HOR058 No. 14. HORNSEY URBAN DISTRICT COUNCIL. MEDICAL OFFICER'S REPORT FOR THE YEAR 1896 To the Members of the Hornsey Urban District Council. Gentlemen, In my quarterly reports for the year 1896, I have estimated the population of the District at 62,076 ; this result being obtained by taking the number of houses according to the rate books at Lady Day (10,346), and calculating an average of six persons to each house. In my last Annual Report I stated—" 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 5½ 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 six persons residing in each house in the District. On this basis the population of the District would be not far short of 60,000 persons." Having still further reason to believe this to be true, and also having regard to the fact that in the Review of the Chairman of the Council of the work of the year 1895-6, these figures are used, I cannot do better than apply them in calculating the birth and death rates, &c., in the present Report. The Births for the year amount to 1,294, being 152 more than were registered for 1895; this gives a birth-rate of 20.84 per 1,000 inhabitants. This rate is very low, comparing with 212 per 1,000 inhabitants for 1895, 23.37 „ „ 1894, and 23.26 „ „ 1898. The birth-rate for England and Wales for 1896 was 29.7 per 1,000 inhabitants. The Deaths for the year from all causes amount to 523, giving a death-rate of 8.42 per 1,000 inhabitants. This compares with 10.49 per 1,000 inhabitants for 1895, 9.85 „ „ 1894, 11.88 „ „ 1893, and 10.95 „ „ 1892. The death-rate for England and Wales for 1896 was 17.1 per 1,000 inhabitants. 2 This death-rate for Hornsey is very low, even when compared with that for 1894, and it is with considerable satisfaction that I can state that it is the lowest annual death-rate ever recorded for the District. The death-rate for the first quarter of 1896 was 8.5 Do. „ second „ „ 7.47 Do. „ third ,, ,, 8.89 Do. „ fourth „ „ 8.82 1st Quarter. 2nd Quarter. 3rd Quarter. 4th Quarter. Total Deaths. Death rate. The following table gives the deaths which have been registered in each of the eight Wards of the District during the four quarters of the year:— Highgate 16 19 19 22 76 8.73 per 1,000 Muswell Hill 7 1 4 8 20 9.03 „ Crouch End 4 9 6 8 27 5.77 „ Hornsey 32 37 36 34 139 10.04 „ North Haringey 13 27 22 20 82 8.19 „ South Haringey 18 6 18 9 51 8.52 „ Stroud Green 15 9 17 21 62 6.80 „ Finsbury Park 27 8 16 15 66 8.75 „ Total deaths 132 116 138 137 523 8.42 per 1,000 8 In this calculation five deaths which occurred at the Isolation Hospital in the Muswell Hill Ward were taken from the number of deaths occurring in that Ward and added to the deaths in the Hornsey Ward from which the patients were received. One of the deaths in the Highate Ward was that of a child at Cromwell House. For the year 1895 the deaths in the Highgate Ward were 86, giving a death-rate of 116 per 1,000 inhabitants, against 76 or 8.73 for 1890 ; for Muswell Hill Ward 14 deaths or 6.8 death-rate, against 20 and 9 03 for 1896; for Crouch End Ward 25 deaths or 5.94 deathrate, against 27 and 5.77 for 1896; for Hornsey Ward 162 deaths or 13.9 death-rate, against 139 and 10.04 for 1896 ; for North Haringey Ward 102 deaths or 11.7 death-rate, against 82 and 8.19 for 1896 ; for South Haringey Ward 33 deaths or 6.49 death-rate, against 51 and 8.52 for 1896; for Stroud Green Ward 55 deaths or 714 death-rate, against 62 and 6 8 for 1896; and for Finsbury Park Ward 88 deaths or 12.6 death-rate, against 66 and 8 75 for 1896. This shows that there is a decrease in the number of deaths in four Wards, when compared with 1895, namely, of 10 in Highgate, 23 in Hornsey, 20 in North Haringey and 22 in Finsbury Park, making a total of 75 ; whilst on the other hand there was increased mortality in the remaining four Wards, to the extent of 6 in Muswell Hill, 2 in Crouch End. 18 in South Haringey, and 7 in Stroud Green. From this it will be seen that, while the increased deaths amount to 75, and the decrease to 33, there is in the aggregate a decrease of 42 deaths, the totals amounting in 1896 to 523, and in 1895 to 565. The difference in the death-rates of the various Wards, on a comparison of the two years, leads to the inquiry whether any special reasons can be assigned for the increased or lessened mortality, and, after carefully considering this question, I have come to the conclusion that no such special reasons can be found, and that the differences are merely such as are incidental to comparisons made of two years only, and which would in great probability not occur (at any rate to so great an extent) when an average, say, of 10 years is taken. As the District was only divided into Wards in 1894, the Ward death-rate was first calculated in 1895, so that at the present time comparison with one year only can be made. In analysing these Ward death-rates it will be found that, where, in 1896, there is a smaller mortality, the figures compare with 4 unusually high ones for the previous year, and this will be readily seen when the death-rates are put in tabular form, as follows:— Highgate Ward .. .. death-rate, 1896, 8.73; death-rate, 1895, 11.6. Hornsey Ward .. .. „ „ 10.04; „ „ 13.9. North Haringey Ward .. „ „ 8-19; „ ,, 11.7. Finsbury Park Ward .. „ „ 8.75; „ „ 12.6. On the other hand, where the death-rates for 1896 are higher, they compare with rates which are unusually low:— Muswell Hill Ward death-rate, 1896, 9.03 ; death-rate, 1895, 6.8. South Haringey „ „ „ 8.52; ,, ,, 6.49. Whilst in the Crouch End and Stroud Green Wards, although there were registered two more deaths in the former and seven in the latter, yet owing to the estimated increase in the population, there is a small decrease in the death-rate, that of Crouch End being 5.77 for 1896, and 5.94 for 1895, and that of Stroud Green being 6.8 for 1896, and 714 for 1895. The Zymotic Death Rate amounts to 0.93 per 1,000 inhabitants, 58 deaths having been registered as due to the eight principal Zymotic diseases. Seven occurred in the first, 16 in the second, 24 in the third, and 11 in the fourth quarter. This death-rate compares with 1.11 for 1895, 1.12 for 1894, 0.96 for 1893, 0.94 for 1892, 0.7 for 1891, and 1.15 for 1890. The following table shows the deaths in the District from the eight principal Zymotic Diseases for the last seven years:— 1890. 1891. 1892. 1893. 1894. 1895. 1896. Small Pox Measles 13 2 7 5 5 13 6 Scarlet Fever 8 3 4 9 1 8 8 Diphtheria 10 6 11 16 23 21 12 Fever 5 1 3 6 6 5 6 Whooping Cough 14 14 13 2 22 10 17 Diarrhoea 6 5 6 9 1 8 9 Cholera - - - - - - - Totals 51 31 44 47 58 60 58 5 It is satisfactory to notice that there has been no mortality in the District from either small pox or cholera during the last seven years. Measles has been less fatal this year than last, 6 deaths comparing with 13 for 1895. The deaths from scarlet fever are five more than for 1895, and those from diphtheria nine less ; whilst whooping cough proved fatal in 17 cases, comparing with 10 for 1895, and fever and diarrhoea respectively caused 6 and 9 deaths, comparing with 5 and 8 for 1895. All the cases of diarrhoea occurred in the third quarter, and in children under five years of age. The deaths from diseases other than zymotic are as follows :— 1890 1891 1892 1893 1894 1895 1896 From Pulmonary Consumption 40 38 28 35 40 43 30 „ Bronchitis, Pneumonia, and other Pulmonary Diseases 108 122 118 139 87 105 96 ,, Brain Diseases 54 59 63 69 68 50 58 „ Heart „ 42 42 46 61 40 64 68 „ Rheumatism 7 2 1 5 4 4 3 „ Ague — — — — — — — „ Puerperal Diseases 2 5 10 3 2 — 1 „ Pyæmia 1 — — — 1 — 1 „ Erysipelas 4 2 2 4 — — — „ Malignant Diseases, Cancer, &c. 18 22 24 37 31 22 31 „ Injuries 10 11 12 11 15 15 11 „ Various other Causes 158 157 160 139 153 202 166 Totals 444 460 464 503 441 505 465 6 Ages at which the Deaths Occurred. 1895. 1896. One year and under 144 133 One year to five years 77 56 Five years to fifteen years 20 25 Fifteen years to twenty-five years 21 21 Twenty-five years to sixty-five years 166 149 Sixty-five years and over 137 139 565 523 The infant mortality, that is, the deaths under one year to births registered, works out at 102.7 per 1,000, and the deaths under five years to 146 0 per 1,000, whilst the percentage of deaths under one year is 25.4. The mortality under one year per 1,000 inhabitants, amounts to 2.14 against 2.67 in 1895 and 2.0 in 1894, and the mortality under five years to 3.04 per 1,000 inhabitants, comparing with 4.1 for 1895 and 3.0 in 1894. The mortality for 65 years and over amounts to 2.25 per 1,000 inhabitants, comparing with 2.54 for 1895. The infant mortality may be considered small, as it compares with the rate of mortality among infants under one year of age to 1,000 births registered in England and Wales, namely,—148 for 1896, which was about the mean proportion in the 10 years, 1886-1895. 7 Scarlet Fever. Typhoid Fever. Diphtheria. Erysipelas. Small Pox. Continued Fever. Puerperal Fever. Membranous Croup. Compulsory Notification of Infectious Disease. The following table gives in detail the cases of Infectious Disease as notified for each quarter of the year, and a comparison with other years— During 1st quarter 1896 '95 '94 '96 '95 '94 '96 '95 '94 '96 '95 '94 '96 '95 '94 '96 '95 '94 '96 '95 '94 '96 '95 '94 40 295 44 4 10 3 23 18 32 10 14 18 2 — 1 1 — — 2 1 4 — — ... During 2nd quarter 139 46 54 3 3 5 16 14 43 13 5 14 1 — 2 — 1 — 2 2 1 — — ... During 3rd quarter 214 33 43 13 7 9 33 27 24 8 15 9 1 1 1 — — — 1 — 1 — 2 ... During 4th quarter 137 46 48 14 26 23 23 30 18 8 11 10 — 4 — — 1 3 — 1 — 1 2 ... Total 530 420 189 34 46 40 95 89 117 39 45 51 4 5 4 1 2 3 5 4 6 1 4 ... No case of Cholera has been reported during the year. 8 Scarlet Fever. Diphtheria. Typhoid Fever. Erysipelas. Small Pox. Membranous Croup. Continued Fever. Puerperal Fever. Total. From the following table will be seen the various Wards in which the 709 cases notified occurred : — Highgate 51 12 3 3 2 — — — 71 Muswell Hill 3 5 3 1 — — — — 12 Crouch End 20 14 2 3 — — — 1 40 Hornsey 238 16 8 13 — 1 1 3 280 North Haringey 88 16 6 6 — — — — 116 South Haringey 26 13 3 6 — — — 1 49 Stroud Green 75 15 4 1 2 — — — 97 Finsbury Park 29 4 5 6 — — — — 44 Totals 530 95 34 39 4 1 1 5 709 9 The Compulsory Notification of Infectious Diseases 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 530 in 1895, 420 Diphtheria 95 ,, 89 Typhoid Fever 34 ,, 46 Puerperal Fever 5 ,, 4 Erysipelas 39 ,, 45 Continued Fever 1 ,, 2 Membranous Croup 1 ,, 4 and Small Pox 4 ,,5 709 615 The number 709 compares with 615 for 1895, 410 for 1894, 618 for 1893, 340 for 1892, 349 for 1891, and 240 for 1890. 82 cases were reported in the first quarter of the year, 174 ,, „ ,, second ,, ,, 270 „ „ „ third „ „ 183 „ „ „ fourth „ „ 709 Scarlet Fever shows an increase of 110 cases over 1895. As will be seen, it increased from 40 cases in the first to 139 in the second, and reached its maximum in the third quarter, when 214 cases were reported, decreasing in the fourth quarter to 137. This disease was most prevalent in the Hornsey Ward, and, in order to check it as far as possible, a house-to-house inspection was made of the portion of the District from which the majority of the cases were reported, and other means taken to arrest its progress, and I think I cannot do better than add to this Report a verbatim statement of my remarks laid before the Council in the second quarterly report to the following effect:— " The spread of this disease is, I believe, to a large extent to be accounted for by the mildness of the cases, which have been in several instances not notified until desquamation had set in and had consequently been the means of extending the infection. 10 Another reason for this is that the first cases being of so mild a nature it has not been considered desirable to have them at once taken to a hospital. They have consequently been treated at home in the hope that they could be properly isolated, resulting in many instances in other cases in the infected houses. There seems to be an opinion, which has been frequently expressed to me lately, that, because a case of Scarlet Fever is a mild one, it can be effectually isolated at home, and the period during which it is infectious is correspondingly short, whereas it is a well-known fact that, the less severe the case, the longer is the time taken generally for the completion of the desquamation. It should also be understood that it by no means follows that a mild case may not be the means of communicating the disease to another patient in a much more severe form. With a view to stopping the spread of this disease, special means are being taken in the districts principally affected, and a circular note is to be sent to the medical gentlemen practising in the neighbourhood, urging them to use their best endeavours to the same end, but principally to impress on parents the paramout necessity of sending first cases as promptly as possible into hospital, and, failing that, to see that instructions as to isolating the patients at home are strictly carried out." Typhoid Fever.—Fever cases of this disease have been notified, the number 34 for 1896 comparing with 46 for 1895, and with 40 for 1894. Most of the cases occurred in the latter half of the year. No Ward has been free from this disease, and, taking the population into account, the disease has been distributed pretty evenly over the whole of the District. Diphtheria.—About the average number of cases have been notified, namely, 95 for 1896, comparing with 89 for 1895, and with 117 for 1894. There were more cases in the 3rd than in any other quarter, and less in the second. This disease, like Typhoid Fever, has been distributed throughout the whole of the District, no single Ward having been exempt from it. Neither can it be said that it has particularly affected any Ward. From this the conclusion may be drawn that it has been due to strictly local causes, and that no general insanitary condition predisposing to the occurrence of this disease exists in any of the Wards. The usual custom of having the drains, &c., of 11 the houses in which cases of Diphtheria or Typhoid Fever occur has been followed out, with the result that many cases of insanitary condition have been detected, and the necessary alterations made. Erysipelas.—Has been less prevalent, there having been 39 cases in 1896, comparing with 45 in 1895, and with 51 in 1894. Small-Pox.—Four cases only have been notified, comparing with 5 in 1895, and 4 in 1894 ; 2 occurred in the Highgate Ward, and 2 in the Stroud Green Ward. The former were, as soon as possible, taken to the Small-Pox Hospital, and the latter, which were modified in character, were treated at home. Continued Fever.—Only 1 case was notified, and this, I have reason to believe, ultimately proved to be a case of Rheumatic Fever. Puerperal Fever.—Five cases were notified, against 4 in 1894 and 6 in 1894. Membranous Croup.—Only 1 case was notified, comparing with 4 in 1895 and none in 1894. On comparing the total number of infectious cases notified in 1896, namely,—709, with 615 notified in 1895, it will be seen that the difference is chiefly made up of scarlet fever cases, 530 comparing with 420, or an increase of 110. The other diseases which show an increase are Diphtheria 6, and Puerperal Fever 1, making a total increase of 117. On the other hand— Typhoid Fever shows a decrease of 12 cases, Membranous Croup „ „ 3 ,, Small Pox „ „ 1 „ Erysipelas „ „ 6 „ and Continued Fever „ ,, 1 „ Total 23 By deducting the 23 decreases from the 117 increases, the balance of the total increase (94) between the 709 cases notified in 1896, and the 615 in 1895 is arrived at. 12 Isolation Hospital.—305 cases have been treated during the year, comparing with 139 for 1895, and with 125 for 1894. Of these 305, five died, three were discharged as soon as possible (having been sent in on mistaken diagnoses), 255 left the hospital well, and 42 were still under treatment at the end of the year. The five deaths occurred from— Diphtheria, a child of three years, Typhoid Fever, a male 41 years, Scarlet Fever, a male 2 years, Scarlet Fever, a female 25 years, and Broncho-Pneumonia, a male 17 years of age. This last case was that of a deformed imbecile, who was admitted for Scarlet Fever, but, owing to the fact of his great deformity and to his inability to leave his bed, he was not able to take the usual baths, and so at the end of six weeks desquamation was not quite finished, and he was then attacked with the illness which proved fatal. The three cases alluded to as discharged as soon as possible, were—1 a case of Measles sent in as Scarlet Fever, and 2 cases of Follicular Tonsillitis sent in as Diphtheria. There were under treatment at the beginning of the year 7 patients, five being cases of Scarlet Fever, and 2 of Diphtheria. The following table shows the number of cases admitted during each of the twelve months of the year, and the diseases for which they were admitted:— Scarlet Fever. Diphtheria Typhoid Fever. Total. January 4 2 — 6 February 2 1 — 3 March 2 1 1 4 April 19 5 — 24 May 16 3 — 19 June 31 1 — 32 July 48 3 — 51 August 38 1 — 39 September 35 3 — 38 October 28 4 — 32 November 30 — — 30 December 20 — — 20 273 24 1 298 18 It is satisfactory to notice that a larger percentage of the Scarlet Fever cases notified in 1896 were sent into the Hospital, as compared with the cases notified and sent into the Hospital in 1895. Out of 420 cases notified in 1895 only 125 were admitted into the Hospital, whilst for 1896 the number of admissions was 273 out of 530 notified cases, or rather more than half. This is also shown to be the case in the quarters of the year :— First Quarter cases admitted, 8 ; cases notified, 40. Second ,, „ ,, 66; ,, „ 139. Third „ 121; „ „ 214. Fourth „ „ „ 78; „ „ 187. Before passing from the subject of Scarlet Fever, I should like to allude to the great advantage Scarlet Fever cases treated in an Isolation Hospital have over those treated at home. In the former case patients are able as soon as their condition permits (which is usually in about 10 to 14 days) to avail themselves of out-door exercise and sunshine, which materially aid the progress of the cases, and greatly assist in getting rid of the infection. On the other hand, where the patient has to be isolated in a private house, in only very exceptional cases indeed can facilities be afforded, which will enable such patient to take open-air exercise without in some way breaking through the isolation. In fact, in practice it is found that patients suffering from Scarlet Fever and treated at home are usually confined to one or two rooms, until they can be pronounced free from infection, a period often lasting from 6 to 8 weeks. There can be no doubt, I think, that children especially will be found to get on much better when enabled to play out-of-doors with their fellow sufferers, and the condition of such children at the end of their illness will compare very favourably with that of less fortunate sufferers who have been confined to their homes, as regards both their general health and their freedom from infection. Diphtheria.—Twenty-four patients were admitted to the Hospital, but, as already stated, two proved to be cases of inflammation of the tonsils. The number compares with eight for 1895. There was only one death from this disease, a result, I believe, mainly due to the success of the Anti-toxin treatment, which was adopted in nearly every case. 14 Tracheotomy was successfully performed in the case of a little girl, who, after being in for several days, had a relapse of the disease with membrane extending into the larynx, and necessitating the operation. Only one case of Typhoid Fever was admitted (that of a man aged 41 years), which terminated fatally. Stated shortly, the 305 cases were accounted for as follows :— 305 cases treated 5 died, 3 discharged as ineligible, 255 left Hospital well, and 42 were under treatment at end of year. 805 The Hospital washing has all been done at the laundry situated on the spot, and this constitutes a great improvement on the old plan of having it sent to the Sanitary Depot at Hornsey. During the year, owing to the greater number of cases treated and to the fact that some of them have been of a very severe nature, it has been found necessary to obtain the aid of private nurses. The number of the nursing staff is, however, being raised, and will, no doubt, in time be of sufficient strength to cope with the ordinary requirements. I have to thank the Matron for very cordially working with me in promoting the welfare of the patients and in generally managing the establishment. My thanks also are due to the nurses, who have cheerfully carried out the instructions given, and devoted themselves with energy to the very often arduous duties involved in their vocation. Cost of Maintenance of Patients and Resident Staff at the Hospital.—This works out at a lower figure than for last year, namely,—7s. 10½d. for each person per week, comparing with 9s. 1d. Thi3 is mainly to be accounted for by the numbers treated being greater, especially when, as was the case during the year, a considerable proportion of the patients were children. 15 Sanitary Defects, Nuisances and Sanitary Work.—1 append tabular statements of the sanitary work carried out in the District during the year, and also Table A of the Deaths and Table B of the Population, Births, and new cases of Infectious Disease coming to the knowledge of the Medical Officer of Health during the year. These tables explain themselves, but by the courtesy of the Council's Engineer and Surveyor I am enabled to supplement them in the case of matters referring to the Dust Destructor, Sewers (flushing and ventilation of), and Gullies with the following details :— Dust Destructors.—The whole of the twelve cells in the Council's Refuse Furnaces at the Hornsey Sanitary Depot have been in operation during the year, the system of collection and disposal of the house refuse having been continued in the same manner as before, and the satisfactory way in which this work is carried out is shown by the fact that for the whole year only 76 complaints of non-removal, equal to an average of 1½ per week, were received. The applications for removal numbered 817, or an average of about 6 per week. The following will show the quantity of refuse collected and burnt:— Year 1895. Year 1896. Loads 7,846 9,451 Tons 10,092 12,106 These 12,106 tons of house refuse have been cremated in the furnaces without nuisance of any kind. Sewers.—About 1½ miles of new stoneware pipe sewers have been laid during the year, the figures being :— Foul Water Sewers 1,410 Yards. Surface Water Sewers 1,147 „ Total 2,567 „ i6 The sewers reconstructed during the year (about three-quarters of a mile) have been as under:— 9-in. and 12-in. Sewer in Park Road, Length Crouch End 616 Yards. 15-in. Sewer in Archway Road, Highgate 450 ,, 18-in. Do. Northwood and Clare- mont Roads, Highgate 193 „ 9-in. Do. Fortis Green 83 ,, 9-in. Do. Stanhope Road 30 „ Total 1,372 „ Flushing.—Careful attention has been given to the flushing of the sewers, and several old manholes have been inverted, which will prevent any accumulation of soil. A number of cast-iron hand and flushing discs have also been fixed in the manholes. The quantity of water used for the purpose during the year amounted to 19,866,000 gallons. Ventilation of Sewers.—The ventilation of the sewers has been improved by the erection of 32 upcast shafts. The surface ventilators in the roads have been closed in all cases where these new vertical shafts have been put up. Gullies.—Wherever nuisances have been found to arise from old gullies, principally owing to their not being properly trapped, new gullies with effective water-seals have been substituted with good results. I remain, Gentlemen, Your obedient Servant, HENRY CLOTHIER, M.D., (Lond.), Medical Officer of Health. 17 (C I.) COUNTY OP MIDDLESEX.—SANITARY WORK, 1896. 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 Notified. 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 Notice. Total Number of Inspections and Re-inspections. Letters Written. Cautionery Notices given. Statutory Orders Issued. Summonses Served. Convictions Obtained. Houses, Premises, &c., Cleansed, Repaired, Ac. 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 Regulations. Number Observed during the Year. Number of Nuisances therefrom Abated. Number Removed from District. HORNSEY URBAN DISTRICT. 901 709 72 273 1803 3656 5535 Numerous. 234 19 1 'Order made and £2 2s. costs allowed), 53 3 18 223/1895 (C II.) COUNTY OF MIDDLESEX.—SANITARY WORK, 1896. Sanitary Districts. Schools. Workshops and Work-places. Laundries. Bakehouses. Slaughterhouses. Cow-sheds. Dairies and Milk-shops. 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 Inspection. 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. 25 Every six months. 9 Weekly. 9 Monthly. 31 Monthly. 6 29 19 224/1895 (C III.) COUNTY OF MIDDLESEX.—SANITARY WORK, 1896. Sanitary Districts. Water Supply and Water Service. Privy & Ash Pits, Ash & Earth Closets. Drainage and Sewerage. Note.—Asterisks or other signs appearing opposite a District, signify that those columns of the District are taken together. Wells 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, &c. Closed as Polluted. New, Provided. Cleansed, Repaired, Covered, &c. 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, &c. Supplied with Water, or supply rendered efficient. Ventilated. Examined, Tested, Exposed, &c. Unstopped, Repaired, Trapped, &c. Waste Pipes, Rain Water Pipes, &c., Disconnected. Soil Pipes and Drains Ventilated. Disconnecting-Trays or Chambers Inserted. Reconstructed. New Laid. Rendered Impervious, Emptied, Cleansed, &c. Abolished, and Drain Connected to Sewer. Yards of Neu Sewers Laid. Yards of Sewers Reconstructed. HORNSEY URBAN DISTRICT. • All excepting few isolated Cottages. Practically all. Surfaee water Sewers 1147 yards. — — — 12 188 2 127 — 50 — — - — 154 104 104 9 100 146 131 277 115 103 90 14 — 8 100 2557 1372 Foul water Sewer 1410 yards. 20 225/1895 (C IV.) COUNTY OF MIDDLESEX.—SANITARY WORK, 1896. 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. Rooms stripped and cleaned. 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, Ac. 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, Ac., 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 700 350 3500 24 196 107 Weekly 76 14 68 35 53 39 — 34 18 — 3 65 27 26 102 — - — None — — K2 3. (A) TABLE OF DEATHS during the ) ear 1896, 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. Mortality prom all Causes, at subjoined Ages. Mortality from subjoined causes, distinguishing Deaths of Children under Five Years of Age. 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. Smallpox. Scarlatina. Diphtheria. Membranous Croup. Fevers. Cholera. Erysipelas. Measles. Whooping Cough. Diarrhoea and Dysentery. Rheumatic Fever. Phthisis. Bronchitis, Pneumonia, and Pleurisy. Heart Disease. Malignant Disease. Injuries. All Other Diseases. Total. Typhus. Enteric or Typhoid. Continued Relapsing. Puerperal. (a) (d) (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 22 HORNSEY URBAN DISTRICT 523 133 56 25 21 149 139 Under 5 5 upwds Under 5 5 upwds. Under 5 5 upwds. Under 5 — 4 6 1 — 1 - - - - - 4 17 9 1 — 33 3 5 105 189 Area and Population of the District to which this Return relates. Area in acres, 2,809. Population 1891, 44,205. Estimated to middle of 1896, 62,076. Death rates— General, 8.42 per 1,000 population, estimated to middle of 1896. Infant (under 1 year of age), 102.7 per 1,000 births registered. 5 upwds Under 5 - 4 6 - - 5 - - 1 - - 2 - - 2 30 63 65 31 6 119 334 5 upwds. Under 5 5 upwds. Under 5 5 upwds. Under 5 5 upwds. Under 5 5 upwds. Totals 523 133 56 25 21 149 139 Under 5 — 4 6 1. — 1 - - - - - 4 17 9 1 — 33 3 — 5 105 189 5 upwds. — 4 6 — - 5 — — 1 - — 2 — — 2 30 63 65 31 6 119 334 The subjoined numbers have also to be ta sen into account in judging of the above records of mortality. Deaths occurring outside the district among persons belonging thereto. Under 5 5 upwds. - 3 Deaths occurring within the district among persons not belonging thereto. Under 5 5 upwds. 1 1 HENRY CLOTHIER, M.D., Lond. k211. (b) TABLE OF POPULATION, BIRTHS, AND OF NEW CASES OF INFECTIOUS SICKNESSV coming to the knowledge of the Medical Officer of Health, during the year 1896, 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. 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. Number of such Cases Removed from their Homes in the several Localities for Treatment in Isolation Hospital. Census 1891. Estimated to middle of 1896. Smallpox. Scarlatina. Diphtheria. Membranous Croup. Fevers. Cholera. Erysipelas. Smallpox. Scarlatina. Diphtheria. Membranous Croup. Fevers. Cholera. Erysipelas. Typhus. Enteric or Typhoid. Continued Relapsing. Puerperal. Typhus. Enteric or Typhoid. 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 44,205 62,076 1,294 Under 5 5 upwds. HIGHGATE WARD Under 5 2 51 12 3 3 - 5 — 5 upwds. 2 24 5 MUSWELL HILL WARD Under 5 3 5 3 1 — — 5 upwds. ■ 1 2 CROUCH END WARD Under 5 20 14 2 l 3 - — 5 upwds. 4 1 HORNSEY WARD Under 5 238 16 l 8 1 3 13 47 2 — 5 upwds. - 108 7 1 NORTH HARINGEY WARD Under 5 88 16 6 6 3 — 5 upwds. 26 1 SOUTH HARINGEY WARD Under 5 26 13 3 1 6 2 — 5 upwds. 11 1 STROUD GREEN WARD Under 5 2 75 15 4 1 j ! 3 - 5 upwds. 26 4 FINSBURY PARK WARD Under 5 29 4 5 6 I 1 1 5 upwds. Under 5 12 1 5 upwds. Under 5 5 upwds. Totals 44,205 62,076 1,294 Under 5 4 530 95 1 34 1 5 39 - 61 2 — 5 upwds. 2 212 22 1 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 within the District, situated Coppett's Road, Muswell Hill. HENRY CLOTHIER, M.D., Lond.