AC 4367 STE-2 Metropolitan Borough of Stepney ANNUAL REPORT For the Year 1937 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. Nail & Co., Ltd., Printers to the Council, 170, Farringdon Road, E.C.1 Metropolitan Borough of Stepney ANNUAL REPORT For the Year 1937 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.I 2 PUBLIC HEALTH COMMITTEE (November, 1936, to October, 1937.) Ex-Officio : His Worship The Mayor (Councillor J. C. Lawder, J.P.) Chairman: Councillor (Mrs.) A. P. Bunn. Vice-Chairman: Councillor J. L. Fine, J.P. 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 „ (Dr.) M. L. Barst „ (Mrs.) H. Rampling „ D. J. Berry ,, (Mrs.) H. Roberts „ (Mrs.) R. V. Dubury. ,, J. Sambrook „ (Mrs.) L. Frankel „ L. Schaverin „ I. J. Kudish „ (Mrs.) S. Spicer „ (Mrs.) H. Long „ L. Tanaman MATERNITY AND CHILD WELFARE COMMITTEE. (November, 1936, to October, 1937.) Chairman : Councillor (Mrs.) L. Frankel. Vice-Chairman: Councillor (Mrs.) H. Rampling. The Members of the Public Health Committee. 3 STAFF OF THE PUBLIC HEALTH DEPARTMENT on the 31st December, 1937. Medical Officer of Health and Chief Administrative Tuberculosis Officer: F. Roantree O'Shiel, l.r.c.p.i., l.m., d.p.h. (Liverp.) Deputy and Assistant Medical Officer of Health : E. J. O'keeffe, b.a., m.r.c.s., l.r.c.p., d.p.h. 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) G. D. Freeland. (1, 3, 4) (J. Keniry. (3) J. H. Brownlee. (1, 3, 4) H. J. Green. (1, 2, 4) S. S- Lowther. (3, 4) J. J. Coveney. (3) C. F. Guy. (2) J. G. McCarthy. (3) W. Cue. (1, 3) W. H. Haworth. (3) R. Roper. (3, 4) R. W. G. Day. ( 3) W H. Howard. (1, 3) W. F. Smith. (2, 4) W. T. Twynham. (2) Food. H. Abson. (1, 2, 4) T. w. Dee (2, 4) A. C. Brown. (2, 4) S. Vogler. (3, 4) Other 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. Mrs. H. Hiles. (m. & c.w.) M. Pliskin. Miss G. Boulton. (m.& c.w.) W.P.Howard. Miss P. Romaine. Miss G.A-Carthy. (m.&c.w.) Miss M. W. Hunt. (m. & c.w.) (m.&C.w.) W. J. Dixon. C. H. Lowry. E. P. Simpson. (3) S. Embleton. J. G. Lyons. Miss A. I. Ward. Miss M. Fitzgerald. J. McMullon. (m.&c.w.) (m. & c.w.) r. Mahoney E. P. Webber. (3) W. E. Hart. h. f. mayo. 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. †Health 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 : J. W. Crawford, m.d., m.b., b.ch., d.p.h. 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. Clerks : Miss O. M. Chapman and 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. Ancesthetist (part-time): M.J. O'Toole, m.b., b.ch., b.a.o. 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 Certificated Midwife. Exam. Joint Board. 8. Trained Nurse. 4. ,, Meat and Other Foods. 9. Certificate Soc. of Apothecaries t Also Child Protection Officers, 4 Public Health Department, 43, White Horse Street, Stepney, London, E.l. 23rd May, 1938. To the Mayor, Aldermen and Councillors of the Metropolitan Borough of Stepney. Your Worship, Ladies and Gentlemen, I have the honour to submit to you this, my second Annual Report, being the Annual Report on the health and sanitary conditions of the Metropolitan Borough of Stepney for the year 1937. There are several encouraging features in the annual statistics which it gives me pleasure to report. Amongst these are the marked improvement in the infantile mortality rate—60.5 per 1,000 live births—which is, in fact, the lowest infantile mortality rate ever recorded in the Borough. Concurrently, deaths from those diseases which conduce most largely to fatalities amongst infants were markedly reduced. I refer particularly to measles and diarrhoea. This year (1937) with the year 1935 is the second in the history of the Borough in which no deaths from measles occurred, whilst the deaths from infantile diarrhoea were reduced from 71 to 24. The maternal mortality rate was 2.43 per 1,000 births. There were 7 maternal deaths. Infectious disease notifications decreased by 1,163—mainly due to the comparative absence of measles—and deaths from infectious diseases decreased from 107 to 70. There were 115 fewer cases of scarlet fever and no deaths, and though there were 173 more cases of diphtheria the disease was mild and the deaths were 4 less than in the previous year. There was 1 death from typhoid and none from small-pox. Tuberculosis notifications of new cases occurring in the Borough were 45 less than in the previous year. An unusual epidemiological feature during the year was the apparently large number of cases of Sonne dysentery occurring amongst people of all ages in the Borough. Fortunately, this form of bacillary dysentery, caused by the Bacillus Sonne, is mild in all cases except infants under 1 year. The short, though sharp, nature of the attack, the absence of marked symptoms other than diarrhoea and the almost invariable recovery within a week tended to cause the disease to be overlooked, so that practically the only cases notified were those which occurred in hospitals, where diagnosis by laboratory examination was a routine measure. But, from comments heard and observation in the Borough generally, it appeared likely that the complaint was pretty general throughout Stepney during the months of November and December. According to the Registrar-General's estimate, the population of the Borough decreased by 4,700 in 1937, the year under review. The birth-rate was 13.5 compared with 14,7 the previous year. 6 The death-rate was 12.2 compared with 12.6 the previous year. Deaths from all causes decreased by 141 and births by 308. The event of the year in the Public Health world was undoubtedly the nation-wide Campaign to Encourage the Wider Use of the Health Services, in which the Borough co-operated fully. The campaign commenced in September and has extended into the present year, 1938. Cinematograph displays and lectures were given throughout the Borough and up to the end of the year over 27,000 leaflets and posters were distributed. Much enthusiasm was shown by the staff, and considerable work put in after hours and otherwise in connection with the lectures and distribution of literature, etc. I am most grateful for their help in this most important work, and there is no doubt an untold amount of good must have been done for the cause of the . Health of the Public, by this most useful effort in propaganda. I have much pleasure in welcoming Dr. E. J. O'Keeffe and Dr. J. W. Crawford to the medical staff of the Public Health Department. The post of Deputy Medical Officer of Health, vacant since 24th December, 1936, was filled on 26th May, 1937, by the appointment of Dr. O'Keeffe, who comes to us from the Borough of Bermondsey Public Health Department and has taken over the work in the Maternity and Child Welfare section with energy and enthusiasm. The post of Assistant Tuberculosis Officer, vacant since the appointment of Dr. Harley Stevens to the senior post on 1st August, 1936, was served by temporary medical officers until 18th September, 1937, when Dr. C. F. Price commenced duties. Dr. Price was appointed by the Council on 28th July but resigned again in October to take up an appointment elsewhere. Dr. Crawford, then appointed, commenced duties as Assistant Tuberculosis Officer on 1st December, 1937. His long experience in the tuberculosis service of the London County Council and elsewhere are proving a valuable asset to the medical services of the Borough. Mr. R. H. Waterman, a sanitary inspector, who had been in the service of the Borough since July, 1907, retired on pension on 30th November and carries with him into retirement the best wishes of the staff. His place was taken by Mr. J. J. Coveney of the clerical staff, who recently obtained his sanitary inspector's certificate and who is most deserving of congratulations on his success. Mr. F. Crockford, after over 16 years' service as caretaker of the Council's Tuberculosis Dispensaries, and previously in the service of the voluntary tuberculosis associations in the Borough, retired owing to ill-health on 6th August and, I deeply regret to report, passed away in January of this present year. The London County Council (General Powers) Act, 1937, came into force on 20th July and contains provisions for the inclusion of Noise amongst Public Health nuisances and also extends to all tenement houses the provisions made for the storage and cooking of food. 6 In response to Circular No. 1550 "Children under School Age" of the Ministry of Health of 27th October, 1936, the Borough Council established two new Toddlers' Clinics in the Borough, an account of which will be found in this report, and in accordance with Circular 1643a, a leaflet (pages 110-112) was prepared for distribution from local post offices, giving full information of the Local Health Services. I have to report that the food section had a year of activity and much has been done to improve the food and milk supply of the Borough. Interesting details of the samples submitted to the Public Analyst are contained in his report, particularly in relation to milk adulteration and cream cheese. His full and explicit account of the relative properties of cream cheese and soft cheese, and the constant substitution of the latter for the former makes interesting reading. The cleanliness of much ice cream sold in the Borough, as revealed by bacteriological examination, is not satisfactory. It would appear that a case could be made for the pasteurisation of all mix used in the manufacture of ice cream and for the sterilisation of all utensils. It is hoped that by the rigorous inspection of ice cream premises the manufacturers and vendors may be induced to aspire to a higher standard. Progress made in Housing during the year included the confirmation without modification of seven Clearance Orders made by the Council. Three large Clearance Orders were also made by the London County Council. 184 underground rooms were dealt with during the year. 12 were closed by closing orders, 22 were made to comply by alteration and 150 were dealt with in the Clearance Orders. 639 cases of Overcrowding were relieved during the year. The "appointed day" under the Housing Act, 1936, has not yet been reached in Stepney. Once more I should like to express my thanks to the Chairmen and Members of the Committees for the support and consideration received from them, and to the staff of the department my high appreciation of the interest they have taken in their work and their helpful co-operation. I am, Your Worship, Ladies and Gentlemen, Your obedient Servant, F. R. O'SHIEL, Medical Officer of Health. 7 SUMMARY OF STATISTICS, 1937. Area of Borough (in acres) 1902.766 Population (1937) (Registrar-General's estimate) 203,100 Number of inhabited houses (end of 1937) according to Rate Books 35,612 Rateable value 31st December, 1937 £1,704,885 Sum represented by a penny rate £6,785 Total. Male. Female. Live Births Legitimate 2,661 1,383 1,278 Birth Rate per 1,000 of the estimated resident population 13.5 Illegitimate 98 56 42 Total Live Births 2,759 1,439 1,320 Still Births 105 57 48 Rate per 1,000 total (live and still) births 36.6 Total Births 2,864 1,496 1,368 Deaths 2,479 1,364 1,115 Death rate per 1,000 of the estimated resident population 12.2 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 2 0.69 No. 30 Other puerperal causes 5 1.74 Total 7 2.43 Death rate of Infants under one year of age : All infants per 1,000 live births 60'5 Legitimate infants per 1,000 legitimate live births 57'8 Illegitimate infants per 1.000 illegitimate live births 132'6 Deaths from Cancer (all ages) 331 „ „ Measles (all ages) — „ „ Whooping Cough (all ages) 14 „ „ Diarrhoea (under 2 years of age) 41 I.— STATISTICS AND SOCIAL CONDITIONS OF THE AREA. Population.— The estimate of the Registrar-General to the mid-year 1937 is 203,100. Births.— The total number of live births of Stepney residents during the year was 2,759—1,439 males and 1,320 females—or 308 less than in the previous year. Births in Public Institutions in the Borough.— The birth-rate was 13.5 per 1,000 of the population. 4,198 births occurred in Public Institutions in the Borough, of which 1,829 belonged to Stepney and 2,369 belonged to other Boroughs. 8 1,488 births occurred in the East End Maternity Hospital :— 340 belonged to Stepney, and 1,148 to outlying Districts. 853 births occurred in the London Hospital :— 338 belonged to Stepney, and 515 to outlying Districts. 311 births occurred in the St. George-in-the-East Hospital :— 230 belonged to Stepney, and 81 to outlying Districts. 991 births occurred in the Mile End Hospital:— 738 belonged to Stepney, and 253 to outlying Districts. 553 births occurred at 24, Underwood Street:— 182 belonged to Stepney, and 371 to outlying Districts. 1 birth occurred in the London Jewish Hospital which belonged to an outlying District. 1 birth occurred in St. Peter's Hospital which belonged to Stepney. Births in Outlying Districts.—152 births occurred outside the Borough, the parents being residents of Stepney. Twins.—37 sets of twins were born in the Borough during the year : 32 sets were live births. 1 set was still-born. 4 sets were 1 live birth and 1 still birth in each case. 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 2,068 92 (b) At home:— Notified by doctors 61 1 „ private midwives 144 1 „ doctors and midwives from Institutions 576 15 2,849 109 Marriages.— The total number of marriages which took place during the year was 2,241, or 31 less than in the previous year. The proportion of persons married was 22.0 per 1,000 of the population. Deaths.— 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 2,479—1,364 males and 1,115 females—or 171 more than in the previous year. The death-rate for the whole Borough was 12.2 per 1,000 of the population. Deaths in Public Institutions in the Borough.—2,264 deaths occurred in Public Institutions in the Borough, of which 1,414 belonged to Stepney and 850 belonged to other Boroughs. 9 Belonging Belonging to to Stepney. other Boroughs. East End Maternity Hospital, Commercial Road 6 12 Princess Elizabeth of York Hospital for Children, Shadwell 32 67 London Hospital, Whitechapel Road 129 511 London Jewish Hospital, Stepney Green 48 29 Mile End Hospital, Bancroft Road 531 71 St. George's Hospital, Raine Street 345 62 St. Peter's Hospital, Vallance Road 307 91 Sick Room Help Society, 24, Underwood Street 6 4 Stepney Institution, South Grove 10 3 Deaths in Outlying Districts.— There were 441 deaths of persons belonging to the Borough in various Institutions outside the Borough:— Mental Hospitals 95 Hospitals for Infectious Diseases 41 Hospitals and Institutions 305 In addition there were 22 deaths of Stepney residents in private houses outside the Borough. Public Assistance and Unemployment.— 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:— 1937. Men. Women. Children. Total. 2nd January 1,619 2,420 1,819 5,858 25th December 1,367 2,146 1,297 4,810 1936. 4th January 1,980 2,840 2,751 7,571 26th December 1,595 2,394 1,793 5,782 (b) Number of registered unemployed:— Total. 18th October, 1937 5,832 males 1,061 females and 188 juveniles 7,081 26th October, 1936 5,461 „ 703 „ „ 231 „ 6,395 II.— GENERAL PROVISION OF HEALTH SERVICES. Changes in Staff.— The following appointments and changes in the staff took place during the year:— Dr. E. J. O'Keeffe was appointed Deputy and Assistant Medical Officer of Health on the 26th May, thereby filling the vacancy created by my appointment as Medical Officer of Health on the 24th December, 1936. Dr. C. F. Price was appointed Assistant Tuberculosis Officer and Assistant Medical Officer of Health on the 28th July, thus filling the vacancy created by Dr. Harley Stevens' promotion to Senior Tuberculosis Officer on the 1st August, 1936. Dr. Price left on the 31st October to take up a new appointment and on the 27th October Dr. J. W. Crawford was appointed in his place. Dr. J. P. Reidy, part time anaesthetist at the Council's Dental Clinic, resigned at the end of July and Dr. M. J. O'Toole, who had been doing the work temporarily, was appointed to the position on the 26th January, 1938. 10 Mr. R. H. Waterman, a district sanitary inspector, retired on superannuation on the 30th November and Mr. J. J. Coveney, a qualified clerk in the department, was appointed to fill the vacancy on the 27th October. Mr. T. W. Dawson, a clerk, resigned on the 2nd January to take up a new appointment. Mr. R. Mahoney and Mr. J. Harvey, clerks, were transferred to this department from another department of the Council on the 9th February. The latter left to take up another appointment under the Council and Mr. J. G. Lyons, a clerk, was transferred to this department from another department of the Council to fill his place on the 7th June. Miss O. M. Chapman was appointed on the 24th February as a clerk in the Tuberculosis section and Miss A. I. Ward was appointed the same date as a clerk in the Maternity section. Mr. W. E. Hart and Mr. H. F. Mayo were appointed as junior clerks on the 24th February. Mr. F. Crockford, the caretaker at the Steel's Lane Tuberculosis Dispensary, retired owing to ill-health on 6th August. 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 97 visits were made by them during the year, i.e., 2 Measles, 82 Ophthalmia Neonatorum and 13 Pemphigus Neonatorum. Midwives.—There are 6 Midwives practising in the Borough, and in addition there are 21 employed by the voluntary associations. The midwives are under the supervision of the London County Council. Laboratory facilities.—The number of bacteriological examinations made at the Mile End Hospital on behalf of the Public Health Department during the year was 2,633. These consisted of:— No. Positive. No. Negative. Totals. Swabs (for Diphtheria bacilli) 292 2,333 2,625 Blood (for Typhoid bacilli) 1 5 6 Dysentery — 2 2 There were 844 specimens of sputum examined at the Tuberculosis Dispensaries. 168 of these were found to be positive. 11 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 350 Female 392 Children 84 Other 59 14,395 99,501 General and Maternity. Voluntary. Mile End Hospital Bancroft Road 465 excluding cots 7,465 Ante-natal 959 Post-natal 335 Other 15,041 General and Maternity. L.C.C. St. George's-in-the-East Hospital, Raine Street. 410 excluding cots. 4,641 Ante-natal 296 Post-natal 81 Other 9,162 General. and Maternity. L.C.C. St. Peter's Hospital, Vallance Road. 404 excluding cots. 4,337 2,489 General. L.C.C. South Grove Institution, South Grove. 649 — — Public Assistance. L.C.C. London Jewish Hospital, Stepney Green. Male 41 Female 51 Children 12 Other 5 1,572 13,625 General. Voluntary. Princess Elizabeth of York Hospital for Children, Glamis Road. Children 135 1,958 53,439 General. Voluntary. East End Maternity Hospital, Commercial Road. Lying-in 49 Waiting 6 Isolation 1 Labour 4 Observation 3 1,492 263 Maternity. Voluntary. Jewish Maternity Hospital, Underwood Street. Maternity beds 34 557 Midwifery cases 47 Maternity. Voluntary. National Health Campaign.— In a message to the country in September, the Prime Minister, the Rt. Hon. Neville Chamberlain, exhorted the people to participate in a coming campaign of national importance, namely, the National Campaign to Encourage the Wider Use of the Health Services 1937/1938. The Minister of Health, the Rt. Hon. Sir Kingsley Wood, urged all local authorities to co-operate in this nation-wide effort to improve the health of the people. On the 4th May, the Public Health and Maternity and Child Welfare Committees agreed to co-operate with the Central Council for Health Education in the Campaign by the distribution of leaflets, display of posters and the inauguration of lectures and film displays on Public Health and its services. A feature of the Campaign was the provision of large numbers of posters and folders free of charge by the Central Council for Health Education advertising local health services. The following is an account of the lectures and film displays which took place up to December:— 12 Date: Friday, 29th Oct. Thursday, 25th Nov. Tuesday, 30th Nov. Tuesday, 14th Dec. Place: Limehouse Library Mile End Library Stepney Jewish School. St. George's Library. Lecture: "At Your Service" (General Health Services). "Your Maternity and Child Welfare Service." The Public Health Service (to Parents and Children). "Food and Health" (Nutrition). Lecturer: Dr. F. R. O'Shiel (M.O.H.) Dr. E. J. O'Keefe (Deputy M.O.H.) Dr. E. J. O'Keefe (Deputy M.O.H.) Miss M. H. Keating (Nat. Council for M. & C.W.) Films: "Disinfestation." "100 Years of Progress." "The Empty Bed." "Citizens of the Future." "Rules for Junior." "Two Little Pigs." - "Food and Growth." "A Drink of Water." "Digestion." " Vitamins." Chairman: Councillor (Mrs.) Bunn (Chairman Public Health Committee). Councillor (Mrs.) Frankel (Chairman Maternity and Child Welfare Committee). — Councillor R. E. T. Knowlden (Chairman Libraries and Museums Committee). Attendance: 70 65 105 50 Propaganda took place in the form of the display of posters each month, and, preceding each lecture, folders were distributed embodying the provisions of the special local health services together with information concerning the lectures, as follows:— Outdoor Indoor Classroom Date. Subject. Posters. Posters. Posters. Folders. October Use Your Health 350 100 25 9,800 Services. November and Maternity and Child 350 100 25 9,778 December Welfare Services. The Outdoor Posters were displayed throughout the Borough on hoardings, notice boards and Council vehicles. The Indoor Posters were exhibited in the Borough Infant Welfare Centres, Offices, Conveniences and Depots, while the "Classroom" Posters were displayed at the Infant Welfare Centres, Creches and Children's Libraries. Folders were overprinted with lecture propaganda at the Council's expense and were distributed throughout the district through the media of the Libraries, Infant Welfare Centres, Tuberculosis Dispensaries, Day Nurseries and Clubs. In addition, there were distributed 5,000 handbills on Nutrition and 2,000 copies of a booklet issued by the London County Council entitled " Highways to Health." TUBERCULOSIS. Tuberculosis Dispensaries.— The present time-table of routine sessions for old patients is as follows and in addition new patients and contacts are seen daily:— Main Dispensary, Steels Lane. Branch Dispensary, 35, Stepney Green. 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 13 I am indebted to Dr. Harley Stevens, the Senior Tuberculosis Officer, for the following account of the activities of the Tuberculosis Dispensaries during the year:— This year the procedure for assisting families to obtain adequate housing accommodation has been simplified and there is good co-operation between the Public Health Department of the Borough Council and London County Council. More contacts have been examined and facilities for promoting their welfare have been utilised to a greater extent than formerly. More children were boarded out under the London County Council Scheme in 1937 than in any previous year. The machinery for obtaining accommodation for suitable children in London County Council convalescent homes is extremely simple and smooth in operation from the Dispensary point of view. The Borough Council's scheme for providing extra nourishment for tuberculous patients continues to be a valuable aid towards the recovery of such patients. In addition, extra nourishment for contacts as well as for patients is available to families in receipt of assistance from the Public Assistance Committees or the Unemployment Assistance Board if their condition requires it. With regard to extra nourishment generally, the co-operation of the Relieving Officers and the Area Officers has been very helpful and the assessment of family requirements has been carried out with every consideration for the Tuberculosis Officers' wishes. Following a meeting of Metropolitan Tuberculosis Officers during the year the scale of extra nourishment was to some extent standardised in the London Boroughs. The Jewish Board of Guardians have continued to assist their own people upon the recommendation of the Tuberculosis Officers and the Borough's responsibility for extra nourishment for these patients has been adjusted accordingly. A number of women patients have availed themselves of the London County Council scheme enabling infected mothers to spend the latter months of pregnancy in a Sanatorium and have their babies in hospital. The scheme is excellent in theory but it is difficult to persuade some young mothers to continue Sanatorium treatment afterwards unless it is constantly impressed upon them that complete separation from their babies is desirable because of the high incidence of fatal tuberculosis in such infant contacts. Their own health is also likely to suffer from the strain of caring for a baby and irreparable damage to the lungs may result. The latter argument appears to have little weight with a young mother eager to undertake the personal care of her first child. Friendly co-operation between the general hospitals of the London County Council and the Dispensaries has been of great help to us and I have no doubt the regular hospital visiting by the Tuberculosis Officers has assisted in the precision of diagnosis, initiating suitable treatment and facilitating the placing of patients. The patients are always glad to see the Tuberculosis Officers and on our part the access to the wards enables us to establish early contact with new admissions. It would be a great loss to the Dispensary 14 service if the arrangement whereby Tuberculosis Officers act as Visiting Consultants to the general hospitals were discontinued or if the function of Consultant became a nominal one. I am pleased to say the amount of X-ray work has increased and is now more in accord with the amount required. Owing to the reduction in charges for films and the free screening facilities provided by the London County Council, the cost should not be appreciably more than formerly. The number of changes in the temporary medical officers during the past three years has handicapped the Dispensary work and, with two permanent Tuberculosis Officers, there should be a further improvement in Dispensary figures. Tuberculosis After-care.— During 1937 the Tuberculosis Care Committee held ten meetings. 421 cases of tuberculosis, new and old, came before them for consideration, and of these nearly 200 were after-care cases needing advice or help. The voluntary charitable organisations were approached where possible, and they gave valuable help in many cases. The Jewish Board of Guardians assisted needy Jewish patients in various ways. In several cases a weekly allowance was made while a wage earner was receiving treatment, arrears of rent were paid twice for a family, and one patient was provided with tools to enable him to start work, besides many grants of extra nourishment and convalescent treatment being given. The Charity Organisation Society have again assisted many cases during the year. Six people recommended for convalescence obtained it through this Society, one patient was helped with the cost of dental treatment, insurance contributions were paid for another patient, and the relatives of two patients were allowed the fare to visit them at sanatorium. The Invalid Kitchens again gave extra nourishments and dinners to several patients who were not eligible for this from other sources, and the United Services Fund provided clothing for three ex-soldiers entering sanatorium, besides paying twice for an ex-soldier to visit his child receiving treatment at the seaside. The Public Assistance Department of the London County Council assisted financially several families recommended to them by the Care Committee, and the London County Council where necessary provided extra clothing required by patients undergoing treatment. Two fresh applications were received by patients requiring a separate bed on discharge from sanatorium, and these were supplied on loan through the Borough Council. One man being nursed at home was lent a bed rest by the Council. With the "Dr. Ferguson Memorial Fund" the Committee was able to help many patients from its own resources who otherwise could not have been assisted. From the Care Committee Fund twelve destitute men were allowed grants of pocket money to buy little extras at sanatorium; insurance arrears were paid for a patient to enable him to come into benefit, and the relatives of three patients were allowed the fares to visit them at sanatorium. 15 The sending of pocket money to the poorest patients is greatly appreciated. The men write letters expressing pathetically their gratitude for the difference these half-crowns make to their stay in sanatorium amongst people who are nearly all better off than themselves. Handicraft Class.— The handicraft class has had a very good year. The usual 46 classes were held and several new members joined. A sewing machine was purchased out of the Dr. Ferguson Memorial Fund money, which sews leather, cloth, and softer materials. This has proved a great boon to the class. Sixteen dressing jackets for the use of patients examined at the dispensary were made at the class, and several of the patients have been usefully and happily occupied on such work for the greater part of the year, making it unnecessary for a sale of work to be held. The work of the ex-Service men was again disposed of at the Imperial Institute Armistice Sale held each November, and very little work was left on hand by the end of the year. Boarded-out Contacts.—31 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 9 118 Pneumo-Thorax Refills at Brompton " 3 63 „ „ „ London Chest „ 23 274 „ „ „ Royal Chest „ 3 29 „ „ „ Colindale „ 1 15 „ „ „ Grove Park „ 1 9 Solganol or Sanocrysin treatment at the London Chest Hospital 5 43 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 528 grants were made to 190 persons, the total cost being approximately £425. 16 Memo. 37/T (Revised). Ministry of Health Form T. 145. A. Return showing the work of the Dispensaries for the year 1937:— 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 149 75 3 4 12 10 10 7 161 85 13 11 564 *(b) Diagnosis not completed - - - - - - - - 9 5 1 4 (c) Non-tuberculous — - - - - - — — 119 90 35 31 B.— Contacts examined during the year— (a) Definitely tuberculous 2 - - - - - - - 2 - - - 700 *(b) Diagnosis not completed — — - — — — — — — - - (c) Non-tuberculous - - - - - - - - 88 166 209 235 C.— Cases written off the Dispensary Register as:— (a) Recovered 40 32 12 12 5 9 16 18 45 41 28 30 1,138 (b) Non-tuberculous (including any such cases previously diagnosed and entered on the Dispensary Register as tuberculous) - - - - - - - - 216 262 249 267 D.— Number of Cases on Dispensary Register on December 31st:— (a) Definitely tuberculous 665 347 67 53 61 39 95 68 726 386 162 121 1,414 (b) Diagnosis not completed - - - - - - - - 9 5 1 4 1. Number of cases on Dispensary Register on January 1st 1,698 2. Number of cases transferred from other areas and cases returned after discharge under Head 3 in previous years 239 3. Number of cases transferred to other areas, cases not desiring further assistance under the scheme, and cases " lost sight of " 486 4. Cases written off during the year as Dead (all causes) 163 fi. Number of attendances at the Dispensary (including Contacts) 5.685 6. Number of Insured Persons under Domiciliary Treatment on the 31st December 314 7. Number of consultations with medical practitioners :— (а) Personal 352 (b) Other 447 8. Number of visits by Tuberculosis Officers to homes (including personal consultations) 514 9. Number of visits by Nurses or Health Visitors to homes for Dispensary purposes 5,284 10. Number of:— (а) Specimens of sputum, etc., examined 844 (б) X-ray examinations made in connection with Dispensary work 796 11. Number of "Recovered" cases restored to Dispensary Register, and included in A(a) and A(b) above — 12. Number of " T.B. plus" cases on Dispensary Register on December 31st 695 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 31st December. 17 Form T145a. (a) PULMONARY TUBERCULOSIS. Supplementary Annual Return showing in summary form (a) the condition at the end of 1937 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 1927 1927 1928 1929 1930 1931 Class T. B. minus Class T.B. plus Class T.B. minus Class T.B. plus Class T.B. minus Class T.B. plus Class T.B. minus Class T.B. plus Class T.B. minus Class T.B. plus Class T.B. minus Class T.B. plus Group 1 Group 2 Group 3 Total (Class T.B. plus) Group 1 Group 2 Group 3 Total (Class T.B.plus) Group 1 Group 2 Group 3 Total (Class T.B. plus) Group 1 Group 2 Group 3 Total (Class T.B. plus) Group 1 Group 2 Group 3 Total (Class T.B. plus) Group 1 Group 2 Group 3 Total (Class T.B. plus) (a) Remaining on Dispensary Register on 31st December. Disease Arrested. Adults M. 16 9 12 — 21 1 — — — — 4 1 2 — 3 2 4 1 — 5 1 4 3 1 8 7 2 4 — 6 F. 7 5 8 — 13 1 — 1 — 1 3 4 2 — 6 5 2 — — 2 — 3 2 — 5 3 3 2 — 5 Children 7 2 — — 2 3 1 — — 1 2 — — — — 5 — 1 — 1 2 — — — — 3 — — — — Disease not Arrested Adults M. 6 11 11 2 24 1 5 3 — 8 1 — 4 — 4 — 4 9 1 14 — 7 7 — 14 1 4 7 — 11 F. — 5 9 1 15 2 2 2 — 4 — 2 1 — 3 1 — 2 — 2 — 2 5 — 7 — 1 6 — 7 Children - - - - - - - - - - - - - - - - - - - - - - - - - - - 2 — 2 Condition not ascertained during the year 14 10 12 — 22 5 — 3 — 3 10 3 2 — 5 13 2 3 — 5 11 5 1 1 7 8 3 9 — 12 Total on Dispensary Register at 31st December 50 42 52 3 97 13 8 9 — 17 20 10 11 — 21 26 12 16 1 29 14 21 18 2 41 22 13 30 — 43 (b) Not now on Dispensary Register and reasons for removal therefrom. Discharged as Recovered Adults M. 36 19 9 — 28 12 4 — — 4 11 2 4 — 6 11 5 2 — 7 7 2 1 — 3 8 2 2 — 4 F. 26 30 7 — 37 13 3 1 — 4 7 6 2 — 8 14 5 — — 5 7 6 1 — 7 8 5 1 — 6 Children 13 2 — — 2 7 4 — — 4 7 5 — — 5 5 — — — — 10 1 — — 1 4 1 — — 1 Lost sight of, or otherwise removed from Dispensary Register 105 79 55 1 135 17 14 15 1 30 20 21 13 2 36 36 14 18 1 33 31 17 22 4 43 55 26 34 1 61 Dead. Adults M. 15 13 33 9 55 7 4 9 2 15 5 2 8 3 13 12 4 10 2 16 5 11 14 5 30 9 5 19 11 35 F. 9 8 14 4 26 3 4 4 — 8 5 3 3 1 7 6 8 9 2 19 9 3 8 5 16 9 11 13 4 28 Children 2 - - - - - - - - - - - - - - - - 1 - 1 - 2 - - 2 - - - - - Total written off Dispensary Register. 206 151 118 14 283 59 33 29 3 65 55 39 30 6 75 84 36 40 5 81 69 42 46 14 102 93 50 69 16 135 Grand Totals 256 193 170 17 380 72 41 38 3 82 75 49 41 6 96 110 48 56 6 110 83 63 64 16 143 115 63 99 16 178 18 PULMONARY TUBERCULOSIS—continued. Condition at the time of the last record made during the year to which the return relates 1932 1933 1934 1935 1936 1937 Class T.B. minus Class T.B. plus Class T.B. minus Class T.B. plus Class T.B. minus Class T.B. plus Class T.B. minus Class T.B. plus Class T.B. minus Class T.B. plus Class T.B. minus Class T.B. plus Group 1 Group 2 Group 3 Total (Class T.B. plus) Group 1 Group 2 Group 3 Total (Class T.B. plus) Group 1 Group 2 Group 3 Total (Class T.B. plus) Group 1 Group 2 Group 3 Total (Class T.B. plus) Group 1 Group 2 Group 3 Total (Class T.B. plus) Group 1 Group 2 Group 3 Total (class T.B. plus) (a) Remaining on Dispensary Register on 31st December. Disease Arrested. Adults M. 4 3 4 2 9 20 6 5 — 11 13 4 2 — 6 4 2 - - 2 - - - - - - - - - - F. 1 6 2 — 8 7 3 1 — 4 8 3 — — 3 4 1 1 - 2 - - - - - - - - - - Children 7 1 - — 1 12 — — — — 9 1 — — 1 7 - - - - - - - - — - - - - - Disease not Arrested. Adults M. 1 2 14 — 16 4 6 17 3 26 7 14 18 - 32 14 7 32 2 41 29 15 33 2 50 35 3 61 7 71 F. 2 3 9 — 12 4 6 7 1 14 2 4 8 1 13 5 8 11 — 19 13 5 13 1 19 25 6 25 2 33 Children — — 2 — 2 — — — — — 2 1 2 — 3 5 3 2 — 5 5 1 — — 1 7 — — — — Condition not ascertained during the year 6 7 3 1 11 9 4 6 — 10 10 8 2 — 10 8 4 3 - 7 3 1 4 - 5 - - - - - Total on Dispensary Register at 31st December 21 22 34 3 59 56 25 36 4 65 51 35 32 1 68 47 25 49 2 76 50 22 50 3 75 67 9 86 9 104 (b) Not now on Dispensary register and reasons for removal therefrom. Discharged as Recovered Adults M 5 1 2 — 3 - - - - - - - - - - - - - - - - - - - - - - - - - F 6 1 1 — 2 - - - - - - - - - - - - - - - - - - - - - - - - - Children 7 - - - - - - - - - - - - - - - - - - - - - - - - - - - - - Lost sight of, or otherwise removed from Dispensary Register 70 31 39 2 72 64 39 32 3 74 53 24 26 3 53 32 14 23 2 39 16 3 18 1 22 5 — 6 1 7 Dead Adults M 11 12 22 11 45 9 13 30 17 60 8 13 21 28 62 12 6 31 11 48 4 3 23 20 46 4 — 22 16 38 F. 4 8 7 6 21 2 4 14 12 30 5 4 14 8 26 7 — 6 3 9 1 1 10 5 16 1 — 4 7 11 Children 1 1 — — 1 2 1 — 2 3 1 — 2 - 2 1 — — 1 1 - — — — 1 — — — — Total written off Dispensary Register 104 54 71 19 144 77 57 76 34 167 67 41 63 39 143 52 20 60 17 97 21 7 51 26 84 11 — 32 24 56 Grand Totals 125 76 105 22 203 133 82 112 38 232 118 76 95 40 211 99 45 109 19 173 71 29 101 29 159 78 9 118 33 160 19 (b) NON-PULMONARY TUBERCULOSIS Supplementary Annual Return showing in summary form (a) the condition at the end of 1937 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 1927 1927 1928 1929 1930 1931 Bones and Joints Abdominal Other Organs Peripheral Glands Total Bones and Joints Abdominal Other Organs Peripheral Glands Total Bones and Joints Abdominal Other Organs Peripheral Glands Total Bones and Joints Abdominal Other Organs Peripheral Glands Total Bones and Joints Abdominal Other Organs Peripheral Glands Total Bones and Joints Abdominal Other Organs Peripheral Glands Total (a) Remaining on Dispensary Register on 31st December. Disease Arrested Adults M. 3 - - - 3 - - - - - - - - - - - - - - - - - 1 - 1 - - 1 — 1 F. 2 - 1 — 3 — — — — — 1 — — 1 2 — — — — — 1 — — — 1 1 — — — 1 Children 5 — — 1 6 3 1 — 2 6 2 — 1 1 4 2 — 2 — 4 3 — 3 3 9 1 1 2 10 14 Disease not Arrested Adults M. — — 2 — 2 — — — — — 1 — — — 1 — — — 1 1 — — 1 — 1 1 — — — 1 F. 1 - 1 - 2 - - - - - - - 1 - 1 - - - - - - - - 1 1 - - - - - Children — — 1 1 2 - - - - - - - - - - 2 — 1 1 4 — — — — — 1 — 1 — 2 Condition not ascertained during the year 1 — 3 2 6 — — — — — 2 — — 2 4 1 — — 1 2 3 1 1 1 6 — — — 2 2 Total on Dispensary Register at 31st December 12 — 8 4 24 3 1 — 2 6 6 — 2 4 12 5 — 3 3 11 7 1 6 5 19 4 1 4 12 21 Transferred to Pulmonary - - - - - - - - - - - - - - - - - - - - 1 - - - - - - - - - (b) Not now on Dispensary Register and reasons for removal therefrom. Discharged as Recovered Adults M. — 2 1 5 8 1 — — — 1 2 — — 2 4 1 1 — 1 3 2 — 1 2 5 1 - — 1 2 F. — — 1 3 4 1 — — 1 2 — — — — — 1 — 1 2 4 — — — — — 2 — 1 — 3 Children 14 2 3 9 28 3 3 1 6 13 3 1 2 16 22 4 3 — 7 14 2 2 — 10 14 3 3 — 6 12 Lost sight of, or otherwise removed from Dispensary Register 18 6 7 23 54 4 1 4 7 16 5 1 3 2 11 11 3 5 6 25 7 4 7 8 26 15 3 8 13 39 Dead Adults M. — — 1 1 2 1 — — — 1 — — 1 — 1 — — 1 — 1 — — 1 2 3 — 1 1 — 2 F. - - 2 - 2 - - - - - - - - - - - - - - - - - - - - - - - - - Children - 1 — 1 2 1 — — 1 2 — — — — — — — — — — — — — 1 1 — — — 1 1 Total written off Dispensary Register 32 11 15 42 100 11 4 5 15 35 10 2 6 20 38 17 7 7 16 47 11 6 9 23 49 21 7 10 21 59 • Grand Totals of (a) and (b) (excluding those transferred to Pulmonary). 44 11 23 46 124 14 5 5 17 41 16 2 8 24 50 22 7 10 19 58 18 7 15 28 68 25 8 14 33 80 20 NON-PULMONARY TUBERCULOSIS—continued. Condition at the time of the last record made during the year to which the return relates. 1932 1933 1934 1935 1936 1937 Bones and Joints Abdominal Other Organs Peripheral Glands Total Bones and Joints Abdominal Other Organs Peripheral Glands Total Bones and Joints Abdominal Other Organs Peripheral Glands Total Bones and Joints Abdominal Other Organs Peripheral Glands Total Bones and Joints Abdominal Other Organs Peripheral Glands Total Bonus and Joints Abdominal Other Organs Peripheral Glands Total (a) Remaining on Dispensary Register on 31st December. Disease Arrested Adults M. 1 — 1 — 2 3 — 2 2 7 — — — — — 2 — — - 2 — 1 1 1 3 - - - - - F. — — 1 — 1 — — 1 1 2 — 1 — 1 2 — — — 2 2 — — — 1 1 — - - — — Children 3 2 2 7 14 3 1 1 9 14 1 1 3 3 8 1 — — 6 7 — — — — — — — — — — Disease not Arrested Adults M. — — — — — — 1 — — 1 3 — 1 — 4 1 — — — 1 4 — 3 — 7 4 - 3 4 11 F. 2 — — — 2 2 — 1 — 3 — — — — — — — — — — 1 1 — — 2 6 1 2 1 10 Children 3 — — — 3 4 — — — 4 3 — 2 — 5 4 — — 2 6 3 - 1 5 9 5 1 — 8 14 Condition not ascertained during the year 2 — — 2 4 1 — 2 3 6 2 — 1 3 6 1 — 1 2 4 — — 1 2 3 — — — — — Total on Dispensary Register at 31st December 11 2 4 9 26 13 2 7 15 37 9 2 7 7 25 9 — 1 12 22 8 2 6 9 25 15 2 5 13 35 Transferred to Pulmonary 1 - - - - - - - - - 1 - - - - - - - 1 - - - - - - - - - - - (b) Not now on Dispensary Register and reasons for removal therefrom. Discharged as Recovered Adults M. — 1 — - 1 — — — 2 2 - - - - - - - - - - - - - - - - - - - - F. — 1 — 3 4 — 1 — 2 3 — 1 — — 1 — — — — — — — — — — — — — — — Children 3 — — 3 6 — — 1 5 6 - - - - - - - - - - - - - - - - - - - - Lost sight of, or otherwise removed from Dispensary Register 9 4 1 17 31 3 2 3 14 22 1 2 4 13 20 4 1 5 5 15 3 2 3 5 13 — — — 1 1 Dead Adults M. - - - - - - - 1 1 2 1 1 1 — 3 — 3 - — 3 1 — — — 1 — — 1 — 1 F. — — — — — — — — — — — — -- — — — — 1 — 1 2 - 1 — 3 — — — — — Children 1 — 3 1 5 — — 1 1 2 1 1 2 — 4 1 - 3 — 4 — — 3 — 3 — — 2 — 2 Total written off Dispensary Register 13 6 4 24 47 3 3 6 25 37 3 5 7 13 28 5 4 9 5 23 6 2 7 5 20 — — 3 1 4 Grand Totals of (a) and (b) (excluding those transferred to Pulmonary) 24 8 8 33 73 16 5 13 40 74 12 7 14 20 53 14 4 10 17 45 14 4 13 14 45 15 2 8 14 39 21 SUMMARY OF WORK DONE AT THE DENTAL CLINIC—(a) TUBERCULOSIS. Particulars of Patients. Number of Fillings. Number of Scalings. Extraction Cases. Dentures. Number of Dressings. Number for Advice. Denture Visits. Number of New Patients Number of Attendances. Simple. Root. Without Anaesthetic. Local Administrations. Gas Administrations. Number of Teeth Extracted. Upper. Lower. Re-models Repairs. Women 102 5 — 1 — 4 18 61 7 8 — 8 1 13 60 11 Children 7 — — — — — 2 24 — — — — — 3 3 2 Men 60 — — — — 7 1 22 7 7 — 6 — 5 48 4 Total 169 5 — 1 — 11 21 107 14 15 — 14 1 21 111 17 No. of Ordinary sessions held 10 No. of Gas „ „ 12 (b) MATERNITY. Women 835 19 — 53 — 20 158 1062 72 62 — 14 4 134 459 99 Children 48 — — — — — 24 82 — — — — — 30 — 26 Total 883 19 — 53 — 20 182 1144 72 62 — 14 4 164 459 125 No. of Ordinary sessions held 12 No. of gas „ „ 22 22 MATERNITY AND CHILD WELFARE. In May Dr. E. J. O'Keeffe was appointed Deputy and Assistant Medical Officer of Health in charge of the Maternity and Child Welfare Service, and he commenced his duties on 19th July. During the year two of the Health Visitors, Miss M. Bailey and Miss S. Foucar, 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 December, 1937, to January, 1938. These classes are invaluable for keeping the Health Visitors abreast of modern methods in maternity and child welfare. The only change to record in the premises of welfare centres in the borough is that the Borough Council welfare centre at 401, Mile End Road, has been transferred to 17, Rhondda Grove, in the same district. The attendances at the infant welfare centres continue to be satisfactory. One of the important activities of the infant welfare centres is the training and advising of the mothers in the proper care, feeding and clothing of their children. This training in babycraft is given by the Health Visitors at the welfare centres by means of talks or individual instruction and advice. During the year a knitting competition was held for the mothers attending the welfare centres. This was very successful both with regard to the number and the standard of the entries, and served to stimulate the interest of the mothers in the principles of correct clothing for their children. The effect of this training of the mothers is reflected in the sensible clothing that the majority of infants and young children wear nowadays. Toddlers' Clinics. (Circular No. 1550).—The Council reviewed the arrangements in the Borough for supervising the health of children under school age, following the receipt of Circular No. 1550 from the Ministry of Health, and decided on establishing two toddlers' clinics to be held monthly, one on either side of the Borough. The toddlers' clinics were established accordingly, one at Limehouse Town Hall to cater for the area served by the following municipal infant welfare centres Limehouse Town Hall, Burdett Road, St. George's Town Hall, and Riverside Mansions Centres, one at Hughes Mansions to cater for the area served by the following municipal infant welfare centres:— Vallance Road, Newark Street and Cottage Grove Centres. The toddlers' clinic sessions are held on the second Friday in each month at Vallance Road Centre and on the fourth Friday in each month at the Limehouse Town Hall Centre. The first toddlers' clinic session was held at Limehouse Town Hall Centre on 24th September. The children attending the toddlers' clinics are selected by the medical officers of the infant welfare centres and the health visitors, or are referred by parents. The health visitors concentrate on securing the attendance of those toddlers who have never previously attended a centre or who have attended a centre only during the infancy period or very occasionally. Of the number who attended the toddlers' clinic—15% had attended infant welfare centres regularly, 49% attended during infancy period or only occasionally, and 36% had never previously attended an infant welfare centre. 23 The examination by the doctor at the clinic is a comprehensive one on the lines of a school medical inspection. Defective children are referred to their family doctor or hospital and cases requiring dental treatment to the Borough dental clinic. All defective children are followed up by the health visitor to ascertain what steps the parents have taken to carry out the doctor's instructions with regard to remedying of the defects. Children with serious defects are called up again for re-examination. The following is a summary of defects found:— Malnutrition 4 Squint 0 Dental Caries 13 Tonsils 13 Adenoids 2 Cervical Adenitis 11 Heart disease 1 Non-tuberculous lung disease 2 Rickets Present 3 Past 7 Genu Valgum 7 Deformity of chest 2 Deformity of spine 0 Umbilical hernia 4 Miscellaneous 27 96 (Note.— For figures of attendances at todders' clinics see Table on p. 34.) Ante-natal Clinics.— The total attendances at the Borough ante-natal clinics continue to increase. For 1936 the figure was 585, for 1937, 687. The majority of cases attending the Vallance Road Ante-natal Clinic are booked for delivery at Mile End Hospital, whilst the majority of cases attending the Limehouse Ante-natal Clinic are confined at home with a private midwife in attendance. Infantile Mortality.— The total infantile mortality for the year was 167, giving an infant mortality rate of 60.7 which, it is a pleasure to note, is the lowest recorded for this Borough. In the previous year, 1936, the corresponding figures were 307 and 100.09 respectively, which were very unusually high due to a measles epidemic, its concurrent broncho-pneumonia and associated increased mortality due to diarrhoea. The mortality figures for infants under one year for these three diseases for the past three years were, 1935. 1936. 1937. Measles Nil 15 — Pneumonia and Broncho-pneumonia 34 56 37 Diarrhœa 31 71 24 As noted in the 1936 report, the mortality from diarrhoea occurred throughout all quarters of the year with two peaks in the curve, one in the first quarter and one in the third quarter of the year. The highest peak in 1937 was in the third quarter of the year, whereas in 1935 the highest peak occurred in the first quarter, probably due to the measles epidemic which 24 reached its apex in the early part of that year. Whilst it is expected that the general trend of the infantile mortality curve will continue downward, periodic rises due to epidemics or exceptional conditions are bound to occur. The biennial measles epidemic which is due again early in 1938 will doubtless adversely affect the infant mortality figures. Maternal mortality.—There were seven maternal deaths in 2,864 births, giving a maternal mortality rate of 2.43 as compared with 1.56 for 1936. Of the seven maternal deaths, two were due to puerperal sepsis and five were due to other causes. Two deaths due to puerperal sepsis. (1) Septic infection following obstructed labour and caesarean section. (2) Septic infection following abortion. Five deaths due to other causes. (1) Acute heart failure. (2) Obstetric shock. Post partum haemorrhage. (3) Post partum hæmorrhage, ante partum haemorrhage, placenta praevia. (4) Acute heart failure, asthma and chronic bronchitis. (5) Shock due to injection of fluid into the uterus with the object of procuring abortion. Every maternal death occurring in the Borough is investigated. Reports are received from the doctors and midwives connected with the case and these are examined to ascertain whether or not the case was one in which the death of the mother could have been avoided. The reports of the foregoing seven cases were considered and the deaths classified as follows:—Two deaths were definitely unavoidable. In two cases death was definitely avoidable. In one of these two cases death was the result of admitted self-induced abortion; in the other it was the result of an attempt to induce abortion by a person who was later sentenced to three years' penal servitude for the manslaughter of this woman. One death was probably avoidable. In this case, if the patient had co-operated and accepted hospital treatment, her general health would have been so improved that her prospects of passing safely through her confinement would have been materially increased and death would probably have been prevented. Two deaths were probably unavoidable. It is extremely difficult in some cases from the available evidence to give a more definite classification of these deaths. 25 MATERNITY MORTALITY IN LONDON BOROUGHS, 1937. 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 1.06 3.17 4.23 1.02 3.06 4.08 Kensington 0.9 2.3 3.3 0.9 2.3 3.2 Hammersmith 0.5 1.6 2.1 0.5 1.5 2.0 Fulham 0.0 3.1 3.1 0.0 2.9 2.9 Chelsea 0.0 0.0 0.0 0.0 0.0 0.0 Westminster 3.9 4.8 8.8 3.7 4.7 8.4 North Districts. St. Marylebone 2.33 2.33 4.66 2.23 2.23 4.46 Hampstead 0.98 1.97 2.95 0.956 1.91 2.87 St. Pancras 2.1 1.3 3.4 2.0 1.2 3.2 Islington 1.99 1.11 3.10 1.94 1.07 3.01 Stoke Newington 0.0 4.0 4.0 0.0 3.9 3.9 Hackney 0.34 1.04 1.39 0.33 1.01 1.34 Central Districts. Holborn 3.57 0.0 3.57 3.4 0.0 3.4 Finsbury 0.0 2.46 2.46 0.0 2.40 2.40 City of London 0.0 0.0 0.0 0.0 0.0 0.0 East Districts. Shoreditch 0.82 2.45 3.27 0.79 2.38 3.17 Bethnal Green 1.59 0.79 2.38 1.53 0.77 2.3 Stepney 0.72 1.8 2.5 0.69 1.74 2.4 Poplar 0.47 0.47 0.94 0.46 0.46 0.92 South Districts. Southwark 0.46 2.77 2.33 0.45 2.68 3.13 Bermondsey 0.0 0.70 0.70 0.0 0.68 0.68 Lambeth 1.29 0.77 2.06 1.24 0.74 1.98 Battersea 0.0 1.87 1.87 0.0 1.81 1.81 Wandsworth 0.76 2.53 3.29 0.73 2.45 3.18 Camberwell 0.95 0.95 1.90 0.92 0.92 1.84 Deptford 0.0 0.7 0.7 0.0 0.6 0.6 Greenwich 0.75 0.0 0.75 0.72 0.0 0.72 Lewisham 0.33 0.99 1.32 0.32 0.96 1.27 Woolwich 0.0 1.41 1.41 0.0 1.35 1.35 Maternity and Child Welfare Services (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 1937. 1.—Population of the area served by the Council:—203,100. 2.—Number of births notified in that area during the year under the Notification of Births Act, 1907, Section 203 of the Public Health Act, 1936, or Section 255 of the Public Health (London) Act, 1936, as adjusted by any transferred notifications : (a) Live births, 2,849. (b) Still births, 109. (c) Total, 2,958. (d) By midwives, 2,685. (e) By doctors and parents, 273. 26 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 14. (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, 13.5. (c) Number of visits paid during the year by all Health Visitors:— (i) to expectant mothers —First visits, 1,605. Total visits, 3,551. (ii) to children under 1 year of age:—First visits, 2,604. Total visits, 18,684. (iii) to children between the ages of 1 and 5 years:—Total visits, 35,415. 4.—Infant Welfare Centres. (a) Number of Centres provided and maintained by the Council, 7. (b) Number of Centres provided and maintained by Voluntary Associations, 9. (c) Total number of attendances at all Centres during the year:— (i) by children under 1 year of age, 29,677. (ii) by children between the ages of 1 and 5 years, 22,255. (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, 2,142. (ii) between the ages of 1 and 5 years, 430. (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, 2,061. (ii) over 1 year of age, 4,131. (/) Percentage of notified live births represented by the number in (d): (i) 75.18. 5.—Ante-natal and Post-natal Services. (a) Ante-natal and Post-natal Clinics (whether held at Infant Welfare Centres or at other premises):— 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 24,212 1,329 (iv) Total number of women who attended at the Clinics during the year* 4,853 1,182 27 (b) Total number of expectant mothers ante- 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 quantity of milk supplied during the year to expectant and nursing mothers and young children (i) By the Council—Dried milk 7,258½ packets. Liquid milk 27,443½ gallons. Virol, etc. 3,311 lbs. (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. I. Separate maternity institutions provided by the Council. Institutions (with maternity wards) transferred to the Council under Part I of the Local Government Act, 1929. Institutions provided by Voluntary Associations and subsidised by the Council. Number of Institutions nil nil The Council make a grant of £100 per annum to the East End Maternity Hospital. Number of maternity beds (exclusive of isolation and labour beds) nil nil 1 Total number of women admitted to these beds during the year nil nil 28 Number of beds (included in the figures above) allocated to, and reserved for, expectant mothers in need of hospital treatment nil nil - Total number of women admitted to these beds during the year. - - — II. Number of women (if any) sent by the Council during the year to other Maternity Institutions, nil. 28 8.—Homes and Hospitals for Sick or Ailing Children under 5 years of age. I. Separate Institutions provided by the Council for these cases Institutions (with accommodation for these cases) transferred to the Council under Part I of the Local Government Act, 1929. Institutions provided by Voluntary Associations and subsidised by the Council. Number of Institutions nil nil nil Number of beds provided for such children nil nil nil Total number of children admitted to these beds during the year.. nil nil nil II. Number of such children (if any) sent by the Council during the year to other institutions, 1. 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, 175. (d) Total number of such cases sent by the Council during the year to other convalescent institutions, 212. Total number sent to convalescent institutions through the Voluntary Association including (c), 522. 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 29 (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 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 195 (c) Total number of attendances of children at these nurseries during the year, 36,055. 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 *14 14 2 12 (2) Pemphigus Neonatorum Not notifiable 2 1 — (3) Puerperal fever 7 7 — 6 (4) Puerperal pyrexia 33 33 — 33 (5) Measles and German measles (in children under 5 years of age) 59 180 1 19 (6) Whooping Cough (do.) Not notifiable — — — (7) Epidemic Diarrhœa (do.) Not notifiable - — — (8) Poliomyelitis (do.) 5 - - 5 Polio encephalitis 1 - - 1 *Number of cases in which vision was unimpaired 12, impaired —, or lost — „ ,, ,, the patient died —, removed from district 2, or was „ „ still under treatment at the end of the year — ,, „ any other category —. 30 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, 1 (part time maternity nurse). (ii) by Voluntary Associations, 2 (whole time maternity nurses). (b) Total number of cases attended during the year by these nurses, 517. 14.—Consultants. Number of cases in which the services of a consultant have been provided during the year for a private medical practitioner under the Council's maternity arrangements nil 15.—Home Helps. Number of cases in which home helps have been provided during the year (the numbers of cases where this assistance has been given by Voluntary Agencies, by arrangement with the Council, should, if possible, be stated separately) 25 16.—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 2 (ii) from other causes 5 (b) Number of these cases which died:— (i) at home 2 (ii) in institutions 5 17.—Child Life Protection (Sections 206 to 220 of the Public Health Act, 1936, or Part XIII of the Public Health (London) Act, 1936.) (a) Number of persons who were receiving children for reward at the end of the year 19 (b) Number of children:— (i) at the end of the year 21 (ii) who died during the year nil (iii) on whom inquests were held during the year nil (c) Number of Child 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 Children Act, 1908, the proviso to Sec. 209 (2) of the Public Health Act, 1936, or Sec. 258 (3) of the Public Health (London) Act, 1936 nil 31 (e) Proceedings taken during the year:— No. of cases. Act and Section under which proceedings were taken. 1 Public Health (London) Act, 1936, section 257 (4). (/) Number of cases in which the local authority has given a sanction during the year:— (i) under (a) of Section 3 of the Children Act, 1908 Sec. 210 of the Public Health Act, 1936, or Sec. 259 of the Public Health (London) Act, 1936 nil (ii) under (b) of Section 3 of the Children Act, 1908, Sec. 210 of the Public Health Act, 1936, or Sec. 259 of the Public Health (London) Act, 1936 nil (iii) under (c) of Section 3 of the Children Act, 1908, Sec. 210 of the Public Health Act, 1936, or Sec. 259 of the Public Health (London) Act, 1936 nil (g) Number of orders obtained during the year under Section 67 of the Children and Young Persons Act of 1932, Sec. 212 of the Public Health Act, 1936, or Sec. 261 of the Public Health (London) Act, 1936 (i) from a court of summary jurisdiction 1 (ii) from a single Justice 2 Feeding of Infants. Breast fed at birth 90.87% „ „ at six months 63.11% Artificially fed at birth 9.12% „ „ at six months 30.57 % No. of Infants breast fed at birth 2,424 ,, „ artificially fed at birth 180 No. of Infants dead before the visit of Health Visitor 47 „ „ removed before the visit of the Health Visitor 152 „ „ Untraced 17 Maternity Outfits.—No sterilized maternity outfits were supplied through the Municipal Ante-natal Clinics during the year. Health Visiting.—There are 7 Municipal Infant Welfare Centres and 9 Voluntary Centres in the Borough. Details of the work of the Health Visitors and Centres are given on pages 33 and 34. Prevention of Deafness.—Four cases received treatment under the arrangements with the London County Council for the treatment of children, suffering from ear defects. Convalescent Treatment.—During the year, mothers and children were sent away to the homes mentioned below:— Home. Mothers. Children. St. Mary's, Dover 45 59 All Saints' Convalescent Home, Eastbourne 6 63 Zachary Merton, Rustington 7 10 St. Mary's, Birchington 11 11 69 143 32 Provision of Milk and Meals to Expectant and Nursine Mothers and Children.— The following table shows the approximate quantity and cost of milk, etc., distributed during the year:— No. of Grants. Quantity. Cost. Cows' Milk— £ s. d. Free 7,662 26,757½ gals. 2,803 8 2¾ Half-Price 192 686 35 14 5 Dried— Free 1,657 7,056½ pkts. 561 5 11 Half-Price 48 202 „ 7 17 3½ Virol, etc.— Free 3,231 3,217 lbs. 225 0 8½ Half-Price 94 94 „ 3 5 3 Total 12,884 27,443½ gals. £3,636 11 9¾ 7,258½ packets. 3,31 lbs. The number of dinners supplied by the Stepney Invalid Kitchen, White Horse Street, on the grounds of health, to expectant and nursing mothers who are in necessitous circumstances, was 1,522, at a cost to the Council of £50 12s. 10d. Home Helps.—The number of cases in which home helps have been provided under the Borough Council's Scheme has increased from 15 in 1936, which was the first complete year of working the Scheme, to 25 during the year under review. This service is a boon to the poorer mothers in the Borough, enabling them to accept treatment, if necessary, and to go through confinement relieved of the cares and worries of family and household. The scheme has worked smoothly during the year and in no case has there been any serious complaint from mother or home help. The Council's panel of home helps consists of selected women, each applicant being interviewed before being placed on the list. Artificial Sunlight Treatment.—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. 9 children received such treatment free of cost. Maternity Nursing.—Maternity Nurses were supplied in two instances in doctors' cases under the Council's Scheme free of cost to the patients. Child Life Protection.—Total visits of the eleven Child Protection Visitors to homes of foster mothers 233 Total visits of the eleven Child Protection Visitors to foster children 287 Other visits made by these visitors 200 33 Visits by Health Visitors.—The following table shows the number of visits, etc., paid by the Municipal Health Visitors during the year. HEALTH VISITORS' REPORT. DISTRICT Wapping Shadwell, 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, Shadwell, 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 Railey Miss Blackmore Miss Brazier Miss Carty Miss Clements Miss Clifford Miss Cordwell Miss Foucar Miss Gibbs Miss Styles Total Visits:— Primary 101 315 206 232 257 325 242 357 251 318 2,604 Revisits:— To infants under 1 year 231 277 543 548 291 381 648 490 477 543 4,429 To children between 1-5 years 678 826 1019 1,267 813 914 927 933 897 1,483 9,757 Ante-natal:— Primary 18 59 29 49 44 72 52 41 10 35 409 Subsequent — 7 2 30 3 48 3 1 - - 94 Ophthalmia Neonatorum — 4 1 1 2 2 1 1 1 1 14 Puerperal Pever — 2 1 — 2 - - - 2 - 7 „ Pyrexia 2 4 3 1 1 8 4 7 3 - 33 Measles - 20 13 2 - 6 8 17 7 8 81 „ Revisits - 2 1 1 - - 1 - 1 - 6 Miscellaneous 164 261 93 217 246 449 485 102 38 81 2,136 Attempted visits 192 484 612 393 168 472 269 339 198 394 3,521 Infant Life Protection: Visits to homes of foster mothers - 52 48 15 1 5 2 27 4 3 157 Visits to foster children — 64 39 17 1 1 20 30 11 17 200 Other visits — 23 — — — 1 — 3 1 2 30 Totals 1,386 2,400 2,610 2,773 1,829 2,684 2,662 2,348 1,901 2,885 23,478 CENTRES ATTENDED:— Municipal 170 205 160 167 199 161 170 133 70 203 1,638 Voluntary 7 - 1 - - 1 - 116 90 - 215 Totals 177 205 161 167 199 162 170 249 160 203 1,853 34 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. Cottage Grove Burdett Road Mon. Wed. Thurs. Thurs. Wed. Tues. Fri. Tues. Thurs. Tues. Fri. Wed. No. of Infant Welfare Sessions (total) 48 51 - 52 51 49 49 52 52 53 42 51 550 .. Attendances of Infants 1,295 1,263 — 1,770 1,483 1,511 1,010 681 1,478 1,478 201 674 12,844 „ „ Children 1 to 5 755 1,028 - 1,198 680 1,174 803 684 1,847 1,178 118 863 10,028 „ Infants on Registers at end of the year 135 — 112 103 214 137 77 119 897 „ Children on Registers at end of the year 349 — 217 142 228 323 184 153 1,596 „ Ante-Natal Sessions — — 51 — — — — 52 — — — — 103 „ „ New Cases — — 113 — — — — 70 — — — — 183 „ „ Subsequent Attendances - - 246 - - - - 258 - - - - 504 „ Doctors' Consultations 48 51 51 52 51 49 49 52 62 53 — 51 659 Toddlers Clinics: No. of sessions held 4 — — — — — 3 — — — 7 No. of first attendances 31 - - - - - 22 - - - 53 Total Attendances 31 - - - - - 22 - - - 53 No. of toddlers found with defects 29 — — — — — 17 — — — 46 Total No. of defects found 60 — - — — — 36 — — - 96 35 Infantile Mortality.—The deaths from stated causes at various ages under one year of age are shown in the table below:— Cause or 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 17 8 3 4 32 16 21 11 16 96 F. 19 3 2 1 25 8 19 13 6 71 Small-pox M ... ... ... ... ... ... ... ... ... ... F. ... ... ... ... ... ... ... ... ... ... Chicken-pox M. ... ... ... ... ... ... ... ... ... ... F. ... ... ... ... ... ... ... ... ... ... 2 Measles M. ... ... ... ... ... ... ... ... ... ... F. ... ... ... ... ... ... ... ... ... ... 3 Scarlet Fever M. ... ... ... ... ... ... ... ... ... ... F. ... ... ... ... ... ... ... ... ... ... 4 Whooping Cough M. ... ... ... ... ... ... ... ... 1 1 F. ... ... ... ... ... ... 2 ... 2 4 5 Diphtheria and Croup M. ... ... ... ... ... ... ... ... ... ... F. ... ... ... ... ... ... ... ... ... ... 10 Tuberculous Meningitis M. ... ... ... ... ... ... ... 1 ... 1 F. ... ... ... ... ... ... ... ... ... ... 10 Abdominal Tuberculosis M. ... ... ... ... ... ... ... ... ... ... F. ... ... ... ... ... ... ... ... ... ... 10 Other Tuberculosis Diseases M. ... ... ... ... ... ... ... ... ... ... F. ... ... ... ... ... ... ... ... ... ... 11 Syphilis M. ... ... ... ... ... ... ... ... ... ... F ... ... ... ... ... ... ... ... ... ... 19 Bronchitis M. ... ... ... ... ... 2 1 1 ... 4 F. ... ... ... ... ... ... 1 ... ... 1 20 Pneumonia (all forms) M. 1 2 ... 2 5 5 6 6 5 27 F. ... ... 1 ... 1 1 4 3 1 10 23 Diarrhoea M. ... ... ... ... ... 2 4 ... 5 11 F. ... ... ... ... ... 2 6 4 1 13 23 Enteritis M. 1 ... ... ... 1 1 3 ... 1 6 F ... ... ... ... ... ... 3 2 ... 5 27 Gastritis M. ... ... ... ... ... ... ... 1 ... 1 F. ... ... ... ... ... ... ... ... ... ... 31 Congenital Malformations M. 4 1 ... 1 6 2 2 ... ... 10 F. 4 1 ... ... 5 2 ... 1 ... 8 31 Premature Birth M. 6 2 ... ... 8 1 ... ... ... 9 F. 10 2 1 1 14 1 ... ... ... 15 31 Atrophy, Debility & Marasmus M. ... 1 ... ... 1 2 ... ... ... 3 F 3 ... ... ... 3 1 ... ... ... 4 31 Atelectasis M. 1 ... ... ... 1 ... ... ... ... 1 F. 1 ... ... ... 1 ... ... ... ... 1 31 Injury at Birth M. ... ... ... ... ... ... ... ... ... ... F. ... ... ... ... ... ... ... ... ... ... 31 Convulsions M. ... ... ... ... ... ... ... ... ... ... F. ... ... ... ... ... 1 ... ... ... 1 34 Suffocation, overlying M. ... ... ... ... ... ... ... ... ... ... F. ... ... ... ... ... ... ... ... ... ... 35 Rickets M. ... ... ... ... ... ... 2 ... ... 2 F. ... ... ... ... ... ... 1 ... ... 1 35 Meningitis (not tuberculous) M. ... ... ... 1 1 ... 1 ... 2 4 F. ... ... ... ... ... ... 1 ... ... 1 35 Laryngitis M. ... ... ... ... ... ... ... ... ... ... F. ... ... ... ... ... ... ... ... ... ... 35 Erysipelas M. ... ... ... ... ... ... ... ... ... ... F. ... ... ... ... ... ... ... ... ... ... 35 Other causes M. 4 2 3 ... 9 1 2 2 2 16 F. 1 ... ... ... 1 ... 1 3 2 7 36 Ill defined M. ... ... ... ... ... ... ... ... ... ... F. ... ... ... ... ... ... ... ... ... ... Totals ... 36 11 5 5 57 24 40 24 22 167 36 INFANTILE MORTALITY Etc., IN LONDON BOROUGHS, 1937. Borough. Estd. Res. population (mid. 1937). Live births rate per 1,000 population Death rate per 1,000 population. Infantile Mortality rate per 1,000 live births. Crude. Adjusted. West districts. Paddington 138,300 13.65 13.05 12.91 66 Kensington 175,600 12.1 13.3 12.4 83 Hammersmith 126,500 15.1 12.6 13.0 68 Fulham 138,900 13.9 13.08 13.2 56 Chelsea 56,510 10.8 14.1 12.0 59 City of Westminster 124,300 8.2 11.5 11.8 58.7 North districts. St. Marylebone 92,110 9.36 13.10 12.98 73 Hampstead 90,690 11.2 11.6 10.9 54 St. Pancras 181,900 13.0 12.7 13.0 62 Islington 295,400 15.25 12.9 13.02 66 Stoke Newington 50,250 14.9 12.5 12.0 37.5 Hackney 206,700 13.8 11.1 11.7 43.38 Central districts. Holborn 34,600 8.09 11.85 12.68 79 Finsbury 58,700 13.8 14.6 15.9 71 City of London 8,980 6.1 11.2 12.4 36.3 East districts. Shoreditch 82,240 14.86 12.47 13.72 54 Bethnal Green 94,560 13.3 12.5 14.1 54 Stepney 203,100 13.5 12.2 14.2 60.5 Poplar 136,800 15.5 12.6 14.0 61 South districts. Southwark 147,400 14.7 13.6 14.1 64 Bermondsey 98,790 14.4 12.3 14.0 59 Lambeth 273,800 14.1 13.2 13.0 68 Battersea 143,500 14.94 12.89 12.76 70.43 Wandsworth 341,700 11.53 12.36 11.43 62 Camberwell 224,800 14.08 12.83 12.83 58 Deptford 96,580 15.1 11.8 12.3 45 Greenwich 95,990 13.88 12.03 12.27 50 Lewisham 226,000 13.9 10.8 10.9 46 Woolwich 149,400 14.2 11.1 11.7 40 37 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: Limehouse Town Hall, Commercial Road ... 2 to 5* ... ... ... 2 to 5* ... ... 10 Toddlers 4th Friday in month ... 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* 10 Toddlers 2nd Friday in month ... St. Phillips Institute, Newark Street ... ... ... ... ... 2 to 5* ... ... ... ... 17, Rhondda Grove ... ... ... 2 to 5* ... ... ... 2 to 5* ... ... (b) Voluntary: Mission Hall, Carr Street ... ... ... 2 to 5* (also sewing) ... ... ... ... ... ... Stepney Infant Welfare Centre, St. Matthews Hall, 86a, White Horse St., Commercial Rd. 10.30 (sunlight) 2* ... ... 10.30* (sunlight) 2.15 to 4.15 (sewing) 10.30 (dental) 2.30 (lectures on home nursing and infant care) 10.30 (sunlight) 2* The Superintendent is available at her flat nearby for consultation any day from 8 a.m. to 10 p.m. Memorial Hall, The Highway, Shad well ... ... ... 2 to 4* ... 2 to 4* ... 2.30 to 4 (sewing) ... ... Dame Colet House29, Duckett Street also 9.15 to 11 (minor dressings) 2* 9.15 to 11 (minor dressings) 2* 9.15 to 11 (minor dressings) 2.30 (sewing and health talk) 9.15 to 11 (minor dressings) ... 9.15 to 11 (minor dressings) ... 10, Duckett Street ... 3 (sunlight) ... ... ... 2.30 (sunlight) ... ... ... 2.30 (sunlight) Sunlight with the doctor by arrangement. 12, St. Clare Street, Minories ... 2 to 4* ... 2.30 to 4 (knitting and lecture) ... 2.30 to 4 (sewing and lectures) ... 2 to 4* ... ... Toddler s' dinners daily, 12.30. Mothers dinners daily,2. Jewish Infant Welfare Centre, Bernard Baron Settlement, Berner Street ... 2 to 5* ... 2 to 4 (sewing) ... 2 to 5* ... ... ... ... Jewish Mothers Welcome, Bernard Baron Settlement, Berner Street 9 to 11 (advice to mothers and minor ailments) 2 to 4 (sewing) 9 to 11 (advice to mothers and minor ailments) 1.45 to 4* 9 to 11 (advice to mothers and minor ailments) ... 9 to ll (advice to mothers and minor ailments) 1.45 to 4* and dental 1.30 to 2.30 at 17, Leman Street 9 to 11 (advice to mothers and minor ailments) ... Toddlers first Tuesdayi each month, 11 to 12.30. *Denotes that there is a Doctor in attendance. 38 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* 10 to ll Post natal alternate Thursday 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 to l* ... ... ... Hughes Mansions, Vallance Road ... ... 10 to 1* ... ... ... ... ... ... ... (b) London County Council: Mile End Hospital, Bancroft Road 10 2 ... ... 10 2 to 4 ... 2 ... ... St. George's Hospital, Raine Street ... ... ... ... ... ... ... 2 ... ... Also Saturdays. 11.30. (c) Voluntary: East End Maternity Hospital, 396, Commercial Road 9 2 ... 2* 9 ... ... ... 9 ... Jewish Maternity Hospital, 24, Underwood Street 10 to 12* ... ... ... ... ... 10 to 12* ... ... ... London Hospital, Whitechapel Road ... ... 9* ... 9* ... ... ... ... ... CRECHES. Voluntary : Day Nursery, Memorial Hall, The Highway, Shadwell ... ... Tb is is an open air nursery a nd it is open from May to October. ... ... Jewish Day Nursery, 23, New Road ... ... ... ... ... ... ... ... ... ... Port of London Day Nursery, 5, Pier Head, Wapping ... ... ... ... ... ... ... ... ... ... Marie Hilton Creche, Stepney Causeway ... ... ... ... ... ... ... ... ... ... St. Paul's Day Nursery, Wellclose Square ... ... ... ... ... ... ... ... ... ... BABIES' NURSING HOME. 587, Commercial Road (Now closed) ... ... ... ... ... ... ... ... DAY NURSERY SCHOOL—L.C.C. Old Church Road ... ... ... ... Open Mondays to Fridays. ... ... ... ... *Denotes that there is a doctor in attendance. 39 III.—SANITARY CIRCUMSTANCES OF THE AREA. Scavenging.—I am informed by the Public Cleansing Officer that there have been no extensions or improvements during the year in the services controlled by the Public Cleansing Department. Shops Act, 1934.—1,653 inspections were carried out during the year. It was found necessary to serve 59 notices, i.e., 24 with respect to sanitary accommodation, 17 to ventilation, and 18 with respect to temperature. No applications were received for exemption under Section 10(2) of the Act. Human Remains.—A licence was issued by the Home Office for the exhumation of human remains from the vaults of the Tower Hamlets Mission (Children's Hall) and for their reinterment at Brookwood Cemetery. The exhumation was supervised by a Sanitary Inspector and commenced on 22nd November and finished on 15th December. It involved the removal of 800 to 1,000 bodies which were placed in 226 cases. Pharmacy and Poisons Act, 1933.—8 persons were entered in the List of Persons entitled to sell Poisons included in part II of the Poisons List. 6 were removed from the list as the sale of poisons was given up, and the total number on the List is 82. 289 inspections and visits were made by the sanitary inspectors during the year. Legal proceedings were taken in respect to the sale of poisons at premises not listed by this Authority. £2 2s. 0d. costs were imposed. Smoke Nuisances.—438 observations were made by the Sanitary Inspectors for the detection of nuisances from smoke, which necessitated the serving of 66 Intimations for the abatement of the nuisance. Complaints.—2,809 written complaints were made to me during the year, which were duly investigated. Of these 105 were from H.M. Inspector of Factories relating to workshops, 121 from the London County Council respecting verminous school children, 3 from the London County Council respecting premises under the Shops Act, 1934, and 2,580 related to the condition of houses, etc. In addition inspections were made as a result of complaints made to the Sanitary Inspectors. Drainage.—The Sanitary Inspectors supervise all drainage work. Full particulars as to the work done by them are given on pages 50 and 51. 2,146 drains were tested during the year. Of these, 357 were found to be defective. Improvements were effected in the sanitation of a school in the Borough by the replacement of 19 trough closets with 17 modern pans and traps Rats and Mice.—During the year 916 complaints were received as to nuisances from rats or mice. As a consequence 938 drains were tested and in 358 instances they were found to be defective. 410 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. 40 Record of Rat Destruction carried out by the Council's Ratcatchers from lst January to 31st December. No. of premises visited 1,136 „ „ visits 17,890 „ „ dead rats found poisoned 56 „ „ rats caught in our traps 1,869* „ „ premises cleared of rats as reported by the Occupiers 409 „ „ new rat complaints during this period 592 *1,513 of these were actually brought into the Depot and destroyed. The poisons used were as follows:— Rodine 37,498 cubes. Barium carbonate 34,422 „ Phosphor paste 39,911 „ Extract of Squills 15,604 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 1937:— Extra Rat Weeks. Dates (inc.) Poisoned baits laid in Baits laid Manholes. Side-entTances, Eaten. Uneaten. First 1st to 7th February 174 17 1,328 68 Second 3rd to 8th May 188 17 913 137 Third 26th July to 31st July 215 27 1,649 124 National Rat Week—1st to 6th November. The Council adopted a similar procedure as in previous years. Notices, drawing the attention of the public to the matter, were inserted in four local newspapers. Communications were sent to 13 local cinemas, requesting that notices be displayed on the screen, drawing attention to National Rat Week. 72 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 250 different positions throughout the Borough. A total of 1,592 portions of bait were laid, of which number 1,484 were eaten. The Council employ three men as ratcatchers, who give their whole time to rat destruction. 41 Houses Let in Lodgings.—There are 3,356 houses let in lodgings. It became necessary to serve 986 "intimations" for contravention of the byelaws, and to institute legal proceedings in seven instances. Rent and Mortgage Interest Restrictions Acts.—82 applications for certificates as to houses not being in a reasonable state of repair were received, 69 of them were granted, 11 were refused and 2 were withdrawn. 26 applications were received for reports that the work mentioned on certificates already issued had been satisfactorily executed, 16 were granted and 10 were refused. Water Certificates.—Certificates were granted under the provisions of the Public Health (London) Acts as to dwelling houses having a proper and sufficient supply of water with respect to 13 houses and 437 tenements. Hairdressers' Shops.—Annual certificates are granted respecting Hairdressers' Shops in the Borough, which come up to a certain standard of cleanliness. Four certificates were granted during the year. Mortuary and Shelter.—The number of bodies deposited in the Mortuary during the year was 342. 42 Jewish bodies were officially "watched." 166 inquests were held in the Coroner's Court, and 235 post mortem examinations were made. The shelter is used for the accommodation of contacts of infectious disease while their homes are being disinfected. It was not found necessary to admit any persons during the year. Report supplied to the L.C.C:— Premises. No. in borough on 31st December, 1937. No. of Inspections. No. of Prosecutions. Common lodging houses 16 258 — Seamen's lodging houses 10 108 — Cowsheds (licensed) 17 128 — Slaughterhouses (licensed) nil — — Other offensive trades 51 338 — Milkshops:— Dairy premises 203 1,273 14 Purveyors bottled milk 414 Ice cream premises 366 563 2 Registered foster mothers 19 233 — Nurse children kept 21 287 — Restaurants and eating houses 385 567 — Smoke Nuisances. (1) No. of observations 438 (5) No. of legal proceedings — (2) No. of intimations served 66 (6) No. of convictions — (3) No. of complaints received 72 (7) Amount of penalty and costs (4) No. of Statutory notices served 1 imposed in each case — 42 Cleansing and Disinfection. No. of adults cleansed 165 No. of (a) after infectious premises diseases 1,147 No. of children cleansed — cleansed (b) for vermin 1,040 (c) after Tuberculosis 135 Water Supply to Tenement Houses. No. of premises supplied 17 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) — Housing. 9. Number of houses (wholly or 1. Total number of houses in the in Part) the subject of Closing borough 37,206 orders (excluding underground rooms) nil Public Health Act. 2. No. of houses inspected on 10. Number of Closing Orders account of complaints 2,580 determined (i.e., houses made Illness 1,422 fit) 1 3. Number of statutory notices served 2,896 11. Overcrowding (Housing Act, 1936) 4. Number of houses repaired or Number of families found to nuisances remedied 10,483 be living in overcrowded conditions 6,738 Housing Act (1936). Number of overcrowded fam- 5. Number of houses inspected— ilies who have obtained alternhouse to house (Housing Con- ative accommodation 639 solidated Regs. 1925) 595 6. (a)Number of houses included 12. Number of houses erected by in representations by the the Borough Council for workBoroughMedical Officer under ing classes during year 354 Sec. 25 of H.A. 1936 68 (b) Number of houses demol- 13. Underground Rooms. ished following representa- . tion by Borough Medical Number occupied but unfit 5,949 Officer under Sec. 25 of H.A. Number closed or modified 1936 — occupation approved 185 7. Number of houses repaired under Sections 9 and 10 of 14. Houses Let in Lodgings. H.A.1936: Number in Borough 3,356 (a) by owners , nil (b)by L.A. in default of owners nil Number of inspections 1,838 8. Number of houses demolished : Number of prosecutions 7 (a) in pursuance of orders Number of complaints remeunder Sec. 11 of the Housing died under the By-laws (not Act, 1936 * 3 included under any other (b) Voluntarily nil heading) 85 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) 59 1st January to 31st December, 1937 German Measles — — Whooping Cough — — Rheumatic Fever (0-16) — — Chicken Pox — — Zymotic Enteritis — — 43 Canal Boats Acts, 1877 and 1884.—Pursuant to the Third Section of the Canal Boats Act, 1884, the Metropolitan Borough of Stepney, being the Registration Authority under the 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 taken by them as such authority during the year 1937 to give effect to the provisions of the said Acts and Regulations, viz.:— (1) Canal Boats coming within the district are inspected by a Sanitary Inspector, who receives a sum of £10 per annum for the performance of this duty. His inspection is irrespective of the examination of Boats made by the Examining Officer prior to their registration. (2) The number of boats inspected was 18. Seven children were found on the boats. There were no contraventions of the Acts and Regulations. No boats were registered during the year. Home Office Form 572. Factories, Workshops and Workplaces.—1.—Inspections. Premises. Number of Inspections. Written Notices. Prosecutions. Factories (Including Factory Laundries) 1,650 300 1 Workshops (Including Workshop Laundries) 855 258 — Workplaces Other than Outworkers' premises) 223 48 - Totals 2,728 606 1 44 2.—Defects found. Particulars. Number of Defects. Number of Prosecutions. Found. Remedied. Referred to H.M. Inspector. Nuisances under the Public Health Acts:— Want of cleanliness 272 272 — 1 Want of ventilation 20 19 — - Overcrowding 1 1 — - Want of drainage of floors 4 4 — — Other nuisances 300 300 1 — Sanitary Accommodation insufficient 29 28 — — unsuitable or defective 165 165 — — not separate for sexes 44 44 — — Offences under the Factory and Workshop Act:— Illegal occupation of underground bakehouse (s 101) - - - - Other offences (Excluding offences relating to outwork which are included in Part 3 of this report.) 1 - 1 - Totals 836 833 2 1 3.—Registered Workshops. Workshops on the Register (s. 131) at the end of the year 1937. Number. Bakehouses 84 Boot, Shoe and Slipper Making 75 Cabinet Making 65 Furriers 126 Hat and Cap Manufacturers 45 Laundries 10 Rag Sorting, etc. 47 Wearing Apparel (Tailors, Milliners, Dressmakers, etc., etc.) 808 Miscellaneous 455 Total 1,715 45 4.—Other Matters Class. Number. Matters notified to H.M. Inspector of Factories:— Failure to affix Abstract of the Factory and Workshop Act (s. 133), 1901 13 Action taken in matters referred by H.M. Inspector as remediable under the Public. Health Acts, but not under the Factory and Workshop Act (s. 5), 1901 Notified by H.M. Inspector 105 Reports (of action taken) sent to H.M. Inspector 105 Other 9 Underground Bakehouses (s. 101):— Certificates granted during the year — In use at the end of the year 42 Outworkers.—The net number of outworkers on the Register is 2,343 and they are engaged in the trades as follows :— Making, cleaning, etc., of wearing apparel ... ... 2,216 Furriers 26 Umbrellas 17 Boots and shoes 28 Boxes 9 Flag making ... ... ... ... ... ... 1 Christmas cards ... ... ... ... 3 Carnival novelties ... 3 Artificial flowers ... ... ... 7 Handbags 1 Feather curling ... ... ... ... 2 Invisible mending ... ... ... ... ... 1 Dolls ... ... ... ... ... ... ... 1 Dyers and Cleaners ... ... ... ... ... 1 Christmas crackers ... , . 7 Art needlework ... 1 Leather goods 3 Ties 2 Toys 2 Millinery ... ... ... ... ... ... 6 Paper garlands ... ... ... ... ... 4 Fancy goods ... 2 2,343 46 The number of inspections made to outworkers' premises was 591, and the number of premises where sanitary defects were found to exist was 322. Notifiable infectious disease occurred in 71 outworkers' premises. There are 89 firms in the Borough employing outworkers, and of these firms 82 sent in lists twice in the year and 7 once. These related to a net number of 1,580 outworkers, of which 951 were resident in the Borough and 629 were transferred to other Districts. In addition, 385 lists relating to a net number of 1,392 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, cleaning, etc. 288 236 Furniture and upholstery 16 15 Umbrellas 4 3 Paper, etc., boxes, paper bags 4 4 Fur pulling 5 2 Lace, lace curtains and nets 1 1 Artificial flowers 1 1 Cosaques, Christmas crackers, etc. 3 3 Total 322 265 There are 1,722 factories and 362 workplaces in the Borough. Rag Flock Acts.—24 inspections were made during the year to 8 premises subject to the provisions of the Rag Flock Acts. Cowsheds.—There are 17 cowsheds in the Borough. During the year 128 inspections were made to the cowsheds, and it was found necessary to serve 19 notices for minor matters. Offensive Businesses.—There are 51 authorised Offensive Businesses in the Borough, i.e., 1 Knacker's Yard, 1 Soap Boiler, 2 Tripe Boilers, 5 Dressers of Fur Skins and 42 Slaughterers of Poultry. 338 inspections were made to these premises during the year and 18 notices were served for minor matters. 10 persons were licensed under the Slaughter of Animals Act, 1933, as Slaughtermen at a Knacker's Yard in the Borough. Slaughterhouses.—There are no slaughterhouses, other than those used for poultry, in the Borough. Lodging Houses.—There are 16 common lodging houses. 258 inspections were carried out during the year and 15 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 11th February and the following information ascertained:— 47 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 2047 541 41 1306 360 13 29 60 32 — 40 31 — In addition to the above, there are 10 Seamen's Lodging Houses. 108 inspections were made of them during the year, 6 notices were served for minor nuisances. Legal proceedings were instituted by the Council on 29th November for keeping a common lodging house without being duly licensed. The premises consisted of 6 bedrooms, 2 containing 5 beds in each, all being always occupied by the same persons and 2 common rooms, one for meals and the other for social purposes. The lodgers were all Indians, and it was stated that they had lived there for 2 or 3 years. Defendant stated that they were all employees kept by him for 4s. 6d. each per week, and produced rent books. The case was adjourned until 15th December when it was held by the Magistrate that the premises were not a common lodging house and he dismissed the summons on payment of £5 5s. 0d. costs against the Council. This case was taken in the nature of a test case. There appears to be no definition of a common lodging house in the Public Health (London) Act, 1936. 48 Sanitary Inspection—The following tables show the work of the District Sanitary Inspectors:— REPORT OF INSPECTIONS, ETC. BY THE DISTRICT SANITARY INSPECTORS—1937. W. E. Anstee. J. H. Brownlee. J. J. Coveney. W. Cue. R. W. G. Day G. D. Freeland. H. J. Green. C. F. Guy. W. H. Haworth W. H. Howard. J. Keniry. S. Lowther. J. G. McCarthy. R. Roper. W. F. Smith. W. T. Twynham. R. H. Waterman. Totals Bakehouses 40 28 2 6 24 25 14 19 13 11 7 20 22 24 33 25 11 324 Common Lodging Houses 36 18 — 16 — 45 10 — 15 — 18 — — 51 — 16 7 232* Complaints 518 706 66 522 951 641 1,171 671 486 159 552 812 1,111 555 783 695 218 11,717 Factories 130 96 8 32 57 33 138 79 94 51 22 78 21 322 208 191 90 1,650 Houses let in Lodgings 118 130 5 3 81 235 139 69 160 42 77 50 55 224 272 168 10 1,838 House to House 25 62 — 22 10 47 16 142 48 22 126 66 32 140 95 279 228 1,360 Infectious Disease 70 59 20 74 131 62 67 92 73 100 103 119 123 42 140 55 92 1,422 Offensive Trades — 34 1 — — 69 14 5 3 1 22 61 13 72 4 17 22 338 Outworkers 28 35 — 27 63 — 97 44 1 1 9 10 13 93 45 131 — 597 Restaurants and Eating Houses 33 36 — 65 29 7 17 6 42 14 25 73 127 15 49 29 567 Markets (week-end) 3 2 1 1 3 4 2 3 3 3 3 2 2 1 2 2 2 39 Seamen's Lodging Houses 10 1 — 73 - - - - - - 24 - - - - - - 108 Workplaces 23 6 — 5 5 13 8 17 38 11 14 6 3 34 33 4 3 223 Workshops 82 61 — 5 42 45 81 92 112 56 12 33 30 28 60 61 55 855 Shops Act 135 89 — 95 3 107 145 66 101 45 34 200 20 375 157 52 29 1,653 *In addition, 26 inspections to Women's Common lodging Houses were made by Miss Whitty. 49 REPORT OF INSPECTIONS, ETC. BY THE DISTRICT SANITARY INSPECTORS—1937—Continued. W. E. Anstee. J. H. Brownlee. J. J. Coveney. W. Cue. R. W. G. Day G. D. Freeland. H. J. Green. C. F. Guy. W. H. Haworth W. H. Howard. J. Keniry. S. Lowther. J. G. McCarthy. R. Roper W. F. Smith. W. T. Twynham. R. H. Waterman. Totals Pharmacy & Poisons Act 37 11 — 84 24 20 5 2 9 7 28 3 4 27 10 10 8 289 Rag Flock Acts — — — 4 — — — - — — 6 — — — — 10 24 Miscellaneous 1,314 908 52 768 1,384 577 666 1,062 1,139 836 1,202 992 661 1,811 1,543 1,030 1,749 17,694 Observations re Smoke Nuisance — 1 — 191 54 17 3 4 6 2 4 19 6 36 1 7 87 438 Re-Visits 1,413 1,818 247 1,830 2,343 2,058 2,296 1,680 893 2,619 998 1,821 2,277 971 1,551 2,385 1,883 29,083 Intimations served 442 489 42 445 754 642 943 582 486 1,135 327 512 874 477 599 869 686 10,304 Statutory Notices served 99 127 4 50 290 177 249 235 134 429 114 196 175 90 159 238 130 2,896 No. of Summonses taken out — 4 — 8 — — 17 5 5 1 — 4 — 6 2 1 — 53 50 RETURN OF SANITARY WORK, 1937. W.E. Anstee. J. H. Brownlee. J. J. Coveney. W. Cue. R. W. G. Day G.D. Freeland. H. J. Green. C. F. Guy. W. H. Haworth W. H. Howard. J. Keniry. 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 - 6 - 1 1 2 5 - - - 2 - - 3 - - 1 21 Bakehouses: No.ofcleansings of 11 16 — 10 17 20 17 15 12 12 13 10 16 10 9 24 8 220 Cisterns cleansed, covered and repaired 1 38 — — — — 8 — 3 1 11 2 21 23 - 108 Dampness in premises remedied 112 94 12 105 200 240 168 116 223 245 120 163 191 104 252 224 78 2,647 Drains—Cleansed or repaired 104 55 — 54 51 60 86 24 73 43 50 40 42 112 48 73 51 966 Constructed or reconstructed 47 25 — 23 14 17 65 44 44 23 19 82 35 67 20 26 25 576 Dust receptacles provided 82 52 1 67 118 75 111 94 73 127 62 84 197 95 76 83 114 1,511 Number of dwelling rooms cleansed 155 208 40 510 955 378 608 265 331 428 416 437 951 352 280 405 678 7,397 Houses ventilated beneath the lower floor 9 7 5 5 6 5 7 3 8 4 4 63 Improved light and ventilation provided to rooms 7 7 4 4 10 12 3 3 4 3 3 4 8 7 5 84 Manure receptacles provided or reconstructed 2 1 _ 3 - 1 - 7 Offensive accumulations removed 52 23 — 10 42 44 81 13 34 23 16 9 24 21 12 84 20 508 51 RETURN OF SANITARY WORK, 1937—Continued. W. E. Anstee. J. H. Brownlee. J. J. Coveney. W. Cue. R. W. G. Day G. D. Freeland. H. J. Green. C. F. Guy. W. H. Haworth | W. H. Howard. J. Keniry. 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 71 51 4 66 106 37 135 54 54 92 149 64 85 59 128 151 92 1,398 No. of repairs to roofs 127 125 21 228 349 216 141 221 183 376 90 154 408 133 202 213 299 3,486 Sink, bath and lavatory pipes fixed or repaired 68 80 3 70 128 30 348 37 34 75 334 125 200 179 72 199 26 2,008 Smoke nuisances abated 26 7 1 23 2 12 10 — 21 — 12 — — 5 3 2 124 Urinals fixed or repaired 3 16 — — 5 — 8 — 7 — 19 6 8 21 2 14 109 Verminous rooms cleansed 113 68 — 25 19 214 34 14 80 40 24 14 1 35 43 19 12 755 Waterclosets—Cleansed or repaired 97 102 6 105 124 98 241 55 80 104 49 66 87 153 103 275 84 1,829 „ Light and ventilation provided 3 43 — 12 2 — 207 1 7 3 3 1 138 - 254 6 680 „ Pans and traps fixed 26 34 — 43 85 24 288 24 68 39 172 53 156 157 36 277 43 1,525 „ Provision or repair of flushing apparatus 82 24 3 41 78 29 394 39 36 67 183 26 158 132 36 332 61 1,721 Water supply to houses reinstated or repaired 34 26 2 18 16 — 3 10 16 17 9 5 36 4 10 34 15 255 Yards, areas and forecourts cleansed, paved, or paving repaired 83 20 1 41 84 46 72 22 22 53 10 67 32 30 96 112 36 827 Floors, windows, staircases, fireplaces and coppers repaired 143 185 19 291 544 190 387 238 257 431 223 219 462 382 229 355 271 4,826 Miscellaneous 152 206 2 145 136 205 273 607 300 663 216 473 151 181 463 263 102 4,538 52 Legal Proceedings:— Date. Matter of Information or Complaint. t. 1937 Public Health(London) Act, 1936. 8th Jan. Failing to abate nuisance caused by defective paving at 123/5, New Road. Work completed. Case withdrawn on payment of £2 5s. 0d. costs. 14th Jan. Failing to abate nuisance caused by defective main roof, etc. at 16, Great Alie Street. Fined £2 0s. 0d. Pay £2 8s. 0d. costs. 22nd Jan. Failing to abate nuisance caused by dirty walls and ceiling of top floor front room at 71, Plumbers Row. Ordered to do the work within 14 days. Fined £2. Pay £2 8s. 0d. costs. 5th Feb. Failing to abate nuisance caused by defective drain, roof and dirty walls and ceiling at 7, Milward Street. Ordered to do the work within 14 days. Pay £2 8s. 0d. costs. 16th Feb. Failing to abate nuisance arising from defective roof at 145, Bancroft Road. Ordered to do the work within 14 days. Pay £2 8s. 0d. costs. 16th Feb. Failing to abate nuisance arising from defective roof, damp wall, etc., at 2, Bradwell Street. Ordered to do the work within 14 days. Pay £2 8s. 0d. costs. 17th Feb. Failing to abate nuisance arising from defective roof, etc., at 11, Doveton Street. Ordered to do the work within 7 days. Pay £2 8s. 0d. costs. 26th Feb. Failing to abate nuisance arising from defective sink waste pipe at 29, Turner Street. Work done at time of hearing. Case withdrawn. Pay £2 5s. 0d. costs. 12th March Failing to abate nuisance caused by defective roof and floors at 53, Varden Street. Pay £2 5s. 0d. costs. 12th March Failing to abate nuisance caused by dirty walls and ceilings and defective floor at 57, Varden Street. Pay £2 5s. 0d. costs. 30th March Failing to abate nuisance due to the dirty condition of 89 Wilkes Street. Ordered to do the work within 14 days. Pay £2 8s. 0d. costs. 30th March Failing to abate nuisance due to the dirty condition of 91, Wilkes Street. Ordered to do the work within 14 days. Pay £2 8s. 0d. costs. 30th March Failing to abate nuisance due to the dirty condition of 97, Wilkes Street. Ordered to do the work within 14 days. Fined £3 0s. 0d. Pay £2 8s. 0d. costs. 31st March Failing to comply with a Magistrate's Order made on 17th February, respecting nuisances at 11, Doveton Street. Fined £5 0s. 0d. Pay £3 3s. 0d. costs. 1st April Accumulation of rubbish in yard, filthy floor and bedding, and congestion of floor space at 18, Spring Gardens. Ordered to abate nuisance within 7 days. 14th April Failing to abate nuisance arising from defective roof at 27, Rectory Square. Pay £2 8s. 0d. costs. (Case adjourned from 31st March to ascertain whether roof had been made weatherproof) . Repairs satisfactory. 53 Date. Matter of information or complaint. Result. 26th April Failing to abate nuisance, viz, dirty condition of rooms at 9, Camperdown Street. Case withdrawn on payment of £2 5s.h 0d. costs(Work being done at time of hearing.) 30th April Failing to abate nuisance, viz., roof defective, and rooms dirty at 3, Dalgleish Place. Ordered to do work within 14 days. Pay £2 8s. 0d. costs. 30th April Failing to abate nuisance, viz., roof defective and rooms dirty at 4, Dalgleish Place. Ordered to to work within 14 days. Pay £2 8s. 0d. costs. 30th April Failing to abate nuisance, viz., inadequate yard drainage at 5, Dalgleish Place. Ordered to do work within 14 days. Pay £1 7s. 0d. costs. 30th April Failing to abate nuisance, viz., inadequate yard drainage at 6, Dalgleish Place. Ordered to do work within 14 days. Pay £1 7s. 0d. costs. 5th May Failing to abate nuisance caused by dirty walls and ceiling, and defective fireplace at 8, Vine Court. Case withdrawn, work done before hearing. Pay £2 5s. costs. 13th May Failing to abate nuisance caused by damp wall, etc., at 139, Whitechapel Road. Ordered to do work within 7 days. Pay £2 8s. 0d. costs. 18th May Failing to abate nuisance arising from defective roof at 15, Wolsey Street. Pay £2 8s. 0d. costs. Previously adjourned from 27th April and 4th May. 21st June Failing to repair defective gutter, sink waste, damp walls, etc., at 16, Burdett Road. Fined £2 0s. 0d. Pay £2 8s. 0d. costs. 5th July Failing to abate nuisance arising from damp, defective and dirty walls and ceilings at 3, Canal Road. Fined £3 0s. 0d. Pay £2 8s. 0d. costs. 12th July Failing to repair defective roof at 26, Frederick Place. Fined £2 0s. 0d. Pay £2 8s. 0d. costs. 12th July Failing to keep an ice cream wafer holder in a cleanly condition on 26th June, 1937, at 208, Commercial Road. Dismissed under Probation of Offenders Act on payment of 5s. costs. 27th July Depositing for sale chocolates in a room at 46, Old Montague Street, which was used as a sleeping place, on 14th May. Fined £1 0s. 0d. Pay £5 5s. 0d. costs. 3rd August Failing to notify Local Authority of the removal of a foster child in her care at 105, St. Pauls Road. Dismissed under Probation of Offenders Act. 19th August Maintaining his grocery shop at 18, Fieldgate Street, in a dirty condition on 22nd June. Fined £1 0s. 0d. 29th Sept. Failing to abate a nuisance arising from defective roof, etc., at 6, Frimley Street. Fined £5 0s. 0d. with £2 8s. 0d. costs and ordered to abate nuisance within 7 days. 7th Oct. Failing to abate a nuisance caused by defective drain at Turner House. Fined £5 and £2 8s. 0d. costs. (7 days order.) 8th Oct. Failing to abate a nuisance caused by an accumulation of refuse in yard of 79, New Road. Pay £2 8s. 0d. costs.(7 days order.) 8th Oct. Failing to abate a nuisance caused by an accumulation of refuse at 81, New Road. Pay £2 8s. 0d. costs.(Nuisance abated before hearing.) 54 Date. Matter of information or complaint. Result. 20th Oct. Failing to abate nuisance arising from defective yard paving, defective sink waste pipe and dirty and defective walls and ceilings at 78, Medway Road. Fined £2. Pay £2 8s. 0d. costs. Defendant ordered to abate nuisance within 14 days. 26th Oct. Failing to keep utensils used for making ice cream wafers in a cleanly condition on 10th September, at 594, Mile End Road. Fined £1. Pay £1 Is. 0d. costs. 4th Nov. Using the premises 93, Redmans Road for the preparation of preserved fish intended for sale, such premises not being registered. Fined 10s. 4th Nov. Failing to maintain the common yard, passage, landings and staircase in a cleanly state ; permitting the main sink waste pipe to be in a foul and offensive condition; accumulation of refuse, and dirty condition of empty bakehouse adjoining. at 135, Jubilee Street. Fined £3. Pay £2 8s. costs. Order made to abate the nuisance within 14 days. 11th Nov. Failing to abate nuisance caused by foul water closet soil pan, and not maintaining yard in cleanly state at 24, Spital Street. Fined £1. Pay £2 8s. costs. Order to do work within seven days. 30th Nov. Failing to abate a nuisance caused by dirty water-closets at 103/7, New Road. Case withdrawn. Work done. Pay £2 5s. costs. 15th Dec. Keeping of 11, Alie Street as a common lodging-house without licence. Summons dismissed. Defendant awarded £5 5s. costs. 29th Dec. Failing to abate nuisance caused by foul water closets, and yard not maintained in clean condition at 22, Spital Street. Fined £2. Pay £2 8s. costs. Order to abate nuisances within seven days. 30th Dec. Failing to abate nuisance arising from defective roof, etc. at 54, Alie Street. Adjourned from 16th December. Fined £2. Pay £2 8s. costs. Work done at time of hearing. 30th Dec. Failing to abate nuisance arising from defective roof, eaves- gutter, etc. at 56, Alie Street. Adjourned from 16th December. Fined £2. Pay £2 8s. costs. Work done at time of hearing. 30th Dec. Failing to abate nuisances arising from defective water-closet cistern, eaves gutter, etc. at 33, Scarborough Street. Adjourned from 16th December. Pay £1 4s. costs. Work done. 30th Dec. Failing to abate nuisances arising from defective roof, etc. at 5, East Tenter Street. Adjourned from 16th December. Pay £1 4s. costs. Part of work done. Summons withdrawn. Premises now vacant. London County Council Drainage Bye-Laws. 15th Jan. Constructing a sink waste pipe contrary to L.C.C. Byelaws, at 117, New Road. \ Case dismissed under the Probation of Offenders Act on payment of 10s. 6d. costs. 20th Jan. Improperly constructing a soil-pipe at 102, Hanbury Street. Fined 10s. 20th Jan. Failing to deposit drawings before executing drainage work at 58, Newark Street. Fined £1. Pay £1 Is. 0d. costs. 20th Jan. Executing drainage work contrary to byelaws at 58, Newark Street. Fined £1. 55 Date. Matter of Information or Complaint. Result. 8th Feb. Failing to give notice re repair of defective drain at 43, Stainsby Road. Dismissed under Probation of of Offenders Act. Pay 10s. 6d. costs. 16th March Failing to give notice re installation of lavatory basins and waste pipe at 139, Salmon Lane. Fined £1 0s. 0d. 23rd Sept. Executing drainage work at 261, Commercial Road East, contrary to drainage Bye-laws. Case withdrawn on advice of Council's Solicitor. (Proceedings taken against another person. See following case.) 12th Oct. Failing to give notice before executing drainage work at 261, Commercial Road East. Dismissed under Probation of Offenders Act, on payment of £1 Is. 0d. costs. 12th Oct. Executing drainage work contrary to Byelaws at 261, Commercial Road East. Dismissed under Probation of Offenders Act on payment of £1 Is. 0d. costs. . Stepney Borough Council Byelaws,(Yard paving.) 30th April Failing to remedy defective yard paving at 5, Dalgleish Piace. Dimissed under Probation of Offenders Act on payment of £1 Is. 0d. costs. 30th April Failing to remedy defective yard paving at 6, Dalgleish Place. Dismissed under Probation of Offenders Act, on payment of £1 Is. 0d. costs. Public Health (Preservatives in Food) Regulations. 16th Sept. Selling 1/2 lb of minced meat on 5th August, at 223, Mile End Road, containing 460 parts of sulphur dioxide per million parts. Fined £1 0s. 0d. Pay £2 2s. 0d. costs. Merchandise Marks Act, 1926. 1th March Exposing for sale on 29th November, 1936, at 71, Burdett Road imported meat, the same not bearing anv "indication of origin." Fined £10 0s. 0d. Pay £5 5s. 0d. costs. 6th July . v . . Exposing for sale frozen (imported) meat, at 26, Rhodeswell Road the same not bearing any "indication of origin" on 1st May. Fined £2 0s. 0d. Pay £2 2s. 0d. costs. Food and Drugs (Adulteration)A ct, 1928. 12th Jan. Selling milk on 1st December, 1936, 6.3 per cent. deficient in fat.(B.714). Case dismissed under Probation of Offenders Act. Defendant ordered to pay £2 2s. 0d. costs. 10th Feb. For selling milk on 31st December, 1936, 23 per cent. deficient in fat.(Sample B.790). Dismissed under Probation of Offenders Act. Pay £2 2s. 0d. costs. 11th Feb. Selling milk on 26th November, 1936, deficient of 2.4 per cent. solids-not-fat equivalent to the addition of at least 6.4 per cent. of water.(Hortvet). (Sample C.781). Fined £2 0s. 0d. Pay £5 5s. 0d. costs. 56 Date, Matter of Information or Complaint. Result. 12th Feb. Selling milk on 6th January, deficient of 52.3 per cent. of fat and 10.6 per cent. of solids-not-fat, equivalent to the addition of at least 13.8 per cent. of water.(Sample C.13). Fined £1. Pay £2 2s. 0d. costs. 12th Feb. Selling milk on 6th January, deficient of 26.3 per cent. of fat and 2.1 per cent. of solids-not-fat, equivalent to the addition of at least 2.8 per cent. of water.(Sample C.16). Fined 10s. 0d. Pay £2 2s. 0d. costs. 24th Feb. Selling milk on 14th January, deficient of 32 per cent. of fat.(Sample B.28). Dismissed under Probation of Offenders Act. Pay £2 2s. 0d. costs. 24th Feb. Selling milk on 14th January, deficient of 18 per cent. of solids-not-fat (at least 19.1 per cent. added water Hortvet), and 28.3 per cent. deficient in fat.(Sample B.27). Fined 10s. 0d. Pay £2 2s. 0d. costs. 25th Feb. Selling milk on 20th January, deficient of 18.3 per cent. of fat and 33.9 per cent. of solids-not-fat, equivalent to the addition of at least 36 per cent. water(Hortvet).(Sample C.49). Fined £3. Pay £2 2s. 0d. costs. 25th Feb. Selling milk on 20th January, deficient of 5 per cent. of fat and 5.9 of solids-not-fat.(Sample C.50). Fined £1. Pay £2 2s. 0d. costs. 26th Feb. Selling milk on 21st January, deficient of 5.6 per cent. of solids-not-fat, equivalent to the addition of 5.1 per cent. of water(Hortvet).(Sample C.56). Dismissed under Probation of Offenders Act. Pay £2 2s. 0d. costs. 4th March Selling milk on 6th January, 32 per cent. deficient in fat.(Sample C.14). Dismissed under probation of Offenders Act. Pay £3 3s. 0d. costs. 12th March Selling milk on 20th January, 6.7 per cent. deficient in fat and 24.7 per cent. solidsnot-fat.(Equivalent to the addition of 27.4 per cent. of water, Hortvet).(Sample C.47). Dismissed under Probation of Offenders Act. Pay £2 2s. 0d. costs. 15th March Selling milk on 27th January, 16.7 per cent. deficient in fat and 27.1 per cent. deficient in solids-not-fat.(At least 30.6 per cent. added water, Hortvet).(Sample B.60). Fined £1 0s. 0d. Pay £1 Is. 0d. costs. 19th March Selling tincture of iodine on 4th February, 42.8 per cent. deficient in potassium iodide, and 33.1 per cent. deficient in iodine.(Sample B.81). Dismissed under Probation of Offenders Act. Pay £2 2s. 0d. costs. 23rd March Selling milk on 29th January, 35.9 per cent. deficient in solids-not-fat.(At least 37 per cent. added water, Hortvet).(Sample B.79). Fined £3 0s. 0d. Pay £2 2s. 0d. costs. 23rd March Selling milk on 29th January, 35.9 per cent. deficient in solids-not-fat.(At least 37 per cent. added water, Hortvet).(Sample B.79). Case not dealt with, as proceedings were taken against the other partner in the firm for the offence,(see previous case). 57 Date. Matter of Information or Complaint. Result. 24th March Selling milk on 9th February, 6.8 per cent. deficient in solids-not-fat.(At least 6.4 per cent. added water, Hortvet).(Sample B.89) Case dismissed under Probation of Offenders Act. Pav£2 2s. 0d. costs. 24th March Selling bread and butter on 13th February, the fat of which consisted of 100 percent. margarine.(Sample B.104). Fined £2 0s. 0d. Pay £2 2s. 0d. costs. 5 th April Selling milk on 18th February, deficient of 16.7 per cent. of fat and 5.8 per cent. of solids-not-fat, equivalent to at least 6.6 per cent. of added water(Hortvet).(Sample C. 125.) Fined £2 0s. 0d. Pay £2 2s. costs. 5th Feb. Selling milk on 2nd March, 58.3 per cent. deficient in fat.(Sample C. 149.) Fined £2 0s. 0d. Pay £2 2s. 0d. costs. 5th April Selling milk on 2nd March, deficient of 6.1 per cent. of solids-not-fat, equivalent to at least 7.7 per cent. of added water(Hortvet).(Sample C. 145.) Fined £1 0s. 0d. Pay £1 Is. 0d. costs. 5 th April Selling milk on 8th March, 4.8 per cent. deficient in solids-not-fat. At least 6 per cent. added water(Hortvet).(Sample B. 144.) Fined £1 0s. 0d. Pay £1 Is. 0d. costs. 20th April Selling milk on 19th March, 9.3 per cent") deficient in fat. (Sample C. 208.) Fined £2 0s. 0d. Pay £2 2s. 0d. costs. 20th April Selling milk on the 19th March, 9.3 per cent. deficient in fat.(Sample C. 209.) Case not separately dealt with. 4th May Selling milk on 23rd March, 6.5 per cent. deficient in solids-not-fat. At least 6.8 per cent. added water(Hortvet).(Sample B. 187.) Case dismissed under Probation of Offenders Act. Pay £2 2s. 0d. costs. 13th May Selling milk on 13th April, 20.3 per cent. deficient in fat.(Sample C. 240.) Case dismissed under Probation of Offenders Act. Pay £3 3s. 0d. costs. 14th May Selling milk on the 6th April, 19.2 per cent. deficient in solids-not-fat and 23.3 per cent. deficient in fat. At least 22.5 per cent. added water(Hortvet).(Sample B. 212.) Fined £3 0s. 0d. Pay £2 2s. 0d. costs. 21st May Selling milk on 6th April, 49.3 per cent. deficient in fat.(Sample B. 213.) Case dismissed under Probation of Offenders Act. Pay £2 2s. 0d. costs. 21st May Selling rolls and butter on 19th April, the fat of which contained 15 per cent. of margarine.(Sample B. 240.) Fined £5 0s. 0d. Pay £2 2s. Od costs. 30th June Selling milk on 20th February, which was deficient of 3.4% of the minimum amount of solids-not-fat, equivalent to the addition of at least 5.3% added water. (Hortvet.) Sample C.137. Dismissed under Probation of Offenders Act. Pay £4 4s. 0d. costs. 58 Date. Matter of Information or Complaint. Result. 22nd July Selling cream cheese on 2nd June, which contained only 16.6% of butter fat, and which was made from whole milk. Sample B. 339. Fined £1 1s. 0d. Pay £2 2s. 0d. costs. 22nd July Selling cream cheese on 2nd June, which contained only 15.3% of butter fat, and which was made from whole milk. Sample B.337. Fined £1 0s. 0d. Pay £2 2s. 0d. costs. 1st Oct. Obstructing the Inspector at 28, Burslem Street by refusing to take payment for 1/2 lb. minced meat on 12th August. Fined £2. Pay £2 2s. 0d. costs. 1st Oct. Exposing for sale 1/2-lb. minced meat which on analysis contained 2,890 parts of sulphur dioxide per million parts, on the 12th August,(Sample A.73.) Fined £1. Pay £1 1s. 0d. costs. 18th Oct. Selling milk on 3rd September, which was deficient of 22.1% of solids-not-fat, and 41.7% deficient of fat(shewing the presence of at least 24.3% of added water(Hortvet.)(Sample C.550.) Fined £3. Pay £2 2s. 0d. costs. 18th Oct. Selling milk on 3rd September, which was deficient of 8.2% of solids-not-fat, equivalent to the addition of at least 10.6% of water(Hortvet).(Sample C.551.) Case not proceeded with, as it was dealt with under Milk & Dairies(Amendment) Act, 1922. 18th Oct. Selling milk on 3rd September, which was deficient of 8.4% of solids-not-fat, equivalent to the addition of at least 10.6% of water (Hortvet). (Sample C.552.) Fined £3. Pay £2 2s. 0d. costs. 19th Oct. Selling bread and butter on 14th September, the fat of which consisted of 100% margarine.(Sample B.519.) Fined £2. Pay £2 2s. 0d. costs. 27th Oct Selling milk on 13th September, which was 16.7% deficient in fat and 25.1% deficient in solids-not-fat. At least 25.4% added water(Hortvet).(Sample B.508.) Fined £5. 27th Oct. Selling milk on 13th September, which was 20.7% deficient in fat and 27.8% deficient in solids-not-fat. At least 28.7% added water(Hortvet).(Sample B.509.) Fined £5. 27th Oct. Selling milk on 13th September, which was 14.7% deficient in fat and 23.5% deficient in solids-not-fat. At least 24.5% added water(Hortvet).(Sample B.507.) Case withdrawn. This offence was dealt with under the Milk & Dairies (Amendment) Act, 1922. 27th Oct. Wilfully obstructing the sampling officer at 68, Jane Street inasmuch as he refused to sell him a quart bottle of milk on 13th September. Fined £1. 29th Oct. Selling rolls and butter on 14th September, the fat of which consisted of margarine. (Sample B.520.) Fined £1 and £2 2s. 0d. costs. 8th Nov Selling milk on 23rd September, which was deficient of 9.4% of solids-not-fat, equivalent to the addition of at least 10.9% of water(Hortvet).Sample C.614. Fined £5. Pay £1 3s. 0d. costs. 60 Date. Matter of Information or Complaint. Result. 18th March Selling milk on 15th January, containing at least 1.1 per cent. added water, Hortvet.(Sample B.40). Case withdrawn. 18th March Selling milk on 15th January, containing at least 1.1 per cent. added water, Hortvet.(Sample B.39). Case withdrawn. 18th March Selling milk on 9th February which contained at least 1.1 per cent. of added water Hortvet.(Sample C.101). Summons dismissed 18th March Selling milk on 19th February, which contained at least 1.1 per cent. of added water, Hortvet. (Sample C.136). Summons dismissed. 23rd March Selling milk on 25th January which contained at least 14.9 per cent. added water, Hortvet. (Sample B.48). Dismissed under Probation of Offenders Act. Pay £2 2s. 0d. costs. 31st March Selling milk on 7th March which contained at least 3.4 per cent. added water, Hortvet.(Sample C.176). Case withdrawn. 6th April Selling milk on 21st January deficient of 8.6 per cent. of solids-not-fat, equal to at least 10.4 per cent. added water(Hortvet).(Sample C. 53.) Fined £2 0s. 0d. Pay £3 3s. 0d. costs. 18th October Selling milk on 3rd September, which which was deficient of 8.2 per cent. solids-not-fat, equivalent to the addition of at least 10.6 per cent. of water(Hortvet).(Sample C. 551.) Fined £3. Pay £2 2s. 0d. costs. On the application of the Council, the Magistrate ordered the removal of Vendor's name absolutely from the Register of Dairymen and Purveyors. 27th October Selling milk on 13th September, to which water had been added. At least 24.5 per cent. added water(Hortvet).(Sample B.507.) Fined £10 0s. 0d. On the application of the Council, the Magistrate ordered the removal of Vendor's name from the Register of Dairymen, and Purveyors of Milk Milk and Dairies (Consolidation) Act, 1915 21st October Failing to have their name and address 15, Narrow Street conspicuously inscribed on their milk float on 20th August. Fined £2. Pay £1 Is. 0d. costs. 27th October Failing to have name and address (68,Jane Street) conspicuously inscribed upon a vehicle from which he was selling milk in a public place on 13th September. Fined £1. Pharmacy and Poisons Act, 1933. 26th October Selling at 161, Commercial Street, a poison listed in Part II without being on the Local Authority's List. Pay £2 2s. 0d. costs. London County Council Bye-Laws for Regulating the Conduct of a Fried Fish Vendor. 12 th October Failing to discharge the vapour caused by fish-frying at 7, High Street, Whitechapel on 23rd June, in the manner prescribed in the Bye-laws. Fined £2. Pay £2 2s. 0d. costs. 61 Date. Matter of Information or Complaint. Result. Milk and Dairies Order, 1926. 18th Jan. Removing the cap of a sealed bottle of milk at 4 8, Hessel Street, on the 11th November, 1936. Dismissed under the Probation of Offenders Act on payment of £1 1s. 0d. costs. 18th Jan. Removing the cap of a sealed bottle of milk at 149, Charles Street, on the 27th November, 1936. Case not separately dealt with. 18th Jan. Carrying on the business of a dairyman upon unregistered premises at 149, Charles Street,on the 27th November, 1936. Fined £1. Pay £1 ls.0d. costs. 18th Jan. Removing the cap of a sealed bottle of milk at 33, Gt. Alie Street, on the 27th November, 1936. Fined £1. Pay £1 1s. 0d. costs. 18th Jan. Carrying on the business of a dairyman upon unregistered premises at 33, Gt. Alie Street, on 28th October, 1936. Fined £1. Pay £1 Is. 0d. costs. 25th Feb. Filling a bottle with milk and sealing it otherwise thanon registered premises(25, Gore Road, E.), i.e., in Mary Ann Street on 25th January. Fined £3. Pay £2 2s. 0d. costs. 9th April Failing to keep clean interior of dairy at 4, Milward Street, and utensils therein, on 11th March. Fined £3 0s. 0d. Pay £2 2s. 0d. costs. 30th June Selling milk on 20th February, in the Borough of Stepney without being registered in the Borough.(Vendor registered at 103, High Street, S.W.11.) Dismissed under Probation of Offenders Act. Pay£l ls. 0d. costs. 17th August Selling "loose" cream on 23rd June, at 7, Cable Street, the premises not being registered as a dairy. Fined £2 0s. 0d. Pay £2 2s. 0d. costs. 17th August Selling "loose" cream on 24th June at 12 Jubilee Street, the premises not being registered as a dairy. Fined £1 0s. 0d. Pay £1 Is. 0d. costs. 19th August Depositing for sale at 18, Fieldgate Street, on 22nd June, "loose" cream, the premises not being registered as a dairy. Fined £2 0s. 0d. Pay £2 2s. 0d. costs. 19th August Obstructing an Inspector in the course of his duty when inspecting the grocery shop at 18, Fieldgate Street, on 22nd June. Fined £1 0s. 0d. 21st Sept. Maintaining a dairy at 25, Sutton Street, in a dirty condition on 12th August. Fined £1 0s. 0d. Pay £2 2s. 0d. costs. 29th Sept. Failing to maintain dairy at 78, Pelham Street, in a cleanly condition on 13th September. Fined £2 0s. 0d. Pay £2 2s. 0d. costs. 27th October Carrying on the business of of a dairyman at 68, Jane Street, such premises not being registered. Fined £5. Pay £7 7s. 0d. costs 62  No . of Summonses. Fines. Costs. £ s. d. £ s. d. Public Health(Preservatives in Food) Regulations 1 1 0 0 2 2 0 Public Health(London) Act, 1936 47 44 10 0 95 7 0 London County Council Drainage Byelaws 9 3 10 0 4 4 0 London County Council Byelaws(Fried Fish Vendors) 1 2 0 0 2 2 0 Merchandise Marks Act, 1926 2 12 0 0 7 7 0 Milk and Dairies(Consolidation) Act, 1915 2 3 0 0 1 1 0 „(Amendment) Act 1922 21 23 5 0 15 15 0 „Order, 1926 15 23 0 0 26 5 0 Pharmacy and Poisons Act, 1933 1 - - 2 2 0 Stepney Borough Council(Yard Paving) Byelaws, 2 - - 2 2 0 Food and Drugs(Adulteration) Act, 1928 46 65 0 0 86 6 0 Total 147 177 5 0 244 13 0 IV.—HOUSING. Slum Clearance.—During the year the Council made Clearance Orders as follows:— Houses. Persons to be displaced. Parnham Place Clearance Area 25 89 Bull Stake Court Clearance Area 2 10 Little Tongue Yard Clearance Area 5 13 Mundys Place Clearance Area 10 37 Griggs Court, Sugar Loaf Court and Goodmans Yard Clearance Area 14 92 Gowers Walk and Webbs Place No. 1 Clearance Area 10 39 Gowers Walk and Webbs Place No. 2 Clearance Area 2 15 68 295 An Inquiry was held by the Ministry of Health and all the Orders were confirmed without modification. The L.C.C. also passed Clearance Order resolutions in respect to the following areas within the borough:— Persons to be Houses. displaced. Ocean Street Areas 729 4,456 Phoebe Street Areas(part in Stepney) 274 1,611 Christian Street Areas 270 1,339 63 The rate of progress of slum clearance is dependent on the provision of rehousing accommodation and it is gratifying to be able to report accelerated progress, which, I am hopeful will be not only maintained, but increased in the near future. Underground Rooms.—At the beginning of the year there were 6,134 underground rooms which did not comply with the Housing Act and the regulations made thereunder. During the year closing orders were made in respect of 12 underground rooms. A closing order was determined in respect of 1 underground room which had been altered and made to comply with the regulations. 22 other underground rooms were altered and made to comply and 150 unfit underground rooms were dealt with in Clearance Areas thus leaving 5,949 still to be dealt with. Overcrowding.—The overcrowding survey in 1935 revealed the fact that 7,632 families were overcrowded. Also that 424 other families would be overcrowded within two years by reason of children attaining the age of 1 or 10 years respectively. From May, 1936, to the end of December, 1937, 1,230 certificates of overcrowding(Orange Forms) had been sent to the L.C.C. Of this number the L.C.C. have rehoused 280 families, 47 within the Borough and 233 outside. In the process of slum clearance, 444 cases of overcrowding have been abated. 81 overcrowded families are known to have found accommodation for themselves. 89 cases of overcrowding have been abated by Owners transferring tenants. Summary. Number of families overcrowded as per survey 7,632 Additional to date as per survey 424 8,056 Number Abated. By L.C.C. as result of Orange Forms 280 By Slum Clearance 444 Abated privately 170 894 During the year two large blocks of Borough Council flats were opened:— John Scurr House, Branch Road, consisting of 119 flats, on July 24th and Arbour House, Arbour Square, consisting of 76 flats, on October 23rd. In the process of redevelopment within the Borough, rehousing must necessarily be in blocks of flats and it is imperative that provision for the physical and social recreation, particularly for the children and youth, should be kept well to the fore. The L.C.C. are the rehousing authority in the case of overcrowding, and here again the rate of progress in abating overcrowding is dependent on the provision of "alternative accommodation." 64 One great difficulty which will have to be faced is the case of large families. There are no flats within the borough large enough to accommodate many of them and for economic reasons they are unable to remove to the outside cottage estates. Another factor which very materially affects both overcrowding and slum clearance is the large number of elderly single persons and aged couples, many of whom are mainly subsisting on old age pensions or public assistance. I fully appreciate the reluctance of many of these people to leave the district where they have spent the whole of their lives, and also many of them are too old or infirm to live entirely on their own responsibility and are being looked after by married children or relatives who live with or near to them. As far as is reasonably possible, the desires of these old people should be considered. Nevertheless to provide a large number of one roomed flats for these people within the Borough is a matter of considerable difficulty, being uneconomic for a housing authority. There is no doubt that, an ideal solution of the problem would appear to be to make special provision, for such of these old persons as desired to avail of it, on an estate as near to London as possible, where they could be easily visited by their friends and relatives and that on such an estate, provision should be made for their physical and social requirements thus enabling them to spend their remaining years of life in a happy and healthy environment. This would not only conduce to their personal welfare but in many cases where at present, they are a great source of anxiety to their relatives, the latter would be relieved of much of this anxiety, and moreover, a large amount of accommodation within the Borough would be set free for those who must live near their place of employment. Statistics.—I.—Inspection of dwelling houses during the year:— (1) (a) Total number of dwelling houses inspected for housing defects(under Public Health or Housing Acts) 21,218 (b) Number of inspections made for the purpose 28,122 (2) (a) Number of dwelling houses(included under sub-head (1) above) which were inspected and recorded under the Housing Consolidated Regulations, 1925 595 (b) Number of inspections made for the purpose 595 (3) Number of dwelling houses found to be in a state so dangerous or injurious to health as to be unfit for human habitatation 255 (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 10,483 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 7,831 65 3.—Action under Statutory Powers during the Year:— (a) Proceedings under sections 9, 10 and 16 of the Housing Act, 1936:— (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 2,689 (2) Number of dwelling houses in which defects were remedied after service of formal notices:— (а) By owners 2,689 (b) By Local Authority in default of owners - (c) Proceedings under sections 11 and 13 of the Housing Act, 1936:— (1) Number of dwelling houses in respect of which tion Orders were made 2 (2) Number of dwelling houses demolished in pursuance of Demolition Orders 3 (d) Proceedings under section 12 of the Housing Act, 1936:— (1) Number of separate tenements or underground rooms in respect of which Closing Orders were made 12 (2) Number of separate tenements or underground rooms in respect of which Closing Orders were determined, the tenement or room having been rendered fit 1 No. of underground rooms made to comply by reason of informal action 22 4.—Housing Act, 1936—Part IV.—Overcrowding:— (a) (i) Number of dwellings overcrowded at the end of the year 6,738 (ii) Number of families dwelling therein 6,738 (iii) Number of persons dwelling therein 39,484 (b) Number of new cases of overcrowding reported during the year - (c) (i) Number of cases of overcrowding relieved during the year 639 (ii) Number of persons concerned in such cases 3,744 (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(See page 63.) - 66 Housing accommodation provided.—620 families in the Borough took accommodation on the London County Council housing estates as follows:— Amhurst Road, E.8 1 Hollybush Gardens, E.2 2 Ann Street, E.14 1 Honor Oak, S.E.22 4 Bakers Alley, E.3 1 Isle of Dogs Housing Soc., E.14 1 Barnsbury, N.l 1 Kenmore Park, Middlesex 9 Beachcroft Buildings, E.l 1 Kingshold, E.8 2 Becontree, Essex 240 Lowood Buildings, E.l 1 Bekesbourne Buildings, E.14 2 Medland Street, E.14 2 Bellingham, S.E.6 7 Millbank, S.W.1 1 Bewley Buildings, E.l 1 Millwall, E.14 12 Boundary Street, E.2 22 Mottingham, Kent 9 Bourne, E.C.1 1 Norbury, Surrey 1 Bow Bridge, E.3 3 Northampton Street, E.C.1 1 Brightlingsea Buildings, E.14 1 Northwold, E.5 6 Cable Street, E.l 6 Pott Street, E.2 21 Central Street, E.C.1 1 Prestons Road, E.14 9 Churchway, N.W.1 1 Ranwell Street, E.3 1 Clissold, N.16 7 St. Helier, Surrey 11 Collingwood,E.l 10 St. Katherines,E.l 71 Dellow Buildings,E.l 1 Stamford Hill,N.16 4 Downham,Kent 9 Shipwright House, E.14 6 Dukes Court, W.C.1 1 Shore, E.9 1 Ellen Street,E.l 7 Streatham, S.W.16 1 Gillingham,Kent 1 Valette,E.8 1 Haggerston,E.8 2 Wapping,E.l 19 Hanbury Street,E.l 20 Waterloo Road, E.2 1 Hanwell,W.7 10 Wellington, E.2 50 Herbrand Street, W.C.1 1 West Ferry Road, E.14 2 Holland, E.l 11 Whitmore, N.l 1 House to House inspection.—List of streets in which all houses have been inspected as a result of House to House inspection during the year 1937:— Limehouse. Mile End. St. George's. Whitechapel. Mr. Coveney. Mr. Day. Mr. Anstee. Mr. Brownlee. Nil. Park Road. Mariner Street. Augustine House. Mr. Cue. Mr. Guy. Star Place. Bulwer House. Whites Gardens. Lytton House. Tomlins Terrace. Bradwell Street. Nelson Place. Mr. McCarthy. Buckeridge Street. Mr. Freeland. Brittens Court. Spring Gardens. Dupont Street. Coburgh Court. Mr. Green. Hope Place. Cornwall Road. Mr. Haworth. Nelson Street. Railway Place. Drivers Buildings Christopher Court. Settles Street. Reform Place. Faith Street Ferriers Court. Durer Place. Mr. Roper. Mr. Waterman. Frimley Street. Gt. Alie Street. Alexandra Buildings. Barnardo Street. Globe Road Buildings. Meredith Buildings. Branch Road. Artillery Lane. Brook Street. Goveys Place. Artillery Passage. Dorset Street. Grebe Court. Mr. Keniry. Blossom Street. James Place. Willow Street. Day Place. Camperdown Street. Sage Street. Pell Place. Solander Street. Mr. Howard. Pell Street. Cobb Street. Nil. Stephen House. Drum Yard. Twenty five and a Half Court. Duval Street. Elder Street. 67 Mile End. Whitechapel. Mr. Lowther. Mr. Roper. Ewing Street. Fleur de Lis Buildings. Forester Street. Maplin Place. Fleur de Lis Street. Murdock Cottages. Frying Pan Alley. Stanfield Road. Grey Eagle Street. Mr. Smith. Baker Court. Half Moon Passage. Baker Street. Bedford Cottages. Jerome Street. Leyden Street. Bedford House. Loom Court. Bedford Street. Quaker Street. Cohens Court. Rosetta Place. Sandys Row. Mr. Twynham. Cholsey Buildings. Finch Street. Green Dragon Yard. Montague Place. Nathaniel Buildings. Puma Court. Tailworth Street. V. INSPECTION AND SUPERVISION OF FOOD. Particular attention is being paid to the sampling of milk supplied to school-children and to the various hospitals in the Borough. The marking of butter, fruit and meat exposed for sale in shops in the Borough, in accordance with the Merchandise Marks Act, is, on the whole, satisfactory. Twenty summonses were issued under the Milk and Dairies(Amendment) Act, 1922, in respect of samples of milk which were found, upon examination by means of the Hortvet Freezing Point Test, to contain added water. In three of the cases, application was successfully made to the Magistrate for the removal of the defendants from the register of Dairymen and Purveyors of Milk. Four of the summonses were issued against an itinerant vendor supplying milk to retailers and a school in the Borough, for delivering milk containing 1.1 per cent. added water(Hortvet). One summons was dismissed and the other three were withdrawn. Expert evidence was called by the defence refuting the figure of 0.530°C. as the minimum depression of genuine milk. It was stated that figures of less than 0.530°C. had been obtained from individual cows. The firm summoned sold mixed milk from several herds from farms in the West Country. The company concerned, however, had itself sampled milk from individual farms and several showed the presence of 68 added water, up to 10 per cent. The Medical Officer of the district in which the farms were situated, was communicated with and it is pleasing to relate that with his co-operation and that of the Company, the quality of the milk delivered to shopkeepers and schools in Stepney by this company has shown a decided improvement. The number of dairy premises during the last three years has decreased by 138 and the number of persons selling milk in sealed bottles and cartons has increased by 110. Every effort has been made to induce dairymen carrying on business upon unsatisfactory premises to change over to bottled milk, and this has met with great success. There is a tendency in this Borough for many different kinds of shops to sell milk in sealed bottles and the number on the register is 414. It is also noted that the sale of milk in cartons is on the increase. The inspection of ice cream premises claims a large part of the Food Inspectors' time during the summer months. In addition to the 366 premises where ice cream is manufactured and sold, much ice cream is sold from stalls and vehicles in the public streets, and these, of course, are also subject to inspection. Two summonses were issued in respect of dirty utensils and the vendors were fined. Seven summonses were issued against persons carrying on the business of dairymen without being registered. The following is a summary of the inspections, etc., by the four special Inspectors engaged in the supervision and inspection of food:— H. Abson. A. C. Brown. T. W. Dee. S. Vogler. Totals. Bishopsgate Goods Station *20 — †218 — 238 Butcher and Bacon shops 479 — — — 479 Butcher and Bacon stalls 383 — — — 383 Butter and Margarine premises — 37 — 24 61 Complaints 7 45 21 32 105 Cowsheds — 69 — 59 128 Fish shops — 62 — 13 75 Greengrocers and Fruiterers — — 255 — 255 Ice Cream premises — 284 — 279 563 London Fruit Exchange — —• 289 — 289 Markets(Daily) 188 589 11 374 1,162 Markets(Week-end) 2 2 2 2 8‡ Milkshops — 676 — 597 1,273 Prepared Food premises 188 124 — 200 512 Spitalfields Market — — 396 — 396 Wharves 530 — 586 — 1,116 Wholesale Grocers. — 76 — 97 173 Miscellaneous visits 80 133 49 161 423 Revisits 256 314 276 737 1,583 Samples taken—Food and Drugs 21 737 — 818 1,576 „ „ Other 36 97 29 69 231 No. of Summonses taken out 5 36 52 93 *Of these, 18 were special night or early morning inspections. † „ 80 ‡ 39 inspections were also made by District Sanitary Inspectors. 69 Milk Supply. No on No of No of Notices Register. Inspections. Served. Dairy premises 203 1,273 180 Purveyors' bottled milk 414 - 114 Itinerant vendors 72 - 1 Cowsheds 17 128 19 10 samples of milk were submitted to the Bacteriologist for the detection of tuberculosis(guinea pig inoculation). 7 of the samples were undesignated milk and 3 were "Tuberculin Tested." In one of the latter, the two animals inoculated both died of an intercurrent infection, therefore no report was available. A further sample from the same source, together with the remaining 8 samples were satisfactory. 72 samples of milk were taken in course of delivery to various schools in the Borough. 37 of the samples were submitted for chemical analysis, 34 for bacteriological examination and 1 for the detection of tuberculosis(guinea pig inoculation). Of these, 1 sample examined by chemical analysis proved to be unsatisfactory(C.136). Legal proceedings were taken in this case. 4 samples examined bacteriologically proved to be unsatisfactory.(For action taken see tables of samples submitted for bacteriological examination). The remainder of the samples were satisfactory. 32 samples of milk were taken in course of delivery to various hospitals and institutions in the Borough. Of these, 28 were submitted for chemical analysis, 3 for bacteriological examination and 1 for the detection of tuberculosis(guinea pig inoculation). All the samples proved to be satisfactory. 24 "appeal to cow" samples were taken from 3 cowsheds in the Borough. 18 of the samples were taken from 1 cowshed and of these, 6 were found to be deficient in fat. The cowkeeper was advised to replace cows giving inferior milk, and to alter his times of milking. These requirements were carried out and no further trouble experienced. The remainder of the samples were satisfactory. The following samples were submitted for bacteriological examination:— Nature of sample. No. of samples. Number unsatisfactory and action taken. Milk(Pasteurised) 40 4. These were school samples taken from two different vendors. In one case the vendor was requested to carry out certain requirements; this was done and subsequent samples examined proved to be satisfactory. In the case of the other vendor, the M.O.H. of the borough concerned was notified. Milk(Tuberculin Tested) 3 — Milk(Undesignated) 5 2. Taken from same vendor who was requested to improve method by which he cleansed his utensils. Gherkins 4 — Roll 1 1 Examined as a result of a complaint that it contained foreign substance. This proved to be correct and the vendor was cautioned. Cocoanut Candy 1 — Chocolate Wafers 1 — Milk Bottles 2 2 Taken from same vendor. Improvement in method of washing bottles brought about. Pea Meal 1 — Taken in connection with food poisoning inquiry. Salmon and Shrimp Paste 2 — do. Salmon and Anchovy Paste 1 — do. Miscellaneous 14 These consisted of Semolina, Rice, Soup mixture, Vermicelli, Confectionery, etc., damaged by river water. No evidence of contamination was found. 70 Ice Cream(including Ice Cream Mix and Dried Milk).—12 samples of ice cream, 3 of ice cream mix and 2 of dried milk powder were examined. The majority of the samples were unsatisfactory.(Results of the examinations are shown in the table below). There is no bacteriological standard by which ice cream can be judged. Rigorous inspection of premises where ice cream is manufactured, stored or sold, together with the education of all persons engaged in the handling of the product is essential. Compulsory pasteurisation of the mix and sterilisation of all utensils used in the preparation and storage of ice cream would considerably improve matters. 3 samples of ice cream mix were taken from a firm who manufacture and sell ice cream mix in several parts of the country. The first two(B.424, B.425) were unsatisfactory. Milk powder used in the manufacture was suspected as being unsatisfactory and samples taken(B.426, C.493) proved this. The manufacturer changed over to another supply and a subsequent sample of ice cream mix containing milk powder from the new source was taken(C.494) and found to be satisfactory. Sample No. Nature of Sample. No. of bacteria per c.c. Minimum amount showing Coliform bacilli. Observations of Bacteriologist. B.347 Ice Cream 50,000 0.001 c.c. Coliform content too high for cleanliness. B.348 do. 40,000 0.01 c.c. Ice Cream not of highest type. B.388 do. 20,000 0.1 c.c. do. B.389 do. 15,000 0.01 c.c. do. B.396 do. 200,000 0.1 c.c. Poor quality, bacteriologically. B.397 do. 500,000 Absent in 1 c.c. Probably pasteurised primarily and deteriorated from age or handling. C.429 do. Satisfactory. do. Example of a clean ice cream. C.430 do. 500,000 0.001 c.c. Of poor bacteriological quality and high coliform content. C.457 do. 17,000 1 c.c. Not a high count although not reaching highest standard. C.492 do. 400,000 0.001 c.c. Poor quality, bacteriologically. B.535 do. 3 Absent in 1 c.c. Unusually good result. B.536 do. 116,000 do. Very good bacteriological result. B.424 Ice Cream Mix. 150,000 0.1 c.c. Pasteurisation advisable if used for ice cream. B.425 do. 125,000 0.1 c.c. do. C.494 do. 2,000 Absent in 1 c.c. High standard bacteriologically. B.426 Dried Milk Powder. 80,000 grm. Absent in 1 grm. Pasteurisation advisable if used for ice cream. C.493 do. 40,000 grm. do. Presumably large number of bacteria would be destroyed in pasteurisation. 76 licences were issued under the Milk (Special Designations) Order, 1936, being 9 less than in the previous year, as follows:— Dealer's Supplementary Licences. Licences. "Pasteurised" 35 13 "Tuberculin Tested" 22 6 Butchers' Shops and Stalls.—862 inspections were made during the year and 3 notices were served for minor infringements of the Meat Regulations. 71 Ice Cream Premises.—The number on the register at the end of the year was 366. 563 inspections were made and 60 notices served. No. on No. of No. of register. notices inspections. Butter and Margarine Factories. served. Butter and Margarine Factories 5 - Wholesale Dealers in Margarine 45 7 61 Preserved Food Premises. Preserved Fish premises 112 130 512 Preserved Meat premises 165 13 Merchandise Marks Act.—255 visits were made to Greengrocers and Fruiterers shops and stalls and 59 notices were served for infringements of the Act with regard to the marking of Apples and Tomatoes. Grocers, dairies and butchers' shops were visited in connection with the marking of imported goods, particularly butter, dried fruits and meat and in this respect it was found necessary to serve 100 notices. There has been a noticeable improvement in the marking of the commodities mentioned, although it was found necessary to institute legal proceedings in 2 cases with regard to the marking of imported meat. Wholesale Grocers, etc.—173 visits were made to Wholesale Grocers and 21 notices were served. 83 notices were served in respect of miscellaneous food premises. Bakehouses.—324 inspections were made during the year. Restaurants and Eating Houses.—There are 385 such premises in the Borough and 567 inspections were made to them during the year. 64 notices were served regarding their unsatisfactory condition. Certification of Food Products for Export.—14 certificates have been issued respecting the export of consignments of food products prepared within the Borough:— 2 to Italy. 1 to Australia. 2 to Syria. 7 to Canada. 2 to the United States of America. 739 other certificates were issued in respect of unsound food destroyed. Unsound Food.—1,116 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:— 72 Fresh Meat and Poultry. Tons Cwts. Qtrs. lbs. 2 sides and 1 shoulder of Mutton — — 3 6 Preserved Meat and Poultry. Bacon 1 1 1 0 1,078 tins Beef 2 12 3 23 96 „ Ham Roll — 4 2 12 371 „ Pork 1 0 0 12 70 „ Rabbit and Vegetables — — 1 10 100 „ Sausages — 2 2 20 1,554 „ Tongues 3 6 2 19 Fresh Fruit and Vegetables. 820 packages of Bananas 17 3 0 22 16 „ Carrots — 4 0 0 27 barrels Grapes - 11 2 0 29 cases Grape Fruit - 5 0 0 33 boxes Lemons 1 17 1 8 27 cases Melons - 18 2 0 313 „ Onions 5 13 0 0 940 „ Oranges 35 3 3 8 2 crates Plums — — 1 22 40 bags Potatoes 1 18 0 24 1,346 baskets Tomatoes 15 15 0 14 Preserved Fruit and Vegetables. 1,888 tins Assorted Fruits 2 0 1 4 72 „ Asparagus — 1 1 2 82 „ Apricot Pulp — 14 0 26 1,320 „ Oranges — 5 0 8 7,435 „ Pears 4 7 0 4 2,755 „ Pineapple 2 13 1 22 18 boxes Prunes — 4 2 0 17 tins Quince Pulp — 3 0 21 199 boxes Sultanas 2 8 2 0 260 cases and 381 tins Tomatoes and Puree 14 3 0 4 Preserved Fish. 60 tins Assorted Fish — — 1 27 23 cases tinned Anchovies 1 1 0 0 342 tins Crab — 4 0 26 120 „ Herrings — 1 2 3 200 „ Lobster — — 3 16 300 „ Pilchards — 2 0 26 2,947 „ Salmon 4 2 0 21 Sundries. 1,543 tins Assorted canned goods 2 7 0 14 3 bags Rice — 2 3 9 1 „ Rice Sweepings — — 1 19 80 tins Soup — — 3 0 68 part cases Tea — 7 0 0 14 cases shelled Walnuts — 7 0 0 123 17 3 4 73 The following foodstuffs have been destroyed during the year under the Public Health (London) Act, 1936:— Tons Cwts. Qrs. lbs. (a) Spitalfields Market and London Fruit Exchange. 9 trays Almonds in Shell — 1 0 14 100 boxes Apples 5 0 2 4 195 boats Apricots 1 18 1 16 244 packages Cabbage 4 19 0 0 25 crates Carrots — 7 0 0 3 bags Cocoanuts — 3 0 0 12 boxes Dates — — — 9 3 bags Figs — 1 2 0 135 packages Grapes 1 5 2 6 15 boxes Grape Fruit — 11 1 0 9 „ Mandarines — 2 0 1 31 „ Melons 1 18 3 0 1 „ Onions — — 1 17 4,610 „ Oranges 156 3 2 0 17 bags Parsnips — 6 0 0 22 trays Peaches — 2 3 0 310 boxes Pears 6 18 3 22 2 cases Pineapples — 1 1 20 5 boats Plums — — 3 16 82 boxes Tomatoes — 18 1 0 181 0 1 13 (b) Other Premises. Fruit and Vegetables. , 37 cases Apples — 14 0 0 98 crates Beans 1 8 0 0 60 bags Cabbage 2 7 0 0 184 tins Cherries — 3 0 12 43 „ Cucumbers — 7 0 0 1 „ Dried Fruit — — — 22 3 barrels Horse Radish — 1 0 0 43 boxes Pears — 15 2 16 82,216 tins „ 36 4 0 8 270 „ Pineapple — 3 0 0 17 crates Plums — 3 0 4 2 sacks Potatoes — 2 0 0 46 boxes Radishes — 6 0 0 83 baskets Strawberries — 1 2 0 20 tins peeled Tomatoes — — 2 4 Fish. Assorted fresh Fish — 1 0 25 3,438 tins Assorted Fish — 17 2 12 10 „ Anchovies in Brine — 1 2 2 1 box Cod — — — 123/4 1 „ Plaice — 1 0 0 370 tins Herrings in Marinade — 2 0 0 13 boxes Kippers — 1 2 24 1,200 tins peeled Shrimps — — 5 0 74 Meat and Poultry. Tons Cwts. Qtrs. lbs. Bacon — 17 0 5 895 tins Beef 1 10 0 10 1 set Bullocks Lungs (Tuberculosis) — — — 9 42 Calves Tongues (includes 1 Tuberculosis) — — 2 10 Ham — 6 0 13 1 Ox Tongue (Actinomycosis) — — — 7½ 3 Pig's Heads (Tuberculosis) — — 1 4 1 Pig's Head and Collar (Tuberculosis) — — — 14½ 10 tins Pork — — 2 4 4 „ Tongue — — — 24 22 „ Veal — — 3 13 Sundries. Assorted Foodstuffs 3 19 1 4 11 tins Biscuits — — 3 6 14 „ Caviare — — — 23 6 Cereals — — 1 0 Chocolate — 16 0 21 Chocolate Dates — — 3 21 Chocolate Wafer Biscuits — 2 0 0 Cocoa Powder — 1 3 0 Milk Powder — 2 3 26 27 jars Pickles — — 1 4 ,800 tins Plum Pudding 2 2 3 12 Soft Sugar — — — 4 54 6 0 12¾ 75 128 Detention Notices and 131 Release Notices were issued during the year in respect of 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 36,191 carcases. 53 — 36,189 carcases. 53 — Tallow 3,941 casks. 55 1,582 8 0 0 4,321 casks. 68 1,792 0 0 0 Raisins 747 packages. 3 9 6 3 0 — — — Tomato Puree (tinned) 1,040 cases. 2 52 0 0 0 790 cases. 4 39 10 3 12 Bacon 5 boxes and 6 sides. 2 — 13 1 4 — — — Soft Sugar — — — 100 bags. 2 10 0 0 0 Tea. — — — 510 cases and 68 part cases. 1 31 5 0 0 Dried Plums 96 cases. 1 1 4 0 0 78 cases. 1 — 19 2 0 Sugar Sweepings 21 bags. 1 1 12 0 20 21 bags. 1 1 12 0 20 Figs 855 bags. 1 42 15 0 0 230 bags. 1 11 10 0 0 Crab 4 cases and 16 tins. 1 — 1 3 4 — — — Ham Roll (tinned) 5 cases. 1 — 1 2 12 — — — Apricot Pulp (tinned) 6 cases. 1 — 6 0 0 - — — Pears 82,216 tins. 1 36 4 0 8 - — — Tongues 574 tins. 1 1 16 3 18 - — — Pork 371 tins. 1 1 0 0 12 - — — Anchovies (tinned) 23 cases. 1 — 19 3 21 — — Assorted Fish (tinned) 361 cases. 1 — — - — Grape Fruit 29 cases. 1 — 5 0 0 - - — Assorted Canned Goods 35 cases and 61 tins. 1 1 2 1 2 — - — 76 There were 2,220 carcases of imported mutton examined for Caseous Lymphadenitis by the cutting of the lymphatic glands. Of these, 3 or .13 per cent were found diseased, as compared with .2 per cent in 1936. 779 chests of Tea Sweepings weighing 40 tons 17 cwts., were removed from warehouses for chemical purposes. A sample taken from a parcel of 750 cases of Californian Raisins landed at a wharf in the Borough was, on analysis, found to contain 850 parts of sulphur dioxide per million, which is in excess of the maximum permissible quantity. A detention notice was served and the whole of the parcel subsequently re-exported. On 20th January, 23 cases containing 503 one-kilo and 1,030 half-kilo tins of Anchovies in Salt were landed at a wharf in the Borough. As a number of the tins were blown a detention notice was served and a full examination made with the result that, with the exception of 150 one-kilo tins, the whole of the parcel was, on external appearance, unsatisfactory. On notification of this, the owners of the goods replied that "tins containing anchovies in salt may look unsound but this is due to the maturity of the fish which is in perfect condition," and asked for permission to draw samples for submission to experts, which was granted. The experts subsequently reported that, in their opinion, the condition of the one-kilo tins was due to slack tops; that the contents were sound, and that the condition of the half-kilo tins was due to the fact "that the fish were stale when first salted." One half-kilo tin, one apparently sound, and one blown one-kilo tins, were analysed for tin content. The former contained 3.86 grains per pound and the latter 1.21 and 3.69 grains per pound respectively. A one-kilo tin was submitted for bacteriological examination and no evidence of decomposition was found probably due to the large amount of salt content; a certain amount of gas was evident, probably hydrogen. The fact of the presence of an excess of tin in the majority of the tins rendered the contents unfit for food and the whole of the parcel was destroyed. It would appear that heavily salted fish kept in tin containers for any length of time will act on the metal and absorb the tin, generating a gas in the process, and thereby causing a blown tin. Zeebrugge-Harwich and Calais-Harwich Train Ferry.—98 special midnight and early morning visits were made by the Food Inspectors. In addition, 140 inspections were made by day. At Bishopsgate Station. The total weight of fresh fruit and vegetables examined was 9,514 tons. This consisted of :— Belgian Pears. Bulgarian Grapes. Dutch Lettuce. Greek Grapes. Hungarian Apricots, Cherries, Gooseberries, Grapes, Melons, Peaches, Plums, Strawberries and Tomatoes. Italian Apples, Apricots, Almonds, Cauliflowers, Cherries, Grapes, Lemons, Melons, Onions, Oranges, Peaches, Pears, Peas, Plums, Potatoes and Strawberry Pulp. Roumanian Apples and Grapes. Tasmanian Apples (via Switzerland). Turkish Grapes and Melons, 77 Austrian Poultry, Belgian Bacon, Eggs and Fish, Bulgarian Eggs and Poultry, Dutch Butter, Hungarian Carp and Poultry, Italian Butter, Cheese, Nuts and Poultry, Roumanian Poultry, Serbian Poultry and Yugo Slavian Bacon, Eggs and Poultry were also examined. The following foodstuffs were found to be unsound and were destroyed:— tons. cwts. qrs. lbs. 22 trays Almonds in shell — 2 3 0 70 „ Apricots — 7 3 6 1,854 packages Cherries 5 10 1 0 1,620 bags Chestnuts 30 4 2 0 733 trays Grapes 5 16 0 18 217 crates Lettuce 1 10 2 0 89 Melons - 9 1 2 20 trays Peaches - 2 2 0 6 packages Pears - — 2 20 207 „ Plums 1 5 2 14 18 bags Potatoes - 9 2 0 1,410 boxes Strawberries 9 2 0 50 Turkeys - 4 2 6 46 13 2 10 A departure from the usual practice of sending citrous fruit in cases was the sending of some trucks of Sicilian Bitter Oranges in bulk. It was thought that this would possibly damage the fruit, but consignments arrived in sound and wholesome condition. A first consignment of Italian Strawberries preserved in sulphur dioxide, arrived during May. A sample was taken and submitted for analysis and the preservative content found to be within the permissible limit. A first and experimental consignment of Hungarian Strawberries in a specially constructed container, refrigerated by means of dry card ice (solidified carbon di-oxide) arrived on 10th June. The consignment consisted of 3,500 small packages weighing 1 ton 9 cwts. Owing, I am informed, to the delay in transit, the Strawberries were not in a good condition and it was found necessary to destroy 1,410 boxes. Greek Grapes began to arrive in August and regular consignments were subsequently received generally in very good condition. On 1st November, a consignment of 473 packages of Bulgarian Grapes arrived in a wasty condition. These were allowed to go to the London Fruit Exchange for sorting under supervision. The final consignment of soft fruit arrived on 10th November. During the month of December, a large quantity of Poultry, chiefly Turkeys, arrived from various countries in a sound, wholesome condition. 79 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 fourteenth Annual Report, dealing with the work carried out in the Borough Laboratory during the year 1937. During the year, 1,706 samples were submitted to me for examination. These samples were made up as under:— Foods 1,438 1,544 Drugs 106 Public Health Department ... 141 Borough Engineer ... 10 Public Cleansing Officer ... 2 Private ... 3 Cowshed Samples ... 6 1,706 The 1,544 samples of foods and drugs were purchased or taken by Inspectors under the Food and Drugs (Adulteration) Act, and consisted of:— Formal Samples 960 Informal Samples 584 1,544 Out of 960 formal samples 91, or 9.5 per cent, were adulterated, and of 584 informal samples 43, or 7.4 per cent, were adulterated, making a total of 1,544 samples, out of which 134, or 8.7 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 Adulterated Percentage Adulterated Preservative Found. Ammoniated Tincture of Quinine 3 2 66.7 Arrowroot 3 - - None Aspirin 3 - - — Baking Powder 8 - - None Beef Cubes 2 - - None Beer 3 - - 1 Blanc Mange Powder 3 - - None Boracic Powder 2 - - — 80 Table A—Continued. Nature. Number of Samples. Number Adulterated Percentage Adulterated Preservative Found Borax 1 - - - Boric Ointment 3 — — — Bread and Butter 69 12 17.4 — Butter 55 2 3.6 None Cake 6 — — None Camphorated Oil 6 — — — Caraway Seeds 3 — — — Cascara Sagrada Tablets 1 — — — Castor Oil 4 2 50.0 — Cheese 16 — — None Chocolate Cakes 13 — — None Cocoa 3 — — — Cocoanut 5 — — None Coffee 9 — — — Condensed Milk 5 — — None Cooked Meats 11 — — 2 Corn Flour 3 — — None Cream 11 — — None Cream Buns 6 6 100 — Cream Cheese 19 15 79.0 None Curry Powder 2 — — None Custard Powder 3 — — None Dried Fruit 14 — — 8 Dried Milk 3 — — None Dried Mint 6 2 33.3 — Dried Mushrooms 1 — — None Dripping 6 1 16. 7 — Egg Substitute Powder 12 — — 1 Epsom Salts 2 — — — Eucalyptus Oil 3 — — — Fish Cake 2 — — None Fish Paste 3 — — None Flour 3 — — None Fruit Drinks 4 — — 1 Gelatine 3 — — 3 Glauber's Salt 3 — — — Glycerine 6 — — — Glycerine and Lemon 1 — — — Grape Fruit Curd 1 — — None Gregory's Powder 2 — — — Ground Cinnamon 9 — — — Ground Ginger 1 — — None Honey 3 — — None Hydrogen Peroxide 1 — — — Ice Cream 6 — — None Iodine Ointment 3 — — — Iodine Paint 2 — — 81 Table A.—Continued. Nature. Number of Samples Number Adulterated Percentage Adulterated Preservative Found Jam 8 - - 3 Jelly 6 — — 2 Lard 9 2 22.2 — Lard Substitute 4 3 75.0 — Lemonade Powder 3 - - None Lemon Curd 3 - - None Liniment of Turpentine 3 — — — Magnesia 7 7 100 — Margarine 51 2 3.9 None Milk 890 67 7.5 None Minced Meat 16 2 12.5 2 Mustard 6 - - - Oatmeal 3 - - None Olive Oil 3 - - - Parrish's Food 3 - - - Pearl Barley 6 — — None Peas 3 — — None Pepper 6 — — None Potassium Citrate 1 — — - Rice 10 - - None Saccharine Tablets 4 1 25.0 - Sago 3 1 33.3 None Sauce 3 — - None Sausage 4 1 25.0 2 Seidlitz Powder 3 — — - Smoked Salmon 6 - — None Sodium Bicarbonate 8 - — — Sodium Citrate 1 - - - Spice 3 — — — Spirits 13 1 7.7 — Steak Pie 3 — — None Suet 8 1 12.5 — Sugar 6 1 16.7 None Sulphur Ointment 4 — — — Sweets 11 — — 1 Tartaric Acid 3 — — - Tea 6 — — - Tincture of Iodine 15 3 20.0 - Tinned Foods 7 — — None Vinegar 5 — — None Xmas Pudding 1 — — None Zinc Ointment 5 — — — 1,544 134 8.7 26 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. 82 Table B shows the number of samples taken under the Act with the percentage of adulteration, and also the total number of samples examined durine the Dast ten vears. Table B. Year. Samples taken under the Act. N umber Adulterated. Percentage Adulterated. Bact. Examinations. Miscellaneous Samples. Total Samples. 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 1937 1,544 134 8.7 - 162 1,706 Of the samples taken under the Act 1,438 consisted of foods and of these 119, or 8.3 per cent., were adulterated; of the remaining 106 samples consisting of drugs, 15, or 14.2 per cent., were adulterated. Legal Proceedings.— Offences were committed in 146 cases. These were dealt with as shown below:— Adulterated. Other offences. Total. Formal Proceedings 47 12 59 Caution 33 — 33 No action 11 — 11 Informal 43 — 43 134 12 146 Fines and costs totalled £242 15s. Od. Milk.— 890 samples of milk were analysed. Of these 67, or 7.5 per cent., were adulterated. In addition 6 cowshed samples were obtained for examination by the Hortvet freezing point method. These samples showed freezing points varying from —0.549° to —0.566°C. Table C shows the number of samples of milk examined and the percentages of adulteration during the last ten years. Table C. 1923. 1929. 1930. 1931. 1932. 1933 1934. 1935. 1936. 1937. Number of samples. 923 923 900 881 974 928 1005 965 984 890 Percentage of adulteration. 4.1 3.9 2.2 3.0 2.6 2.2 4.6 7.7 8.6 7.5 The percentage of adulteration still remains at a fairly high figure. Table D shows the extent of the adulteration and the action taken in each case. 88 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 7 - - 1.1 Vendor cautioned. C 13 52.3 10.6 13.8 Vendor fined £1 with £2 2s. costs. C 14 32.0 - - Discharged under the Probation of Offenders Act. Vendor paid £3 3s. costs. B 13 — — 1.3 Vendor cautioned. C 16 — 2.4 2.5 Vendor fined 10/- with £2 2s. costs. C 24 26.3 2.1 2.8 No action. C 25 — — 1.3 Vendor cautioned. B 27 28.3 18.0 19.1 Vendor fined 10/- with £2 2s. costs. B 28 32.0 - - Discharged under the Probation of Offenders Act. Vendor paid £2 2s. costs. B 30 — 1.8 3.0 Vendor cautioned. B 32 — 2.7 4.2 Vendor cautioned. B 33 — — 1.5 Vendor cautioned. B 39 — — 1.1 Summons withdrawn. B 40 — — 1.1 Summons withdrawn. C 47 6.7 24.7 27.4 Discharged under the Probation of Offenders Act. Vendor paid £2 2s. costs. C 50 5.0 5.9 — Vendor fined £1 with £2 2s. costs. C 53 — 8.6 10.4 Vendor fined £2 with £3 3s. costs. C 56 5.6 5.1 Discharged under the Probation of Offenders Act. Vendor paid £2 2s. costs. C 49 18.3 33.9 36.0 Vendor fined £3 with £2 2s. costs. B 48 5.0 11.8 14.9 Discharged under the Probation of Offenders Act. Vendor paid £2 2s. costs. B 60 16.7 27.1 30.6 Vendor fined £1 with £1 Is. costs. B 63 — — 1.3 Vendor cautioned. B 65 — — 1.7 Vendor cautioned. B 79 — 35.9 37.0 Vendor fined £3 with £2 2s. costs. C 66 8.7 — — Vendor cautioned. C 75 7.0 — - Vendor cautioned. C 94 — 1.2 2.6 No action. C 96 — — 1.1 No action. C 101 — 1.2 1.1 Summons dismissed. B 89 - 6.8 6.4 Discharged under the Probation of Offenders Act. Vendor paid £2 2s. costs. C 120 — — 3.8 No action. C 125 16.7 5,8 6.6 Vendor fined £2 with £2 2s. costs. C 136 — — 1.1 Summons dismissed. C 137 - 3.4 5.3 Discharged under the Probation of Offenders Act. Vendor paid £4 4s. costs. B 108 — 2.4 1.7 Vendor cautioned. C 145 — 6.1 7.7 Vendor fined £1 with £1 1s. costs. C 149 58.3 — — Vendorfined £2 with £2 2s. costs. C 165 — 1.4 3.4 No action. C 172 — — 1.9 No action. C 174 — 1.8 2.8 No action. C 176 — 1.8 3.4 Summons withdrawn. 84 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 144 - 4.8 6.0 Vendor fined £1 with £1 Is. costs. B 152 — 2.8 3.0 Vendor cautioned. C 197 44.3 — — Vendor cautioned. C 208 9.3 — — Vendor fined £2 with £2 2s. costs. C 209 9.3 — — Same vendor as C208. Not separately dealt with. B 187 - 6.5 6.8 Discharged under the Probation of Offenders Act. Vendor paid £2 2s. costs. B 212 23.3 19.2 22.5 Vendor fined £3 with £2 2s. costs. B 213 49.3 - - Discharged under the Probation of Offenders Act. Vendor paid £2 2s. costs. B 215 60.0 - — Sample purchased informally. C 240 20.3 - - Discharged under the Probation of Offenders Act. Vendor paid £3 3s. costs. C 278 9.7 - — Vendor cautioned. C 305 9.7 - — Vendor cautioned. C 308 6.0 - — Vendor cautioned. C 314 8.0 - — Vendor cautioned. B 329 4.0 - — Vendor cautioned. C 392 14.0 - — Vendor cautioned. B 407 6.0 - Vendor cautioned. C 550 41.7 22.1 24.3 Vendor fined £3 with £2 2s. costs, and removed from register absolutely. C 551 — 8.2 10.6 Vendor fined £3 with £2 2s. costs. C 552 — 8.4 10.6 Vendor fined £3 with £2 2s. costs. B 507 14.7 23.5 24.5 Vendor fined £10 and removed from register. B 508 16.7 25.1 25.4 Vendor fined £5. B 509 20.7 27.8 28.7 Vendor fined £5. C 614 — 9.4 10.9 Vendor fined £10 with £2 6s costs. C 683 13.3 — — Vendor cautioned. C 775 - 6.1 6.8 Vendor cautioned. Notes on Table D. During the early part of the year a large number of samples were submitted which showed only slight amounts of water. These samples were all traced to wholesale sources. During January and February there were 20 samples showing by the Hortvet freezing point test a minimum of added water ranging from 1.1 to 4.2 per cent, of added water, also by the same test 11 other samples showing a minimum figure of less than 1 per cent, of added water. There seemed to be no doubt that the milk supplied by these firms was being consistently adulterated and although the amount of water shown was small it was decided to take legal proceedings in the hope of putting a 85 stop to this sophistication. For the defence two analysts gave evidence to the effect that they based their calculations on a minimum depression of 0.520°C. as against, at that time, the usually accepted figure of 0.530°C. The use of such a figure would suggest that the samples were just genuine. The magistrate decided that there was a doubt about the minimum figure and dismissed the cases without costs. Three other cases were withdrawn. The wisdom of taking proceedings in these cases, although dismissed, has since been amply proved. The wholesalers concerned immediately caused samples to be taken from the farmers from whom they received their supplies and it was found that farmers from certain districts were adding large percentages of water. These adulterated supplies when mixed with the large bulk of genuine milk from other farms (the composition of this milk being above the legal minimum) had the effect of producing a mixed milk showing the small amounts of added water found in so many samples taken in this Borough. Since then the supplies have been satisfactory. As a proof of this I would point out that counting watered samples only there were during the first three months of the year, i.e., up to the time the cases were taken, 39 adulterated samples. Since then, for the remaining nine months of the year, there have been nine watered samples only and these were all grossly adulterated samples not connected with the wholesale supply. Samples C550, C551 and C552 were obtained from the same vendor, who was fined in each case and removed from the register. Samples B507, B508, B509 were obtained from the same vendor. He was fined in each case and removed from the register. See also " Other offences." The average composition of the samples of milk, genuine and adulterated, received during the year is shown below. Six cowshed samples are not included. Table E. Month. Number examined. Fat per cent. Solids-not-fat per cent. Total Solids per cent. January 95 3.41 8.47 11.88 February 81 3.53 8.64 12.17 March 85 3.27 8.64 11.91 April 80 3.42 8.68 12.10 May 55 3.42 8.73 12.15 June 78 3.32 8.77 12.09 July 30 3.43 8.70 12.13 August 75 3.47 8.63 12.10 September 9.2 3.52 8.59 12.11 October 77 3.75 8.76 12.51 November 72 3.68 8.78 12.46 December 70 3.73 878 12.51 Whole Year 890 3.50 8.67 12.17 Legal Minimum - 3.00 8.50 - 86 The quality of the milk sold in the Borough was, as usual, the best in the last months of the year. It will be noted that the average percentage of solids-not-fat during the month of January is less than the legal minimum. This abnormal figure is due to the fact that, out of the 95 samples examined in January, 24 were adulterated. 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. 1928 3.67 8.65 12.32 1929 362 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 1937 3.50 8.67 12.17 Hospitals, etc., Samples.— 28 samples of milk were taken on delivery for chemical examination from various institutions in the Borough. The average composition of the milk was:— Fat, 3.59 per cent., and solids-not-fat 8.72 per cent. School Samples.—37 samples of milk were taken on delivery at schools in the Borough. The average composition of the samples was:— Fat 3.55 per cent., and solids-not-fat 8.73 per cent. Bread and Butter.—69 samples, consisting of either bread and butter or rolls and butter, were examined. Of these 4 samples of bread and butter and 8 samples of rolls and butter were adulterated. B 95. Rolls and butter (Informal). The fat consisted of margarine. B 96. Bread and butter (Informal). The fat consisted of margarine. B 104. Bread and butter (same vendor as B 96). The fat consisted of margarine. Vendor fined £2 with £2 2s. 0d. costs. B 222. Rolls and butter (Informal). The fat contained 40 per cent, of margarine. B 240. Rolls and butter (same vendor as B 222). The fat contained at least 15 per cent, of margarine. Vendor fined £5 with £2 2s. Od. costs. B 485. Rolls and butter (Informal). The fat consisted of margarine. B 492. Bread and butter (Informal). The fat consisted of margarine. B 520. Rolls and butter (same vendor as B 485). The fat consisted of margarine. Vendor fined £1 with £2 2s. 0d. costs. B 519. Bread and butter (same vendor as B 492). The fat consisted of margarine. Vendor fined £2 with £2 2s. 0d. costs. B 665. Rolls and butter (Informal). The fat consisted of margarine. 87 B 706. Rolls and butter (Informal). The fat contained at least 40 per cent, of margarine. B 722. Buttered Rolls. The fat consisted of margarine. Discharged under the Probation of Offenders Act. Vendor paid £2 2s. 0d. costs. Butter.— Out of 55 samples of butter analysed, 2 samples were found to be adulterated. B 703. Contained at least 50 per cent, of margarine. Vendor fined £1 with £2 2s. Od. costs. B 705 (Informal). Contained at least 50 per cent, of margarine. Condensed and Dried Milk.— 5 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.— 11 samples of cream examined were genuine and free from preservative. In 7 of these samples the fat ranged from 40.0 per cent, to 54.5 per cent., with an average of 46.1 per cent. In the remaining 4 samples the fat ranged from 22.4 per cent, to 26.8 per cent., with an average of 24.5 per cent. 3 of the latter samples consisted of tinned cream and 1 was sold loose under the name of " Economy Cream." Cream Buns.— 6 samples of cream buns were examined. None of the samples contained cream. Cream Cheese.— Since and including the year 1926, 57 samples of Cream Cheese have been analysed and of these 42 samples were adulterated. 7 were sold as Soft Cheese and complied with that description. One sold as Double Cream Cheese was made from whole milk. Out of 49 samples sold as Cream Cheese 6 were made from single cream, 2 from very thin cream, cream, 23 from whole milk. 11 from partially skimmed milk, 4 from skimmed milk and 3 from separated milk. Legal proceedings were taken in one case in 1926 and one case in 1927 and a conviction was obtained in each case. Until the years 1933, 1935 and 1936 no further samples were taken as it was thought that this kind of cheese was a cheap locally-made product and that real cream cheese was not expected to be obtained. As, however, none of these later samples sold as cream cheese consisted of cream cheese the Public Health Committee in 1936 authorised the Medical Officer of Health to inform purveyors in the Borough that it was an offence to sell soft cheese made from milk as cream cheese and during the year with which this report deals three convictions have been obtained. The following short notes show broadly the differences between the various types of cheese. Soft Cheeses are made from whole milk by draining the curd without heat or pressure. They are non-pressed, cheeses. In the soft cheeses made and sold locally the percentage of fat varies round about 20 per cent. Sometimes, however, as mentioned above in samples obtained in the Borough, partially skimmed or separated milk is used and then the percentage of fat may be very small. Well known types of soft cheeses are Camembert and Brie; these are made by a special process. Hard cheeses are pressed cheeses 88 made from whole milk except some Dutch varieties and contain about 30 per cent, of fat. The curd is subjected to heavy pressure in order to eventually form the hard cheese. Cream Cheeses are soft cheeses made from cream. According to a pamphlet issued by the Ministry of Agriculture and Fisheries there are in general two varieties of cream cheese manufactured. (1) Double Cream Cheese, made from cream containing 50 per cent, of fat. (This cheese will contain about 60 to 70 per cent, of fat). (2) Single Cream Cheese made from cream containing 25 to 30 per cent, of fat. (This cheese will contain about 40 to 50 per cent, of fat). There is no legal standard for cream cheese. There is, however, a legal standard for cream cheeses stamped with the national mark. This standard requires Extra Selected (Double Cream) Cheese to contain 70 per cent, of fat and Selected Cream Cheese to contain 55 per cent, of fat. (Statutory Rules and Orders, 1935, No. 1351). Of 19 samples of cream cheese analysed during the year 15 samples were adulterated. C 87 (Informal). Consisted of hard cheese made from whole milk. C 88 (Informal). Consisted of hard cheese made from whole milk. C 105. Consisted of soft cheese made from whole milk. Vendor cautioned. B 112. Consisted of soft cheese made from whole milk. Vendor cautioned. B 277 (Informal). Consisted of soft cheese made from whole milk. B 278 (Informal). Consisted of soft cheese made from whole milk. B 279 (Informal). Consisted of soft cheese made from whole milk. B 337. Consisted of soft cheese made from whole milk. Vendor fined £1 with £2 2s. Od. costs. B 338. Consisted of soft cheese made from partially skimmed milk. Vendor cautioned. B 339. Consisted of soft cheese made from whole milk. Vendor fined £1 with £2 2s. Od. costs. C 656 (Informal). Consisted of soft cheese made from whole milk. B 642. Double Cream Cheese. Consisted of soft cheese made from whole milk. Discharged under the Probation of Offenders Act. Vendor paid £5 5s. 0. costs. C 701. Consisted of soft cheese made from whole milk. Vendor cautioned. B 731 (Informal). Consisted of soft cheese made from whole milk. B 732 (Informal). Consisted of soft cheese made from whole milk. Of the above unsatisfactory samples sold as cream cheese, the two hard cheeses contained 20.8 and 20.0 per cent, of milk fat respectively ; the twelve soft cheeses contained 11.2, 17.6, 19.0, 20.2, 21.5, 15.3, 7.8, 16.6, 20.7, 22.2, 16.1 and 16.9 per cent, of milk fat respectively and the sample sold as Double Cream Cheese contained 14.4 per cent, of milk fat. Dried Mint.— 6 samples of dried mint were examined. Of these 2 samples were found to be adulterated. C 726 (Informal). Contained at least 20 per cent, of ailanthus leaves. 89 C 771 (Same vendor as C 726). Contained at least 3 per cent, of ailanthus leaves. Vendor cautioned. Dripping.— Out of 6 samples of dripping analysed, one sample was unsatisfactory. B 183 (Informal). Contained 7.2 per cent, of free fatty acids. Lard.— Of 9 samples of lard examined, 2 samples were found to be adulterated. B 99 (Informal). Consisted of lard substitute. B 100 (Informal). Consisted of lard substitute. Lard Substitute.— 4 samples of lard substitute were analysed and of these three samples were adulterated. C 86 (Informal). Contained 10.8 per cent, of water. B 167 (Informal). Contained 10.9 per cent, of water. B 280 (Same vendor as B 167). Contained 10.0 per cent, of water. No action taken. Margarine.— Of 51 samples analysed, two samples were found to be adulterated. B 678 (Informal). The fat contained 40 per cent, of milk fat. B 704. The fat contained 60 per cent, of milk fat. Vendor fined £10 with £3 3s. Od. costs. Minced Meat.— 16 samples were examined and of these 2 samples were unsatisfactory. Sulphur dioxide preservative is prohibited in meat. A 62. Contained 460 parts sulphur dioxide per million. Vendor fined £1 with £2 2s. 0d. costs. A 73. Contained 2,890 parts sulphur dioxide per million. Vendor fined £1 with £1 Is. 0d. costs. Vendor was also fined for obstruction. (See "Other Offences"). Sago.— Of 3 samples examined, one sample, C 547 (Informal), consisted of tapioca. Sausage.— 4 samples of sausage were examined and one sample was found to be adulterated. A 59. Pork Sausage. Contained 220 parts sulphur dioxide per million without declaration or notice of the presence of preservative. Vendor cautioned. Spirits.— 7 samples of whisky, 3 samples of brandy and 3 samples of gin were analysed. Of these 1 sample of whisky was adulterated. B 433. Whisky (Informal, sold as 30 degrees under proof). Contained 4.1 percent, excess water. A further sample taken formally from the same vendor complied with the description. Suet.— 8 samples of suet and shredded suet were examined, 1 sample of shredded suet was unsatisfactory. B 296 (Informal). 2.9 per cent, deficient in fat. A further sample taken formally from the same vendor was satisfactory. 90 Sugar.— 3 samples of Demerara sugar and 3 samples of icing sugar were analysed. One sample of Demerara sugar was adulterated. C 671. Demerara Sugar (Informal). Contained 3.2 grains tin per pound. The remaining stock was destroyed. Drugs.— Of 106 drugs analysed, 15 or 14.2 per cent, failed to comply with the requirements of the British Pharmacopoeia and were returned as adulterated. Ammoniated Tincture of Quinine. B 56 (Informal). 13.3 per cent, deficient in ammonia. B 107. 26.7 per cent, deficient in ammonia. Vendor cautioned. Castor Oil. C 463 (Informal). Excessive acidity (Acid value 13.7). C 506 (Same vendor as C 463). Excessive acidity (Acid value 13.7). Vendor cautioned. Magnesia. B 297 (Informal). Consisted of effervescent magnesium sulphate. B 298 (Informal). Consisted of effervescent magnesium sulphate. B 299 (Informal). Consisted of effervescent magnesium sulphate. B 334. Consisted of effervescent magnesium sulphate. Vendor cautioned. B 336. Consisted of effervescent magnesium sulphate. Vendor cautioned. C 394 (Informal). Consisted of magnesium carbonate. C 422. Same vendor as C 394. Consisted of magnesium carbonate. Vendor cautioned. Saccharine Tablets. C 284 (Informal). 26.0 per cent, deficient in saccharin. A further sample purchased formally from the same vendor was satisfactory. Tincture of Iodine. B 54 (Informal). 34.3 per cent, deficient in iodine and 40.7 per cent. deficient in potassium iodide. B 81 (Same vendor as B 54). 33.1 per cent, deficient in iodine and 42.8 per cent, deficient in potassium iodide. Discharged under the Probation of Offenders Act. Vendor paid £2 2s. Od. costs. C 657 (Informal). Contained 1.3 times the limit of iodine and 1.7 times the limit of potassium iodide. A further formal sample from the same vendor was satisfactory. Poor Quality Samples.— These comprise samples of inferior grade or of doubtful character and are 39 in number. 30 of these consisted of milk. Other poor quality samples were:— Flour (2), Butter (2), Jam, Margarine, Camphorated Oil, Iodine Ointment and Sulphur Ointment. 91 Offences other than Adulteration.—Milk.—For filling milk bottles other than on registered premises one vendor was fined £3 with £2 2s. Od. costs. For the omission of the name and address on the can, etc., two vendors were fined £2 and £1 Is. 0d. costs and £1 respectively. The unregistered vendor of adulterated samples B 507, B 508 and B 509 was fined £5 with £7 7s. 0d. costs and was also fined £1 for obstruction. One vendor who was not registered paid £1 Is. Od. costs. Cream.— 3 unregistered vendors were fined £2 with £2 2s. 0d. costs, £1 with £1 Is. Od. costs and £2 with £2 2s. 0d. costs respectively. Margarine.— The vendor of adulterated sample B 704 was fined £10 with £3 3s. Od. costs as the factory was not registered and £10 with £3 3s. 0d. costs for not complying with the labelling regulations. Minced Meat.— The vendor of adulterated sample A 73 was fined £2 with £2 2s. Od. costs for obstruction. Miscellaneous Samples.— 162 miscellaneous samples were submitted for analysis. These include 6 cowshed samples. Of the remaining 156 samples, 134 were foods, and of these, 20 or 14.9 per cent, were unsatisfactory. Public Health Department.— 141 samples submitted by the Public Health Department comprised the following:— Metallic Contamination. 59 samples were examined and of these 16 were unsatisfactory. Satisfactory samples were:— Tinned Brisling (13), Tinned Sild (13), Tinned Pineapple (3), Tinned Fish (3), Tinned Herrings (2), Tinned Salmon (2), Tinned Vegetable Mayonnaise (2), Tinned Anchovies (1), Tinned Silver Fish (1), Tinned Sardines (1), Tinned Potato Salad (1) and Tinned Jellied Pork (1). All the above were examined for tin. Unsatisfactory samples were Tinned Brisling (7) (contained 2.2, 3.9, 2.5, 4.1, 2.6, 3.1 and 2.8 grains tin per pound respectively); Tinned Shrimps (3) (contained 3.9, 2.9 and 4.5 grains tin per pound respectively); Tinned Sild (3) (contained 2.6, 5.2 and 2.8 grains tin per pound respectively); Tinned Anchovies (2) (contained 3.9 and 3.7 grains tin per pound respectively) and Tinned Plum Pudding (contained 3.0 grains tin per pound. Preservatives.— 58 samples were examined and of these 2 were unsatisfactory. Satisfactory samples were:— Raisins (16) and Sultanas (5); these contained no preservative and Raisins (17), Sultanas (7) and Strawberry Pulp (1); these contained preservative in amount less than the permitted quantity. Smoked Salmon (8) and Salt (2) examined for formalin were free from this preservative. Unsatisfactory samples were:— Raisins (2), containing 870 and 850 parts sulphur dioxide per million respectively. Fit for food.— 4 samples were examined with regard to their fitness for human consumption. 2 samples of Condensed Milk and 1 sample of Jam were satisfactory, 1 sample of Cream Cheese was unsatisfactory. 92 Metallic Contamination and Preservative.— One sample of Tinned Puree examined for tin and preservative and one sample of Tinned Peas examined for copper and preservative were satisfactory. Export.— 2 samples of Bacon, 1 sample of Turtle Soup and 1 sample of Meat Extract were free from preservative. Cause of Illness.— 3 samples, said to have caused illness, consisted of Rum, Sardines and Tinned Salmon. These were free from harmful ingredients or impurities. Other Samples.— Other samples were:— Formalin 2 (complied with the requirements of the specification), drainage water (no sewage detected), plaster (contained salt), milk (free from dirt) and 4 samples of dust. Rag Flock Act. According to the standard of cleanliness required by the Rag Flock Regulations, rag flock must not contain more than 30 parts of chlorine in 100,000 parts of the flock. One formal sample containing 44 parts of chlorine per 100,000 was unsatisfactory. Pharmacy and Poisons Act. One sample of Paste analysed contained 13 per cent, of barium carbonate. Borough Engineer. 10 samples comprised: Carbolic Powder 7 and Cold Bitumen 3. Public Cleansing Officer. 1 sample of Carbolic Powdlr and 1 sample of Carbolic Soap were examined. Private Samples. 3 samples consisted of Colouring Matter, Fruit Pie and Cakes. I wish to express my appreciation of the able assistance given me throughout the year 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.l. April, 1938. 93 VI.— PREVALENCE OF, AND CONTROL OVER, INFECTIOUS AND OTHER DISEASES. Notifications.— 1,596 notifications (other than of tuberculosis) were received, or 1,163 less than in the previous year, largely due to the absence of measles during this year. The notification rate for the whole Borough was 7.8 per 1,000 of the population. Scarlet Fever.— 381 cases were notified during the year, or 115 less than in the previous year. 370 of these cases were removed to hospital. There were no deaths from scarlet fever during the year. Diphtheria.— 644 cases were notified during the year, or 167 more than in the previous year. 638 of these cases were removed to hospital. The death rate for the whole Borough was .03 per 1,000 of the population. There were 7 deaths, of which 6 were of children from 1 to 5 years of age, and 1 child over 5 years of age ; the case mortality was 1.08 per cent., the same as in the previous year. Anti-Diphtheritic.- This serum is supplied on request to the general practitioners of the Borough. During the year 40 tubes, each containing 4,000 units, were issued from the Public Health Office. Diphtheria Immunisation.— The following is a report of the work at the Council's Diphtheria Immunisation Clinic from Dr. W. W. King Brown, the Council's part-time Medical Officer of the Clinic. "This is the first occasion on which it has been possible to review briefly a whole years' work of the clinic. From the table appended it will be seen that the clinic has made considerable progress, and on the whole the attendance can be considered satisfactory. "It is interesting to note that 21 % of the children tested gave a 'Schick negative' response to their test. This indicates a fairly high degree of 'herd immunity' to diphtheria. This is the usual experience in crowded areas. "During the greater part of the year, the method of immunisation employed was that of three injections of toxoid-anti-toxin mixture (T.A.M.) as outlined in last year's report, and the results of final Schick tests in the table refer to this method. The figure of only 2.7% still susceptible after the test can be considered good, but it is hoped that it will be improved upon. "In October it was decided to try a two injection method of immunisation using alum precipitated toxoid (A.P.T.). It was thought that the reduction in the number of doses required from three to two would perhaps result in a greater number of children completing the full course of treatment. "During the year under review none of these latter cases came up for the final Schick test, so that nothing can yet be stated as to the efficiency of the Schick test in Stepney, but from experience elsewhere it will be probably found to give a result at least as good as the T.A.M. method, and possibly somewhat better. "During 1937, five children who had attended the clinic were notified as cases of diphtheria. Of these two had not completed their treatment, and so these cannot be considered as cases of failure to immunise, one was found to be a carrier and not to be suffering from clinical diphtheria, and in the 94 fourth case no evidence of the disease could be traced. The remaining one case was reported to be suffering from a 'very mild tonsillar diphtheria.' There can be no doubt that this last child was saved from a severe attack by his previous inoculation." (a) Total number of clinics held 47 (b) Total number of all attendances of children at same (either for Schick or Immunisation) 2206 (c) Number of Primary Schick tests 456 (d) Number of Final Schick tests 334 (e) Number of Immunisation Inoculations given 1010 (/) Number of Immunisation Certificates given 349 (g) Number of individuals who have attended the clinic for the first time during the year 466 (h) Number aged 12 months and under when they made first attendance 9 (i) Number aged 1 year to 6 years inclusive when they made first attendance 278 (j) Number aged 6 years to 14 years inclusive when they made first attendance 177 (k) Number of adults, viz., from 15th birthday upwards who attended 2 (I) Number who failed to return for reading of first Schick 6 (m) Number who began but failed to complete their immunisation doses 28 (n) Number who failed to come for final Schick (or for reading of final Schick) 37 (o) Number found immune after first Schick and not therefore inoculated 21% 106 (p) Number found to be still susceptible after one complete course 9 2.7% (q) Number of latter given a second course 9 (r) Number of (q) found immune after second course 2 (s) Number still in course of treatment at end of year and not yet complete 72 (t) 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 1 Enteric Fever.— There were 5 cases notified during the year. All were removed to hospital. There was 1 death. 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.— 8 cases of acute poliomyelitis were notified. All were removed to hospital. 95 Encephalitis Lethargica.— No cases were notified during the year. 2 deaths occurred, the death-rate being .009. Cerebro-Spinal Meningitis.— 9 patients were notified during the year, of which 8 died. The death rate for the whole Borough was .03 per 1,000 of the population. Measles.— 59 cases were notified. There were no deaths. Polio-encephalitis.— There were 2 cases notified. Both of which died in hospital. Ophthalmia Neonatorum.— There were 14 cases notified as against 12 in the previous year. 12 cases were removed to hospital. Puerperal Fever and Puerperal Pyrexia.— 7 cases of puerperal fever and 33 cases of puerperal pyrexia were notified during the year, or 2 more than in the previous year. All these cases were duly investigated and there were 5 deaths. 39 cases were removed to hospital. Pneumonia Malaria and Dysentery Regulations.— 276 cases of Pneumonia, and 28 of Dysentery were notified under the Regulations during the year. There were 171 deaths from Pneumonia, or 10 less than in the previous year. 99 of these were in persons over 45 years of age. No cases of Malaria were notified. Wrong Diagnosis.— 109 cases of infectious diseases removed to hospital were found not to be suffering from the disease stated on the certificate. Of these, 10 were cases of scarlet fever, 92 of Diphtheria, 4 of Dysentery and 3 of Poliomyelitis, 50 cases were notified by private practitioners and 59 were from public institutions. Food Poisoning.— 10 cases were notified, or 2 more than in the previous year. 96 NOTIFIABLE DISEASES (OTHER THAN TUBERCULOSIS) DURING THE YEAR, 1937. Disease Total Cases Notified. In Age Groups. Cases admitted to Hospital Total Deaths. Under 1 year. 1— 2— 3— 4— 5— 10— 15— 20— 35— 45— 65 and over Total Smallpox — — — — — - — — — — — - - — - Scarlet Fever 6 27 29 42 45 135 47 28 19 2 1 — 381 370 — Diphtheria 30 46 48 ',3 79 233 67 27 32 6 2 1 644 638 7 Enteric Fever — — — — — — 1 2 2 — — — 5 5 1 Measles 6 13 7 14 19 — — — — — — — 59 19 — Puerperal Fever - - - - - - - - 6 1 — — 7 6 2 Puerperal Pyrexia — — — — — — — 3 24 6 — - 33 33 3 Erysipelas 3 — 1 1 — 5 6 6 25 15 39 17 118 82 - Encephalitis Lethargica — — — — — — — — — — — — — — 2 Cerebro-spinal Fever 3 1 — 1 — 1 — — 1 1 1 - 9 9 8 Ophthalmia Neonatorum 14 - - - - - - - - - - - 14 12 — Food Poisoning — — — — — — — 2 4 1 2 1 10 4 — Polio-myelitis 1 — 1 2 1 2 — 1 — — — — 8 8 — Polio-encephalitis — — — — 1 1 — — — — — — 2 2 2 Membranous Croup — — 1 — — 1 — — — — — — 2 2 — Dysentery 2 4 2 8 — 5 2 1 1 1 2 — 28 28 — Malaria — — — — - - - - - - - - - — — Pneumonia 33 23 20 17 8 18 12 16 36 20 44 29 276 136 171 Totals 98 114 109 158 153 401 135 86 150 53 91 48 1,596 1,354 196 97 Whooping Cough.— The number of deaths was 14, or 8 less than in the previous year. All of these occurred in children under 5 years of age (6 of them under 1 year). The death rate was .06 per 1,000 of the population. Diarrhoea.— There were 48 deaths, 58 less than in the previous year. 36 of these deaths, or 75.0 per cent., were in children under 1 year of age. The death rate was .2 per 1,000 of the population. Zymotic Diseases.— The total deaths from diseases of a Zymotic character was 70, or 122 less than in the previous year. They include all deaths from Small Pox, Scarlet Fever, Diphtheria, Typhoid Fever, Measles, Whooping Cough and Diarrhoea. The death rate was .3 per 1,000 of the population. Influenza.— The number of deaths was 73, or 57 more than in the previous year. As usual these occurred in elderly persons. The death-rate for the whole Borough was .35 per 1,000 of the population. Cancer.—-The number of deaths from cancer was 331, or 27 more than in the previous year. The death-rate for the whole Borough was 1.6 per 1,000 of the population. 31 were under 45 years of age—15 males and 16 females. 137 were between 45 and 65 years of age—76 males and 61 females. 114 were between 65 and 75 years of age—67 males and 47 females. 49 were 75 years of age and over—23 males and 26 females. The organs and parts of the body affected were as follows:— Male. Female Mouth, Throat and alimentary canal 32 8 Other abdominal organs 77 59 Generative organs — 13 Breast ... — 19 Skin — 1 Lung and Pleura 20 5 Bones ... 3 1 Other specified Organs 47 43 Other undefined 2 1 Totals 181 150 Heart Disease.— There were 784 deaths from Heart disease (408 males and 376 females) or 4 less than in the previous year. The death-rate for the whole Borough was 3.8 per 1,000 of the population. Diseases of the Respiratory Organs.— The number of deaths from diseases of the Respiratory Organs (excluding Tuberculosis) was 262 or 6 less than in the previous year. The death-rate for the whole Borough was 1.2 per 1,000 of the population. Scabies.— The arrangements with Bethnal Green for the treatment of adults and with the London County Council for the treatment of children under school age were continued. During the year 152 adults were sent to Bethnal Green and 304 children were treated at the L.C.C. Bathing Station. 98 Cleansing and Disinfection.— 165 persons were cleansed during the year and had their clothing disinfected. All were adults and they were cleansed because of vermin. 2,322 rooms were fumigated and the bedding, etc., removed and disinfected by steam. Of these, 1,147 rooms were fumigated because of infectious disease, 135 as a result of pulmonary tuberculosis, and 1,040 because they were verminous. In addition to these, scabies occurred in 1,306 families and the bedding was taken away and disinfected by steam. The disinfection of second-hand clothing, prior to export to South Africa and the supervision of the packing of the goods was carried out as in previous years. The number of such articles dealt with this year reached 27,405. The total number of articles disinfected for all purposes was 59,297. Bug Eradication.— The year 1937 completes the first full year of the operation of the Hydrogen Cyanide Fumigation Chamber. The furniture and effects of 379 families were treated in the chamber before being rehoused ; of this number 18 were done for the Stepney Housing Trust, 1 for the Corporation of the City of London, thus leaving a total of 360 for families rehoused in Council Flats. Particulars of rehousing are given below: Name of Flats. No. of familes rehoused. Andrewes House 17 Arbour House 56 Brook Street Buildings 1 Brunton House 4 Edward Mann Buildings 2 Faraday House 2 Gosling House 11 Hardie House 1 Hughes Mansions 5 John Scurr House 115 Limehouse Fields 101 Maxwell Dwellings 1 Newell House 1 North East Passage 1 Potter Dwellings 2 Regent House 5 Ring House 5 Riverside Mansions 25 St. Anne's House 2 Wainwright House 3 360 1,473 inspections we're made to 788 flats during the year, and of this number 345 were found to be infested, and suitable steps were taken for the eradication of vermin, either by means of fumigation or spraying with insecticide according to the degree of infestation. 99 The following figures summarise the disinfestafion work carried out: No. of flats fumigated 85 No. of rooms fumigated 386 No. of flats sprayed 93 No. of rooms sprayed 1,208 The construction of the Incinerator for the destruction of old furniture and effects left by outgoing tenants from slum clearance areas, was completed during the year and came into operation on the 16th June. Arrangements have been made with the Public Cleansing Officer whereby a dust-van calls immediately after the departure of the furniture van to remove any old furniture, etc., that may be left by the tenants who are being rehoused. The signature of the tenant, consenting to the removal and destruction, is always obtained in the first place. This service is welcomed by the tenants who much prefer to have the articles destroyed rather than leave them behind. By the inauguration of this scheme, a definite attempt is being made to curtail the supply and sale of infested articles often of little value or even worthless, to second-hand dealers. The total amount of old furniture, etc., destroyed was 30 tons 18f cwts. From this a quantity of scrap metal (bedsteads, etc.) amounting to 4 tons 14£ cwts. was salved and disposed of to a scrap-metal merchant at a price of £3 10s. Od. (1) The number of :— (a) Council houses— (i) found to be infested, 345; (ii) disinfested, 345. (b) Other houses— (i) found to be infested, 611. (ii) disinfested, 611. (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. 100 Public Health (Tuberculosis) Regulations, 1930. Ministry of Health Form T.138 1937. PART I —Summary of Notifications during the period from the 1st January, 1937, to the 31st December, 1937, 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 — 12 25 32 29 25 28 9 161 202 ,, Females — 1 1 1 14 13 31 10 9 4 1 85 96 Non-pulmonary Males 1 5 3 5 6 — 4 1 2 2 1 30 31 „ „ Females 1 5 2 — 4 4 5 — 1 — 1 23 23 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 1 — 1 2 8 6 3 3 5 30 Females — — — 1 2 5 6 1 — 3 1 19 Non-pulmonary Males 1 1 — 1 — 1 4 1 — — 1 10 „ „ Females — 2 — 1 — 1 1 — 1 — — 6 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 — — transferable deaths from Registrar General — — Posthumous notifications 22 8 "Transfers" from other areas (other than transferable deaths) 27 8 Other Sources — — PART III. NOTIFICATION REGISTER. Number of cases of Tuberculosis remaining at the 31st December, 1937, on the Registers of Notifications kept by the Medical Officer of Health. Pulmonary Non-pulmonary Total Cases Males Females Total Males Females Total 981 570 1551 273 206 479 2,030 Number of cases removed from the Register(s) during the year by reason inter alia of:— 1. Withdrawal of notification 10 5 15 5 2 7 22 2. Recovery from disease 39 35 74 23 19 42 116 3. Deaths 114 40 154 10 7 17 171 T.B. Patients who died from other diseases 14 6 20 2 — 2 22 4. Otherwise: "Transfers" to other areas 54 33 87 19 6 25 112 101 New Cases of Tuberculosis and Mortality.—Particulars of new cases of tuberculosis and of all deaths from the disease in Stepney during 1937. 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 5 5 — — 4 4 5 1 1 3 2 — — — — 10 — 1 5 — — 2 — — 15 12 14 6 4 8 9 2 — 20 25 13 — 4 9 6 — — '25 32 31 4 5 28 6 1 1 35 29 10 1 — 18 4 — — 45 25 9 2 1 24 6 1 2 55 28 4 2 — 16 5 — — 65 and upwards 9 1 1 1 11 2 1 — Totals 161 85 30 23 114 40 10 7 The death rate for the whole Borough was '84 per 1,000 of the population. Public Health (Prevention of Tuberculosis) Regulations, 1925.—These regulations provide that persons suffering from Tuberculosis of the Respiratory tract shall not be employed in the handling of milk or milk receptacles. Power is given to the Council to cause such persons to discontinue their employment. It was not found necessary to take action under the regulations during the year. 102 RETURN RESPECTING THE VACCINATION OF CHILDREN WHOSE BIRTHS WERE REGISTERED IN STEPNEY FROM JANUARY 1st TO DECEMBER 31st, 1936 INCLUSIVE. M.379 Registration Sub-Districts comprised in the Vaccination Officer's District. Number of Births retrrned in the 'Birth List Sheets" as registered from 1st January to 31st December, 1936. Number of these Births duly entered by 31st January, 1938, 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) (5) (6) (6) (7) Limehouse 1.731 427 3 — 913 57 St. Georges, East 550 197 1 — 212 22 Total 2,281 624 4 — 1,125 79 Whitechapel 1,703 853 4 — 502 92 Mile End 1,181 338 2 — 550 111 Total 2,884 1,191 6 — 1,052 203 103 Registration Sub-Districts comprised in the Vaccination Officer's District. Number of these Births which on 31st January, 1938, remained unentered in the "Vaccination Register" on account (as shown by "Report Book") of Number of these Births remaining on 31st Jan., 1938, 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 1937. 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 1937. 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 — 255 14 62 507 926 St. Georges, East — 24 13 81 342 210 Total — 279 27 143 849 1,136 Whitechapel 2 202 15 33 925 498 Mile End — 88 21 71 377 637 Total 2 290 36 104 1,302 1,135 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 6 3 Total number of certificates for the year 1937 sent to other Vaccination Officers 206 131 104 SUMMARY OF PRIMARY VACCINATIONS DURING THE YEAR JANUARY TO DECEMBER, 1937 (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 Parents removed out of district. Otherwise not found. No. of entries in lists sent to public vaccinator Health of child. Condition of house. Prevalence of infectious disease. Whitechapel 1,494 925 137 — — 498 2 897 17 349 Mile End 1,234 377 57 — — 637 — 402 12 313 Other vaccinations 9 — — — — — — — — Li mehouse 1,717 507 39 — — 926 3 894 68 174 St. Georges 527 342 55 — — 210 — 93 61 296 Other Vaccinations — — — — — — — — — Total 4,972 2,160 288 — — 2,271 5 2,286 158 1,132 105 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, 1937. 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 296 47 343 15 Shadwell do. Dr. E. Lipman 136 19 155 31 Mile End do. Dr. S. Mikhail 212 23 235 3 St. George-in-the-East District Dr. B. Billig 238 26 264 9 „ „ „ „ Dr. P. Steinber 26 1 27 1 Mile End Hospital Dr. A. Randle 6 — 6 — do. Dr. Craig. 4 — 4 — Limehouse District Dr. W. S. R, Thomas 82 17 99 17 Totals 1,000 133 1133 76 106 VII.—STATISTICS PROVIDED BY THE REGISTRAR GENERAL. TOTAL DEATHS BY CAUSE AND AGE IN THE METROPOLITAN BOROUGH OF STEPNEY. 1937. S.D.24 CAUSES OF DEATH. Sex. All Ages. 0— 1— 2— 6— 15— 25— 35— 45— 55— 65— 75— ALL CAUSES M. 1,364 95 23 21 28 40 67 56 158 289 359 228 F. 1,115 71 17 11 15 41 33 57 97 167 305 301 1. Typhoid and paratyphoid fevers M. F. 1 1 2. Measles M. F. 3. Scarlet Fever M. F. 4. Whooping cough M. 5 1 2 2 F. 9 5 3 1 6. Diphtheria M. 5 1 4 F. 2 1 1 6. Influenza M. 37 1 1 2 2 1 8 6 9 5 F. 36 1 2 1 2 6 10 14 7. Encephalitis lethargica M. 1 1 F. 1 1 8. Cerebro-spinal fever M. 4 1 1 F. 4 1 1 1 1 9. Tuberculosis of respiratory system. M. 115 1 17 27 18 24 17 10 1 F. 38 1 15 6 4 5 5 1 1 10. Other tuberculous diseases M. 9 1 3 2 1 2 F. 8 3 1 1 2 11. Syphilis M. 3 1 1 1 F. 1 1 12. General paralysis of the insane, tabes dorsalis. M. 5 1 2 1 1 F. 4 2 2 13. Cancer, malignant disease M. 181 3 1 3 7 19 57 67 23 F. 150 2 4 10 25 36 47 26 14. Diabetes M. 17 2 7 5 3 F. 36 4 9 22 1 15. Cerebral hemorrhage, etc. M. 32 1 5 10 11 5 F. 42 1 3 10 17 11 16. Heart disease M. 408 3 3 7 7 38 90 140 120 F. 376 1 1 2 8 6 13 18 51 114 162 17. Aneurysm M. 5 2 2 1 F. 3 1 1 1 18 Other circulatory diseases M. 49 2 13 21 13 F. 62 1 1 9 27 24 19. Bronchitis M. 44 3 1 1 9 12 11 7 F. 23 1 1 3 4 7 7 107 TOTAL DEATHS BY CAUSE AND AGE IN THE METROPOLITAN BOROUGH OF STEPNEY, 1937—(continued). CAUSES OF DEATH. Sex. All Ages. 0— 1— 2— 5— 15— 25— 35— 45— 55— 65— 75— 20. Pneumonia (all forms) M. 105 24 8 4 2 3 2 2 8 21 16 15 F. 66 13 5 2 2 1 4 6 4 8 21 21. Other respiratory diseases M. 18 2 1 1 1 3 2 6 2 F. 6 1 1 1 1 1 1 22. Peptic ulcer M. 19 3 5 6 4 1 F. 6 2 3 1 23. Diarrhoea, etc M. 22 17 3 1 1 F. 26 19 2 1 1 1 24. Appendicitis M. 8 1 2 1 2 F. 6 1 1 1 1 1 25. Cirrhosis of liver M. 1 F. 3 3 26. Other diseases of liver, etc. M. 1 l F. 12 l 2 2 5 2 27. Other digestive diseases M. 19 1 l l 4 4 4 l F. 18 1 1 2 1 3 5 4 28. Acute and chronic nephritis M. 29 2 1 1 5 6 9 5 F. 29 1 3 5 5 5 29. Puerperal sepsis F. 2 1 1 30. Other puerperal causes F. 5 4 1 31. Congenital debility, premature birth, malformations, etc. M. 32 30 1 1 F. 26 26 32. Senility M. 2 2 F. 3 1 2 33. Suicide M. 13 2 2 2 4 3 F. 8 1 1 3 1 2 34. Other violence M. 55 6 3 1 4 8 7 1 5 6 7 7 F. 32 1 1 1 4 1 3 3 9 9 35. Other defined diseases M. 120 8 3 2 9 8 12 10 21 31 16 F. 77 5 1 5 3 4 8 9 12 18 12 36. Causes ill-defined, or unknown M. F. 4 2 2 Deaths under 1 year of age : Legitimate Illegitimate M. 87 8 F. 66 5 108 S.D. 52.A. (1) Estimated Mid-year Resident Population (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 2,573 77 1,211 1,439 Females 2,385 75 1,140 1,320 Illegitimate Live Births Males 58 11 13 56 Females 37 13 8 42 (3) STILLBIRTHS. Stillbirths registered Inward transfers Outward transfers Stillbirths allocated to the Borough Total 1 Stillbirths (Legitimate and Illegitimate) Males 97 4 44 57 Females 79 2 33 48 Illegitimate Stillbirths Males 5 1 1 5 Females 2 1 1 2 (4) NOTIFIABLE INFECTIOUS DISEASES. (number of cases notified during the 53 weeks ended 2nd January, 1938) Smallpox Scarlet fever Diphtheria Enteric fever Pneumonia Puerperal fever Pueperal pyrexia Erysipelas — 378 645 5 279 7 33 118 (5) Area Comparability Factor, applicable to the "All Causes" crude death rate only 1.17 109 S.D.55 Birthrates, Deathrates, Analysis of Mortality Maternal Death-rates, and Case-rates for certain Infectious Diseases in the year 1937. England and Wales, London, 125 Great Towns and 148 Smaller Towns. (Provisional Figures based on Weekly and Quarterly Returns.) England and Wales. 125 County Boroughs and Great Towns including London. 148 Smaller Towns (Resident Populations 25,000 to 50,000 at 1931 census). London Administrative County. Rates per 1,000 population. Births:— Live 14.9 14.9 15.3 13.3 Still 0.60 0.67 0.64 0.54 Deaths:— All causes 12.4 12.5 11.9 12.3 Typhoid and Paratyphoid Fever 0.00 0.01 0.00 0.00 Small-pox — — — — Measles 0.02 0.03 0.02 0.01 Scarlet Fever 0.01 0.01 0.01 0.01 Whooping Cough 0.04 0.04 0.03 0.06 Diphtheria 0.07 0.08 0.05 0.05 Influenza 0.45 0.39 0.42 0.38 Violence 0.54 0.45 0.42 0.51 Notifications:— Small-pox 0.00 — 0.00 — Scarlet Fever 2.33 2.56 2.42 2.09 Diphtheria 1.49 1.81 1.38 1.93 Enteric Fever 0.05 0.06 0.04 0.05 Erysipelas 0.37 0.43 0.34 0.44 Pneumonia 1.36 1.58 1.20 1.18 Rates per 1,000 Live Births. Deaths under 1 year of age 58 62 55 60 Deaths from Diarrhoea and Enteritis under 2 years of age 5.8 7.9 3.2 12.0 Maternal Mortality:— Puerperal Sepsis 0.97 Not available. Others 2.26 Total 3.23 Rates per 1,000 Total Births (i.e. Live and Still.) Maternal Mortality:— Puerperal Sepsis 0.94 Not available. Others 2.17 Total 3.11 Notifications:— Puerperal Fever 13.93 17.59 11.52 4.15 Puerperal Pyrexia 14.34 110 APPENDIX. (Leaflet of Information issued to local Post Offices in response to Circular 1643a of the Ministry of Health.) METROPOLITAN BOROUGH OF STEPNEY. HEALTH SERVICES. AMBULANCES—Accidents: To call a London County Council ambulance by 'phone in case of accident, (a) where a dialling system is in operation—dial 999 and ask the exchange simply for ambulance, or, (6) where no dialling system is in use follow the directions given in the kiosk. Other purposes : Application to be made to the London County Council, County Hall, S.E.I. Tel. : Waterloo 3311. BIRTHS, DEATHS AND MARRIAGES. The address and hours of attendance of the Registrars are as follows :— Births and Deaths. Limehouse 45a, Barnes Street. Monday to Friday,40 a.m. to 12.30 p.m. Monday, 2 p.m. to 4 p.m. Wednesday, 2.30 p.m. to 4 p.m. Friday, 5.30 p.m. to 7.30 p.m. Saturday, 10 a.m. to 12 noon. Mile End Old Town 100, Burdett Road Monday to Saturday, 9.30 a.m. to 12.30 p.m. Monday and Thursday, 2.30 p.m. to 4.30 p.m. Tuesday, 5 p.m. to 7 p.m. St. George's 242, Cable Street. Monday to Saturday, 10 a.m. to 1 p.m. Monday, Tuesday and Wednesday, 2 to 4.30 p.m. Friday, 5.30 p.m. to 7.30 p.m. Whitechapel 36a, Newark Street. Monday to Friday, 10 a.m. to 1 p.m. Tuesday and Thursday, 4 p.m. to 5 p.m. Friday, 5 p.m. to 7 p.m. Saturday, 10 a.m. to 12 noon. Marriages.—The Superintendent of Births, Deaths and Marriages attends at the Register Office, 25, East Arbour Street, on Monday to Friday from 10 a.m. to 4 p.m. and on Saturday from 10 a.m. to 1 p.m. DENTAL CLINIC. A dental clinic for mothers and children under school age attending the infant welfare centres and for tuberculosis patients is held at 35, Stepney Green, E. Applications to be made at the infant welfare centres or the tuberculosis dispensaries. DIPHTHERIA IMMUNISATION. A clinic is held at 35, Stepney Green, E., every Friday at 2 p.m., where the necessary appointments can be made. DISTRICT NURSING. Enquiries to be made at the East London Nursing Society, 7, Stainsby Road, E.14. Telephone No. : East 2381. HOSPITALS. Timetable for out-patients at local voluntary hospitals is as follows:— East End Maternity Hospital (STEpney Green 1536), 384-398, Commercial Road, E.l Obstetric (booking) Tu., Th., 9-12 ; Mon. to Fri., 6-8. Jewish Maternity Hospital (BIShopsgate 1929), 24, Underwood Road, E.L Ante-natal Mon., Th., 10-12. *Infant Welfare Tu., Wed., 2-4.30. Post-natal Alternate Wed., Teeth Mon., 10.30-12.30 9.30-12. * For Children born in the Hospital District only. London Jewish Hospital (STEpney Green 4251), Stepney Green, E.L Medical Mon. to Fri., 1. Children Tu., 1; Fri., 9.30. Surgical Wed., 1; Fri., 9.30. Eye Tu., 8.45; Fri.,1 Diseases of Women Tu., 9.30. Throat, Nose and Ear Mon., Wed., 8.30 a.m. Obstetric Skin Th., 1. 111 London Hospital (BIShopsgate 8333), Whitechapel, E.I. Medical Weekdays, Men, 1; Throat, Nose and Ear Mon., Tu., Th., Fn., 9. Women, 2. Skin Tu., Th., Men, 8.30 a.m., Surgical Weekdays, X. Women, 10. Diseases of Women Wed., 1 ; Sat., 9. Teeth Mon. to Fri., 9. Obstetric Tu., Wed., 9. Orthopaedic Tu., Fri., 9. Ante-natal Genito-Urinary Wed., Th., 1; Fri., 8.30; Sat., Men, 9, Women, 10. Children's Dept Tu., Wed., Fri., 9. Electrical Mon., Tu., Wed., Fri., 9. Eye Mon., Wed., Th., Heart Mon., Th., 1. Sat., 9. Nervous Mon., Wed., 1.30. New patients should attend the receiving room of the Hospital 30 minutes before the times mentioned. Princess Elizabeth of York Hospital for Children (STEpney Green 3341-3342), Shadwell, E.l. Medical Mon.-Th., 1-2 ; Skin Th., 9-10. Tu., Fri., Sat., 9-10. Teeth Th., 1-2. Surgical Tu., Sat., 9-10 ; Orthopaedic Wed., 1-2. Wed., Th., 1-2. Genito-Urinary Th., 1-2. Eye Mon., 1-2. Plastic Surgery Wed., 10.30 by ment. Throat, Nose and Mon., 1-2 ; Fri., 9-10. Rheumatism Fri., 1-2. Ear Nervous and Mental Mon., Tu., 1-2. Whooping Cough Th., 9-10. Facilities for out-patients are also always available at the London County Council Hospitals: Mile End Hospital, Bancroft Road; St. George-in-the-East Hospital, Raine Street; St. Peter's Hospital, Vallance Road. MATERNITY AND CHILD WELFARE. The addresses of the child welfare centres and ante-natal clinics, etc., are as follows:— Centres : Jewish Maternity Hospital, 24, Under- East Stepney Jewish Centre, Constitu- wood Road. tional Hall, Redman's Road. St. Phillip's Institute, Newark Street. Hughes Mansions, Vallance Road. Jewish Mothers' Welcome, Bernard 12, St. Clare Street, Minories. Baron Settlement, Berner Street. Jewish Infant Welfare Centre, Bernard St. George's Town Hall, Cable Street. Baron Settlement, Berner Street. Riverside Mansions, New Gravel Lane. Memorial Hall,The Highway, Shadwell. Stepney Infant Welfare Centre and Limehouse Town Hall, Commercial Babies' Nursing Home, St. Road. Matthew's Hall, White Horse Road. Dame Colet House, 10 and 29, Duckett 17, Rhondda Grove. Street. Mission Hall, Carr Street. Ante-Natal Limehouse Town Hall, Commercial East End Maternity Hospital, 39G, Clinics : Road. Commercial Road. St. George's Hospital, Raine Street. Mile End Hospital, Bancroft Road. Hughes Mansions, Vallance Road. Jewish Maternity Hospital, 24, Under- London Hospital, Whitechapel. wood Road. Creches : Marie Hilton Creche, Stepney Cause- Day Nursery, Memorial Hall, The way. Highway, Shadwell. St. Paul's Day Nursery, Wellclose Port of London Day Nursery, 5, Pier Square. Head, Wapping. Jewish Day Nursery, 23, New Road. Full particulars as to the areas and times of sessions of all the above centres can be obtained from Medical Officer of Health, 43, White Horse Road, E. PUBLIC ASSISTANCE. The addresses of the day relief stations serving the Borough of Stepney are :— Hanbury Street, Whitechapel, E.l ; Barnes Street, Limehouse, E.14; Raine Street, Wapping, E.l.; Bancroft Road, Mile End, E.l. A night and week-end duty office to deal with applications after the normal office hours is established at— Hanbury Street relief station; Harley College, Bow Road, E.3; and 86, High Street, Poplar, E.14. 112 TUBERCULOSIS DISPENSARIES. These dispensaries are situated at— Devonport Street, E.l, and at 35, Stepney Green. Particulars as to hours of attendance can be obtained at the Dispensaries. UNEMPLOYMENT ASSISTANCE BOARD. Area Office : 14, West India Dock Road. 'Phone No. : East 1280. VACCINATION OFFICERS. The address of the Vaccination Officers is the Public Health Offices, 43, White Horse Road, E. The hours of attendance are Monday to Friday 9.30 a.m. to 5 p.m. and on Saturday 9.30 a.m. to 1 p.m. VENEREAL DISEASE. All enquiries can be made at : L.C.C. (Whitechapel) Clinic, Turner Street. For further information on all the above services apply to : The Medical Officer of Health, 43, White Horse Road, E.l. Office hours : Monday to Friday, 9.30 a.m. to 5 p.m. Saturday, 9.30 a.m. to 1 p.m. Telephone No. : STEpney Green 2484 (4 lines). 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 39 IV. Housing 62 V. Inspection and Supervision of Food 67 VI. Prevalence of, and Control over Infectious and other Diseases 93 VII. Statistics provided by the Registrar-General 106 After care, Tuberculosis 14 Analyst's Report 79 Ante-Natal Clinics 23, 26, 38 Ante-Natal and Post-Natal Services 26 Area of Borough 7 Artificial Sunlight Treatment 32 Bacteriological Examinations 10 Bakehouses 71 Births 17, 108 Births Act, Notification of 8, 25 Bishopsgate Goods Station 76 Bug Eradication 98 Butcher Shops and Stalls 70 Butter Factories 71 Canal Boats Acts 43 Cancer 97 Cerebro-Spinal Fever 95 Cheese 87 Child Life Protection 30, 32, 41 Cleansing of persons 42, 98 Committees, List of Members 2 Complaints of nuisances 39 Contracts—Tuberculosis 15 Convalescent Treatment 28, 31 Cowsheds 41, 46 Crfiches, List of 38 Dairies and Milkshops 41, 69 Day Nurseries 29, 38 Deafness, prevention of 31 Deaths 8, 106 Dental Clinic 21 Diarrhœa 97 Diphtheria 93 Diphtheria Immunisation 93 114 PAGE. Diphtheritic Serum 93 Disinfection 42, 98 Drainage 39 Dysentery 95 Eating Houses 41, 71 Encephalitis Lethargica 95 Enteric Fever 94 Extra Nourishment, Supply of 15 Factory and Workshops 43 Fines and Costs 62 Finsen Light 15 Food and Drugs Acts 55, 79 „ Inspection 67 „ Poisoning 95 „ Premises 68, 71 „ Products, Certification of 71 „ Regulations (Imported) 71 Sampling 68, 69, 79 „ Zeebrugge-Harwich Ferry 76 „ Calais-Harwich Ferry 76 Foster Mothers 30, 32, 41 Greengrocers and Fruiterers 71 Hairdressers' Shops 41 Handicraft Class 15 Health Propaganda 11 Health Services 110 Health Visitors, work of 26, 33 Heart Disease 97 Home Helps 25, 32 Home nursing 30 Heme Office, report to (form 572) 43 Hospital facilities 11 Houses-let-in-Lodgings 41 House to House Inspection 66 Housing:—Statistics 42, 62 „ Slum Clearance 62 „ Accommodation 66 „ Overcrowding 42, 63 Human Remains 39 Ice Cream Premises 41, 70 Infant Welfare Centres, List of 37, 38 Infant Welfare Centres, Work at 26, 34 Infantile Mortality 23, 35 Infants, Feeding of 31 115 PAGE. Infectious Diseases 93 „ „ Summary of, 96 „ „ Wrong Diagnosis 95 Influenza 97 Laboratory facilities 10 Legal Proceedings 52 Lodging houses, Common and Seamen's 41, 46 London County Council, Report to 41 Malaria 95 Marriages 8 Margarine premises 71 Maternal Mortality 24 Maternity Nursing 30-32 Maternity and Child Welfare Centres, etc., List of 37-38 „ „ „ Committee, List of members 2 „ „ „ Services (Form MCW 96 Revised) 25 „ Centres, Work at 26, 34 „ Outfits 31 Measles 29, 42,95 Merchandise Marks Act 71 Midwives 10 Milk—(Special Designations) Order 70 „ Analysis of 69, 82 Milk Proceedings re 55 „ and Meals, Provision of 27,32 Milkshops 41 Ministry of Health, Returns to 16-17, 25,43, 100-102, 105 Mortuary 41 National Health Campaign 11 Notifiable diseases 93 Nursing in the Home 10 Offensive Businesses 41; 46 Ophthalmia Neonatorum 29, 95 Outworkers 45 Overcrowding 42, 63, 65 Pharmacy & Poisons Act 39 Pneumo-Thorax refills 15 Pneumonia 95 Polio-Myelitis 94 Population 7 Public Cleansing 39 Public Health Committee, List of members 2 Puerperal Fever and Pyrexia 95 Rag Flock Acts 46 Rats and Mice Destruction 39 116 PAGE. Registrar General Statistics 106 Rent and Mortgage Interest, etc., Act 41 Respiratory Diseases 97 Restaurants and Eating Houses 41,71 Sampling 68-69, 79 Sanitary Inspectors:—Inspections 48 „ „ Notices served 49 „ „ Return of sanitary work 50 Sanocrysin Treatment 15 Scabies 97 Scarlet Fever 93 Scavenging 39 Shelter 41 Shops Act 39 Slaughter of Animals Act, 1933 46 Slum Clearance 62 Small-pox 94 Smoke Nuisances 39, 41 Social Conditions 9 Special Treatment (Tuberculosis) 15 Staff 3, 9 Statistics, Summary of 7 Sunlight Treatment, Artificial 32 Toddlers' Clinic 22 Tuberculosis: Dental clinic 21 „ Dispensaries, Report on 12 „ „ Returns (Fcrms T 145 & T 145a) 16-20 „ New Cases and Mortality 101 „ Summary of Notifications, (Form T 138 Rev.) 100 „ Regulations, 1930 100 1925 101 „ Deaths 101 Twins 8 Underground Rooms 42, 63 Unemployment 9 Unsound Food 71 Vaccination 102 „ by Public Vaccinators 105 „ Officers Returns (form M. 379 and form N) 102-104 Verminous persons and premises 42, 98 Water Certificates 41 Whooping Cough 97 Workshops and Workplaces 43 Wrong Diagnosis of Infectious Diseases 95 Zymotic Diseases 97