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Public Health. 227
(v.) The physician in charge of the dispensary shall supply to the medical officer
of health of the borough from which the patientsare drawn, such information as the medical
officer of health may reasonably require, and the county medical officer of health shall
be entitled to receive this information from the borough medical officer of health. The
physician in charge of the dispensary shall also furnish the requisite information to any
medical practitioner carrying out domiciliary treatment, or in a case which is referred to
a sanatorium to the medical officer of that institution.
(vi.) The scheme shall include provision for home visitation of patients, either by
the dispensary physician or by the medical officer of health of the borough and his staff
and for the examination by the dispensary physician of such cases as the medical officer
of health or a medical practitioner may require, either at the dispensary or in the homes
of suspects and contacts.
(vii.) The scheme shall be conducted with reasonable economy and the arrangements
and expenditure shall be annually submitted to the Council for its approval.
(viii.) The scheme shall provide for distinguishing clearly between the cost of
treating insured and uninsured persons, having regard to the opinion expressed by the
Council that insured persons should not be paid for out of the rates.
The Council also suggested to local sanitary authorities that they should make arrangements to
pay for patients, residing in the districts under their respective jurisdiction, attending dispensaries
attached to hospitals in any part of the Administrative County of London.
A number of schemes were under consideration and it was possible in two cases, viz., Southwark
and Chelsea, to give a qualified approval before the end of the year.
During the year under review the reports presented to the Council on the administration of
Part IV. of the London County Council (General Powers) Act, 1907, showed that between the date
of the coming into operation of the Act and 31st December, 1913, 13,321 samples of milk fonvarded
from places outside the county had been examined, with the result that 1,323, or 9 9 per cent., proved
tuberculous. During the year, 2,900 samples were taken. Of these the examination of 2,682 samples
was completed, of which 251 were found to be tuberculous. The Councils veterinary inspector has
visited, for inspection purposes, since the Act came into operation, 2,423 farms and inspected 65,795
cows, of which number 663, or one per cent., were found to be affected with tuberculosis of the udder.
During the year 261 farms were visited and 9,649 cows were examined, of which 26 were found with
tuberculous udders. The owners of the animals affected undertook that the use for human consumption
of the milk should be discontinued immediately.
Under the provisions of the London County Council (General Powers) Act, 1904, the cows in
London cowsheds are examined about five times in the year by a veterinary inspector appointed by
the Council. During the year under review 12 animals have been seized and slaughtered under the
Act, the post-mortem examination showing in each case that the udder of the animal was
tuberculous.
The machinery provided under this Act for the seizure and slaughter of cows was, however,
not utilised after 1st May, 1913, as on that date the Tuberculosis Order of 1913, issued by the Board
of Agriculture and Fisheries under the Diseases of Animals Acts, came into force. The Order provides
for the notification to the Council, as the local authority for the execution of the Order in the
Administrative County of London, exclusive of the City of London, of any case in which (1) any cow
is, or appears to be, suffering from tuberculosis of the udder, indurated udder or other chronic disease
of the udder, or (2) any bovine animal which is, or appears to be, suffering from tuberculosis with
emaciation.
Upon receipt of such notification the Council is required to cause a veterinary inspector to
examine the animal and if, as the result, the Council is satisfied that the animal is suffering from
tuberculosis with emaciation or, in the case of a cow, is suffering from tuberculosis of the udder or
is giving tuberculous milk, the Council is to give notice to the owner and to the Board that the
animal is to be slaughtered. Before the slaughter of the animal its value, in its condition at the time
of valuation, is to be agreed upon by the Council and the owner, or, failing agreement, is to be
settled by a valuer. The special authority of the Board has to be obtained before the animal can be
slaughtered if (1) the owner objects, or (2) the agreed value of the animal exceeds £30.
The Order also provides (1) for precautions to be taken in respect of milk from cows which are,
or appear to be, suffering from chronic disease of the udder or tuberculosis with emaciation or which
are suspected of giving tuberculous milk ; (2) for the detention and isolation of any cow which is
or appears to be, suffering from chronic disease of the udder, or any bovine animal which is, or appears
to be, suffering from tuberculosis with emaciation ; (3) for the cleansing and disinfection of that part
of a shed or other erection in which a cow suffering from tuberculosis of the udder or giving tuberculous
milk or any bovine animal suffering from tuberculosis with emaciation has recently been placed or
kept.
The powers of the Council under its General Powers Act of 1904 to deal with tuberculous animals
are more limited than those conferred upon it by the Order, as under the Act the Council can deal only
with cows suspected to be suffering from tuberculosis of the udder. Moreover, there is a considerable
difference with regard to the payment of compensation for animals slaughtered. Under the Act of
1904, in the event of the animal slaughtered being found to have been suffering from tuberculosis of
the udder, the Council is required to pay to the owner three-fourths of the agreed or ascertained value
of the animal before slaughter, or the sum of £22 10s. whichever shall be the less, and, in the event of
the animal being found not to have a tuberculous udder, the amount payable is the full value or £30,
whichever is the less, 'plus £1.
23610 GG 2
Milk.