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68
As regards infection, to show that there is need for legislation for regulating the conduct of
the business of bakers, a case that came under my observation last year may be cited. It was that
of a journeyman baker, more especially concerned in the making of confectionery, who was reported
by a registered medical practitioner to be following his employment at an underground bakehouse
while suffering "with very active secondary syphilis," and, therefore, "a danger to the community
in general." I saw the man who admitted that he had contracted syphilis three months previously,
and had not been professionally treated, but had obtained medicines from a chemist. He was
suffering from secondary syphilitic throat and mouth affection, and I took steps forthwith to get
him admitted to the Lock Hospital.* This case emphasizes the need for a by-law prohibiting any
person from plying his occupation of journeyman baker whilst suffering from any infectious or
contagious disease. There is no statutory provision for the need, section 69 of the Public Health
(London) Act, 1891, dealing only with persons suffering from a notifiable infectious disease. It
reads as follows:—
"A person who knows himself to be suffering from a dangerous infectious disease shall not
milk any animal, or pick fruit, and shall not engage in any occupation connected with food, or
carry on any trade or business in such a manner as to be likely to spread the infectious disease;
if he does so he shall be liable to a fine not exceeding ten pounds."
A further case may be cited (it was referred to in the third report last year) of a journeyman
baker resident in the borough, who for two or three nights had worked at an underground bakehouse
in an adjacent borough, with a person suffering from small-pox—which he himself subsequently
developed at his own home, where he was detained under observation. The offence in
this case, which comes within Section 69, was unwitting. Another case may be mentioned of a
journeyman baker notified as suffering from facial erysipelas, and who was following his employment
at an underground bakehouse; and yet another, that of a baker regularly following his occupation
whilst suffering from epithelial cancer of the face.
Operative bakers are known to be liable to a form of eczema popularly described as "baker's
itch." Exposed, moreover, as they are, to alternate heat and cold, they are prone to consumption.
That a person suffering from this disease, with cough and spitting, is an unfit person to be
employed at a bakehouse, or in any business connected with the preparation of food for man, is
a self-evident proposition, and any reasonable code of by-laws would certainly prohibit such employment;
but I am not sure that, at present, a consumptive person could be legally prevented
from following his occupation even at a dairy.
By-laws applicable to bakehouses would presumably prohibit smoking, with attendant spitting,
which is commonly practised, as the bakehouse sub-committee of the Public Health Committee
can testify from personal observation.
Mention might be made of other matters pointing to the need of restrictive regulations—as
the washing or drying of clothes in a bakehouse, general untidiness, and want of attention to cleanliness;
but the desirability for regulation of the trade is really too obvious to need further insistence.
I called attention in 1881 to the need of by-laws; and in 1883 the Society of Medical
Officers of Health prepared and circulated "Suggestions for Regulations with respect to Bakehouses."t
Some little time since, the Metropolitan Branch of the Society of Medical Officers of
Health put themselves in communication with the Secretary of State on the subject with, I fear,
no great prospect of an immediately successful issue.
The Bakehouse Sub-Committee, in the report above referred to, and which was unanimously
adopted by the Committee, and by the Council, stated that the "requirements" as to underground
bakehouses, suggested therein, "only very indirectly refer to the user of the bakehouse,'' and that
"the question of the necessity for by-laws regulating such user should . . . receive the attention
of the Committee."
* This case was referred to in a letter to (and formed the subject of comment in) The Lancet of June 27. The patient
had been seen at the out-patient department of a hospital and "found to have secondary syphilis with ulcerations of tonsils,
lips, etc."
† The " Suggestions " were reprinted in my Annual Report for 1902, page 97.