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109
Report of the Medical Officer of Health
by the Council's Medical Officer to the Committee four years ago, the following passage occurs: "The fish
trade has its own inspectors, appointed by the Fishmongers' Company, and action in particular instances,
more particularly as regards shellfish, has been taken by the City Corporation, but no
systematic control by a sanitary authority, such as is now regarded as necessary in the case of other sorts
of food, has hitherto been instituted. A considerable experience of the condition of fish arriving at
shops in the poorer parts of London, acquired by officers of the London County Council, more particularly
during recent years, shows that the inspection carried out at Billingsgate affords no sufficient
security against the consumption of fish unfit for food." This report to the London County Council
was considered by the Sanitary Committee of the Corporation, and that Committee, on 10th June, 1909,
issued a report submitting a memorandum on a scheme, the acceptance of which it was believed by
the Committee would render "persons sending unwholesome fish to the City Fish Markets" liable
to "incur the same risk of prosecution as obtains in the case of the salesmen in the Meat and Provision
Markets." No action appears to have yet been taken upon the Sanitary Committee's report.
During the past summer there has again been evidence of the need of preventing the sale of
unwholesome fish. Some of the retail vendors, in the areas affected by excessive prevalence of typhoid
fever, have told me that they experienced special difficulty during last August with regard to small
plaice. The Fish Trades Gazette records that on 9th August "small plaice was abundant at low figures,"
on 10th August such plaice "was exceptionally plentiful and cheap," and on the 11th August "heavy
quantities of small plaice met a poor market at low figures." As has been pointed out, the evidence
obtained in this investigation points to "steamer plaice" as having been at fault, and I, therefore,
made special enquiries in this connection at Billingsgate. No steamer plaice, I was told, was condemned
during August.
It is the custom with many "friers" not to go to Billingsgate until the higher-priced fish has
been disposed of. Numbers of men do not attempt to buy in the early morning. There is, therefore,
special need of inspection in the case of this "late fish.'' In the Plaice Fisheries Report it is stated
that at Ramsgate the "small stuff" is "given to the crew as a perquisite," or "sold to hawkers and
others on the open space outside the market." At Billingsgate the "late fish" falls largely into the
hands of costers and small " friers," and, in the absence of a complete system of inspection at the market,
the question as to whether the fish shall be sold or not is left to the discretion of the coster or "frier."
Plaice is practically the only fish used by vendors of fried fish which is not gutted as a matter
of course at sea. I was informed at Billingsgate that the nature of the food (shellfish, etc.), of the
plaice makes it possible to retain the gut without injuring the fish; whereas the character of the intestinal
contents of fish consuming "softer" food necessitates removal of the gut forthwith. The practice of
gutting plaice seems, however, to be coming steadily into favour as years go by, but the London
steamer companies do not, as a rule, attempt to gut the small plaice. The extent to which the fish
sold by fried fish vendors has been found to be imperfectly gutted has been referred to in previous
reports (see page 10, Appendix to Report of Medical Officer of Health, 1903). In dealing with small
"dabs," which are sold at times when there are "heavy quantities" available, at ½d. a pound, or say
three or four a penny, cleansing is doubtless often left to be carried out by the purchaser, if performed
at all.
It is a suggestive fact that in the instances last summer, in which several members of one family
were simultaneously attacked by typhoid fever, there was, generally speaking, a history of the consumption
by all the sufferers in each family of small plaice or dabs. The fact that most, or all, of the
consumers of these fish were attacked, points to a degree of infectiousness which requires some special
explanation, and such explanation the absence of gutting of these small fish would possibly supply.
It is clearly desirable, in the interest of the public health, as it appears to be admitted by many
of those who are in a position to have an opinion, it also is in the interest of the fish trader, that no plaice
which has not been gutted should be exposed for sale in the market.
The collection of the information made use of in this report would, of course, have been an
impossible undertaking had I not been largely indebted to others—to the Medical Officers of Health
and Sanitary Inspectors of affected districts, to the Medical Officers of Metropolitan Asylum Board
Hospitals (and in particular to Drs. E. W. Goodall and F. Thomson) and of hospitals and infirmaries, and
to members of the staff of the Council's Public Health Department,
II.—Report by Drs. J. M. Bernstein and W. H. Hamer on Glanders in Man.
As a preliminary to the conduct of this investigation, it was thought necessary to enquire into
the conditions existing in some large London stables in which equine glanders had recently been
reported. Some of the stable workers themselves have voluntarily come to be examined under the
impression that they were the subject of infection, but they were not infected. Other cases of stable
workers have been sent also for examination. One case notified as glanders gave none of the
diagnostic signs and was the subject of syphilis, from which he recovered. In all these bacteriological
investigations were made and various ringworm fungi and bacteria were identified as associated with
the lesions. These included such conditions as horse ringworm, boils, syphilis, and other inflammatory
lesions of the skin,