Hor 05 No. 9. HORNSEY URBAN DISTRICT COUNCIL. MEDICAL OFFICER'S REPORT For the Year 1895. To the Members of the Hornsey District Council. Gentlemen, In my Annual Report for 1894 I estimated the population of the District at 50,700. 1 am, however, of opinion that for the.year 1895 it must be put considerably higher than this, as I find that in May last each Ward contained the following number of houses, viz.— Ward. Houses. Population reckoned at 5½ per house. Higligate 1,363 7,496 Muswell Hill 372 2,046 Crouch End 764 4,202 Hornsey 2,111 11,610 North Haringey 1,572 8,646 South Haringey 923 5,077 Stroud Green 1,399 7,695 Finsbury Park 1,282 7,051 9,786 53,823 At the middle of 1893 I estimated the population at 48,522; at the last census in 1891 it amounted to 44,205, and in 1881 to 22,485. The estimate of 5£ persons per house may now be regarded as a very moderate one, and it would not be unreasonable to assume that there are on an average 6 parwuix residing in emsh house in tho District. On this basts the population of the District would be not far short of 60,000 persons. The death-rate would be correspondingly reduced. The Births for the year amount to 1,142, being 44 less than for 1894. This gives n birth-rate of— 21.2 per 1,000 inhabitants, comparing with— 23.37 „ „ for 1894, 23.26 „ „ „ 1893, 25.26 „ „ „ 1892, 26.20 „ „ „ 1891, and 23.17 „ „ „ 1890. 2 From this it will he seen that the birth-rate is continuously becoming smaller, the births being absolutely less for 1895 than for 1894—notwithstanding the increase in the population. The Deaths for the year from all causes amount to 565, giving a death-rate of 10.49 per 1,000 inhabitants— comparing with 9.85 per 1,000 inhabitants for 1894. 11.33 „ „ „ 1893, 10.95 „ „ „ 1892, 11.11 „ „ „ 1891, and 11.20 „ „ „ 1890. With the exception of 1894, when the death-rate was extraordinarily low, the rate for 1895 may be considered a very favourable one, and gives a very fair criterion as to the general good sanitary condition of the District. The rate for 1895 compares with 19-8 for London, with 20'7 for 33 of the largest English Towns (including London), and with 21-2 for 32 Provincial Towns, , namely, the 32 largest English Towns, exclusive of London. The following table gives the deaths which have been certified in each of the eight Wards comprised in the District, as gathered from the weekly returns of the Registrar— Ward. Deaths. Death-rate per 1,000 inhabitants. Highgate 86 11.6 Muswell Hill 14 6.8 Crouch End 25 5.94 Hornsey 162 13.9 North Haringey 102 11.7 South Haringey 33 6.49 Stroud Green 55 7.14 Finsbury Park 88 12.6 The actual deaths occurring in the Muswell Hill Ward were 19, but, as 5 of these occurred at the Isolation Hospital, I have allocated them to the Wards from which the patients were sent, viz.—2 to Higligate, 1 to Hornsey, 1 to Finsbury Park, and 1 to North Haringey. Comprised in the deaths for the Higligate Ward were also 2 at the Convalescent Hospital (Cromwell House) in connection with the Children's Hospital, Great Ormond Street. One of these, at any rate, could not properly be treated as of a resident in the District, but against that may be placed the death of a child from the Stroud Green Ward at the Great Northern Central Hospital. The Zymotic Death-rate amounts to 1.11 per 1,000 inhabitants, and is practically the same as for 1894, when it was 1.12 per 1,000, and it also compares with 0.96 for 1893, 0.94 for 1892, 0.7 for 1891, and 1.15 for 1890. 3 The following table shows the deaths in the District from the 8 principal Zymotic Diseases for the last 6 years— 1895. 1894. 1893. 1892. 1891. 1890. Small Pox — — — — — — Measles 13 5 5 7 2 13 Scarlet Fever 3 1 9 4 3 3 Diphtheria 21 23 16 11 6 10 Fever 5 6 6 3 1 5 Whooping Cough 10 22 2 13 14 14 Diarrhœa 8 1 9 6 5 6 Cholera — — — — — — Totals 60 58 47 44 31 51 From this it will be seen that there has been no mortality from either Small Pox or Cholera in the District for the last six years. The Zymotic Death-rate 1.11 per 1,000 compares with 2.6 for London, with 2.8 for the 33 principal English Towns (including London) dealt with by the Registrar General in his weekly returns, and with 3.0 for the 32 Provincial Towns. The deaths from Measles are numerically the same as in 1890, but less when the increased population is taken into account, and more than were registered in 1891 to 1894 (inclusive). The mortality from Scarlet Fever (3 deaths) is small, considering the number of cases (420) reported during the year. It has not varied much since the .year 1890, with the exception of 1893, when 9 deaths occurred from this disease. 21 of the deaths were due to Diphtheria—out of 89 cases reported, comparing with 23 deaths and 117 cases reported in 1894. Five deaths occurred from Typhoid Fever,comparing with 6 for 1894 and 1893 respectively, 3 for 1892, 1 for 1891, and 5 for 1890. Whooping Cough is credited with 10 deaths, comparing with 22 for 1894, 2 for 1893, 13 for 1892, 14 for 1891, and 14 for 1890. Seven of the eight fatal cases of Diarrhœa occurred in the third quarter of the year, and all in children under five years of age, and, as I stated in my report for that quarter, "The larger mortality from infantile diarrhoea may in all probability be mainly attributed to the great heat experienced during the quarter." 4 The deaths from diseases other than Zymotic are as follows:— 1895. 1894. 1893. 1892. 1891. 1890. From Pulmonary Consumption 43 40 35 28 38 40 „ Bronchitis, Pneumonia, and other Pulmonary Diseases 105 87 139 118 122 108 „ Brain Diseases 50 68 69 63 59 54 , Heart ,, 64 40 61 46 42 42 „ Rheumatism 4 4 5 1 2 7 „ Ague „ Puerperal Diseases — 2 3 10 5 2 „ Pyaemia — 1 — — 1 „ Erysipelas — 4 2 2 4 „ Malignant Diseases, Cancer, &c. 22 31 37 24 22 18 „ Injuries 15 15 11 12 11 10 „ Various other Causes 202 153 139 160 157 158 Totals 505 441 503 464 460 444 Ages at which the Deaths Occurred. One year and under 144 One year to five years 77 Five years to fifteen years 20 Fifteen years to twenty-five years 21 Twenty-five years to sixty-five years 166 Sixty-five years and over 137 565 This gives n mortality of 2'67 per 1,000 inhabitants for one year and under, and 4T per 1,000 inhabitants for under five years, comparing with 2'0 and 3'0 respectively for 1894. The mortality at and over 65 years gives 2.54 per 1,000 inhabitants. No comparison can be made in this case with previous years, as up to the end of 1894 60 was the time of life taken instead of 65, as at present. The Infant death-rate (under one year) gives the rate of 133.97 per 1,000 births registered. This is higher than the rate for the previous year. This is partly to be accounted for by the larger number of deaths from either prematurity or debility from birth. This rate, 133.97, compares with 166.0 for London, with 182.0 for the 33 large English towns, and with 193.0 for the 32 Provincial towns. 5 Compulsory Notification of Infectious Disease has been in force in this District since the 1st of January, 1890, and under the Act the following cases have been reported during the year— Scarlet Fever 120 in 1894, 189 Diphtheria 89 „ „ 117 Typhoid Fever 46 ,, „ 40 Puerperal Fever 4 „ „ 6 Erysipelas 45 „ „ 51 Continued Fever 2 „ „ 4 Membranous Croup 4 and Small Pox 5 „ „ 3 615 410 The number 615 compares with 410 for 1894, 618 for 1893, 340 for 1892, 349 for 1891, and 240 for 1890. 338 cases were reported in the first quarter of the year, 71 ,, ,, ,, ,, 2nd ,, ,, 85 ,, ,, 3rd ,, ,, 121 ,, ,, ,, ,, 4th ,, ,, 615 6 The following table gives in detail the cases of Infectious Disease as reported for each quarter of the year, and a comparison with other years- Scarlet Fever. Typhoid Fever. Diphtheria. Erysipelas. Small Pox. Continued Fever. Puerperal Fever. Membranous Croup. 1895 '94 '93 1895 '94 '93 1895 '94 '93 1895 '94 '93 1895 '94 '93 1895 '94 '93 1895 '94 '93 1895 '94 '93 During 1st quarter 295 44 47 10 3 3 18 32 12 14 18 24 — 1 2 — — — 1 4 2 — — — During 2nd quarter 46 54 100 3 5 6 14 43 20 5 14 12 — 2 4 1 — — 2 1 1 — — — During 3rd quarter 33 43 90 7 9 12 27 24 42 15 9 14 1 1 1 — — — — 1 1 2 — — During 4th quarter 46 48 129 26 23 4 30 18 64 11 10 20 4 — 4 1 3 1 1 — 2 2 — 1 Totals 420 189 366 46 40 25 89 117 138 45 51 70 5 4 11 2 3 1 4 6 6 4 — 1 No ease of Cholera has been reported during the year. From the following table will be seen the various Wards in which the 615 cases notified occurred:— Scarlet Fever. Typhoid Fever. Diphtheria. Erysipelas. Small Pox. Continued Fever. Puerperal Fever. Membranous Croup. Total. Higligate 21 9 5 3 1 - - - 39 Muswell Hill 6 — 3 1 — — — — 10 Crouch End 14 3 5 1 — — — — 23 Hornsey 66 16 26 22 — — 3 2 135 North Haringey 18 6 16 10 — 1 — 1 52 South Haringey 79 — 6 4 — — 1 90 Stroud Green 88 6 11 1 4 1 — — 111 Finsbury Park 128 6 17 3 — — 1 — 155 Totals 420 46 89 45 5 2 4 4 615 7 Scarlet Fever shows an increase of 231 causes over those of 1894. It was epidemic in certain parts of the District in the first quarter of the year, as 295 cases were notified during that quarter, as against 125 for the remainder of the year. This outbreak was, no doubt, due to milk infection, and I shall again allude to it under the heading of Special Reports. 124 cases were admitted into the Council's Isolation Hospital, which for some time during the epidemic was quite full, and a few cases had in consequence to be refused admission, and some were taken into the London Fever Hospital, Liverpool Road, (Is will be seen by the table, Finsbury Park, Stroud Green, South Haringey and Hornsey Wards were the ones most affected. Typhoid Fever. -6 more cases were notified when compared with 1894. Five were admitted into the Isolation Hospital, and 4 into other hospitals. Diphtheria has been less prevalent during the year, 89 cases comparing with 117 for 1894. Eight cases were admitted into the Isolation Hospital, and several into other hospitals. Small Pox.—5 cases were notified—1 in the Higligate and 4 in the Stroud Green Wards. They were all of the modified typo, and were treated at home. As regards the Stroud Green cases, all of which occurred in one house, I wrote out an order for admission to tlie Small-pox Hospital, but the father said that, unless his children could be taken into our own Isolation Hospital, he would prefer to have them kept at home. He consequently went into lodgings, and the children were isolated and a special nurse obtained. I informed the Vaccination Officer as to both of these outbreaks, with a view to getting those in proximity to the patients vaccinated as soon as possible. I also saw the medical gentlemen in attendance on the cases, and with them visited the patients, and consulted as to isolation, &c. Isolation Hospital.—139 cases have been treated during tlie year 1895, comparing with 125 for 1894. 8 cases were in the Hospital at the beginning of the year, and 7 were under treatment at its close. 125 cases were admitted for Scarlet Fever. One of these, however, proved to be Measles, and the earliest opportunity was taken to send the patient home. 8 were cases of Diphtheria, and 6 were admitted as suffering from Typhoid Fever. One of these, however, proved not to be so, and the patient was, on admission, found to be so dangerously ill that it was considered hazardous to send her home. I may here state that after a few days she died, and the post-mortem examination cleared up any doubt as to whether she had suffered from Typhoid Fever or not, the unanimous opinion of the five medical gentlemen present at the autopsy being that the deceased had not been suffering from that disease. Of the other deaths 2 were from Diphtheria—female aged 35 years, and female aged 3 years. In tlie latter case the disease spread down tlie larynx. 1 death was from Typhoid Fever—female aged 35 years. This patient was very ill on admission, and ultimately died from Pneumonia. The other fatal case, male aged 3 years, was from Scarlet Fever, complicated with Epileptic Fits and Strumous Abscesses, the patient having only three days before admission been discharged from a London Hospital. The remainder of the cases left the Hospital well. 8 In the early part of the year the new Wards, which were commenced in 1894, were finished, and the Hospital now consists of a spacious administrative hlock, with ample accommodation for the Matron, Nurses and servants, and of four Ward blocks, two of which contain two sets of two Wards (male and female) for the treatment of two distinct infectious diseases at tlie same time.. Of the otlier blocks, one, the larger of the two, consisting of two Wards, is used for the treatment of Scarlet Fever cases, which 1 may say have up to the present time been far in excess of any other of the diseases treated here, and the other block, also consisting of two Wards, is used for Diphtheria cases. Eight of the Wards are fully furnished, and the remaining 4 could be made available in a case of emergency in the course of a few days. In tlie first quarter of the year there were 70 patients treated, all of them suffering from Scarlet Fever, and on two occasions there were 60 patients at the same time under treatment. During the last half of the year there were some exceptionally severe cases of Typhoid Fever and Diphtheria; these entailed very arduous duties upon the Matron and Nurses, as also did the care of the large number of cases in the first quarter, though fortunately most of these were not of a severe type. I cannot speak too highly of the efficient manner in which the nursing has been carried out, and I need hardly say that this confidence has materially lessened my anxiety as Medical Attendant at the Hospital. The resident staff at the Hospital at present consists of the Matron, three Nurses, Cook, Laundry woman, first and second Ward-maid, and first and second House-maid. The duties of the Matron have of necessity (owing to the large increase in the Hospital buildings and the consequently larger number of Nurses and servants required, as well as the supervision of the laundry), been materially altered, inasmuch as this general supervision leaves her but little time for nursing; and I believe that the Hospital can be better and more economically worked, when the Matron devotes her time mainly to superintending the nursing, domestic, and laundry requirements, rather than by acting in the Wards as an ordinary nurse. The Nurse last appointed (as Night and Ambulance Nurse) entered on her duties on the 13th of May, the second House-maid on the 22nd of March, the second Ward-maid on the 25th of March, and the Laundry woman on the 29th of July. There has been extra help in the laundry (necessitated mainly owing to the much larger quantity of washing required in the Typhoid cases) to the extent of 4 weeks, and extra Nurses have been obtained during a total, for the year, of 36 weeks. It has been stated that when the last Nurse was appointed, the Hospital was already over-staffed, and that extravagance is displayed in employing too many Nurses, and that the number of Nurses must necessarily depend upon the number of patients, whereas, as a fact, this is not so. Suppose, for instance, that there are under treatment three cases only of different infectious diseases, say, Typhoid Fever, Scarlet Fever and Diphtheria. Each of these cases will require a separate Ward, with two Nurses, one for day and the other for night-work, thus necessitating the employment of six Nurses for three patients, or two more Nurses than we already possess in our present staff. It must also be remembered that some of the severer cases of Tyjihoid Fever require the assistance of at least two Nurses to efficiently perform the duties incidental to such cases. 9 A water-bed has been provided, and has already proved most useful, especially in a case of Typhoid Fever admitted when suffering with a large bed sore. An air mattress, with separate air pillow, lias also been obtained for use in the Ambulance, the shaking in which, notwithstanding the rubber tyres, was much complained of by some of the patients. The following matters relating to the Hospital have been dealt with during the year — Provision of new steam supply to laundry and sterilizer, and of blinds and furniture for new buildings. Recommendation for omission of Clauses 4 and 5 of the rules and regulations for the Hospital. Furniture for Hospital; case of Scarlet Fever taken to the North Eastern Hospital; increase of salary of Matron and first Nurse, and an increase of £2 per annum for Matron's uniform; engagement of second House and Ward-maid. Appointment of additional Nurse to undertake ambulance work and night duty; insurance of vertical boiler and sterilizer. Water supply to Hospital; application for the refunding of expenses incurred with regard to two children treated in the London Fever Hospital; ambulance to be kept at the Hospital, and, except under exceptional circumstances, patients not to be received into tlie Hospital during tlie six months from April to September inclusive later than 7 p.m., and during tlie remaining six months not later than 5 p.m.; floors of two of the Isolation Wards stopped, and floors of all the Wards re-polished; purchase of Sleeper Road at Hospital (left by the contractors) for use in filling up the ground at the rear of the new buildings; Laundry fittings and articles required for bedroom of Laundry woman; advertisement for Laundry woman to live on the premises; tenders for the supply of drugs and provisions. Authorization of Matron to engage Laundry woman ; insurance of new buildings and furniture against loss by fire; outside blind over kitchen window; the fixing of 8 additional telephones in the hospital buildings; water supply. Letter re patient suffering from Diphtheria treated in one of the Metropolitan Asylum's Board's Hospitals; continuation of contract for the supply of bread and flour. Tenders for furniture to be supplied where necessary in the administrative block and for the smaller of the new Ward blocks; the furnishing of the larger Isolation Ward block being deferred. Transfer of milk contract and continuation of contracts for the supply of meat and fish ; continuation of the contracts for the supply of bread and flour. Cost of Maintenance of Patients and Resident Staff at the Hospital.—In order to calculate this I have ascertained the amount expended during the year on milk, butter, eggs, meat, fish, bread, flour, groceries, greengroceries and beer—in fact, on everything 10 which can he fairly included under the head of maintenance. This amount divided hy the number of weeks during which patients and the resident staff have been in the Hospital gives the cost of each person as a little under 9s. Id. per week, a result which must, I think, be in every way considered satisfactory. Water Supply to Hospital.—Tlie Hospital now has a constant water supply by the New River Company; in connection with this, fire hydrants are fixed in various parts of the grounds, and fire hose and apparatus are always kept in readiness. Ambulances.—One is reserved entirely for the removal of cases of Small Pox, and has not been used during tlie year. The other is kept at the Hospital, and is now provided with an air mattress and pillow. Houses Disinfected.—500 rooms have been fumigated by the Inspector of Nuisances after cases of infectious disease, and 300 cleansed and stripped. Articles Disinfected or Destroyed.— 2,500 have been disinfected, and, where necessary, washed. In one house the clothes and bedding were in such a filthy condition that I recommended that they should be burnt, which was accordingly done. Dust Destructors.—Two more cells have been added, making twelve in all. The dust has been collected in the same manner as during last year, there having been 98 complaints of non-removal, equal to an average of about two a week, and the applications for removal have been 266, being an average of five a week. 7,846 loads of dustbin refuse have been treated, weighing 10,092 tons. There has not been any complaint of nuisance caused by the destructor. Drains.—58 houses have had their drains reconstructed, and 83 have had them made good. 94 of the cases were after Diphtheria and Typhoid Fever, at the request of the Medical Officer, 33 after nuisances and complaints, and 14 without notice. Sewers.—A considerable length of new sewer has been laid during the year, and special attention given to the fouling of the brook at the rear of Stanhope Road, resulting in the disconnection of several sewers running into it. There have been several stoppages of sewets laid under the original scheme of drainage of the District, and in respect to the one in Park Road it has been decided to re-lay a considerable length of it. Flushing Sewers—Several improvements have been made in this by heading back the water used in flushing at various points in the District, so that the flush is made more forcible and efficient, and flushing operations have been extended and increased. 11 Manhole Inverts, &C.—The smell from the surface ventilators has heen greatly reduced by the repairing of the bottoms of the manholes. Eighty-four have been reconstructed. Wherever practicable, the surface ventilators have been closed, and nine high shafts have been erected in suitable positions. In ventilating the sewers the constant aim is to close surface ventilators, especially in roads and footpaths, and to substitute other openings at such an elevation and in such positions that they shall not prove a nuisance. Gullies.—A thorough examination has been made, resulting in the reconstruction of all those gullies in that portion of the District where there is only one system of sewers. Dairies, Milkshops, and Cowsheds are periodically visited by the Inspector of Nuisances, and, when necessary, by myself. In every case where registration is applied for I visit and report as to the suitability of the shop for the sale of milk. Houses condemned as unfit for Human Habitation. Four houses were so condemned, and have been repaired. Two of them, however, by means of partitions, had been changed from a single house into two. I recommended that the partitions should be pulled down and the houses reconverted into one. Slaughter Houses.—There are ten in the District, and these are all visited periodically and kept in good sanitary condition. The Mortuary.—Thirty-two bodies have been placed in the Mortuary during the year, and inquests have been held by the Coroner in 31 cases of accidental or sudden death. Water Supply.—The whole of the District is now, since the supply from the New River Company was laid on to the Hospital, supplied by that Company, and about 50 j>er cent, of the houses are supplied on the constant supply system. Special Reports.—On 18th of February I submitted a special Report dealing with the out break of Scarlet Fever in a portion of the District. In it I gave a detailed account of the suddenness of the outbreak, of my suspicions as to its cause, of my visit of inspection to 10 dairy farms in Derbyshire and Staffordshire, and of the recommendations resulting therefrom. On the 11th of March I submitted a further report on this outbreak, and copies of each of these Reports were sent, according to regulations, to the Local Government Board and to the Middlesex County Council. Sanitary Defects, Nuisances, and Sanitary Work.- I append tabular statements of the sanitary work carried out in the district during the year, and also Table A of the deaths and 12 Table B of tlie population, births and new cases of infections sickness coming to the knowledge of the Medical Officer of Health during the year. In conclusion, I bog to thank the Council's Engineer and Surveyor for information as regards the Dust Destructors, the Sowers, the Ventilating Shafts, and other matters, which has enabled me to bring before you the four tables dealing with the sanitary work of the District. I remain, Gentlemen, Your obedient Servant, HENRY CLOTHIER, M.D. (Lond.) Highgate, Feb. 24th, 1896. Medical Officer of Health. (C I.) COUNTY OF MIDDLESEX—SANITARY WORK, 1895 Sanitary Districts. Inspections. Notices. Dwelling-houses. Houses let in separate Dwellings or Lodgings. Common Lodging Houses. Canal Boats used as Dwellings. Movable Dwellings, Caravans, Tents, &c. Note.—Asterisks or other signs appearing opposite a District signify that those columns of the District are taken together. Complaints Received. Cases of Infectious Disease N otified. Number of Premises periodically Inspected. Houses Inspected from House-toHouse. Total Number of Houses, Premises, &c., Inspected. Total Number of Re-inspections after Order or N otice. Total Number of Inspections and Re-inspections. Letters Written. Cautionary Notices Given. Statutory Orders Issued. Summonses Served. Convictions Obtained. Houses, Premises, &c., Cleansed, Repaired, &c. Closed as Unfit for Habitation. Re-opened after Repairs, Alterations, &c. Demolished. Illegal Underground Dwellings Vacated. Number Registered under Bye-laws. Periodical, Frequency, or Number of Inspections. Number of Contraventions. [ Number Registered under Bye-laws, Periodical, Frequency, or Number of Inspections. Number of Contraventions. Number Registered under the Acts. Periodical, Frequency, or Number of Inspections. Number of Contraventions of 1 Regulations. Number Observed during the Year. Number of Nuisances therefrom Abated. Number Removed from District,  HORNSEY URBAN DISTRICT 444 615 68 1,006 1,619 2,685 Very Numerous. 151 4 2 2 12 4 3 (C II.) COUNTY OF MIDDLESEX.—SANITARY WORK, 1895. Sanitary Districts. Schools. Workshops and W ork- places. Laundries. Bakehouses. Slaughter-houses. Cow-sheds. Dairies and Milkshops. Unsound Food. Adulterated Food. Offensive Trades. Mortuaries. Note.—Asterisks or other signs appearing opposite a District, signify that those columns of the District are taken together. Number in District. Periodical, Frequency, or Number of Inspections. Number found Defective. Number in District. Periodical, Frequency, or Number of Inspections. Contraventions of Factory Acts. Number in District. Periodical, Frequency, or Number of Inspections. Contraventions of Factory Acts. Number in District. Periodical, Frequency, or Number of Inspections. Contraventions of Factory Acts. Number on Register. Periodical, Frequency, or Number of Inspections. Contraventions of Bye-laws. Number on Register. Periodical, Frequency, or Number of Inspections. Contraventions of Bye-laws. Number on Register. Periodical, Frequency, or Number of Inspections. Contraventions of Bye-laws. Animals Seized. Articles or Parcels Seized. Samples Taken. Found Adulterated. Number of Premises in District. Periodical, Frequency, or Number of Inspections. Contraventions of Bye-laws. Accommodation. Number of Bodies Received. HORNSEY URBAN DISTRICT 24 ??? 10 "Weekly. 17 Monthly. 25 Frequently. 6 32 (C III.) COUNTY OF MIDDLESEX.-SANITARY WORK, 1895. Sanitary Districts. Water Supply and Water Service. Privy and Ash Pits, Ash and Earth Closets. Drainage and Sewerage. Note. Asterisks or other appearing opposite a District signify that those columns of the District are taken together. Wells. j Houses, Water Laid on to. Percentage of Houses Supplied from Mains. Cisterns. Flush Cisterns Provided to W.C.'s. Draw-Taps Removed from Cisterns to Mains. Percentage of Houses Supplied on Constant System. Water Closets. Percentage of Houses Provided with Water Closets. Drains. Cesspools. Percentage of Houses Draining into Sewers. Sewers. New Sunk. Cleansed, Repaired, Etc. 1 Closed as Polluted. New, Provided. Cleansed, Repaired, Covered, Etc. Overflow Pipes Disconnected from Drains. Above Ground Receptacles Substituted for Pits. Movable Receptacles Substituted for fixed. Water Closets Substituted for Dry Receptacles. New Constructed. New Apparatus Provided. Repaired, Cleansed, Etc. Supplied with Water, or Supply Rendered Efficient. Ventilated. Examined, Tested, Exposed, Etc. Unstopped, Repaired, Trapped. Etc. Waste Pipes, Rain Water Pipes, Etc., Disconnected. Soil Pipes and Drains Ventilated, Disconnecting-Traps or Chambers Inserted. Reconstructed. New Laid. Rendered Impervious, Emptied, Cleansed, Etc. Abolished, and Drain connected to Sewer. Yards of New Sewers Laid. Yards of Sewers Reconstructed. HORNSEY URBAN DISTRICT All excepting few isolated Cottages. 100 3 46 / 35 3 50 2 86 7 43 13 100 149 49 178 60 37 57 1 100 2100 2480 Storm Water Sewers. (C IV.) COUNTY OF MIDDLESEX— SANITARY WORK, 1895. Sanitary Districts. Disinfection. Dust. Dampness. Sundry Nuisances Abated. Contagious Diseases of Animals Infant Life Protection Act. Note.—Asterisks or other signs appearing opposite a District signify that those columns of the District are taken together. Rooms Fumigated. I Rooms Stripped and Cleansed. Articles Disinfected or Destroyed. Dust-bins Repaired. New Bins Provided. Movable Receptacles Substituted for Fixed. Periodical Frequency of Dust Removal. Number of Complaints of Nonremoval Received. Roofs Repaired, &c. Guttering and Rain-pipes Repaired, &c. Gardens, Areas, &c., Levelled and Drained. Yards Paved and Drained. Surface Adjoining Houses Paved. Dry Areas Provided. | Ventilation below Floor Provided. Basements Rendered Impervious. Overcrowding. Smoke. Accumulations of Refuse. Foul Ditches, Ponds, &c., and Stagnant Water. Foul Pigs and other Animals. Other Nuisances. Outbreaks. Animals Infected. Animals Destroyed. Number of Licensed Premises. Number of Children. Number of Deaths. HORNSEY URBAN DISTRICT 500 300 2,500 53 90 111 Weekly. 98 38 49 18 8 24 2 4 10 6 20 K2 3. TABLE OF DEATHS during the Year 1895, in the Hornsey Urban District; classified according to Diseases, Ages, and Localities. Names of Localities adopted for the purpose of these Statistics; public institutions being shown as separate localities. (See note 4 on back of sheet. (Columns for Population and Births are in Table B.) Mortality from all Causes, at subjoined ages. Mortality from subjoined Causes, distinguishing Deaths of Children under Five Years of Age. Smallpox. Scarlatina. Diphtheria. Membranous Croup. Fevers. Cholera. Erysipelas. Measles. Whooping Cough. Diarrhoea and Dysentery. Rheumatic Fever. Phthisis. Bronoliitis, Pneumonia and Pleurisy. Heart Disease. Injuries. All other Diseases. Total. At all ages. Under 1 year. 1 and under 5. 5 and under 15. 15 and under 25. 25 and under 65. 65 and upwards. Typhus. Enteric or Typhoid. Continued. Relapsing. Puerperal. (a) (b) (c) (d) (e) (f) (g) (h) (i) 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 #] HORNSEY URBAN DISTRICT Under 5 5 upwds. Under 5 5 upwds. Under 5 5 upwds. Under 5 5 upwds. 505 144 77 20 21 166 137 Under 5 - 2 12 — — — 1 — — — — 13 10 8 — — 32 2 10 131 221 5 upwds. - 1 9 4 43 73 62 5 142 344 Under 5 5 upwds. Under 5 5 upwds. Under 5 5 upwds. Under 5 5 upwds. Under 5 5 upwds. Totals 565 144 77 20 21 166 137 Under 5 — 2 12 — — — 1 — — — — 13 10 8 — — 32 2 10 131 221 5 upwds. — 1 9 — — - — — — — — — — — 4 43 73 62 5 142 344 The subjoined numbers have also to be taken into account in judging of the above records of mortality. Deaths occurring district among belonging thereto. 1 Under 5 5 upwds. Deaths occurring the district amoms not belonging thereto 3 Under 5 5 upwds. * The heading of column 19 is left blank for the insertion of Influenza, or any other disease which it may be thought desirable to record. Area and Population of the District or divison to which this Return relates. Area in acres, 2,809½. Population (1891)—44,205. Death Rates.—General, 10.49 per 1.000 population estimated to middle of 1895. Infant (under one year of age), 133.97 per 1,000 births registered. K2 11. TABLE OF POPULATION, BIBTHS, AND OF NEW CASES OF INFECTIOUS SICKNESS, coming to the knowledge of the Medical Officer of Health, during the year 1895, in the Hornsey Urban District; classified ac.cordiny to Diseases, Ages and Localities. Names of Localities adopted for tlie purpose of these Statistics; Public Institutions being shown as separate localities. Population at all Ages. Registered Births. Aged under 5 or over 5. New Cases of Sickness in each Locality, coming to the knowledge of the Medical Officer of Health. Numbek of such Cases Rf.moved fkom their Homes in the several Localities for Treatment in Isolation Hospital. Census 1891. Estimated to middle of 1895. Smallpox. Scarlatina. Diphtheria. Membranous Croup. Fevehs. Cholera. Erysipelas. Smallpox. Scarlatina I Diphtheria. Membranous Croup. F-eve11s. Cholera. Erysipelas. . Typhus. Enteiic or ryphoid. Continued Relapsing.^ Puerperal. Typhus. Enteric or ryphoid. Continued Relapsing. Puerperal. (a) (b) (c) (d) (e) 1 2 3 4 5 6 7 8 9 10 11 12 13 1 2 3 4 5 6 7 8 9 10 11 12 13 HORNSEY URBAN DISTRICT Under 5 5 upwds. Under 5 5 upwds. Under 5 5 upwds. Under 5 5 upwds. 44,205 53,823 1,142 Under 5 5 420 89 4 — 46 2 — 4 — 45 — — — 124 8 — - 5 — — — — — — — 5 upwds. Under 5 5 upwds. Under 5 5 upwds. Under 5 5 u pwds. Under 5 5 upwds, Under 5 A 5 upwds. | Under 5 5 upwds. Totals 44,205 53,823 1,142 Under 5 5 420 89 4 — 46 2 — 4 — 45 — — — 324 8 — - 5 — — — — — — 5 upwds. State here whether "Notification of Infectious Disease" is compulsory in the District.—Yes. Since when?—January, 1890. Besides the above-mentioned Diseases, insert in the columns with blank headings the names of any that are notifiable in the District, and fill the columns accordingly. State here the name of the Isolation Hospital used by the sick of the District. Mark (H) the Locality in which such Hospital is situated; and if not within the District, state where it is situated.- -Isolation Hospital in the District, situated at Coppett's Road, Muswell Ilill.