electrode Wirer — 1 Newsvendor 2 1 Engineer 2 — Night Porter 1 — Engineer's Draughtsman — 1 No occupation 15 17 Engineer's Mate — 1 Nurse 4 — Engineer's Mercantile Marine - 1 Nursemaid 1 — Office Cleaner 1 — Felling Hand — 1 Omnibus Conductor 1 — Fishmonger 1 — Packer 1 1 Flower Carrier 1 — Paper Pattern Cutter 1 1 Fountain Pen Maker 1 — Pedlar 4 2 Fur Nailer — 1 Pensioner 1 — Fur Skin Dresser — 1 Plumber 1 1 Furniture Hand 1 — Plumber's Labourer — 1 Furrier 4 1 Porter 3 — Grocery Packer 1 1 Potman 1 — Gas Fitter 1 — Poultry Farmer 1 1 Hairdresser 3 — Presser 7 — Hairdresser's Assistant — 1 Printer 3 — Handyman 1 — Printer's Assistant — 1 Hawker 2 2 Rabbi 1 — Horseflesh Dealer — 1 Rag Sorter 3 — Horsekeeper 1 — Road Sweeper — 1 Hosiery Salesman — 1 Salesman 3 — Hospital Attendant — Saleswoman 2 — Hotel Porter 1 — Scholar 23 2 House Painter — 1 Schoolmaster 1 - 104 Occupation New Cases Notified. Deaths Occupation. New Cases Notified. Deaths School Cleaner — 1 Tinner 1 — Seaman 21 6 Tobacco Stripper 1 — Ship's Butcher 1 — Transport Worker 1 — ,, Fireman 1 — Traveller 2 — ,, Steward 2 3 Travelling Showman 1 — Shoe Sewer — 1 Van Boy 2 — Shop Assistant 1 — Waiter 1 — Shopkeeper 1 — Waitress 1 — Stallholder 1 — Warden 1 — Stationer's Assistant 1 — Warehouseman 3 — Stevedore 2 1 Waterman 1 — Stock-keeper 1 — Wholesale Merchant 1 1 Stoker 2 — Window Cleaner — 1 Tailoring 31 13 Wine Merchant Filler — 1 Taxi Driver — 1 Wood Borer 1 — Tea Packer — 1 344 156 Telephone Receptionist 1 — Thermometer Maker 1 - 105 RETURN RESPECTING THE VACCINATION OF CHILDREN WHOSE BIRTHS WERE REGISTERED IN STEPNEY FROM JANUARY 1st TO DECEMBER 31st, 1935 INCLUSIVE. 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, 1935. Number of these Births duly entered by 31st January, 1937, 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) W (5) (6) (7) Limehouse 1,866 453 1 — 985 50 St. Georges, East 500 169 — — 208 30 Total 2,366* 622 1 — 1,193 80 Whitechapel 1,714 852 — — 520 73 Mile End 984 259 — — 497 87 Total 2,698* 1,111 — — 1,017 160 M.37g Vaccination. 106 Registration Sub-Districts comprised in the Vaccination Officer's District. Number of these Births which on 31st January, 1937, remained unentered in the "Vaccination Register" on account (as shown by "Report Book") of Number of these Births remaining on 31st Jan., 1937, 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 1936. Number of Statutory Declarations of Conscientious Objection actually received by the Vaccination Officer irrespective of the dates of birth of the children to which they relate, during the Calendar Year 1936. 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 — 280 20 77 683 957 St Georges, East — 20 12 61 320 204 Total — 300 32 138 903 1,161 Whitechapel 4 214 11 40 971 494 Mile End 1 62 10 68 383 546 Total 5 276 21 108 1,354 1,040 Limehouse and St. Georges. Whitechapel and Mile End Number of children successfully vaccinated after declaration of conscientious objection had been made. These numbers are included in Column 6 4 2 Total number of certificates for the year 1936 sent to other Vaccination Officers 219 157 SUMMARY OF PRIMARY VACCINATIONS DURING THE YEAR JANUARY TO DECEMBER, 1936 (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 of insusceptibility or of having had smallpox. No. of cases No. of entries in lists sent to public vaccinator Parents removed out of district. Otherwise not found. Health of child. Condition of house. Prevalence oJ infectious disease. Whitechapel 1,726 987 161 - - 494 5 852 26 395 Mile End 1,186 385 64 - - 546 1 308 22 336 Other vaccinations 18 — — — — — — — — Limehouse 1,731 589 36 — 950 2 936 51 198 St. Georges 550 319 39 — - 204 7 60 49 278 Other Vaccinations 24 — — — — — — — — Total 5,193 2,322 300 — — 2,194 15 2,156 148 1,207 107 108 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, 1936. 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 314 61 375 14 Shadwell do. Also St. George's (acting) Dr. E. Lipman 275 41 316 27 Mile End do. Dr. S. Mikhail 165 29 194 6 St. George-in-the-East District Dr. B. Rygate 81 6 87 2 „ „ „ „ Dr. P. Steinberg 48 4 52 1 St. George-in-the-East Hospital Dr. J. G, Leebody — — - 4 Mile End Hospital Dr. A. Randle 10 — 10 — Limehouse District Dr. W. S. R. Thomas 66 12 78 22 Totals 959 153 1112 76 109 TOTAL DEATHS BY CAUSE AND AGE IN THE METROPOLITAN BOROUGH OF STEPNEY, 1936. ESTIMATED RESIDENT POPULATION (MID. 1936): 207, 800. CAUSES OF DEATH. Sex. All Ages. 0— 1— 2— 5— 15— 25— 35— 45— 55— 65— 75— ALL CAUSES M. 1,445 186 34 23 24 54 46 73 145 258 358 244 F. 1,175 119 25 16 18 47 39 51 100 193 217 296 I. Typhoid and paratyphoid fevers M. ... ... ... ... ... ... ... ... ... ... ... ... F. ... ... ... ... ... ... ... ... ... ... ... ... 2. Measles M. 26 7 12 7 ... ... ... ... ... ... ... ... F. 26 10 10 4 2 ... ... ... ... ... ... ... 3. Scarlet Fever M. 1 ... ... 1 ... ... ... ... ... ... ... ... F. ... ... ... ... ... ... ... ... ... ... ... ... 4. Whooping cough M. 12 7 4 ... 1 ... ... ... ... ... ... ... F. 10 5 4 1 ... ... ... ... ... ... ... ... 6. Diphtheria M. 7 1 1 4 1 ... ... ... ... ... ... ... F. 4 2 ... 2 ... ... ... ... ... ... ... ... 5. Influenza M. 6 ... 1 ... ... ... 1 ... ... 2 1 1 F. 10 ... ... 1 l ... ... 1 ... 2 2 3 7. Encephalitis lethargica M. 2 ... ... ... ... ... 1 ... ... ... ... ... F. 2 ... ... ... ... ... 1 ... ... ... 1 ... 8. Cerebro-spinal fever M. 2 1 ... ... ... 1 ... ... ... ... ... ... F. 1 ... ... ... ... ... 1 ... ... ... ... ... 9. Tuberculosis of respiratory system M. 94 ... ... ... ... 13 17 17 15 21 11 ... F. 50 ... ... ... l 18 10 7 4 5 4 1 10. Other tuberculous diseases M. 6 1 ... 2 ... 1 ... ... 1 ... 1 ... F. 8 2 ... 2 1 ... 1 ... 2 ... ... ... 11. Syphilis M. 8 1 ... ... ... 1 ... ... 3 1 2 ... F. 2 ... ... ... ... ... ... 1 ... 1 ... v 12. General paralysis of the insane, tabes dorsalis. M. 6 ... ... ... ... ... ... ... 2 2 2 ... F. 3 ... ... ... ... ... ... 2 ... ... 1 ... 13. Cancer, malignant disease M. 156 ... ... ... ... l 1 12 20 47 56 19 F. 148 ... ... ... 1 ... 1 13 19 37 46 31 14. Diabetes M. 11 ... ... ... ... ... ... ... 2 3 5 1 F. 38 ... ... ... ... ... ... 2 2 14 12 8 15. Cerebral hæmorrhage, etc. M. 38 ... ... ... ... ... ... ... 1 8 19 10 F. 33 ... ... ... ... ... ... 1 4 8 14 6 16. Heart disease M. 412 ... ... ... l 8 4 16 35 87 133 128 F. 374 ... ... ... l 12 10 7 23 62 100 159 17. Aneurysm M. 6 ... ... ... ... ... ... ... 3 1 2 ... F. 5 ... ... ... ... 1 ... ... 1 3 ... ... 18 Other circulatory diseases M. 63 ... ... ... ... ... ... 1 2 6 25 29 F. 73 ... ... ... ... ... 1 1 4 10 26 31 19. Bronchitis M. 47 8 ... ... 1 ... ... 1 7 10 12 8 F. 26 2 ... ... ... ... 2 1 1 3 9 8 S.D.24 TOTAL DEATHS BY CAUSE AND AGE IN THE METROPOLITAN BOROUGH OF STEPNEY, 1936—(continued). CAUSES OF DEATH. Sex. All Ages. 0— 1— 2— 5— 15— 25— 35— 45— 55— 65— 75— 20. Pneumonia (all forms) M. 103 27 11 4 2 2 2 6 15 12 16 6 F. 78 21 7 1 1 3 2 4 12 10 9 8 21. Other respiratory diseases M. 9 ,,, ... 1 ... 2 ... 1 1 3 1 ... F. 8 ... ... ... ... 3 1 ... 1 1 ... 2 22. Peptic ulcer M. 18 ... ... ... ... ... 1 ... 4 6 6 1 F. 3 ... ... ... ... ... ... ... ... 2 1 ... 23. Diarrhoea, etc. M. 62 57 2 ... ... ... ... ... 1 1 1 ... F. 44 39 2 ... ... 1 ... ... ... 1 ... 1 24. Appendicitis M. 10 ... ... ... ... 2 2 2 2 1 1 ... F. 10 ... ... ... ... ... ... ... 3 2 3 ... 25. Cirrhosis of liver M. 8 ... ... ... ... ... ... 3 1 1 2 1 F. 1 ... ... ... ... ... ... ... ... 1 ... ... 26. Other diseases of liver, etc. M. 4 ... ... ... ... ... ... ... ... ... 3 1 F. 5 ... ... ... ... ... ... 1 2 ... 1 l 27. Other digestive diseases M. 19 2 1 ... 2 ... 1 1 2 3 4 3 F. 23 1 ... 1 1 1 l 2 4 3 5 4 28. Acute and chronic nephritis M. 51 ... ... ... ... l ... 2 7 9 15 17 F. 39 ... ... ... 1 ... l 1 3 8 11 14 29. Puerperal sepsis F. 3 ... ... ... ... ... 2 1 ... ... ... ... 30. Other puerperal causes F. 2 ... ... ... ... ... 1 1 ... ... ... ... 31. Congenital debility, premature birth, malformations, etc. M. 64 64 ... ... ... ... ... ... ... ... ... ... F. 31 31 ... ... ... ... ... ... ... ... ... ... 32. Senility M. 7 ... ... ... ... ... ... ... ... ... 2 5 F. 7 ... ... ... ... ... ... ... ... ... 1 6 33. Suicide M. 15 ... ... ... ... ... 2 3 3 3 4 ... F. 3 ... ... ... ... 1 ... ... 1 1 ... ... 34. Other violence M. 59 ... ... 2 8 9 4 4 3 13 9 7 F. 35 3 2 1 2 2 ... ... 1 o 9 10 35. Other defined diseases M. 113 10 2 2 8 13 10 4 14 18 25 7 F. 69 3 ... 3 4 5 4 5 13 14 16 2 36. Causes ill-defined, or unknown M. ... ... ... ... ... ... ... ... ... ... ... ... F. 1 ... ... ... ... ... ... ... ... ... ... 1 Deaths under 1 year of age : Legitimate Illegitimate M. 178 8 F. Ill 8 111 S.D. 62. (1) Estimated Mid-year Resident Population (a) 207,800 (b) (2) LIVE BIRTHS. Live Births registered (excluding re-registrations) Inward transfers Outward transfers Live Births allocated to the Borough Total Live Births (Legitimate and Illegitimate) Males 2,641 90 1,153 1,578 Females 2,524 76 1,111 1,489 Illegitimate Live Births Males 67 12 20 58 Females 63 10 15 59 (3) STILLBIRTHS. Stillbirths registered Inward transfers Outward transfers Stillbirths allocated to the Borough Total Stillbirths (Legitimate and Illegitimate) Males 90 10 29 71 Females 68 4 31 41 Illegitimate Stillbirths Males 2 3 6 Females 6 — — 6 (4) NOTIFIABLE INFECTIOUS DISEASES. (number of cases notified during the 53 weeks ended 2nd January, 1937) Smallpox Scarlet fever Diphtheria Enteric fever Pneumonia Puerperal fever Pueperal pyrexia Erysipelas — 526 530 5 202 2 36 119 (5) Area Comparability Factor, applicable to the "All Canses" crude death rate only 1.17 112 S.D.55 Birthrates, Deathrates, Analysis of Mortality England and Wales, London, Maternal Death-rates, and Case-rates for 122 Great Towns and 143 certain Infectious Diseases in the year 1936. Smaller Towns. (Provisional Figures based on Weekly and Quarterly Returns.) England and Wales. 122 County Boroughs and Great Towns including London. 143 Smaller Towns (Resident Population 25,000 to 50,000 at 1931 census). London Administrative County. Rates per 1,000 population. Births:— Live 14.8 14.9 15.0 13.6 Still 0.61 0.67 0.64 0.53 Deaths:— All causes 12.1 12.3 11.5 12.5 Typhoid and Paratyphoid Fever 0.01 0.01 0.00 0.01 Small-pox — — — — Measles 0.07 0.09 0.04 0.14 Scarlet Fever 0.01 0.01 0.01 0.01 Whooping Cough 0.05 0.06 0.04 0.06 Diphtheria 0.07 0.08 0.05 0.05 Influenza 0.14 0.14 0.15 0.14 Violence 0.52 0.45 0.39 0.52 Notifications:— Small-pox — — — — Scarlet Fever 2.53 2.18 2.48 2.57 Diphtheria 1.39 1.31 1.26 1.69 Enteric Fever 0.06 0.05 0.06 0.06 Erysipelas 0.40 0.38 0.35 0.44 Pneumonia 1.11 1.10 0.96 0.99 Rates per 1,000 Live Births. Deaths under 1 year of age 59 63 55 66 Deaths from Diarrhoea and Enteritis under 2 years of age 5.9 8.2 3.4 14.4 Maternal Mortality:— Puerperal Sepsis 1.40 Not available. Others 2.41 Total 3.81 Rates per 1,000 Total Births (i.e. Live and Still.) Maternal Mortality:— Not available. Puerperal Sepsis 1.34 Others 2.31 Total 3.65 Notifications:— Puerperal Fever 3.27 3.46 2.80 3.03 Puerperal Pyrexia 9.64 9.52 7.57 11.15 113 INDEX. PAGE. I. Statistics and Social Conditions of the Area 7 II. General Provision of Health Services 9 III. Sanitary Circumstances of the Area 36 IV. Housing 56 V. Inspection and Supervision of Food 62 VI. Prevalence of, and Control over Infectious and other Diseases 95 VII. Statistics provided by the Registrar-General 109 After care, Tuberculosis 11 Analyst's Report 73-94 Ante-Natal Clinics 22, 24, 35 Ante-Natal and Post-Natal Services 24 Area of Borough 7 Artificial Sunlight Treatment 29 Bacteriological Examinations 10 Bakehouses 65 Births 7, 8 Births Act, Notification of 8, 24 Bishopsgate Goods Station 71 Bug Eradication 100 Butcher Shops and Stalls 64 Butter Factories 65 Canal Boats Acts 39 Cancer 99 Cerebro-Spinal Fever 96 Cleansing of persons 38, 99 Committees, List of Members 2 Complaints of nuisances 36 Convalescent Treatment 26, 29 Cowsheds 38,42 Creches, List of 35 Dairies and Milkshops 63 Day Nurseries 27, 35 Deafness, prevention of 29 Deaths 8,109 Dental Clinic 21 Diarrhœa 99 Diphtheria 95 Diphtheria Immunisation 95 Diphtheritic Serum 95 Disinfection 38,99 114 PAGE. Drainage 36 Dysentery 97 Eating Houses 38 Encephalitis Lethargica 96 Enteric Fever 96 Extra Nourishment, Supply of 14 Factory and Workshops 40-42 Fines and Costs 56 Finsen Light 14 Food and Drugs Acts 73-94 „ Inspection 62-72 „ Poisoning 97 ,, Premises 63-65 ,, Products, Certification of 65 „ Regulations (Imported) 65-72 „ Zeebrugge-Harwich Ferry 71 „ Calais-Harwich Ferry 71 Foster Mothers 28, 30, 38 Greengrocers and Fruiterers 65 Hairdressers' Shops 38 Handicraft Class 12 Health Visitors, work of 22, 24, 30, 31 Heart Disease 99 Home Helps 28, 29 Home nursing 27 Home Office, report to 40-42 Hospital facilities 10 Houses-let-in-Lodgings 39 House to House Inspection 61-62 Housing:—Statistics - 39, 56-61 „ Slum Clearance 56 „ Accommodation 60 „ Overcrowding 60 „ Overcrowding Survey 58 Ice Cream Premises 65 Infant Life Protection 28, 30, 38 Infant Welfare Centres, List of 34, 35 Infant Welfare Centres, Work at 24, 31 Infantile Mortality 22, 32 ,, „ in London Boroughs 33 Infants, Feeding of 29 Infectious Diseases 95-99 ,, ,, Summary of, 98 115 PAGE, Influenza 99 Laboratory facilities 10 Legal Proceedings 47-55 Lodging houses, Common and Seamen's 38, 42 London County Council, Report to 38-39 Malaria 97 Marriages 8 Margarine premises 55 Maternal Mortality 22, 28 Maternity Nursing 27, 30 Maternity and Child Welfare Centres, etc. 34, 35 „ „ „ Committee, List of members 2 „ „ Services 24-28 „ Centres, Work at 24, 31 ,, Outfits 29 Measles . 27, 39,98 Merchandise Marks Act 51, 62 Midwives 10, 28 Milk—(Special Designations) Order 64 „ Analysis of 63, 76 Milk and Dairies Order 50 ,, and Meals, Provision of 25,29 Milkshops 38, 63 Ministry of Health, Returns to - - 24-28, 101-102, 105-108 Mortuary 38 Notifiable diseases 95 Nursing in the Home 10 Offensive Businesses 38,42 Ophthalmia Neonatorum 27, 97 Outworkers 41, 42 Overcrowding 57, 59 „ Survey 58 Pharmacy & Poisons Act 36 Pneumo-Thorax refills ]4 Pneumonia 97 Polio-Myelitis 96 Population 7 Public Cleansing 36 Public Health Committee, List of members 2 Puerperal Fever and Pyrexia 97 Rag Flock Acts 42 Rats and Mice Destruction 36,37 Rent and Mortgage Interest, etc., Act 37 116 PAGE. Respiratory Diseases 99 Restaurants and Eating Houses 38 Sanitary Inspectors:—Inspections 43,44 „ „ Notices served 44 „ „ Return of sanitary work 45, 46 „ „ Samples taken 63, 73 Sanocrysin Treatment 14 Scabies 99 Scarlet Fever ....... 95 Scavenging 36 Shelter 38 Shops Act 36 Slaughter of Animals Act, 1933 42 Slum Clearance 56 Small-pox 96 Smoke Nuisances 36, 38 Social Conditions 9 Special Treatment (Tuberculosis) 14 Staff 3, 9 Statistics, Summary of 7 Sunlight Treatment, Artificial 29 Tuberculosis: Dental clinic 21 „ Dispensaries, List of 11 ,, „ Return of work (Forms T 145 & T 145a) 15-20 „ Incidence of and Mortality from occupations 102, 103 „ Notifications, Summary of (Form T137 Rev.) 101 „ Regulations, 1930 101 1925 102 „ Deaths 102, 109 Twins 8 Underground Rooms 39, 59 Unsound Food 65-72 Vaccination 105-108 „ by Public Vaccinators 108 „ Officers, Returns by 105-107 Verminous persons and premises 38, 99 Water Certificates 38 Whooping Cough 99 Workshops and Workplaces 40-42 Wrong Diagnosis of Infectious Diseases 97 Zymotic Diseases. 99