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be retained to vaccinate on lists supplied them by the Medical Officers of Health. The
Public Vaccinator would be in reserve also in case of epidemic rush. The central authority,
the Ministry of Health, would issue calf lymph to medical officers of health from the Government
lymph establishment, and these officers would undertake the collecting and forwarding
of any information the Central Authority might require.
I have, so far, in these remarks condensed some considerations set out in the Review
on Small-pox Prevention (Ministry of Health), 1931.
It appears that different sanitary authorities could proceed in the direction indicated
in the report, with differences in practice suited to their circumstances, without any recourse
to immediate change in the present law.
The present administration of the Acts in the City of London shows a 78.5 per cent.
efficiency in securing primary infant vaccinations. The present infant welfare organisation
is used in the education of mothers as to vaccination and re-vaccination, as is indicated by
the Ministry of Health in the above Review.
If and when it be shown that such a use of welfare centres generally throughout the
country not only supplements, but supplants, procedure under the Acts, changes in the
Acts could be advocated in accordance with the request proferred. There appears to be no
sufficient data on which to urge this matter at present.
In all the circumstances, the Corporation were not able to support the proposed abrogation
of the Vaccination Acts.
SUMMARY OF SMALL-POX FOR THE YEAR ENDING 31st DECEMBER, 1932.
The customary disinfection, where necessary, was carried out, and those persons, resident
or employed in the City, who had been in contact with cases of Small-pox, were supervised.
The total number of cases (including missed cases) notified or reported to this Department
during the period ended 31st December, 1932, was 61.
The total number of persons in contact with cases ascertained or notified during the
period ended 31st December, 1932, was 920.
NURSING PROVISIONS.
Measles, etc.—The Corporation has approved of the expenditure of £25 per annum in
respect of the nursing of complicated cases of Measles, Encephalitis Lethargica and Cerebrospinal
Fever, and have also agreed to expend the sum of £30 on provision of medical assistance
and nursing attendance in necessitous cases of Influenza. No action was necessary under
this heading during 1932.
DISTRIBUTION OF DIPHTHERIA ANTI-TOXIN AND ANTI-INFLUENZA VACCINE.
Although City medical practitioners are well aware of the facilities available, only one
application for supplies of diphtheria anti-toxin was received during 1932.
No applications in regard to anti-influenza vaccine were received.
EXAMINATION OF PATHOGENIC BACTERIA.
Any medical practitioner desiring examination of specimens for pathogenic bacteria
in cases of suspected infectious disease occurring amongst their patients residing in the
City may forward them to me at the Guildhall. Arrangements have been made for free
examination, and the result obtained is communicated immediately to the medical practitioner
in attendance. During the year, the following specimens were so dealt with.

PROVISION OF INSULIN.
In accordance with the request made by the Authorities of the University College
Hospital, Insulin has been supplied to one patient resident in the City, and in attendance
at that hospital. The Corporation have power to make this provision under Section 77
of the Public Health (London) Act, 1891, with the approval of the Ministry of Health, but,
so far as I am aware, this is the first patient in regard to whom such powers have been put
into operation. The arrangement has worked satisfactorily
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