Alc 388 LIBRARY WAN 86 Metropolitan Borough of Wandsworth Annual Report of the Medical Officer of Health for the Year 1949 by F. G. CALEY, M.A., M.B., B.Ch., B.P.H., together with the Report of the Public Analyst. REPORT of the Medical Officer of Health for the year 1949 To the Mayor, Aldermen and Councillors of the Metropolitan Borough of Wandsworth Your Worship, Ladies and Gentlemen, I herewith present my Annual Report on the health of the Borough for the year 1949, including the Report of the Public Analyst on the work he has carried out. There has been no unusual mortality during the year. The resident population is estimated at 334,840, an increase of 2,300 over the previous year. The birth-rate for the year was 15.08, compared with 16.70 for 1948. The death-rate was 11.92 compared with 11.28. The infantile mortality has fallen from 31 in 1948 to 26 per thousand births in 1949. There was only one maternal death. Seven cases confirmed as diphtheria occurred during the year, but there were no deaths from this disease. 495 cases of scarlet fever and 2,969 of measles were notified but there were no deaths from either disease. An outbreak of acute poliomyelitis occurred during the summer and early autumn. There were 58 cases subsequently confirmed, with four deaths. I would like to call attention to Tables IV, VII and VIII on pages 9, 16 & 17 which give in tabular form a summary of the reductions which have taken place in infantile and maternal mortality and infectious disease since 1900. 2 Report of the Medical Officer of Health for 1949. This is my twenty-eighth Annual Report, and I would like to place on record my warm appreciation for the willing and loyal service given by the staff of the Department throughout those many years. New services have been inaugurated and from time to time difficulties in administration have had to be overcome. These difficulties appear to have been more numerous since the outbreak of the second World War in 1939 which produced many new and unprecedented problems, some of which are still with us. None of them could have been solved without the co-operation of the staff which has been given so readily. I would also like to thank the Chairmen, Vice-Chairmen and members of the sevferal Committees of the Council connected with the work for which the Department has been responsible for their sympathetic consideration of new problems as they have arisen and for the support they have given me throughout. I am. Your Worship, Ladies and Gentlemen, Your obedient servant, F. G. CALEY, Medical Officer of Health. 3 STAFF. There were few staff changes during the year. Mr. K. J. Winton was appointed a district Sanitary Inspector with effect from the 15th August, 1949, to fill the vacancy caused by the resignation of Mr. E. E. Morgan in May. In July Mrs. G. G. Taylor resigned her appointment as shorthand-typist and Miss N. E. North was appointed to fill the vacancy. There were thus no vacancies in the establishment at the end of the year. STATISTICS AND SOCIAL CONDITIONS. Area 9,199 acres Resident population in 1949 334,840 Wandsworth is the largest of the Metropolitan Boroughs. It has an area of 9,199 acres which includes a number of open spaces with a combined area of 1,202 acres. The population is a varied one, as the Borough contains residential neighbourhoods in addition to several working-class districts. The chief industries carried on are the manufacture of gas, electricity and motor accessories, laundries and general engineering. There is no trade which has any -particular effect on the health of the workers or residents. 4 Report of the Medical Officer of Health for 1949. Extracts from Vital Statistics. No. of Live Births Males Females Total Legitimate 2537 2259 4796 Illegitimate 133 124 257 Total Live Births 2670 2383 5053 No. of stillbirths 57 52 109 No. of deaths 1975 2016 3991 Birth-rate 15.08 Death-rate 11.92 Deaths from puerperal and postabortive sepsis - Rate per 1,000 (Live and Still) Births Deaths from other puerperal causes 1 .19 Total 1 .19 Infantile mortality per 1,000 live births:— All infants 26 Legitimate infants 24 Illegitimate infants 58 Deaths from Cancer 707 ,, Diphtheria 0 ,, Scarlet Fever 0 ,, Measles 0 ,, Whooping Cough 3 ,, Diarrhoea, under 2 years of age 3 ,, Tuberculosis 152 Tuberculosis death-rate .45 There has been no unusual or excessive mortality during the year and no noteworthy outbreaks of illness have occurred. 5 VITAL STATISTICS. Population. The civilian population at the middle of the year was estimated by the Registrar-General to be 334,840, and all the rates used in this Report are based on this figure. Table I shows the approximate population of each Parliamentary Division, based on the above estimation. TABLE I. Population estimated to middle of 1949 Putney 89,205 Central 97,687 Clapham 76,184 Streatham 71,764 Whole Borough 334,840 Births. The total number of births belonging to the Borough registered during 1949 was 5,053, consisting of 2,670 males and 2,383 females. The number for 1948 was 5,556. The birth-rate was 15.08 per 1,000 persons living compared with 16.70 for 1948. The rate for the whole of London during 1949 was 18.5 and for England and Wales 16.7. 257 illegitimate births took place in the Borough compared with 310 in 1948. 6 Report of the Medical Officer of Health for 1949. Deaths. The number of registered deaths which took place in the Borough during the year was 3,666, but 1,368 of these did not belong to the Borough, while 1,693 Borough residents died outside the Borough. The corrected number of deaths for the Borough, after allowing for these factors, was 3,991 of whom 1.975 were males and 2,016 females. The death-rate for the year was 11.92 per 1,000 persons living, compared with 11.28 in 1948. The death-rate for the whole of London for 1949 was 12.2 and for England and Wales 11.7. Table II shows the total number of registered deaths and the death-rates for each division and for the whole Borough. TABLE II. Corrected deaths Deathrate Males Females Total Putney 512 531 1,043 11.69 Central 581 586 1,167 11.94 Clapham 474 464 938 12.31 Streatham 408 435 843 11.74 Whole Borough 1,975 2,016 3,991 11.92 Vital Statistics 7 Causes of Death. Deaths in or belonging to whole district at subjoined ages. Deaths in or belonging to Localities (all ages) Table III is the general mortality Table for the whole Borough and shows the number of deaths from each cause divided into sexes, age groups and sub-districts. TABLE III.—Causes of, and Ages at Death, during the Year 1949. All Ages. Males. Females. Under 1 year. 1 and under 5. 5 and under 15. 15 and under 45. 45 and under 65. 65 and upwards. Putney. Central. Clapham. Streatham. Typhoid and Paratyphoid Fevers ... ... ... ... ... ... ... ... ... ... ... ... ... Cerebrospinal Fever 2 1 1 1 1 ... ... ... ... l 1 ... ... Scarlet Fever ... ... ... ... ... ... ... ... ... ... ... ... ... Whooping Cough 3 1 2 3 ... ... ... ... ... 1 1 ... 1 Diphtheria ... ... ... ... ... ... ... ... ... ... ... ... ... Tuberculosis of Respiratory System 133 83 50 ... ... ... 65 41 27 32 31 41 29 Other forms of Tuberculosis 19 12 7 ... 4 1 3 7 4 5 ... 6 5 Syphilitic Disease 33 24 9 ... ... ... 2 13 18 8 7 9 9 Influenza 45 27 18 2 1 1 6 9 26 9 10 16 10 Measles ... ... ... ... ... ... ... ... ... ... ... ... ... Acute Poliomyelitis and Polioencephalitis 5 2 3 ... 1 2 2 ... ... 4 1 ... ... Acute Infectious Encephalitis 4 ... 4 ... ... ... 1 2 1 2 1 ... 1 Cancer and other Malignant Tumours 707 329 378 1 2 1 36 239 428 187 209 160 151 Diabetes Mellitus 28 10 18 ... ... ... 1 2 25 7 10 4 7 Cerebral Haemorrhage, etc. 384 172 212 1 ... ... 5 72 306 99 107 95 83 Diseases of Heart 1245 572 673 ... ... ... 28 216 1001 319 380 288 258 Other Diseases of Circulatory System 237 91 146 ... ... ... 3 34 200 63 80 56 38 Bronchitis 294 178 116 4 ... ... 5 59 226 78 78 73 65 Pneumonia (all forms) 163 91 72 15 3 ... 4 25 116 49 42 37 35 Other Diseases of Respiratory System 45 25 20 ... ... ... 7 19 19 9 12 9 15 Ulceration of Stomach 30 21 9 ... ... ... 1 10 19 11 10 5 4 Diarrhoea 3 3 ... 2 1 ... ... ... ... ... 1 2 ... Appendicitis 9 5 4 ... 1 ... 1 5 2 4 2 2 1 Other Digestive Diseases 61 23 38 1 ... ... 3 21 36 21 14 13 13 Nephritis 65 30 35 ... ... 1 7 16 41 15 14 17 19 Puerperal and Post-abortive Sepsis ... ... ... ... ... ... ... ... ... ... ... ... ... Other Maternal Causes l ... 1 ... ... ... 1 ... ... ... ... ... 1 Premature Birth 37 23 14 37 ... ... ... ... ... 7 11 7 12 Congenital Malformations 63 36 27 49 2 2 5 4 1 15 24 11 13 Suicide 40 27 13 ... ... ... 15 20 5 13 5 11 11 Road Traffic Accidents 32 27 5 ... 2 3 11 9 7 10 9 8 5 Other Violent Causes 76 34 42 11 1 3 7 7 47 20 25 14 17 All Other Causes 227 128 99 3 2 5 22 36 159 54 79 54 40 All causes 3991 1975 2016 130 21 19 241 866 2714 1043 1167 938 843 8 Report of the Medical Officer of Health for 1949. Infantile Mortality. The number of deaths under one year was 131, the infantile mortality rate being 26 per 1,000 births. This compares with a rate of 31 for each of the two previous years and is the lowest rate ever recorded. For the ten years ending 1939 the average infantile mortality rate was 55, whlie for the ten years ending 1949 the average rate was 37. Maternal Mortality. One death occurred from accidents and diseases of pregnancy but none from puerperal pyrexia, giving a total of one death after childbirth. This is equivalent to a rate of .19 for 1,000 live and still births, compared with .35 in 1948 and .29 in 1947. Enquiries into all maternal deaths, which were commenced in 1928 at the instance of the Ministry of Health, have been continued. Infantile and Maternal Mortality since 1900. In Table IV on page 9 comparative statistics are given to show the trend of infant and maternal mortality during the 49 years which have elapsed since the Borough of Wandsworth was constituted in 1900. The average annual rates of mortality are given for successive periods, the six years, 1939 to 1944, being omitted as the figures were invalidated during that period by the evacuation of mothers and children. In the first ten years—1901 to 1910—the mean rate of infantile mortality was 109 per 1,000 births for each year of the decade. In the next decade the rate fell to 85 and since then has continued to fall until it has now been reduced to 26 per 1,000 births, the lowest rate ever recorded. This outstanding fall in the mortality rate reflects a large saving of infant life in the last 50 years, as indicated in column 3 of Table IV. During the ten years 19011910 7,498 infants died in their first year of life. The corresonding figure for the five years 1945 to 1949 was 905—equivalent to 1,810 for a ten-year period—less than a quarter of the number of infant deaths in the earlier period. In the same period the maternal mortality has fallen from a mean rate of 3.2 in the first decade to .19 for the year 1949. A study of columns 3 and 5 of Table IV will indicate the large number of infant lives, and to a less extent of maternal lives, which have been saved during the period covered by the Table. Vital Statistics 9 TABLE IV. Infantile mortality and maternal mortality in the Borough of Wandsworth during the last 49 years. (1) (2) (3) (4) (5) (6) Infantile Mortality Maternal Mortality Year No. of Births No. of Deaths under 1 year Mean Rate per 1,000 live births Deaths Mean Rate per 1,000 live and still births 1901/10 (10 years) 68,464 7,498 109 226 3.2 1911/20 (10 years) 61,880 5,289 85 199 3.1 1921/30 (10 years) 52,367 2,919 56 181 3.4 1931/38 (8 years) 31,907 1,810 56 116 3.4 1945/49 (5 years) 28,032 905 32 21 .73 1949 5,053 131 26 1 .19 .10 INFECTIVE DISEASES. The number of deaths from notifiable infectious diseases, including all forms of tuberculosis, was 182. From all infective diseases the death-rate was .55 per 1,000— .54 in Putney, .44 in Central, .66 in Clapham, and .57 in Streatham. Table V shows the number of cases of the notifiable infective diseases reported, arranged in various age groups, and Table VI shows the same figures arranged in the sub-districts in which they occurred. Smallpox. No case occurred in the Borough during the year. Following the arrival in London on the 2nd April of the S.S "Mooltan." from which were removed two fatal cases of smallpox, close supervision was kept on all passengers and crew who subsequently came into the Borough. None of these persons developed the disease Diphtheria. Seven cases were confirmed compared with 16 in 1948 and 46 in 1947. Forty other cases were reported, but after admission to hospital were found to be incorrectly diagnosed. There were no deaths. Scarlet Fever. 495 cases of Scarlet Fever were notified or reported compared with 452 in 1948, 343 in 1947 and 356 in 1946. The diagnosis was not confirmed in ten cases. The increase in the number of cases has been associated with a general increase in the incidence of this disease throughout London. There were no deaths from the disease in 1949 as in 1948. Of the total number of cases, 193 or 38.6 per cent. were removed to hospital. Whooping Cough. 611 cases were notified during the year. There were 3 deaths. Infective Diseases 11 TABLE V. Notifiable Diseases. No. of CASES of Infective Diseases Grouped in age Periods. Total Under 1 1—3 3—5 5—10 10—15 15—20 20—35 35—45 45—65 65 and upwards Small-pox - - - - - - - - - - - Diphtheria 7 - 1 1 - 1 1 3 - - - Scarlet Fever 485 - 41 113 272 35 12 8 1 1 2 Measles 2969 96 768 775 1247 36 9 26 7 5 - Whooping Cough 611 45 160 199 191 3 1 11 1 - - Enteric Fever and Paratyphoid Fever 5 - 1 - - - 2 - 1 1 - Malaria 1 - - - - - - 1 - - - Dysentery 61 2 4 22 14 2 1 9 3 4 - Erysipelas 77 - - - 2 1 1 13 8 31 21 Scabies 52 - 2 4 11 5 5 11 7 5 2 Puerperal Pyrexia 23 - - - - - 2 15 6 - - Ophthalmia Neonatorum 8 8 - - - - - - - - - Cerebro-spinal Meningitis 10 1 4 1 1 - - 1 1 1 - Polio-myelitis. 58 - 13 7 18 5 5 8 2 - - Encephalitis Lethargica - - - - - - - - - - - Anthrax - - - - - - - - - - - Pneumonia:— Acute Influenzal 188 3 9 10 17 3 5 25 25 45 46 Acute Primary Tuberculosis—All forms 694 1 9 12 26 18 89 310 95 108 26 Food Poisoning 67 2 2 1 2 2 3 25 9 15 6 Total 5316 158 1014 1145 1801 111 136 466 166 216 103 12 Report of the Medical Officer of Health for 1949. TABLE VI. Notifiable Diseases. Total Cases of Infective Diseases Occurring in Each Ward. Whole Borough Deaths Putney Central Clapham Streatham Putney Thamesfield Fairfield West Hill Southfield Earlsfield Springfield Tooting Graveney Bedford Larkhall Clapham North Clapham Park Thornton Balham Streatham Hill S.t Leonards Streatham Common Streatham South Furz down Small-pox - - - - - - - - - - - - - - - - - - - - - - Diphtheria - - 2 - - - - - - 1 3 - - - - - - - 1 - 7 - Scarlet Fever 26 20 45 10 26 38 34 28 31 33 24 27 25 19 23 5 17 23 17 14 485 - Measles 76 109 143 113 143 169 185 243 205 192 199 122 88 195 125 162 143 136 150 71 2969 - Whooping Cough 8 17 37 33 25 23 50 78 35 34 37 34 12 32 15 17 18 32 31 43 611 3 Enteric Fever and Paratyphoid Fever 1 - 1 - - 1 1 - - 1 - - - - - - - - - - - - Malaria - - - - - - - - - 1 - - - - - - - - - - 1 - Dysentery - - - - - 1 - 42 10 - - - 1 1 - 1 1 2 - 2 61 - Erysipelas - 4 2 11 9 4 4 4 7 4 4 3 2 5 - 3 1 1 3 6 77 - Scabies - 2 1 2 - 4 3 5 5 5 3 1 1 5 7 7 - 2 3 1 52 - Puerperal Pyrexia - 1 - 2 2 - 2 1 1 1 4 2 1 - - 1 - 3 1 1 23 - Ophthalmia Neonatorum - - 1 - - - - - - 1 - 2 - - - - 2 1 - 1 8 - Cerebro-spinal Meningitis - - - 1 1 - 3 2 - - - - - - - - 1 1 - 1 10 2 Polio-myelitis 3 6 4 4 - 2 2 4 2 1 6 4 1 4 4 4 2 2 - 3 58 5 Encephalitis Lethargica - - - - - - - - - - - - - - - - - - - - - - Anthrax - - - - - - - - - - - - - - - - - - - - - - Pneumonia:— Acute Influenzal 8 5 7 6 12 7 13 25 21 13 12 11 8 7 3 9 3 5 5 8 188 20 Acute Primary Tuberculosis—All forms 30 40 44 26 30 29 30 41 48 48 39 26 43 45 36 30 71 3? ?? 3* 694 152 Food Poisoning - - - 1 1 5 4 7 22 6 - - 2 - 3 2 1 7 2 4 67 - Total 152 204 287 209 249 283 331 480 387 341 331 232 184 313 211 241 210 247 235 189 5316 183 Infective Diseases 13 Measles. The number of cases notified during the year was 2,969, compared with 2,668 in 1948, 1,241 in 1947, and 1,997 in 1946. Puerperal Pyrexia. During the year 23 cases of puerperal pyrexia were notified. Encephalitis Lethargica. No case of this disease occurred, but there were four deaths from acute infectious encephalitis. Cerebro Spinal Meningitis. (Cerebro-spinal Fever, Meningococcal Meningitis, " Spotted Fever "). Ten confirmed cases were notified or reported. There were two deaths. A number of other cases were reported but were subsequently not confirmed. In the previous year ten confirmed cases were notified with three deaths. Poliomyelitis and Polio-encephalitis. There were 89 cases of this disease notified or reported during the year and 58 were subsequently confirmed. This figure shows an increase of 43 cases over the total for 1948, but it was less than the number notified during the epidemic of 1947. Four of the 58 cases died. One death also occurred of a case which had been notified in 1947. Dysentery. Seventy-one cases were notified or reported during the year, 38 being from institutions. Ten cases were subsequently held not to be dysentery. Typhoid and Para-typhoid Fever. Six cases were reported during the year, four of which were subsequently confirmed as typhoid and one as para-typhoid. Diagnosis was not confirmed in the remaining case. There were no deaths. 14 Report of the Medical Officer of Health for 1949. Influenza. The number of deaths from Influenza was 45 compared with 10 in 1948, 44 in 1947, 47 in 1946 and 19 in 1945. The death-rate was .13 per 1,000. Influenzal Pneumonia and Acute Primary Pneumonia. These are the notifiable forms of pneumonia. Forty cases of acute influenzal pneumonia and 148 cases of acute primary pneumonia were notified. Three of the former and 17 of the latter died. The total number of deaths credited to all forms of pneumonia during the year was 163 compared with 151 in 1948. Malaria. One case was notified. It was a recurrent case. Erysipelas. 77 cases were notified. No deaths occurred. Other Infective Diseases. 33 deaths occurred from syphilis. Scabies. 52 cases were notified. 285 cases of scabies were treated at the Council's Cleansing Station under the supervision of the two bathing attendants. The majority of the cases were treated by the benzyl benzoate method, and received a course of two baths each. 93 other persons received cleansing treatment for various conditions. Food Poisoning. 67 cases were notified during the year. All these cases were unrelated and in four only were the organisms identified. One sample was submitted to the laboratory for bacteriological examination and the result was negative. There were no deaths. Infective Diseases 15 Analysis of Infectious Disease in the Last 49 Years. Tables VII and VIII have been drawn up to show the trend of infectious disease in consecutive periods since the Borough was constituted in 1900. Five periods are taken to show the comparison, viz., three inter-census periods, each of ten years, from 1901 to 1931, the date of the last Census; the eight-year period from 1931 to 1938 and the five-year period from 1945 to 1949. The mean population of each period has been taken in calculating the case rates and death-rates, which are shown as annual rates per 100,000 of population. The five years 1939 to 1944 inclusive are excluded from the survey as no accurate figures for the war years are available owing to the evacuation of children during that period. Table VII shows the number of cases and deaths, case-rates and death-rates in each period reviewed for scarlet fever, diphtheria and enteric fever, diseases which have been notifiable continuously throughout the 49 years. Table VIII gives similar information for measles, whooping cough and tuberculosis, diseases which have not been notifiable continuously throughout the whole period under review. The number of deaths and death-rates from these three diseases are correct as they are based on the cause of death as certified, but the same reliance cannot be placed on the number of cases and case-rates as the full information as to the number of cases was not always available. It will be seen from Table VII that in 1901 1910 there were 186 deaths from scarlet fever, while in 1945/1949 there were none; that the number of deaths from diphtheria had been reduced from 409 in the earlier period to five in 1945/1949, and the deaths from enteric fever from 132 to nil. There has been a large reduction in the number of cases of these three diseases, the reduction being most marked for diphtheria in recent years. Table VIII shows the extent to which the number of deaths and the death-rates from measles and whooping cough has fallen in the 49 years under review. The death-rate from tuberculosis has been reduced by about a half in the same period. 16 Report of the Medical Officer of Health for 1949. TABLE VII. Analysis of the common infectious diseases during the last 49 years showing the number of cases and deaths occurring in the Borough in each period shown, with annual case rates and death rates calculated per 100,000 of the mean population of the period. Scarlet Fever, Diphtheria, Enteric, which were notifiable continuously during the 49 years. Year Population Scarlet Fever Diphtheria Enteric Cases Deaths Caserate Deathrate Cases Deaths Caserate Deathrate Cases Deaths Caserate Deathrate 1901 1901/10 (10 years) 232,034 census 10112 186 372 6.8 4945 409 182 15.0 860 132 31 4.9 1911 1911/20 (10 years) 311,402 census 9574 106 299 3.3 5728 400 179 12.5 450 54 14 1.7 1921 1921/30 (10 years) 328,656 census 9543 82 280 2.5 7464 337 219 9.8 289 29 8 0.85 1931 1931/38 (8 years) 1938 353,101 census 340,100 6908 32 250 1.2 3295 139 119 4.3 118 9 4.2 0.32 1939/44 Evacuation of children 1945/49 (5 years) 315,334 2033 0 128 0 273 5 17 0.3 24 0 1.5 0 Infective Diseases 17 TABLE VIII. Measles, Whooping Cough, Tuberculosis, where notification was intermittent. Year Population Measles Whooping Cough Tuberculosis fully notifiable since 1912 Cases Deaths Caserate Deathrate Cases Deaths Caserate Deathrate Cases Deaths Caserate Deathrate 1901 1901/10 (10 years) 232,034 census 15164 794 558 29 5119 688 188 25 — 3608 — 133 1911 1911/20 (10 years) 311,402 census 24545 836 768 26 7064 435 221 13.6 6889 3863 215 121 1921 1921/30 (10 years) 328,656 census 19977 298 586 8.7 14811 293 434 8.6 6377 3258 187 95.5 1931 1931/38 (8 years) 1938 353,101 census 340,100 16929 119 610 4.3 8116 122 293 4.4 4933 2115 177 76.2 1939/44 Evacuation of children. 1945/49 (5 years) 315,334 11346 9 719 0.5 3344 27 212 1.7 3283 928 208 59 18 Report of the Medical Officer of Health for 1949. Diseases Reported from Schools. A total of 2,575 infective diseases was reported from schools in the Borough throughout the year. The numbers of each disease were:— Scarlet Fever 248 Chicken Pox 465 Diphtheria 1 Whooping Cough 214 Measles 1162 Mumps 356 German Measles 22 Ringworm 5 Poliomyelitis 14 Scabies 7 Other Diseases 81 Disinfection. During the year 1,945 rooms were disinfected after infectious disease and 535 rooms disinfested for vermin. Bacteriological Examinations. All these examinations are carried out by the Camberwell Research Laboratory which in October, 1948, became a Public Health Service Laboratory directed by the Medical Research Council for the Ministry of Health. The following Table shows the number of examinations in each division and for the whole Borough, also the disease for which the examination was made. TABLE IX. Putney Central Clapham Streatham Whole Borough Diphtheria 164 267 81 128 640 Enteric Fever 11 4 — — 15 Other Diseases 48 23 24 34 129 Total 223 294 105 162 784 19 NON-INFECTIVE DISEASES. The total number of deaths from cancer and malignant disease was 707, the number of males being 329 and females 378. The death-rate was 2.11 per 1,000. The number of deaths in 1949 was 27 less than in 1948. 1,482 deaths occurred from disease of the heart and circulatory system compared with 1,251 in 1948. 1,201 of these deaths were of persons of 65 years of age and above. There were 502 deaths from diseases of the respiratory system compared with 444 in 1948. The number from bronchitis was 294 compared with 242 in 1948, and from pneumonia (all forms), 163 compared with 151 in 1948. Further particulars relative to pneumonia are given on page 14. 100 deaths, 59 males and 41 females, were registered as due to premature birth and developmental diseases, compared with 122 in 1948. 148 deaths were due to violence, 32 of them being due to accidents, 40 to suicide and 76 to other forms of violence. INQUESTS. Inquests were held on 78 persons who died in the Borough and on 117 Borough residents who died elsewhere. Twenty-seven verdicts of death from natural causes were returned and 122 of accidental death; there were 40 suicides, five open verdicts and one of chronic alcoholism. 20 TUBERCULOSIS. Notifications.—The total number of new cases which came to the notice of the Department during 1949 was 694 compared with 699 in 1948. The sources of information regarding the 694 new cases were as follows:— Primary notifications on Form A 533 Notifications from H.M. Forces 15 Unnotified at death 18 Transfers from other sanitary authorities 128 Total 694 Deaths.—The number of deaths certified as due to diseases of a tuberculous nature was 152. Particulars of the new cases and deaths during the year, classified by sexes and age groups are given in the following table:— TABLE X. Age Periods. New Cases. Deaths. Pulmonary. NonPulmonary. Pulmonary. NonPulmonary. M. F. M. F. M. F. M. F. 0 - 1 - - - - - - 1 4 9 5 3 - - 3 1 5 9 9 3 5 — — — — 10 1 7 6 4 — — 1 — 15 34 51 1 3 2 2 — — 20 56 63 4 2 4 4 — 1 25 95 84 2 4 14 12 — 2 35 50 42 3 — 15 12 — — 45 35 16 4 2 11 6 4 — 55 41 10 — — 17 7 2 1 65 and upwards 20 5 — 1 20 7 2 2 Totals 345 297 28 24 83 50 12 7 21 SANITARY INSPECTION OF THE BOROUGH. Work of the Sanitary Inspectors. A Summary of the inspections carried out by the Inspectors is given in Table XI:— TABLE XI. In. spections. ReIn spections. Total. To investigate complaints 14207 37504 51711 Housing reports 1871 — 1871 Notifiable diseases 1253 230 1483 Verminous conditions 70 175 245 Piggeries 88 — 88 Factories, Workplaces, etc. (including Outworkers) 1248 204 1452 Sanitary conveniences 112 — 112 Mews and stables 164 - 164 Other inspections 5765 244 6009 Total 24778 38357 63135 Smoke observations — — 64 Legal proceedings, Attendances at Court — — 64 Table XII gives details of the sanitary operations carried out in the Borough during the year. The number of drains which were tested was 564 and 1,200 were cleansed or repaired. The drains of 269 houses were reconstructed. Damp conditions have been remedied in 1,627 premises, and in 199 of these damp courses were inserted. 22 Report of the Medical Officer of Health for 1949. TABLE XII. Putney Central Clapham Streatham Whole Borough 1. Premises cleansed and repaired 1106 810 1259 714 3889 2. Drains tested 150 165 120 129 564 3. Drains cleansed or repaired 315 361 310 214 1200 4. Water closets cleansed or repaired 315 283 317 210 1125 5. Soil pipes repaired 27 22 59 18 126 6. Waste pipes altered or repaired 86 100 126 68 380 7. Rainwater pipes repaired 55 50 73 48 226 8. Roofs and gutters repaired 620 510 696 413 2239 9. Damp courses inserted 81 36 54 28 199 10. Damp conditions otherwise remedied 347 315 442 324 1428 11. Yards drained or paved 49 34 47 20 150 12. Dustbins provided or repaired 61 115 69 66 311 13. Water cisterns cleansed, covered or repaired 43 24 28 32 127 14. Water supply reinstated 44 21 34 11 110 15. Defective fireplaces remedied 328 238 333 194 1093 16. Defective coppers remedied 18 5 14 10 47 17. Accumulations of rubbish, etc., removed 21 11 22 15 69 18. Urinals cleansed or repaired 2 - 4 — 6 19. Animals improperly kept 8 8 9 3 28 20. Smoke nuisances 4 1 — — 5 21. Other nuisances 174 98 179 116 567 Total 3854 3207 4195 2633 13889 No. of Preliminary Notices served 1774 1630 1999 939 6242 No. of Preliminary Notices complied with 1764 1551 2053 1162 6530 No. of Nuisance Notices served 481 362 510 271 1624 No. of Nuisance Notices complied with 513 369 553 335 1770 Sanitary Inspection of the Borough 23 Water Supply—Cutting-off Notices. During the year, 89 notices with respect to 163 premises were received from the Metropolitan Water Board stating that the supply had been withdrawn. In 47 premises the water supply was cut off for non-payment of rates, 76 because of defects in the service, and in 40 the premises became vacant. Inspection of Sanitary Conveniences. The number of sanitary conveniences is 173; 56 in Clapham, 70 in Putney, 21 in Streatham and 26 in Central Wandsworth; 112 inspections were made during the year and one notice for cleansing was served and complied with. Rodent Control. Energetic measures for rodent control continued throughout the year, the system followed being that of prebaiting laid down by the Ministry of Agriculture and Fisheries. 2,027 rat and mice complaints were received during the year. Following is a summary of the work of the rodent operatives. No. of operatives' calls 22,126 ,, ,, premises prebaited and treated with poison 1,448 ,, ,, premises prebaited and found not troubled 408 ,, ,, premises investigated and found not troubled 430 ,, ,, prebaits and poison baits laid 58,224 ,, ,, drains tested by Sanitary Inspector 334 ,, ,, drains found defective 240 ,, ,, rats estimated killed 14,915 There were eight rodent operatives and one clerk engaged on rodent control duties during the year under the supervision of a Sanitary Inspector. 24 Report of the Medical Officer of Health for 1949. Swimming Baths and Bathing Pools. There are four public swimming bath establishments and one open air swimming pool belonging to the Council, one open air swimming bath owned by the London County Council, one public swimming pool privately owned, and a number of private bathing pools in the Borough. The Queensmere pond on Wimbledon Common has also for many years past been a recognised bathing pond. In four of the Borough Council's swimming baths, the water is purified by a process of continuous circulation through a filtration plant whereby the whole of the water is dealt with every three to four hours and chlorinated automatically during its circulation from the filtration plant to the bath. In the other bath belonging to the Council, each bath is emptied of water as often as necessary and refilled with fresh water, which is continuously circulated and chlorinated automatically the whole time the bath is in use. Certificates Issued in Respect of Rag Washing and Sterilisation. At two factories in the Borough, rags are washed and disinfected under the supervision of the Council's Inspector, and certificates are issued for which a charge is made. During 1949 81 certificates were issued and the amount collected was £24 6s. 0d. Removal of Diseased or Infirm Persons to Institutions. In no case has it been necessary during the year for application to be made to a Court for the removal of diseased or infirm persons nnder the provisions of Section 47 of the National Assistance Act, 1948. Sctrlitdry Inspection of the Borough 25 Eradication of Bed Bugs. The methods employed for freeing infested houses include the stripping of all paper from the walls, the removal of wooden mouldings and skirtings and the application of a blow lamp to the room surfaces. Sulphur and " Cimex " candles are often used by house owners and the spraying of rooms by the disinfecting staff of the Council is carried out, proprietory insecticides being used. Infested bedding is removed to the Disinfecting Station and treated by steam. During the year 242 houses were found to be infested with bed bugs and disinfestation was carried out in all cases. Special steps are taken to ensure that the furniture and clothing of families about to be accommodated in the Council's houses and flats are freed from vermin. Hydrogen cyanide gas is used for the disinfestation of the furniture, which is placed in special vans constructed for the purpose, the process being carried out by a contractor. Bedding is not subjected to hydrogen cyanide but is disinfested by steam at the Council's Disinfecting Station. Mortuary and Crematorium. The Mortuary at Wandsworth was used throughout the year and 319 bodies were received there. Under the Crematorium Regulations, 1930, 809 cremations were authorised during 1949 as compared with 634 in 1948. 26 HOUSING. Statistics Relating to Housing. Public Health Act. No. of houses inspected on account of complaints or illness 15,460 Re-inspections 37,734 Number of sanitary notices served: Intimation notices 6,342 Nuisance notices 1,624 Number of houses repaired or nuisances remedied 6,530 Housing Act, 1936. Number of houses inspected—house to house (Housing Consolidated Regs. 1925). nil. (a) Number of houses included by representations by the Borough Medical Officer under Section 25 of Housing Act, 1936 nil (b) Number of houses demolished following representation by Borough Medical Officer under Section 25 of Housing Act, 1936. 21 Number of houses repaired under Sections 9 and 10 of Hous'ng Act, 1936: (a) by owners nil. (b) by Local Authority in default of owners nil. Number of houses demolished: (a) In pursuance of Orders under Section II of the Housing Act, 1936 3 (b) Voluntarily nil. Number of houses (wholly or in part) the subject of Closing Orders (excluding underground rooms) 2 Number of Closing Orders determined (i.e. houses made fit) 2 Housing 27 Overcrowding (Housing Act, 1936). Number of families found to be living in overcrowded conditions 198 Number of overcrowded families who have obtained alternative accommodation 60 Number of houses erected by the Borough Council for working classes during year 281 Underground Rooms. Number occupied but unfit and action taken 15 Number closed or modified occupation approved 11 Houses Let in Lodgings. Number in Borough 1 Number of inspections 12 Number of prosecutions nil. Number of complaints remedied under the Bylaws (not included under any other heading) 2 Rent and Mortgage Interest Restrictions Acts, 1920—1939. During the year 10 applications were received from occupiers that their houses were not in a reasonable state of repair. All the applications were acceded to and Statutory Certificates were granted. Most of the work to put them in a reasonable state of repair was carried out during the year. 28 Housing Clearance of Insanitary Houses. Saxby Street Area.—It has not yet been possible to complete the clearance of this area which was declared in March, 1938, and approved by the Minister of Health after a public enquiry held in October of that year. Of the 93 red houses in the area, 64 are still occupied. The Weimar Street area, taken over by the London County Council and declared by that authority in December, 1938, has now been cleared and all the houses in it are demolished. Most of the occupiers of the 26 houses in the North Passage Area, declared a Clearance Area in June, 1939, have now been rehoused. Four of the houses are still occupied. The Demolition Orders on 68 and 70 Garratt Lane made in November, 1947, have been complied with. During the year Closing Orders were made on the basement flats at 5 Melrose Road, and 130 Merton Road, and on a cellar dwelling at 4 Rosebery Road. These Orders have been complied with. In 1947 the Council made Closing Orders on 17 basement flats in Byrne Road. Two of these basements are still occupied as it has not been possible to find suitable accommodation for the occupiers. Fourteen of the flats are unoccupied and in one—1 Byrne Road—the Closing Order has been determined as the owner has made it fit for habitation. In a further eight of the Byrne Road basements, no Closing Orders were made as the Council accepted undertakings from the owners to do the necessary works. In five of these the work was carried out shortly afterwards, one has been closed voluntarily and two are still occupied, and it has not been possible for the work to be done. 23 Elms Road.—In 1934 a Closing Order was made on a bedroom in the basement of this house and the order was complied with at once. The Closing Order was determined in October, 1949, at the owner's request, following reconstruction of the whole basement of this house. 29 Food and Food Premises TABLE XIII. NATURE OF PRINCIPAL BUSINESS A. ACTUAL FOOD BUSINESSES CONDUCTED ON THE PREMISES SHOWN IN COLUMN A. No. of St. para;c Premises No. of Shops Distributing Milk Subject to Some Form of Legal Control Other Food Businesses No. of Visits in 1949 As Dairies As Milk Distributing Depots As Slaughter houses. As Wholesale Margarine Premises For Ice Cream For Cooked or Preserved Foods As Fish Fryers As Fish Curers Fishmongers Grocers Confectioners Butchers Greengrocers Food Factories Restaurant Kitchens Others 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. 11. 12. 13. 14. 15. 16. 17. 18. Dairies & Milk Distributing Depots 64 64 30 34 ... ... 8 3 ... ... ... 54 9 ... ... 3 ... 1 1322 Ice-cream Manufacturers 14 ... ... ... ... ... 14 ... ... ... ... ... ... ... ... ... ... ... 189 Grocers & Provisions 584 127 ... ... ... 21 115 155 ... ... 2 584 134 24 31 ... 6 217 4696 Confectioners 433 5 ... ... ... ... 310 ... ... ... ... 27 433 ... ... ... 19 15 2492 Butchers 182 ... ... ... ... ... 2 180 ... ... ... 1 ... 182 ... ... ... ... 2816 Slaughter-houses 3 ... ... ... 3 ... ... ... ... ... ... ... ... ... ... ... ... ... 56 Fishmongers 81 ... ... ... ... ... ... 31 14 41 81 ... ... ... ... ... 2 ... 1223 Fish Fryers 59 ... ... ... ... ... ... 56 59 5 18 ... ... ... ... ... 24 ... 521 Restaurants 409 ... ... ... ... ... 69 ... ... ... 2 3 26 ... ... ... 409 ... 1623 Greengrocers 351 ... ... ... ... ... 3 ... ... ... 1 3 ... ... 351 ... ... ... 1580 Market Stalls 197 ... ... ... ... ... 7 2 1 2 16 18 11 7 107 ... 11 14 25145 Food Factories 35 ... ... ... ... ... 2 2 ... 1 1 10 13 4 ... 35 ... 8 185 Others 161 ... ... ... ... ... 26 ... ... ... 1 30 14 ... 4 ... 6 161 1173 Totals 2573 196 30 34 3 21 556 429 74 49 122 730 640 217 493 38 477 416 43021 30 FOOD AND FOOD PREMISES. There are four Inspectors engaged in the supervision of the food supply. One of them is the Food and Drugs Inspector of the Borough who is occupied in procuring samples of food and drugs for analysis by the Public Analyst, and the supervision of dairy premises. The other three Inspectors, who are designated Food Inspectors, supervise all other premises where food is sold, stored, manufactured or prepared for sale, and one third of the Borough is allocated to each Inspector. In addition they carry out the duties required under the Pharmacy and Poisons Act, 1933, and the Pharmacy and Medicines Act, 1941. With the object of ensuring that all food businesses arc supervised systematically, a register of all premises where a food business is carried on has been compiled and is kept up-to-date. This Register includes not only those premises which are subject to some form of legal control, but also all other premises in which a food business of any description is carried on. Table XIII has been drawn up to show the number of food premises in the Borough and the nature of the business carried on at these premises. It is a common occurence for more than one food business to be conducted on the same premises and the Table is arranged to bring out this fact. In column 1 of the Table the number of separate food premises in the Borough is given, classified according to the nature of the principal business carried on. In columns 3 to 18 the number of different businesses actually conducted from these premises is shown, those which are subject to some form of legal control being specified. The number of shops distributing milk in the Borough is also shown in column 2 of the Table. The total number of food premises on the register in the Borough is 2,573, and during 1949 they were visited on 43,021 occasions. Milk Supply. The Milk and Dairies Regulations, 1949. These Regulations came into force on 1st October, 1949, and require local authorities to keep a register of all persons carrying on the trade of distributor in their district and of all premises within their district which are used as dairies, not being dairy farms. Food and Food Premises 31 Applications have been received from 155 persons to be registered as distributors of milk, including 14 applications from persons with premises outside this Borough, and 30 applications for the registration of premises as dairies. In each case the certificate of registration was granted. The bulk of the milk sold by retail within the Borough is sent out in bottles filled in properly constructed dairies and its quality is good Food and Diugs Act, 1938. 882 samples of milk were submitted for analysis. 876 of these were reported as genuine, with an average fat content of 3.59 per cent. The Milk (Special Designation) (Raw Milk) Regulations, 1949, and The Milk (Special Designation) (Pasteurised and Sterilised Milk) Regulations, 1949. The regulations came into force on 1st October, 1949, and replace The Milk (Special Designations) Regulations, 1936 to 1948. The following licences for the sale of designated milks were granted during the year:— Regulations 1936/48 Regulations 1949 Total Pasteurised 47 51 98 Tuberculin Tested 16 18 34 Tuberculin Tested (Pasteurised) 64 — 64 Sterilised — 193 193 Accredited — — — Total 127 262 389 Licences were not required for the sale of sterilised milk before 1st October. 301 samples of milk were procured from distributors, schools, hospitals and institutions and submitted to the phosphatase test, the methylene blue test, the turbidity test and for bacteriological examination. Twelve of these failed to comply with the prescribed tests. 32 Report of the Medical Officer of Health for 1949. Meat. There are 217 butcher's shops in the Borough. Ths majority are registered under Section 14(1) (b) of the Food and Drugs Act, 1938, for the preparation or manufacture of sausages or potted, preserved, pickled or pressed foods. 2,816 visits were made to these shops during the year. Slaughter of Animals. There are three private slaughter-houses in the Borough and they were visited on 56 occasions during the year. Ten carcases of pigs were inspected before and after slaughter. One liver was found to be inflamed and was condemned. Slaughter of Animals Act, 1933. Section 3 of this Act provides that no animal shall be slaughtered or stunned in a slaughterhouse or knacker's yard by any person who is not the holder of a licence granted by a local authority and in force under this section. During the year one application from a person desirous ot acting as a slaughterman was submitted to the Council and granted. War Time Piggeries. There are now 13 war time piggeries in this Borough and they were inspected on 88 occasions. Unsound Food. 103 consignments of foodstuffs of all kinds were examined at the request of the owners and found to be unsound. After the articles had been destroyed or rendered unsaleable, certificates were granted to this effect. Food and Food Premises 33 Pharmacy and Poisons Act, 1933, and Pharmacy and Medicines Act. 1941. These Acts provide for the listing with the Local Authority of all persons dealing in poisons included in Part II of the Poisons List. The number of applications received for entry on the Council's Register for 1949 was 375, and 751 inspections of these premises were made by the Food Inspectors. The principal businesses conducted on the premises of these applicants is shown in Table XIV. The majority of the listed sellers are also purveyors of food. TABLE XIV.—Part II of Poisons List. Principal Business No. of Premises No. of Inspections Grocers 217 415 Hairdressers 18 41 Drug Stores 24 52 Domestic Stores, Ironmongers, etc. 112 231 Nurserymen 4 12 Total 375 751 34 Report of the Medical Officer of Health for 1949. Water Supply. The bulk of the water supply in the Borough is provided by the Metropolitan Water Board and this has been satisfactory, both in quality and quantity. There are 20 artesian wells in the Borough, 15 of which are in operation, seven for food manufacture and drinking and eight for other purposes. Three samples of water were taken from artesian wells during the year and were found to be free from pollution, and four samples were submitted for analysis on the complaints of two ratepayers. In the first case it was found that there was a sediment consisting of sand and cement in the tank but there was no other contamination and the Public Analyst was of the opinion that the supply for drinking should be provided direct from the main. In the second case the examination showed the water to be free from pollution and in the opinion of the Public Analyst the water was quite safe for drinking purposes Two samples of water were taken from the Queensmere bathing pond on Wimbledon Common at the request of the Medical Officer of Health of Wimbledon. The Food and Drugs Act, 1938. Registration of Premises. Section 14(1) of this Act requires that any premises used or proposed to be used for:— (a) the sale, or the manufacture for the purpose of sale, of ice-cream, or the storage of ice-cream intended for sale; or (b) the preparation or manufacture of sausages or potted, pressed, pickled or preserved food; shall be registered by the owner or the occupier thereof with the local authority. During the year 97 applications for registration under the provisions of Section 14(1) (a) and eight applications for registration under the provisions of Section 14(1) (b) were submitted to the Council. With the exception of one case, all these premises were found to be satisfactory and the registration granted. Food and Food Premises 35 Section 34(1) (b) of this Act requires that no premises shall be used:— for carrying on the business of a wholesale dealer in margarine, margarine-cheese or milk-blended butter; unless they are registered by the Food and Drugs authority for the purpose in question. During the year one application for registration under the provisions of this Section was submitted to the Council and granted. Section 57(1) (a) of this Act requires that it shall not be lawful:— for the occupier of any premises to use them as a slaughterhouse or knacker's yard or permit them to be so used, unless he holds a licence granted under this section by the local authority authorising him to keep those premises as a slaughter-house or, as the case may be, as a knacker's yard. During the year three applications for the renewal of licences to use premises as slaughter-houses were submitted to the Council and granted. Bacteriological Examination of Ice-Cream. During the year 154 samples of ice-cream were tested in accordance with the technique suggested by the Ministry of Health and Public Health Laboratory Service in their Bulletin of March, 1947 The following table gives a summary of the results:— TABLE XV. Methylene Blue Test. Coliform Test. Provisional Grade No. of Samples Coliform in l/10th ml. (non-faecal) No. of Samples 1 30 absent 50 2 14 present 27 3 19 4 12 Total 75 Total 77 36 Report of the Medical Officer of Health for 1949. In addition four samples of ice-cream were examined for the presence of salmonella typi or any other organisms of the enteric group. The examination did not reveal any of these organisms. In addition two samples were submitted to the Methylene Blue Test which was nullified due to interference of colouring or flavouring matter. Analysis of Food and Drugs, 1,999 samples of foods and drugs were procured for analysis during the year. 882 samples of milk, 987 other foodstuffs and 130 drugs. Of these 133 were submitted as formal samples while 1,866 were purchased informally. One or 0.8 per cent, of the formal samples and 30 or 16 per cent, of the informal samples were found to be adulterated or not up to standard. The total adulterations reported were 31 or 1.6 per cent of the samples submitted. The 31 samples found to be adulterated were:—six samples of milk, two of tomato ketchup, two of tincture of iodine, two of zinc ointment, two of fruit preserving tablets, two of potato crisps, two of refreshers, one each of cocoa, lime flavoured cordial, tomato juice, pudding mixture, gravy powder, lemonade, malt vinegar, cooked meat, lemon flavoured powder, sugar confectionery, effervescent drink powder, sherbet fountain, boric acid ointment. Police Court Proceedings It was not necessary to take Police Court proceedings in any of the above cases of adulterated samples but proceedings under Section 9(1) of the above Act were taken in respect of one case of selling food (two slices of meat pie) intended for, but unfit for, human consumption. The Court made an Order discharging the defendant, subject to the condition that he commits no offence during a period of six months from such Order and also ordered him to pay £2 2s. 0d. costs. 37 FACTORIES ACT, 1937 Prescribed particulars required by Section 128 Part I.—(1) Inspections. Premises Number on Register Inspections Number of Written notices Occupiers prosecuted (1) Factories in which Sections 1, 2, 3, 4 and 6 of the Act are to be enforced by Local Authorities 692 369 22 - (2) Factories not included above in which Section 7 of the Act is enforced by the Local Authority 1227 830 102 - (3) Other premises in which Scction 7 is enforced by the Local Authority (excluding outworkers' premises) 11 3 - - Total 1930 1202 124 — (2) Defects. Particulars Number of cases in which defects were found Number of cases in which prosecutions were instituted Found Remedied Referred To H.M.By H.M. Inspector Inspector Want of cleanliness 9 5 2 2 - Overcrowding — 1 — — - Unreasonable temperature 1 - - - - Inadequate ventilation 1 1 — — - Ineffective drainage of floors 1 - - - - Sanitary Conveniences (a) insufficient 8 6 4 5 - (b) unsuitable or defective 192 180 2 3 - (c) not separate for sexes 3 2 - - - Other offences against the Act (not including offences relating to outwork) 20 21 4 3 - Total 235 216 12 13 — 38 Report of the Medical Officer of Health for 1949. Part VIII.—Section 110. Outwork. Nature of work No. of outworkers in August list No. of cases of default in sending lists to the Council No. of prosecutions for failure to supply lists Wearing apparel 237 — — Furniture and upholstery 8 — — Brass and brass articles 1 — — Umbrellas 1 — — Artificial flowers 1 — — Boxes or other receptacles made wholly or partially of paper 22 - - Feather sorting 1 — — Cosaques, Christmas crackers, etc. 2 — — Total 273 — — 39 REPORT OF THE PUBLIC ANALYST FOR 1949. By virtue of the requirements of the Food and Drugs Act, 1938, we have to report that 1,999 samples were examined by us under the Act during the year ended 31st December, 1949, 1,869 articles of food and 130 drugs. All were submitted by your Council's Food Inspector, 133 having been taken with the formalities required by the Act and 1,866 informally. Adulterated Sainoles. Particulars of the samples reported as adulterated are given in the following table. Case No. Nature of sample Nature of Report Formal 321 Tomato ketchup Benzoic acid, 190 parts per million in excess. Informal 72 Milk 11 % deficient in milk fat. 166 Cccoa See complaint samples. 176 Lime Flavour Cordial Sulphur dioxide, 50 parts per million in excess. 438 Tomato ketchup Bcnzoic acid, 350 parts per million in excess. 450 Tomato juice, canned Labelling offence. 604 Milk 17% deficient in milk fat. 255 Iodine, tincture of 38% deficient in potassium iodide. 315 Iodine, tincture of 38% deficient in potassium iodide. Both these samples of iodine were correctly prepared according to the formula of the British Pharmacopoeia, 1932. 986 Zinc Ointment 6% deficient in zinc oxide. 1029 Milk 9% deficient in milk fat. 1030 Milk 9% deficient in milk fat. 1115 Zinc Ointment 15% deficient in zinc oxide. 1160 Pudding mixture Infested. 1268 Gravy Powder Infested with mites. 1308 Lemonade Contained yeast cells. Informal 1347 Malt Vinegar Infested with vinegar eels. 1351 Fruit-preserving tablets 47% deficient in sulphur dioxide. 1371 Fruit-preserving tablets 40% deficient in sulphur dioxide. 1389 Cooked meat Contained some dye. 1485 Milk 1% extraneous water. 1634 Potato crisps Fried in inedible oil. 1635 Potato crisps Fried in inedible oil. 1687 Milk 1% extraneous water. 1711 Refreshers See complaint samples. 1713 Lemon Flavour Powder See complaint samples. 1813 Sugar confectionery See complaint samples. 1837 Effervescent drink powder Non-effervescent. 1838 Refreshers Non-effervescent. 1855 Sherbet fountain Magnesium salts present. 1858 Boric acid ointment A British Pharmacopoeia 1932 ointment. 40 Report of the Medical Officer of Health for 1949. Adulteration. The amount of adulteration detected during the year was:— For formal samples 0.8% For informal samples 1.6% For all samples 1.6% Complaint Samples. Case No. 142. Chocolate Swiss Roll. The complaint was tnat the article was of poor quality. Nothing of a deleterious nature could De identified and the complaint was considered not justified Case No. 166. Cocoa. This was a sample of cocoa-bean from which most of the fat had been extracted and the res.due coarsely ground. It was quite unlit for retail sale and the complaint was considered justihed. Cases Nos. 471 Thirst Quenchers. These samples consisted of and 472. tablets made from tartaric acid and bicarbonate of soda together with a little binding matter. Instructions given with the tablets were that they were to be dissolved in water and the effervescent mixture drunk. It was admitted by the complainant that children were eating the tablets. The complaint was considered not justified. Case No. 1049. Toffee. A single piece of toffee was tested on the complaint that it was suspected to have caused sickness. Nothing untoward was detected and the complaint was returned as not justified. Case No. 1308. Lemonade. This sample was suspected to have caused sickness. On examination it was found to contain yeast cells and the complaint was considered justified as these might produce very unpleasant symptoms. Case No. 1347. Malt Vinegar. This sample was found to be infested with vinegar eels. The complaint was considered justified. Case No. 1389. Cooked Meat. The sample was found to contain a small amount of dye which was confined to the exterior of the meat. The complaint was considered justified. Cases Nos. 1634 Potato Crisps. The oil extracted from these and 1635. samples, about 30% in each case, had a rancid odour and acrid taste, and was unfit for use in food. The complaint was considered justified. Case No. 1673. Whisky. Complaint of flavour. An excellent sample. Report of the Public Analyst 41 Case No. 1711. Refreshers. Coloured and flavoured tablets stated to be prepared from tartaric acid and sodium bicarbonate. The tablets which disintegrated in water with difficulty contained no free tartaric acid and consequently no effervescence was produced as the tablets dissolved. No added flavour could be detected. The complaint was considered justified. Case No. 1712. Lemon Flavour Powder. Sold in a paper packet with a straw. In addition to tartaric acid and sodium bicarbonate, magnesium carbonate sulphate and sodium phosphate was stated to be present. There is no such substance as mag. carb. sulph.; a preparation of magnesium was present. Little effervescence was produced with stirring with water and the resulting mixture was alkaline and the taste unpleasant. The powder has an aperient action and is unsuitable for unrestricted sale to children. Case No. 1813. Sugar confectionery, sold without points. The flavour of an artificial essence of rum type was several times too strong to make a palatable article. The complaint was considered justified. Case No. 1828. Milk. Complaint of quality. The milk was found to be in excellent condition and the constituents well above the average. Mineral Oil. Four samples of fruit cake were examined for the presence of mineral oil; in no case was a positive result obtained. Butter and Margarine. The average water content of the 86 samples of butter proved to be 14.9%, that of the 86 samples of margarine 14.8%. The average content of boron preservative in the samples of margarine, calculated to boric acid was 0.19%. 42 Report of the Medical Officer of Health for 1949. Milk. The average composition of the samples of milk submitted during each month of the year and returned as genuine was as under. Month Number Total Solids Milk Fat Non-fatty solids January 87 12.54% 3.75% 8.79% February 94 12.34% 3 57% 8.77% March 95 12.34% 3 57% 8.77% April 81 12.26% 3.48% 8.78% May 94 12.27% 3.37% 8.90% June 82 12.35% 3.46% 8.89% July 48 12.16% 3.46% 8.70% August 40 12.28% 3.58% 8.70% September 80 12.40% 3.66% 8.74% October 96 12.54% 3.72% 8.82% November 64 12.63% 3.78% 8.85% December 15 12.81% 3.93% 8.88% The average composition of the whole ot the 876 samples ot milk received during the year and returned as genuine was as under:— Total milk solids 12.39% Milk fat 3.59% Non-fatty solids 8.80% We have the honour to be, Mr. Mayor, Ladies and Gentlemen, Your obedient servants, A. H. MUTER, F.R.I.C., F.C.S. Public Analyst. J. E. WOODHEAD, B.Sc., F.R.I.C., Ph.C. Deputy Public Analyst. 325, Kennington Road, S.E.ll. 43 INDEX Pages Accidents, deaths from 19 Acute Encephalitis 13 Analyst Report of 36 Area of Borough 3 Bacteriological Examinations ,, ,, of Milk 31 ,, ,, of Ice Cream 35 Bathing Pools and Swimming Pools 24 Bed Bugs, eradication of 25 Births, Birth Rates 4 Butchers' shops 29 Cancer 19 Cerebro-spinal Meningitis 13 Childbirth, deaths from 4 Circulatory diseases 19 Clearance areas 28 Closing Orders 28 Crematorium 25 Cutting-off-notices—Water Supply 23 Deaths, causes of 7 Death Rates 4 Death Rate from Infective Diseases 10 Death Rate, Infantile 4 Deaths, number of 4 Demolition Orders 28 Diphtheria 10 Diseased or Infirm Persons, removal of 24 Disinfection 18 Dysentery 13 Encephalitis Lethargica 13 Enteric Fever 13 Erysipelas 14 Factories Act, 1937 37 Factories and Workshops 37 Food and Drugs Act, 1938 31 Food Poisoning 14 Food, supervision of 30 Food Factories 29 Food Places, inspection of 30 „ ,, number on Register 30 Houses and premises inspected 21-22 Houses let in lodgings 26 Housing Act, 1936 27 Housing Statistics 26 Hydrogen Cyanide Disinfection 25 Tee Cream, etc., Sale and Storage of 34 Illegitimate Children, Births of 4 Infant Mortality 4-8 Infective Diseases „ ,, cases of 10 „ ,, death-rate from 11 44 Infirm or Diseased Persons, removal of 24 influenza, Deaths and Death-rates 14 influenzal Pneumonia and Acute Primary Pneumonia 14 ,, ,, cases notified 14 Inquests 19 Insanitary Areas 28 Inspections, details of 21 - 22 Malaria 14 Maternal Mortality 4-8 Measles 13 Meat 32 Milk Analysis 42 Milk, Bacteriological Examination of 31 Milk and Dairies Regulations, 1949 30 Milk Premises, etc., on Register 31 Milk (Special Designations) Regulations, 1949 31 Milk Supply 30 Mortuary 25 Non-infective Diseases, deaths from 19 Notification of Infective Diseases 10- 11 Ophthalmia Neonatorum 11-12 Other Infective Diseases, deaths from 14 Outworkers 38 Overcrowding 27 Para-typhoid Fever 13 Pharmacy and Poisons Act, 1933 33 ,, ,, Medicines Act, 1941 33 Piggeries 32 Pneumonia 14 Poliomyelitis and Polio-encephalitis 13 Population 3 Pregnancy, deaths from accident and diseases of 4 Preserved Meat, etc., manufacture of 34 Public Analyst, Report 39/41 Puerperal Pyrexia 13 Pulmonary Tuberculosis, notification of cases of 20 Ragwashintr and Sterilisation. Certificates 24 Rent and Mortgage Interest (Restriction) Acts, 1920—1939 27 Respiratory Diseases 20 Rodent Control 23 Samples, Formal and Informal, number of 23 Sanitary Conveniences, inspection of 21 Sanitar.y Inspection of Borough 21-22 Sanitary operations, Table of 14 Scabies 10 Scarlet Fever 10 Slaughter-houses 32 Slaughter of Animals Act. 1933 32 Smallpox 10 Social Conditions 3 Statistics for-the Borough Suicide, deaths from 2 Swimminf Baths and Bathing Pools 24 Svnhilis. deaths from Tuberculosis 20 Unsound Food 32 Violence, mortalitv from 2 Water Supply 34 cutting-off-notices 23 Whooping Cough 10 Workshops number of 37