HOR 5 BOROUGH OF HORNSEY. PUBLIC HEALTH AND HOSPITAL COMMITTEE. The Mayor (Councillor Alexander Alfred Yeatman, J.P.) Chairman, Alderman H. E. Cooper. Alderman C. D. Dixey, „ J. R. Farquharson, „ J. H. Wilson, Councillor C. Ames, „ H. Boustred, „ H. B. Brackenbury, „ G. A. Double, Councillor W. Gaskell, „ D. Hazel, „ A. G. Lewis, „ R. Moritz, „ W. J. Parkyn, „ G. A. Pigden, and „ J. F. Whyte. MEDICAL OFFICER OF HEALTH'S DEPARTMENT. Chief Sanitary Inspector Mr. W. Thorpe (Assoc. Royal San. Inst.) Assistant do. Mr. E. W. Baldwin (Cert. Royal San. Inst.) Assistant do. Mr. H. T. Taylor (Cert. Royal San. Inst.) Clerk Mr. S. Gilbert. Junior do. A. P. Frost. Matron of the Borough Hospital Miss A. Giles. Veterinary Inspector under Contagious Diseases of Animals Acts Mr. J. Buxton, M.R.C.V.S. Inspector under Shop Hours Acts Mr. R. Robinson. Asst. Medical Officer of Health E. F. W. Bywater, M B., D.P.H. Medical Officer of Health, Medical Superintendent of Borough Isolation Hospital, and School Medical Officer Harold Coates, M.D., D.P.H. To His Worship the Mayor, the Aldermen, and the Members of the Council of the Borough of Hornsey. Gentlemen, I beg to present my Annual Report on the health of the Borough during the year 1910. Once more the death-rate is lower than in any preceding year. Considerably fewer deaths were registered in and belonging to the Borough than in 1909, although it is estimated that the population of the Borough has increased by over 2,000. The fall in the birth-rate, however, is greater than the fall in the death-rate, and the excess in the number of births over the number of deaths is only 656. The infantile mortality, though still very low, is somewhat higher than in 1909. That year, however, was quite an exceptional one. Fewer cases of infectious disease have occurred than for many years past—the number for 1910 is about 30 per cent. below the average of the last 15 years, notwithstanding the great increase in population. The Zymotic death-rate is the lowest the Borough has ever had. Consideration of the remaining vital statistics leads to the same conclusion, that during the year 1910 the public health of the Borough has again attained a very high standard. I am, Gentlemen, Your obedient Servant, HAROLD COATES, M.D.. D.P.H. 3 BOROUGH OF HORNSEY. Summary of Statistics. Area in acres 2,874 Rateable value (District Rate) £660,025 Population Census, 1901 72,056 Estimated Population 1910 94,721 Number of persons per acre, 1910 329 ,, ,, ,, house, 1910 5 755 Estimated birth-rate per 1,000 living, 1910 14.7 Average birth-rate for previous 10 years 18.6 Estimated death-rate per 1,000 living, 1910 7.78 Deaths under 1 year of age, per 1,000 births, 1910 69 Death-rate from Zymotic diseases, 1910 0.27 Infectious Disease (Notification) Act, 1889, adopted October, 1889. Infectious Disease (Prevention) Act, 1890, adopted October, 1890. Public Health Acts Amendment Act, 1890. Parts 2, 3 and 5, adopted October, 1890. Housing of the Working Classes Act, 1890, Part 3, adopted July, 1896. Public Health Acts Amendment Act, 1907, adopted. Population.—The estimate of the population of the Borough, on which all the vital statistics are based, is arrived at by multiplying the number of occupied houses in the Borough, as shown in the rate books, by the average number of occupants per house, as found at the last Census. The first factor is reliable, but it is very doubtful whether the number of persons per house is the same now as ten years ago. In some parts of the Borough it is manifestly incorrect, owing to the increasing number of houses in these portions of the Borough which are now accommodating several families in place of the single family for which the house was originally intended and used. In the absence of a more frequent Census, probably this method of estimation is the best available in a district like Hornsey. On this basis the population for 1910 is 94,721, and 4 this is the figure on which the various vital statistics in this report are based. No doubt next year they will all need revision, when we know the enumerated population. The estimated population for 1909 was 92,389, so that during the year under review the increase of population has been 2,332. The following table shows the yearly increase per cent. for each year since the last Census:— Increase of population during the year. Increase per cent. 1901-1902 2,076 2.8 1902-1903 2,829 3.7 1903-1904 5,775 7.3 1904-1905 986 1.5 1905-1906 1,664 1.9 1906-1907 3,344 3.7 1907-1908 593 0.6 1908-1909 1,575 1.7 1909-1910 2,332 2.4 The rate of growth again appears to be gradually increasing. The table shows the marked fluctuations in the rate of increase over so short a period as 9 years. This year's increase is almost up to the average yearly increase since the 1901 Census. The population of the Borough at the 1901 Census was 72,056. The mean population of 1910 is estimated to be 94,721. The increase of population in the 9¼ years from the date of the Census was therefore 22,665. This is equal to an average yearly increase of 2,450, so that the year's increase 1909-1910 is 112 below the yearly average increase. Last year the difference was much greater. The "natural increase" of population during 1910, i.e., excess of births over deaths, was 656. Owing to the falling birthrate this "natural increase" is becoming less every year, and the district is practically dependent for its growth on attracting residents from other districts. The estimated population at the end of each Quarter of 1910 was as follows:— End of first quarter 94,164 ,, second ,, 94,186 ,, third ,, 94,516 ,, fourth ,, 95,413 5 The Registrar General's estimate of population for 1910 was 98,561, an increase of 2,933 over his estimate for 1909. The following table shows the estimated population for each Ward in 1909 and 1910, with the increase or decrease which has taken place in the interval:— Ward. Estimated population, 1909. Estimated population, 1910. Variation during the year, 30th June, 1909, to 30th June, 1910. Increase. Decrease. Highgate 13,331 13,522 191 — Muswell Hill 13,167 13,720 553 — Crouch End 5,951 6,351 400 — West Hornsey 14,343 14,499 156 — East Hornsey 13,033 13,315 282 — North Haringey 10,086 10,340 254 — South Haringey 5,969 5,899 — 70 Stroud Green 9,354 9,791 437 — Finsbury Park 7,155 7,284 129 — The Borough 92,389 94,721 2,402 70 Muswell Hill continues to be the most rapidly growing Ward, and has now overtaken Highgate as regards population, and is second only to West Hornsey. It is very satisfactory to see the increase in numbers of residents in two of the older Wards—Crouch End and Stroud Green, more especially in Stroud Green, where there was a considerable increase last year. As there has been no building of new houses in Stroud Green Ward, there must be considerably fewer empty houses than for some time past. In North Haringey also a decrease in population of last year is this year replaced by a substantial increase. In the other Wards, except South Haringey, there are satisfactory increases. In South Haringey there is this year a small, loss. For the whole Borough, therefore, there is a total gain of 2,402, and a loss of 70, or a net gain of 2,332. 6 The following table shews the Ward populations at the Census, the estimated population 1910, and the increase in 9¼ years:— Ward. Population, Census 1901. Estimated Population. June 30th, 1910. Increase in 9¼ years. Decrease in 9¼ years. Highgate 10,176 13,522 3,346 — Muswell Hill 5,833 13,720 7,887 - Crouch End 4,761 6,351 1,690 - West Hornsey 18,662 14,499 9,162 - East Hornsey 13,315 North Haringey 10,129 10,340 211 — South Haringey 5,917 5,899 — 18 Stroud Green 9,356 9,791 435 - Finsbury Park 7,222 7,284 62 — 72,056 94,721 22,683 18 This table shews that the older parts of the district near the London boundary have undergone little change in population, except for the increase made by Stroud Green this year. The increase in the more recently developed parts of the Borough has been very great, and the district as a whole has increased its population by over 30 per cent. in 9¼ years. Density of Population.—With the growth of the population of the Borough, the number of persons per acre has increased from 25 at the time of the 1901 Census to 32'9 at the middle of 1910. At the middle of 1909 the density was 321 persons per acre. North Haringey remains much the most thickly-populated Ward, with 82 persons per acre, though East and West Hornsey are gradually creeping up near this figure. Crouch End, with 16 persons per acre, is at the other extreme. Muswell Hill, in spite of its rapid growth, has still only 20 persons per acre, and Highgate 19. The following table shews the density of population for each Ward:— 7 Ward. Area in acres. Population. Number of persons per acre. Highgate 709.5 13,522 19 Muswell Hill 663.5 13,720 20 Crouch End 376 6,351 16 West Hornsey 227.5 14,499 63 East Hornsey 195.5 13,315 68 North Haringey 125 10,340 82 South Haringey 109 5,899 54 Stroud Green 269 9,791 36 Finsbury Park 199 7,284 36 The Borough 2,874 94,721 32.9 Births.—The number of births recorded during 1910 was 1,393. This is a decrease of 115 compared with the number of births registered in 1909. In the preceding twelve months (1909, compared with 1908) there was an increase of 23 in the recorded births. Thirty-one of the births were illegitimate (27 in 1909). Ten of the births occurred at the Edmonton Workhouse, and one at the New Edmonton Infirmary. The birth-rate for the year was 14.7, as compared with 16.3 in 1909. The accompanying chart shows that in 1884 the birthrate was over 33 per 1,000 of the population, and shows the striking decline in the birth-rate during the last 27 years. The number of births and the birth-rate tor each quarter or the year is as follows:— 1910. HORNSEY. ENGLAND AND WALES. No. of Births. Birth-rate. Birth-rate. 1st Quarter 357 15.0 24.8 2nd „ 356 15.0 28.1 3rd „ 368 15.5 24.7 4 th „ 312 13.1 23.3 1,393 14.7 24.7 8 In the first three quarters of the year there was very little variation in the birth-rate, but a big drop took place in the fourth quarter. The birth-rates in certain towns are given below:— London and adjoining districts Tottenham 27.9 West Ham 26.4 Willesden 23.0 Croydon 23.2 London 23.6 East Ham 22.0 Finchley 20.4 Hornsey 14.7 Burnley 24.9 Swansea 32.6 Huddersfield 22.9 St. Helen's 32.6 Wolverhampton 22.6 Middlesbrough 32.2 York 22.6 Wigan 29.8 Aston Manor 23.2 Walsall 27.3 Rochdale 21.6 Stockport 25.7 Reading 19.9 Devonport 23.7 Northampton 19.2 The following table gives the number of births during the year, and the birth-rate for each Ward of the Borough:— WARD. Number of Births recorded during 1910. Birth-rate. Highgate 163 12.0 Muswell Hill 164 11.9 Crouch End 73 11.4 West Hornsey 346 23.8 East Hornsey 217 16.2 North Haringey 160 15.4 South Haringey 78 13.2 Stroud Green 94 9.6 Finsbury Park 98 13.4 The Borough 1,393 14.7 9 Illegitimate Births.—There were 31 illegitimate births recorded in 1910, and 27 in 1909, an increase of 4. The proportion of illegitimate births of the total registered births, 2'2 per cent., as compared with 1.7 per cent. last year, and, though increased, is still very low. Eight of the illegitimate births occurred in the Edmonton Workhouse, and one in the New Edmonton Infirmary, and in the following table these have been allocated to the Wards of the Borough in which the mothers resided before gaining admission to the Workhouse:— Ward. Number of illegitimate births. Per cent. of total births in the Ward. Highgate 4 2.4 Muswell Hill 2 1.2 Crouch End 1 1.3 West Hornsey 7 2.0 East Hornsey 4 1.8 North Haringey 4 2.5 South Haringey 0 0 Stroud Green 4 4.2 Finsbury Park 5 5.0 31 2.2 The number of births for each quarter, with the birth.rate in the various Wards, is as follows:— Ward. 1st Quarter. 2nd Quarter. 3rd Quarter. 4th Quarter. Total Births. Birthrate per 1.000 persons living. BirthsJ Birthrate. Births. Birth. rate. Births. Birthrate. Births. Birthrate. Highgate 46 13.6 38 11.2 35 10.3 44 130 163 12.0 Muswell Hill 42 12.2 38 110 48 13.9 36 10.4 164 11.9 Crouch End 23 14.4 20 12.5 13 8.1 17 10.7 73 11.4 West Hornsey 99 27.3 85 23.4 85 23.4 77 21.2 346 23.8 East Hornsey 59 17.7 63 18.9 56 16.8 39 11.7 217 16.2 North Haringey 30 11.6 43 16.6 52 20.1 35 13.5 160 15.4 South Haringey 16 10.8 24 16.2 18 12.2 20 13.5 78 13.2 Stroud Green 22 8.9 19 7.7 32 130 21 8.5 94 9.6 Finsbury Park 20 10.9 26 12.9 29 15.9 23 12.6 98 13.4 The Borough 357 15.0 356 15.0 368 15.5 312 13.1 1,393 14.7 10 The accompanying chart shews the birth-rate in Hornsey for the past 27 years:- 11 Deaths.—The number of deaths registered in the Borough in 1910 was 626, being 70 deaths less than the number registered in 1909, and 8 fewer than the average number for the last ten years, although the population has greatly increased during this period. The death-rate calculated on these figures (gross death-rate) is 6'60 per thousand of the mean population for the year. This is 0 93 lower than the corresponding rate last year, and is, in fact, the lowest on record. This, however, includes only deaths actually registered in the Borough, and does not include those of Hornsey people dying elsewhere. There were 152 Hornsey people who died outside the district during 1910, viz.:— 42 in the Edmonton Workhouse, 13 in the Great Northern Central Hospital, 64 in other Hospitals outside the Borough, 16 in Lunatic Asylums, and 17 in various other places. On the other hand there were 41 deaths registered in Hornsey of persons non-resident in the district. To get the net deaths belonging to Hornsey we must add to the number of deaths registered in the Borough the number (152) of Hornsey people dying outside the Borough, and deduct the number (41) of deaths registered in Hornsey of persons who normally resided in other districts. This gives us the net number of deaths belonging to Hornsey as 737, a decrease of 50 over the corresponding number for 1909. The death-rate calculated on these figures is the net deathrate, and for the past 6 years is as follows:— Year. Net death-rate. 1905 8.16 1906 8.85 1907 8.49 1908 8.28 1909 8.51 1910 7.78 It is only for these six years that the comparison can be made, as for the years before 1905 the figures referring to deaths of Hornsey people outside the Borough cannot be obtained. The 12 Record of these years is an excellent one, and that for the year 1910 is the best of all. The following table gives the net death-rates for England and Wales, and the 77 Great Towns:— England and Wales 13.4 77 Great Towns 14.3 Hornsey 7.7 West Ham 11.7 Walthamstow 9.1 Leeds 13.7 Handsworth 8.4 Portsmouth 13.8 King's Norton 8.0 Bradford 14.0 East Ham 8.9 Plymouth 13.5 Leyton 9.3 Walsall 12.0 Willesden 9.1 Newcastle-on-Tyne 13.9 York 11.8 Hull 15.2 Reading 9.9 Bolton 13.4 Tottenham 11.4 Sheffield 13.4 Devonport 11.6 South Shields 13.6 Croydon 11.0 Brighton 14.3 West Hartlepool 11.5 Newport (Mon.) 13.4 Burton-on-Trent 11.3 West Bromwich 12.7 Barrow-in-Furness 14.3 Birmingham 13.7 Hastings 12.5 Preston 16.3 Bristol 11.5 Birkenhead 16.2 Gateshead 13.0 Coventry 14.2 Bournemouth 11.7 Wolverhampton 12.5 Smethwick 10.9 Burnley 16.3 Wallasey 12.5 Bury 14.7 Leicester 11.3 Rochdale 14.9 Aston Manor 10.8 Blackburn 14.2 Cardiff 11.9 Nottingham 14.2 Ipswich 13.6 Huddersfield 16.6 Rotherham 13.6 Rhondda 15.6 Grimsby 14.0 Stockport 15.7 Northampton 11.4 Bootle 14.7 Derby 11.1 Sunderland 15.9 Southampton 11.8 Warrington 14.6 Halifax 12.8 Tynemouth 17.1 Norwich 12.5 Great Yarmouth 14.4 Stockton-on-Tees 15.2 Merthyr Tydfil 16.4 London 12.7 Manchester 16.1 13 Salford 15.1 Middlesbrough 16.9 Stoke.on.Trent 16.0 Oldham 17.3 Dewsbury 16.1 Wigan 15.2 St. Helens 14.5 Swansea 17.6 Liverpool 17.7 1909. 1910. The death.rate in Hornsey during the first quarter was 10.5 8.7 „ „ „ second „ 8.1 7.3 „ „ „ third „ 5.6 5.4 „ „ „ fourth „ 9.6 9.6 The following table gives the deaths which have been registered in each Ward during the four quarters of the year, with the corresponding death.rates:— Ward. 1st Quarter. 2nd Quarter. 3rd Quarter. 4th Quarter. Total Deaths. Death. rate per 1,000 persons living. Deaths. Death. rate. Deaths. Death. rate. Deaths. Death. rate. Deaths. Death. rate. Highgate 24 7.1 20 5.9 15 4.4 28 8.2 87 6.4 Muswell Hill 27 7.8 26 7.5 13 3.7 21 6.1 87 6.3 Crouch End 11 6.9 8 5.0 7 4.4 9 5.6 35 5.5 West Hornsey 35 9.6 26 7.1 19 5.2 48 13.2 128 8.1 East Hornsey 26 7.7 15 4.5 23 6.9 21 6.3 85 6.3 North Haringey 25 9.6 26 10.0 13 5.0 28 10.8 92 8.8 South Haringey 16 10.8 6 4.0 11 7.4 17 11.5 50 8.4 Stroud Green 18 7.3 18 7.3 12 5.0 38 15.5 86 8.7 Finsbury Park 24 13.1 29 15.9 15 8.2 19 10.4 87 10.5 Total deaths 206 8.7 174 7.3 128 5.4 229 9.6 737 7.7 The deaths in public institutions have been referred to the Wards from which the patients were removed on entering the public institutions. 14 15 The Ward death-rates for the last 6 years are as follows:— Ward. Death rates per 1,000 1910. 1909. 1908. 1907. 1906. 1905. Highgate 6.4 7.7 7.7 9.7 8.87 7.85 Muswell Hill 6.3 6.3 6.5 5.8 6.16 6.87 Crouch End 5.5 6.8 8.3 6.2 6.03 7 08 West Hornsey 8.1 8.9 9.1 9.1 11.10 10.30 East Hornsey 6.3 9.2 8.7 9.7 9.27 8.0 North Haringey 8.8 9.6 9.7 8.9 9.89 8.44 South Haringey 8.4 6.7 6.7 10.2 9.63 8.58 Stroud Green 8.7 9.1 6.6 7.1 6.92 5.98 Finsbury Park 10.5 12.1 10.9 8.9 11.04 10.22 The Borough 7. 8.5 8.2 8.49 8.85 8.16 These are net death-rates. The rates for years previous to 1905 are not comparable, as it is not possible now to obtain the numbers so as to apply the correction for deaths of residents and non-residents. Except in South Haringey, which has a higher death-rate, and Muswell Hill, where the rate is the same as in 1909, every Ward shows an improvement on the very low death-rates of the preceding year. The figures for East Hornsey are particularly satisfactory, as this is the poorest Ward. In West Hornsey, also, the fall from 11.1 in 1906 to the present death-rate of 8.1 is very good. 16 The following table shows the general and corrected death. rates in Hornsey for past 1 Gross death rate. 2 Net death rate (corrected for Residents and Non.Residents). 3 Death rate (corrected for age and sex distribution). 1882 11.90 1883 12.70 1884 13.34 1885 12.66 1886 11.82 1887 11.57 1888 10.18 1889 9.45 1890 11.20 1891 (Census taken) 11.11 1892 10.78 1893 10.90 1894 9.42 1895 10.15 1896 8.88 1897 8.54 1898 8.94 1899 10.08 1900 8.77 1901 (Census taken) 8.12 1902 8.20 1903 7.51 1904 7.81 1905 7.12 8.16 9.30 1906 7.73 8.85 10.08 1907 7.03 8.49 9.67 1908 7.20 8.28 9.43 1909 7.53 8.51 9.70 1910 6.60 7.78 8.86 Comparing the principal causes of death in 1910 with 1909, the chief gains and losses are shewn in the following table. The principal causes of increased mortality are Cancer, Apoplexy, Enteric Fever, Ulcer of the Stomach, and the group of infantile affections, viz.:—Premature Birth, Debility at Birth and Congenital Defects, and Want of Breast Milk, Marasmus 17 and Convulsions. Also Old Age is assigned as the cause of death in more instances than in 1909. On the other side there are some very striking decreases in mortality from particular diseases. Heart diseases caused 24 fewer deaths than in 1909, Phthisis 16 fewer, Diabetes 15 fewer, Respiratory Diseases 14 fewer, and Measles 11 fewer deaths. Diseases which caused more deaths in 1910 than in 1909:— Number of Deaths. Increase 1910. 1909. Cancer 88 75 13 Old Age 74 66 8 Apoplexy 49 44 5 Enteric Fever 3 0 3 Premature Birth 26 17 9 Debility at Birth and Congenital Defects 17 10 7 Want of Breast Milk, Marasmus and Convulsions 17 12 5 Ulcer and other diseases of the Stomach 16 7 9 Alcoholism and Cirrhosis of Liver 11 9 2 Influenza 16 15 1 Scarlet Fever 4 3 1 The following diseases caused fewer deaths in 1910 than in 1909:— Number of Deaths. Decrease 1910. 1909. Heart Diseases 70 94 24 Bronchitis and Pneumonia 100 114 14 Phthisis 57 41 16 Other forms of Tuberculosis 18 26 8 Bright's Disease 22 30 8 Accidents 7 24 17 Diabetes 2 17 15 Measles 1 12 11 Whooping Cough 10 12 2 Diphtheria 8 10 2 Appendicitis 8 12 4 18 Tuberculosis.—The deaths from Phthisis of the Lung numbered 41, or 16 less than in the previous year, and 12 less than the yearly average for the preceding 5 years. Three of these 41 deaths occurred in persons who had been removed to the Edmonton Workhouse. From forms of Tuberculosis other than Phthisis there were 18 deaths registered, a decrease of 8 compared with the year 1909. The total deaths from all forms of Tuberculosis were, therefore, 59, or 24 less than in the previous year. This is the smallest number of deaths due to Tuberculosis in any year since 1900. Nevertheless nearly one-fourth of the deaths occurring in the middle thirty years of life are due to Phthisis alone. By an Order of the Local Government Board, the Medical Officers and certain other officials in the service of the Poor Law Guardians are directed to notify to the Medical Officer of Health cases of Phthisis occurring among their Poor Law patients. During the year I have had 11 such cases notified to me. In each case a visit or visits have been paid to the house of the patient. In those cases where the patient had not been admitted into the Workhouse, verbal and printed directions were given as to the avoidance of the spread of infection, and where necessary disinfection of rooms or articles of bedding, clothing, etc., has been carried out (see Appendix). Similar preventive measures are carried out in other cases of Phthisis brought to my knowledge, when they appear necessary or desirable. The following table shews the ages at death from Phthisis and from other forms of Tuberculosis:— Years inclusive: 0-4 5-14 15-24 25-34 35-44 45-54 55-64 65 & over Number of deaths from Phthisis 0 0 6 16 5 5 5 4 Other forms of Tuberculosis 12 1 0 2 1 2 0 0 All forms of Tuberculosis 12 1 6 18 6 7 5 4 19 This shews again that the principal incidence of Phthisis is in the middle years of life, and that other forms of Tuberculosis are chiefly fatal in infancy. At the middle years of life, viz.:—15-44 years of age, out of a total of 132 deaths registered for the Borough, 27, or nearly one-fourth, were due to Phthisis alone. The following table is interesting as giving the number of deaths from Phthisis and other forms of Tuberculosis and the number of deaths from the seven principal infectious diseases for the past 9 years:— 1910. 1909. 1908. 1907. 1906. 1905. 1904. 1903. 1902. Phthisis 41 57 53 50 47 58 54 46 45 Other forms of Tuberculosis 18 26 16 19 13 16 23 20 22 Total 59 83 69 69 60 74 77 66 67 Measles 1 12 12 5 18 9 18 15 7 Scarlet Fever 4 3 3 4 6 3 1 1 2 Diphtheria 8 10 9 9 13 8 7 12 9 Small Pox 0 0 0 0 0 0 0 0 2 Enteric Fever 3 0 2 4 5 2 2 0 5 Whooping Cough 10 12 11 19 4 10 17 19 9 Diarrhœa 1 1 9 3 30 6 24 1 1 Total 27 38 46 44 76 38 69 48 35 20 The number of deaths from Phthisis and from all forms of Tuberculosis and the death-rates per 1,000 of the population are given below. Year. N umber of deaths from Consumption of the Lungs. Death-rate per 1,000 persons living from Consumption of the Lungs. Number of deaths from all forms of Tuberculosis. Death-rate per 1.000 persons living from all forms of Tuberculosis. 1910 41 .432 59 .622 1909 57 .616 83 .898 1908 53 .583 69 .759 1907 50 .554 69 .764 1906 47 .540 60 .690 1905 58 .680 74 .868 1904 54 .653 77 .914 1903 46 .591 66 .842 1902 45 .595 67 .886 1901 45 .612 63 .857 1900 37 .525 48 .688 1899 56 .828 1898 36 .556 1897 43 .694 1896 30 .527 1895 43 .769 1894 40 .768 1893 35 .700 The following table shews the deaths from Phthisis and from all forms of Tuberculosis in each of the Wards of the Borough:— WARD. Deaths from Phthisis. Death-rate per 1,000 persons living Deaths from all forms of Tuberculosis. Death-rate per 1,000 persons living. Highgate 4 0.295 6 0.433 Muswell Hill 2 0.145 3 0.218 Crouch End 4 0.629 6 0.787 West Hornsey 4 0.275 11 0.758 East Hornsey 7 0.525 8 0.600 North Haringey 4 0.386 7 0.676 South Haringey 3 0.508 4 0.677 Stroud Green 5 0.510 6 0.612 Finsbury Park 8 1.098 9 1.235 The Borough 0.432 59 0.622 21 Annual death-rates from Phthisis (1896-1910) per thousand persons living. 22 During the past twelve months the Public Health and Hospital Committee has devoted a good deal of attention to the question of the prevention of Consumption. Visits have been paid to various Sanatoria by members of the Committee, and much valuable information obtained. A scheme for the erection of a small Sanatorium was formulated and presented to the Town Council. The necessity for taking active steps to deal with the disease was generally recognised, and it was decided to communicate with the Middlesex County Council with a view to taking into consideration whether it might be more desirable to combine with the other Sanitary Authorities in the County in the provision of Sanatorium accommodation, and to consider what other preventive measures might be adopted. A meeting of the various Sanitary Authorities concerned is to be held at an early date. Cancer.—There were 88 deaths registered as due to Cancer in 1910, an increase of 13, comparing 1910 with 1909. The death-rate from Cancer rose from 0.38 per thousand persons living in 1895 to 0'92 in 1908, and now stands at 0.92. Last year there was a drop in the Cancer mortality, and I then pointed out that in recent years the Cancer mortality had risen considerably, and that when a fall had occurred it was of a purely temporary character. This year the Cancer death-rate has risen to the same level as in 1908, which was the highest that had been then recorded. We are practically in the dark as to the cause of the disease, and as to methods to be adopted for its prevention, if such is possible. 23 Annual death-rates from Cancer per thousand persons living for 16 years 1895-1910. 24 The following table shews the Wards in which deaths from Cancer have occurred during the last 11 years:— Year. Highgate. Muswell Hill. Crouch End. West Hornsey. East Hornsey. North Haringey. South Haringey. Stroud Green. Finsbury Park. Total. Death rate per 1,000 from Cancer. 1910 12 5 4 11 9 15 6 15 11 88 .929 1909 9 10 4 5 11 6 4 13 13 75 .811 1908 17 16 9 5 10 7 3 9 8 84 .924 1907 14 11 2 3 9 11 11 10 5 76 .842 1906 7 8 4 8 8 9 7 6 8 65 .748 1905 13 12 2 7 9 7 4 4 7 65 .762 1904 7 8 3 7 5 5 2 5 7 49 .581 1903 6 4 6 12 15 6 7 6 62 .790 1902 8 3 2 15 8 1 8 6 51 .674 1901 8 3 1 5 6 5 11 8 47 .653 1900 5 5 2 8 3 4 9 5 41 .581 Deaths from Zymotic Diseases.—The number of deaths from each disease for 1910 and preceding years is shewn in the following table: — Number of Deaths 1910-1897 from the seven principal Zymotic Diseases. 1910 1909 1908 1907 1906 1905 1904 1903 1902 1901 1900 1899 1898 1897 Small-pox 0 0 0 0 0 0 0 0 2 0 0 0 0 0 Measles 1 12 12 5 18 9 18 15 7 8 4 6 14 7 Scarlet Fever 4 3 3 4 6 3 1 1 2 0 1 3 0 2 Diphtheria 8 10 9 9 13 8 7 12 9 10 14 4 11 16 Enteric Fever 3 0 2 4 5 2 2 0 5 2 6 0 4 0 Whooping Cough 10 12 11 19 4 10 17 19 9 14 18 20 8 10 Diarrhoen 1 1 9 3 30 6 24 1 1 6 9 32 15 29 Totals 27 38 46 44 76 38 69 48 35 40 52 65 52 64 25 The number of deaths from this group of diseases is the smallest yet recorded, and the low figure is chiefly due to the fact that Measles and Summer Diarhœa have each only caused one death. The death.rate calculated per thousand of the population from these diseases is the Zymotic death.rate, and is shewn below in Hornsey and in England and Wales for a number of years:— Hornsey. Zymotic death rate England and Wales 77 Great Towns 1910 0.27 0.99 1.23 1909 0.41 1.28 1.42 1908 0.50 1.34 1.59 1907 0.48 1.13 1.54 1906 0.87 1.73 2.24 1905 0.44 1.94 1904 0.81 1.94 1903 0.61 1.46 1902 0.44 1.64 1901 0.54 2.05 1900 0.66 2.00 1899 0.89 2.21 1898 0.74 2.22 1897 0.98 2.15 1896 0.93 2.18 1895 1.11 2.14 1894 1.12 2.25 1893 0.96 3.16 1892 0.94 2.76 1891 0.70 1890 1.15 1889 0.60 1888 1.05 1887 0.88 1886 1.42 1885 1.80 1884 1.91 1883 1.05 1882 1.77 Diphtheria caused 8 deaths, as against 10 in 1909, a decrease of two. There were, however, 46 fewer cases notified than 26 in 1909, so that the case mortality is a little higher this year. The disease has been less active both as regards its prevalence and mortality than the average of recent years. Year. Estimated Population. Total No. of Cases of Diphtheria Notified. No. of Deaths Registered from Diphtheria Fatality per cent. No. of Cases treated in Hospital. Attack Rate per 1000 Population. Percentage removed to Hospital. Mortality per 1000 Population. 1 2 3 4 5 6 7 8 9 1890 42,000 50 10 20.0 1 1.19 2.0 0.23 1891 44,184 63 6 9.9 20 1.42 31.7 0.13 1892 46,354 43 11 25.5 2 0.92 4.6 0.23 1893 48,522 138 16 11.6 15 2.84 10.9 0.32 1891 52,977 117 23 11.1 29 2.20 24.7 0.43 1895 55,908 89 21 23.6 8 1.59 9.0 0.37 1896 58,839 95 12 12.6 24 1.61 25.2 0.20 1897 61,818 87 16 18.4 15 1.40 17.2 0.25 1898 64,713 99 11 11.1 45 1.52 45.4 0.17 1899 67,664 101 4 3.9 36 1.49 35.6 0.05 1900 70,597 107 14 13.0 37 1 52 34.8 0.19 1901 73,549 134 10 7.4 28 1.82 20.9 0.10 1902 75,623 99 9 9.0 35 1.31 35.3 0.11 1908 78,452 62 12 19.3 35 0.79 56.4 0.10 1904 84,227 101 7 6.9 56 1.19 56.0 0.08 1905 85,213 153 8 5.2 95 1.79 62.0 0.09 1906 86,877 157 13 8.2 97 1.80 61.7 0.14 1907 90,221 98 9 9.1 70 108 71.4 0.09 1908 90,814 93 9 9.6 51 1.02 54.8 0.09 1909 92,389 151 10 6.6 99 1.63 65.5 0.10 1910 94,721 105 8 7.6 80 1.10 76.7 0.08 The remaining zymotic diseases, as causes of death, call for little remark. Enteric Fever, which did not, in any of the few cases occurring in the Borough in 1909, cause a single death, was the cause of 3 deaths in 1910. Scarlet Fever caused 4 deaths in 1910, one more than in 1909. From Measles only one death was recorded in 1910. This is the first year with such a low mortality from this cause. Whooping. Cough caused 2 fewer deaths in 1910 than in 1909, 10 as against 12. The death-rate from this cause was 0.10 per 1,000 of the population. From Puerperal Fever no deaths occurred in 1910, as compared with 2 in 1909 and 3 in 1908. 27 Ages at Death.— The ages at which deaths occurred are as follows:– 1910 1900 1908 1907 1906 1905 1904 Under 1 year 97 87 95 116 136 106 145 1 year and under 5 years 39 55 52 50 55 43 66 5 years and under 15 ,, 21 21 19 23 32 16 24 15 „ 25 „ 29 27 33 16 34 24 28 25 „ 65 „ 261 309 295 291 269 272 203 65 years and over 290 288 258 270 243 235 224 Total deaths 737 787 752 766 769 696 690 1st Quarter. 2nd Quarter. 3rd Quarter. 4th Quarter. The year. Total Deaths 206 174 128 229 737 Death-rate per 1,000 8.7 7.3 5.4 9.6 7.7 „ England and Wales.. 15.3 12.8 11.4 13.9 13.4 ,, 77 Great Towns 15.8 (76 towns). 13.4 12.4 15.5 14.3 Deaths under 1 year 26 16 20 35 97 Infantile Mortality 72 44 54 112 69 Do. England and Wales 115 91 97 121 106 Do. 77 Great Towns 115 (76 towns). 96 112 137 115 Deaths 1 year—64 years 107 90 61 92 350 Death-rate per 1,000 persons living at these ages 4.7 4.0 2.7 4.1 3.9 Deaths 65 years and over 73 68 47 102 290 Death-rate per 1,000 persons living at these ages 82 76 53 115 81 Infantile Mortality.— During the year 1910 there were 97 deaths of infants under 1 year of age, as against 87 in 1909, and an average of 112 for each of the ten years 1900-1909. The infantile mortality for the year 1910, i.e., deaths under 1 year of age per 1,000 births, is 69 in Hornsey. In 1909 the 28 infantile mortality rate was 57, and the average rate of the 16 years 1894-1909 was 89, the highest being 133 in 1895, and the lowest 57 in 1909. Thus the infantile mortality is again a very favourable one, though higher than in 1909. Including 1909, on only three occasions has the infantile mortality been lower than it is this year. The following table gives the number of infantile deaths and the mortality for each Ward of the Borough: — Number of deaths under 1 year. Infantile Mortality, i.e., deaths under 1 year, per 1,000 births Higbgate 9 55 Muswell Hill 7 42 Crouch End 5 68 West Hornsey 23 66 East Hornsey 12 54 North Haringey 14 87 South Haringey 4 51 Stroud Green 12 127 Finsbury Park 11 112 The Borough 97 69 Last year South Haringey had the distinction of having no infantile mortality. This year there have been infantile deaths in every Ward. The rise in the infantile mortality for the Borough is almost entirely due to the increase in that rate in North and South Haringey, Stroud Green, and Finsbury Park Wards, where, owing to the small number of births, a small increase in the number of deaths sends up the infantile mortality tremendously. The most gratifying feature about these figures, as, in fact, in the vital statistics generally, is the improved position taken by East Hornsey. 29 Infantile Mortality (deaths under 1 year per 1,000 births) 1894-1910. 30  1910 1909 1908 1907 1906 1905 1904 1903 1902 1901 1900 1899 1898 1897 1896 1895 1894 INFANTILE MORTALITY. Total number of Deaths under 1 year of age 97 87 95 116 136 106 143 130 129 127 153 156 158 138 133 144 103 ,, „ „ Births registered 1,393 1,508 1,485 1,524 1,603 1,567 1,659 1,561 1,565 1,511 1,493 1,461 1,342 1,337 1,294 1,142 1,186 Infantile mortality (deaths per 1 000 births) 69 57 63 76 84 67 86 83 82 84 102 106 117 103 102 133 86 ,, „ England and Wales 106 109 121 118 133 128 146 132 133 151 154 „ „ 77 Great Towns 115 118 128 127 145 140 160 144 145 - — . 76 Great Towns. 31 The principal causes of death among infants under one year of age were:— Equal to a death-rate per 1,000 births of Premature Birth, Injury at Birth and Congenital Defects 41 29.1 Atrophy, Debility, Marasmus 13 9.3 Diarrhœal Diseases 2 1.4 Bronchitis and Pneumonia 11 7.8 Convulsions 2 9.3 Meningitis 1 0.7 Whooping Cough 3 2.1 Overlaid in Bed 3 2.1 Tuberculous Diseases 4 2.8 The infantile mortality of towns in Greater London and a number of towns of population approximately equal to that of Hornsey is shown in the following table:— Greater London Towns of approximately equal population to Hornsey. Hornsey 69 Huddersfield 99 Croydon 87 Reading 75 Leyton 66 Devonport 103 Tottenham 86 York 93 Walthamstow 95 Rochdale 104 Willesden 82 Northampton 110 East Ham 94 Aston Manor 111 West Ham 101 Stockport 137 Wolverhampton 107 Walsall 113 St. Helens 123 Middlesbrough 144 Swansea 123 Wigan 131 32 Age. Number of deaths. Under 1 month 40 Under 1 week 27 1 week and under 2 weeks 3 2 weeks ,, 3 7 3 „ „ 4 „ 3 1 month but under 2 months 18 2 months ,, 3 8 3 „ „ 4 11 4 ,, ,, 5 1 5 ,, ,, 6 3 6 ,, ,, 7 1 7 „ „ 8 2 8 ,, ,, 9 2 9 „ 10 5 10 „ 11 2 11 „ „ 12 4 Total deaths under 1 year 97 Of the 97 deaths of infants under 1 year of age, 27, or over one-fourth, occurred during the first week of life, and considerably more than half the deaths under 12 months occurred during the first two months of life. Full particulars of infantile deaths, as to causes and ages, are tabulated at the end of this report. Deaths under one year of age of Illegitimate Children.— There were 31 illegitimate births registered during the year, and 7 deaths under 1 year of age of illegitimate children occurred. This gives an infantile mortality among illegitimate children of 225. The number of legitimate births registered was 1,362, and the number of deaths under 1 year of age of legitimate children was 90. This gives an infantile mortality among legitimate children of 66. 33 The following table gives the principal Ward statistics:— WARD. Estimated population. Birth-rate. Death-rate. Infantile mortality. Highgate 13,522 12.0 6.4 55 Muswell Hill 13,720 11.9 6.3 42 Crouch End 6,351 11.4 5.5 68 West Hornsey 14,499 23.8 8.1 66 East Hornsey 13,315 16.2 6.3 54 North Haringey 10,340 15.4 8.8 87 South Haringey 5,899 13.2 8.4 51 Stroud Green 9,791 9.6 8.7 127 Finsbury Park 7,284 13.4 10.5 112 The Borough 94,721 14.7 7.7 69 Notifications of Infectious Disease.— The notifications of infectious disease received during the year shew a decrease of 101 over those of 1909, the figures being 329 and 430, and are 54 fewer than those of 1908. The decrease is almost a general one, only Enteric Fever shewing an increase of cases notified. Thus, of Scarlet Fever there were 48 fewer cases notified, of Diphtheria 46 fewer, of Erysipelas 7 fewer, and of Phthisis 6 fewer. In the case of Enteric Fever there were 6 more cases notified than in 1909, and of the ten cases notified three proved fatal. Two of the deaths occurred outside the Borough. 1910. Scarlet Fever. Diphtheria Enteric Fever. Puerperal Fever. Erysipelas SmallPox. Phthisis. During 1st quarter 41 27 3 0 3 0 2 2nd quarter 47 21 1 0 7 0 3 3rd quarter 37 27 5 0 8 0 3 4th quarter 48 30 1 1 12 0 2 Total 173 105 10 1 30 0 10 34 Table shewing the cases of infectious disease notified during 1910 and the 20 preceding years: — Disease. 1910 1909 1908 1907 1906 1905 261 1904 1903 1902 1901 1900 1899 1898 1897 1896 1895 1894 1893 1892 1891 1890 Scarlet Fever 173 221 239 283 411 197 203 261 501 186 349 168 264 530 420 189 366 234 143 139 Diphtheria 105 151 93 98 157 153 101 62 99 134 107 101 99 87 96 93 117 139 43 64 50 Enteric Fever 10 4 9 11 25 20 16 15 38 35 32 22 31 31 35 46 40 24 21 15 32 Puerperal Fever 1 1 3 5 1 3 5 2 0 5 2 1 0 2 5 4 6 6 8 1 0 Erysipelas 30 37 39 34 37 39 40 25 33 40 45 42 51 39 39 45 51 70 32 25 17 Small Pox 0 0 0 0 0 1 0 2 35 10 0 2 0 0 4 5 3 11 2 0 1 Cerebro Spinal Meningitis 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 Phthisis 10 16 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 Cholera 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 Total 329 430 383 432 631 477 359 309 466 725 372 517 349 423 709 613 406 618 340 248 239 In only three years on the above record, viz. 1890, 1891, and 1903, have fewer cases of infectious disease been notified, and 35 when the increase of population is taken into account, it will be seen that 1910 is the most favourable year in our experience. The occurrence of the cases in the different Wards is shown below: — Scarlet Fever. Diphtheria Enteric Fever. Erysipelas Puerperal Fever. Phthisis. Total Highgate 18 9 2 3 0 4 36 Muswell Hill 25 13 2 2 0 1 43 Crouch End 10 6 0 2 0 0 18 West Hornsey 47 13 1 8 0 3 72 East Hornsey 27 34 1 7 0 1 70 North Haringey 21 14 l 5 0 1 42 South Haringey 10 7 2 0 1 0 20 Stroud Green 9 7 1 1 0 0 18 Finsbury Park 6 21 0 2 0 0 10 Total 173 105 10 30 1 10 329 The attack rate per 1,000 of the population for the chief of these diseases during the last eight years was as follows:— 1910 1909 1908 1907 1906 1905 1904 1903 1902 Scarlet Fever 1.82 2.39 2.63 3.13 4.73 3.06 2.33 2.58 3.45 Diphtheria 1.10 1.63 1.02 1.08 1.80 1.79 1.19 0.79 1.31 Enteric Fever 0.10 0.04 0.09 0.12 0.28 0.23 0.18 0.19 0.50 Erysipelas 0.31 0.40 0.42 0.37 0.42 0.45 0.47 0.31 0.43 Small Pox 0.0 0.0 0.0 0.0 0.0 0.01 0.0 0.06 0.47 Phthisis 0.10 0.17 0.0 0.0 0.0 0.0 0.0 0.0 0.0 Isolation Hospital.— As compared with the previous year there were 108 fewer patients admitted in 1910, viz.:—565 in 1910 and 673 in 1909. The following table gives particulars of the admissions of patients in recent years. 36 From the following tables it will be seen that Hornsey and Wood Green again made use of the Hospital in almost equal degree, 219 cases being admitted from Hornsey and 231 from Wood Green. There was a falling off in the admissions from both districts, Hornsey sending 52 fewer patients to the Hospital, and Wood Green 39 fewer. From Finchley 113 cases were admitted in 1910, as against 130 in 1909. 1910 1909 1908 1907 1906 1905 Patients in Hospital Jan. 1st 111 68 109 105 74 53 Patients admitted during the year 565 673 494 594 628 419 676 741 603 699 702 472 Patients discharged during the year 562 606 518 572 567 388 Patients dying during the year 26 24 17 18 30 10 588 630 535 590 597 398 Patients remaining in Hospital Dec. 31st 88 111 68 109 105 74 At the beginning of the year there were 111 patients in the Hospital, viz., 51 Hornsey patients, 19 from Finchley, and 41 from Wood Green. The cases were:— Scarlet- Fever Diphtheria Enteric Fever. Total. Hornsey 33 18 0 51 Finchley 9 10 0 19 Wood Green 34 7 0 41 76 35 0 111 During the year there were 565 cases admitted, as follows:— Scarlet Fever. Diphtheria. Enteric Fever. Total. Hornsey 136 80 3 219 Finchley 62 47 4 113 Wood Green 139 88 4 231 Friern Barnet 0 2 0 2 337 217 11 565 37 There were 17 fewer cases admitted from Finchley, compared with 1909, 52 fewer cases were admitted from Hornsey, and 39 fewer from Wood Green. At the end of the year there were 88 cases in the Hospital, viz.:— Scarlet Fever. Diphtheria. Enteric Fever. Total Hornsey 21 8 1 30 Finchley 5 9 1 15 Wood Green 34 7 2 43 60 24 4 88 The following table shews the number of cases of each disease admitted during each month of the year, and the districts1 from which the patients were admitted:— 38  Hornsey Cases. Finchley Cases. Wood Green Cases. Grand Total for the month. Scarlet Fever. Diphtheria. Enteric Fever. Total. Scarlet Fever. Diphtheria. Enteric Fever. Total. Scarlet Fever. Diphtheria. Enteric Fever. Total *January 11 11 0 22 11 3 0 14 15 3 0 18 55 February 8 3 0 11 5 3 0 8 6 4 0 10 29 *March 11 7 0 18 9 12 0 21 14 4 0 18 58 April 16 8 0 24 6 5 0 11 7 16 0 23 58 May 12 1 0 13 6 4 0 9 10 4 0 14 36 June 14 7 1 22 1 2 2 5 3 10 1 14 41 July 3 10 0 13 1 1 0 2 5 12 0 17 32 August 10 9 0 19 2 1 0 3 8 13 0 21 43 September 14 3 1 18 8 7 1 16 14 5 1 20 54 October 17 6 1 24 5 2 0 7 21 3 1 25 56 November 10 9 0 19 7 2 0 9 19 14 1 34 62 December 10 6 0 16 2 5 1 8 17 0 0 17 41 Total for the year 136 80 3 219 62 47 4 113 139 88 4 231 565 * One Diphtheria Patient admitted from Friern Barnet. 39  1894 1895 1896 1897 1898 1899 1900 1901 1902 1903 1904 1905 1906 1907 1908 1909 1910 Number of cases of Diphtheria notified in Hornsey 117 89 95 87 99 101 107 134 99 62 101 153 157 98 93 151 105 Death rate per 1,000 of the population from Diphtheria 0.43 0.37 0.20 0.25 0.17 0.05 0.19 0.10 0.11 0.10 0.08 0.09 0.14 0.09 0.09 0.10 0.08 Number of cases of Diphtheria admitted to the Isolation Hospital 29 8 24 15 45 37* 45* 30* 50* 71* 92* 127* 157* 159* 113* 201* 217* Mortality per cent. of cases treated in the Hospital 24% 25% 4% 20% 13% 13% 11% 16% 14% 11% 4% 5% 8% 5% 6% 7% 7% * Cases admitted to Hospital from districts outside the Borough are included in these figures. 40 The number of outside cases of Diphtheria was for each year: 1899 1 case from outside the Hornsey Borough (or Urban Dist.) 1900 8 cases do. 1901 2 „ do. 1902 15 „ do. 1903 36 „ do. 1904 36 „ do. 1905 32 „ do. 1906 60 „ do. 1907 89 „ do. 1908 62 „ do. 1909 102 „ do. 1910 137 „ do. 41 NUMBER OF CASES TREATED. NUMBER OF CASES TREATED FROM DEATHS. Scarlet Fever. Diphtheria. Enteric Fever. Cerebro Spinal Meningitis. Total. Finchley. Friern Barnet. Wood Green. Hornsey. Total. Scarlet Fever. Diphtheria. Enteric Fever. Total. Case Mortality. 1910 413 252 11 – 676 132 2 272 270 676 5 18 3 26 3.8 1909 517 219 5 – 741 144 1 289 307 741 7 17 – 24 3.2 1908 449 139 15 – 603 161 – 188 254 603 9 8 – 17 2.8 1907 500 181 17 1 699 127 – 261 311 699 6 10 2 18 2.5 1906 506 173 23 – 702 133 – 167 402 702 13 15 2 30 4.2 1905 318 139 15 – 472 94 – 64 314 472 2 7 1 10 2.1 1904 258 102 5 – 365 162 – – 203 365 2 4 1 7 1.9 1903 204 82 10 – 296 92 1 – 203 296 1 8 – 9 3.0 1902 298 50 16 – 364 81 10 – 273 364 2 7 2 11 3.0 1901 349 31 7 – 387 2 2 – 383 387 – 5 – 5 1.3 1900 138 50 9 – 197 5 4 – 188 197 1 5 3 9 4.5 42 The number of patients admitted to the Hospital was smallest in February (29 cases) and highest in November (62 cases). The cost of maintenance (provisions) per inmate (patients and resident staff) per head per week was as follows:— in 1910 6s. 0½d. per head per week 1909 5s. 8¼d. ,, ,, 1908 5s. 11¾d „ „ 1907 6s. 5d. ,, ,, 1906 6s. 2½d. ,, ,, 1905 6s. 8½d. ,, „ 1904 7s. 7d. ,, ,, 1903 8s. 7¼d. „ „ Scarlet Fever.— The number of cases notified in Hornsey during 1910 was 173, and of these 136, equal to 78 per cent. of the cases notified, were admitted to the Isolation Hospital. There were also 62 cases of Scarlet Fever admitted from Finchley and 139 from Wood Green. There were five deaths in the Hospital during the year from Scarlet Fever, giving a case mortality of 1.2 per cent. of the cases of Scarlet Fever under treatment. Diphtheria.— There were 105 cases of Diphtheria notified in the Borough during the year, and of these 80 cases (equal to 76 per cent. of those notified) were admitted to the Isolation Hospital. There were also 47 cases of Diphtheria admitted from Finchley and 88 from Wood Green. There were 18 deaths in the Hospital during the year from Diphtheria, giving a case mortality of 7.1 per cent. of the cases of Diphtheria under treatment. Enteric Fever.— There were ten cases of this disease notified in the Borough during the year, three of which were admitted to the Borough Hospital. There were 4 cases of Enteric Fever admitted from Finchley, and 4 from Wood Green. There were 3 deaths in the Hospital during the year from Enteric Fever, giving a case mortality of 30 per cent. of the cases of Enteric Fever under treatment. 43 Municipal Laboratory.— During the year 1,799 specimens were examined from patients who were, or were suspected to be, suffering from Diphtheria. Of these 1,599 were specimens taken at the Hospital, and 200 specimens were sent in by Medical men practising in the district. There were 57 specimens sent by Medical practitioners for examination from suspected cases of Tuberculosis, 17 examinations of blood for Typhoid re-action, and 13 miscellaneous specimens were received and examined. There were also 35 specimens examined from children suffering from Ringworm who were scholars at the public elementary schools. Altogether 1,921 specimens were examined in the Bacteriological Laboratory, of which 278 were received from Medical men practising in the district. Last year there were 358 specimens received from Medical practitioners. The decrease is no doubt due to the fact that Diphtheria and other infectious diseases have been less prevalent this year. There were 1,810 samples of sewage and effluent analysed and reported on. There were also 36 samples of drinking water examined, and in every case the sample was found to be quite satisfactory. Diseases of Animals Acts.—There were no outbreaks of Glanders during the year. Middlesex (Parasitic Mange) Order, 1909.—During the year 21 horses were found to be affected with Parasitic Mange. Five horses at Highgate were found to be suffering from the disease, 10 at Muswell Hill, 2 at Crouch End, and 4 at Hornsey. The Regulations prescribed by the Order were enforced. There were 5 certificates for the movement of swine issued. Destruction of Dogs.—95 dogs were brought by their owners to be destroyed in the Lethal Chamber at the Sanitary Depot. Sale of Food and Drugs Acts.- Sale of Food and Drugs Acts.—Richard Robinson, Esq., Chief of the Weights and Measures Staff for the County of Middlesex, has kindly supplied me with the following information as to samples of Foods and Drugs taken by the County Council Inspector in the Borough of Hornsey during the year 1910. 44  No of Samples taken. No of Samples adulterated. Butter 163 14 Milk 233 7 Margarine 22 2 White Precipitate Ointment 3 – Olive Oil 3 – Prescription 3 – Arrowroot 2 – Coffee and Chicory 2 1 Bottled Fruit 1 – 432 24 Number of Prosecutions in respect of Butter 7 ,, Convictions ,, ,, 7 Amount of Fines inflicted £14 A summons in respect of adulterated Milk was dismissed on warranty. Note.— The figures given for adulterated samples include a number of adulterated informal sample® in respect of which no proceedings could be taken. There were also 174 informal samples taken by the Inspector to the Borough Council. Six of these were found to be adulterated. Inspection of Meat and other Foods.— All the Inspectors have obtained the special certificate granted by the Royal Sanitary Institute for this work, and the whole of the slaughter-houses and butchers' shops are kept under observation by them. There are nine slaughter-houses and seventy-six butchers' shops in the Borough. Four of the slaughter-houses are only used occasionally for slaughtering sheep. Frequent inspections are made of the slaughter-houses during the time of slaughtering and also at other times. Special attention is paid to butchers' shops at the latter part of the week, when the stock is usually largest. At the time of inspection at slaughter-houses 2 carcases (bullocks) and 6 plucks from bullocks were found to be affected with Tuberculosis; the whole were immediately surrendered, and destroyed by the Corporation at the Destructor. 45 Diseased and Unsound Food.— The following articles have been destroyed at the instance of the Local Authority during the year:— Cwts. Qrs. Lbs. Meat 19 0 14 Fish 1 0 0 Fruit 0 0 12 Factory and Workshop Act, 1901.—Register of Workshops.— The number of Workshops on the Register at the end of 1909 was 368. During the year 1910 30 workshops have been added and 20 taken off the Register, so that at the end of 1910 there were 378 workshops on the Register in Hornsey. They were as follows:— Dressmakers 60 Milliners 29 Bootmakers and repairers 46 Cycle makers and repairers 10 Farriers 8 Picture Frame makers 4 Children's Outfitters 2 Tailors 22 Laundries 37 Restaurant Kitchens 32 Bakers 43 Miscellaneous 85 689 inspections were made and 79 written notices were served. The number of sanitary defects discovered and remedied was 108. As in previous years, want of cleanliness is the most frequent defect to be dealt with. In 60 cases, comparing with 40 for the previous year, the occupier was requested to cleanse, and this was immediately done. In 32 cases the sanitary accommodation was found to be unsuitable, insufficient, or defective. These nuisances were, however, remedied on the owner's or occupier's attention being called to the matter. Home Work.— There are 79 persons on the list of homeworkers, an increase of 2 during the year. In every case the premises occupied have been inspected, but no insanitary condition existed. No case of infectious disease has occurred in a house occupied by a home-worker. 46 Bakehouses.— There are 43 bakehouses in the Borough, being one more than in 1909. There are 5 underground bakehouses in the Borough. Frequent inspections have been made of bakehouses, restaurant kitchens, places where ice cream is made, and other business premises concerned in the preparation of food, and, speaking generally, the conditions found were satisfactory. Dairies and Milkshops, numbering 76, and 4 Cowsheds in the Borough, have been frequently inspected. In 9 instances oontravention of the bye-laws or regulations have been found, and the matters were at once attended to. Nuisances, Drainage, etc.—One hundred and ninety-five complaints have been received during the year. Obstructed or defective drains 47 Defective sanitary fittings 52 Dirty condition of premises 10 Dampness of premises 19 Water in basement 4 Accumulation of refuse 29 Overcrowding 10 Dirty condition of drinking water cistern 3 Nuisanoes caused by the keeping of fowls 5 Rats on premises 5 Other causes 11 At three hundred and thirty-five premises the drains have been tested.— On complaint 86 After infectious diseases 66 House-to-house inspection and other causes 183 In twenty-five instances the drains, water-closets, etc., have been exposed and examined in accordance with Sec. 41 of the Public Health Act, 1875. The usual intimations and statutory notices were served where defects were found. In ninety-one instances the drains, etc., were re-constructed entirely, and in the others the defects found were remedied and the nuisances abated. 47 Drains unstopped and repaired 143 Waste pipes trapped and rainwater pipes disconnected 302 New soil pipes fixed 88 Soil pipes and ventilating pipes repaired 34 Intercepting traps fixed 69 The number of premises now on the list for periodical inspection fs 915, as compared with 907 for last year, 715 for 1908, 705 for 1907, 525 for 1906, 495 for 1905, 412 for 1904, and 152 for 1903. Preliminary notices issued numbered 645, and statutory notices 261. House-to-House Inspections.—The following tabular statement shews in what roads house-to-house inspections have been made during the year, with a summary of the defects found. In each case the nuisances have been remedied. Inspections are in progress at 76 other houses, under section 17 of the Housing, Town Planning, etc., Act, 1909. Sanitary Defects. Premises. Defective Drains. Defective and obstructed Drains repaired. Defective Sanitary Fittings. Defective Water-closets. Dirty condition of Premises. Rainwater Pipes, Gutters, and Roofs defective. Defective Paving. Defective, or want of proper Sanitary Dustbin. Drinking-water Cisterns. Other Defects. Myddelton Road 119 houses .. .. .. 19 45 29 20 14 14 62 Canon Road 23 ,, .. .. .. 5 8 4 2 2 .. 1 Ward's Cottage 12 ,, .. .. .. .. 3 1 .. 1 .. .. Coleridge Buildings 48 ,, .. .. .. 3 3 .. .. .. .. .. Townshends Yard 9 „ .. .. .. 1 2 1 .. 1 .. 3 Verandah Cottages 12 ,, .. .. .. .. 2 .. .. .. .. .. North Road Cottages 20 ,, .. .. .. 3 1 .. .. .. .. .. Denmark Road 33 ,, .. .. .. 7 3 .. 3 3 .. 4 Woodside Cottages 16 ,, .. .. .. 6 12 6 3 4 .. 9 Kent's Yard 6 ,, .. .. .. .. 1 1 .. .. .. .. Enfield Road 31 ,, .. .. 2 1 5 .. .. 2 .. .. Baden Terrace 6 .. .. .. .. 1 .. .. .. .. .. Linden Terrace 6 ,, .. .. .. .. .. .. .. .. .. .. Spencer Road 17 ,, .. 1 1 .. 1 .. 1 .. .. 1 Albert Buildings 3 ,, .. .. .. .. 2 .. 1 .. .. .. Canon Road 23 ,, .. .. 1 .. 6 .. 2 2 .. 4 Crouch Hill 4 ,, 4 .. .. .. .. .. .. .. .. .. ANNUAL REPORT OF THE MEDICAL OFFICER OF HEALTH FOR THE BOROUGH OF HORNSEY, FOR THE YEAR 1910 on the administration of the Factory and Workshop Act, 1901, in connection with FACTORIES, WORKSHOPS, WORKPLACES, AND HOME WORK. 1—INSPECTION OF FACTORIES, WORKSHOPS, & WORKPLACES, Including Inspections made by Sanitary Inspectors or Inspectors of Nuisances Premises. Number of Inspections. Written Notices. Prosecutions Factories (Including Factory Laundries.) 41 2 0 Workshops (Including Workshop Laundries). 578 40 0 Workplaces (Other than Outworkers' premises included in Part 3 of this Report). 111 15 0 Total 730 57 0 2.—DEFECTS FOUND in FACTORIES, WORKSHOPS, & WORKPLACES Particulars. Number of Defects. Number Found. Remedied Referred to H M. Inspector of Prosecutions. Nuisances under the Public Health Acts:— Want of cleanliness 60 60 0 0 Want of ventilation 2 2 0 0 Overcrowding 0 0 0 0 Want of drainage of floors 2 2 0 0 Other nuisances 5 5 0 0 †Sanitary accommodation insufficient 1 1 0 0 unsuitable or defective 31 31 0 0 not separate for sexes 0 0 0 0 Offences under the Factory and Workshot Act:— Illegal occupation of underground bakehouse (s.101) 0 0 0 0 Breach of special sanitary requirements for bakehouses (SS. 97 to 100) 6 6 0 0 Other offences (Excluding offences relating to outwork which are included in Part 3 of this Report) 1 1 0 0 Total 108 108 0 0 † Public Health Acts Amendment Act, 1890, rart 3, adopted Oct.,1890. 3.—HOME WORK. NATURE OF WORK. OUTWORKERS' LISTS, SECTION 107. Inspections of Outworkers' premises OUTWORK IN UNWHOLESOME PREMISES, SECTION 108. OUTWORK IN INFECTED PREMISES, SECTIONS 109, 110. Lists received from Employers. Addresses of Outworkers. Notices served on Occupiers as to keeping or sending lists. Prosecutions. Instances. Notices served. Prosecutions. Instances. Orders made (S.110). Prosecutions (Sections 109, 110) Sending Twice in the year Sending Once in the year. Received from other. Councils. Forwarded to other Councils. Failing to keep or permit inspection of lists. Failing to send lists. Lists. Outworkers. Lists. Outworkers. Contractors. Workmen. Contractors. Workmen. (1) (2) (3) (4) (5) (6) (7) (8) (9) (10) (11) (12) (13) (14) (15) (16) (17) (18) (19) Wearing Apparel— (1) making, &c. 37 0 124 2 0 9 137 104 0 0 0 175 0 0 0 0 0 0 (2) cleaning and washing 4 0 9 1 0 1 Lace, lace curtains and nets Artificial Flowers Nets, other than wire nets Tents Sacks Furniture and Upholstery Fur pulling Feather sorting Umbrellas, Ac. Carding, Ac , of Buttons, Ac. Paper Bags and Boxes Basket making Brush making Racquet and Tennis Balls Stuffed Toys File making Electro Plate Cables and Chains 2 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 Anchors and Grapnels Cart Gear Locks, Latches and Keys Pea Picking Total 43 0 139 3 0 10 137 104 0 0 0 175 0 0 0 0 0 0 4.—REGISTERED WORKSHOPS Workshops on the Register at the end of the year. Number (1) (2) Dressmakers 60 Milliners 29 Tailors 22 Bakehouses 43 Laundries 37 Restaurant Kitchens 32 Miscellaneous 155 Total number of workshops on Register 378 5.—OTHER MATTERS. Class. N umber. (1) (2) Matters notified to H.M. Inspector of Factories:— Failure to affix Abstract of the Factory and Workshop Act (s. 133) 2 Action taken in matters referred by H.M. Inspector as remediable under the Public Health Acts, but not under the Factory and Workshop Act (s. 5) Notified by H.M. Inspector 0 Reports (of action taken) sent to H.M. Inspector 0 Other 14 Underground Bakehouses (s. 101):— Certificates granted during the year 0 In use at the end of the year 5 TABLE 1. VITAL STATISTICS OF WHOLE BOROUGH DURING 1910 AND PREVIOUS YEARS. Name of District:-HORNSEY. Year. Popula tion estimated to middle of each Year. Births. Total Deaths Registered in the District. Total Deaths in Public Institu tions in the District. Deaths of Nonresi dents registered in Public Institutions in the District Deaths of Residents registered in Public Institutions beyond the District. Nett Deaths at all Ages belonging to the District. onder One Year of Age. at all Ages. Number. Kate.* Number. Kate p«?r 1,000 Births registered. Number. Rate.* Number. Kate 1 2 3 4 5 6 7 8 9 10 11 12 13 1900 70,597 1,493 21.15 153 102 619 8.77 11 9 14 624 8.84 1901 73,549 1,511 20.55 127 84 597 8.12 5 2 22 617 8 34 1902 75,623 1,565 20.71 129 82 620 8.20 7 6 25 639 8.44 1903 78,452 1,561 19.91 130 83 589 7.51 13 7 22 604 7.69 1904 84,227 1,659 19.69 145 86 660 7.81 8 3 33 690 8.19 1905 85,213 1,567 18.38 106 67 607 7.12 17 12 101 696 8.16 1906 86,877 1,603 18.45 136 84 672 7.73 35 20 117 769 8.85 1907 90,221 1,524 16.89 116 76 635 7.03 26 18 149 766 8.49 1908 90,814 1,485 16.35 95 63 654 7.20 17 14 112 752 8.29 1909 92,389 1,508 16.32 78 57 696 7.53 43 36 127 787 8 51 Averages for years 19001909 82,796 1,547 18.84 121 78 634 7.70 18 12 72 694 8.88 1910 94,721 1,393 14.70 84 69 626 6.60 17 22 152 737 7.78 *Rates in columns 4, 8 and 13 calculated per 1,000 of the estimated population. Area of District in acres (exclusive of area covered by water) 2,863.442 At Census of 1901. Total population at all ages 72,056 Number of inhabited houses 12,571 Average number of persons per house 5¾ 1. Institutions within the District receiving sick and infirm persons from outside the District. 2. Institutions outside the District receiving sick and infirm persons from the District. 3. Other Institutions, deaths in which have been distributed among the several localities in the District. Isolation Hospital, Muswell Hill. Cromwell House Convalescent Home. Workhouse and Infirmary, Edmonton. Small Pox Hospital, Summers Lane, Finchley. Santa Claus Home. All Saints' Convalescent Home. Fever Hospital, Liverpool Road. Hornsey Cottage Hospital. Middlesex County Asylum, Napsbury. Various Loudon Hospitals. Union Workhouse not in Borough. TABLE II. VITAL STATISTICS OF SEPARATE LOCALITIES IN 1910. AND PREVIOUS YEARS. Name of District:—HORNSEY. Names of Localities. 1. -The whole district 2.—Highgate. 3.—Muswell Hill. 4.—Crouch End. 5.- West Hornsey. 6. —East Hornsey. 7.—North Haringey. 8.— South Haringey. 9.—Stroud Green. 10.—Finsbury Park. Year. Population estimated to middle of each year. Births registered. Deaths at all ages. 1 Deaths under 1 year. Population estimated to middle of each year. Births registered. Deaths at all ages. Deaths under 1 year. Population estimated to middle of each year. Birth6. registered. 1 Deaths at all ages. Deaths under 1 year. Population estimated to middle of each year. Births registered. Deaths at all ages. Deaths under 1 year. Population estimated to middle of each year. Births registered. Deaths at all aRes. Deaths under 1 year. Population estimated to middle of each year. Births registered. Deaths at all ages. Deaths under 1 year. Population estimated to middle of each year. Births registered. Deaths at all ages. Deaths under 1 year. Population estimated to middle of each year. Births registered. Deaths at all ages. Deaths under 1 year. Population estimated to middle of each year. Births registered. Deaths at all ages. Deaths under 1 year. Population estimated to middle of each year. Births registered. Deaths at all ages. Deaths under 1 year. a. b. c. d. a. b. c. d. a b. c. d. a. b. c. d. a. b. c. d. a. b. c. d. a. b. c. d. a. b. c. d. a. b. c. d. a. b. c. d. 1900 70,597 1,493 624 153 1901 73,549 1,511 617 127 1902 75,623 1,565 639 129 1903 78,452 1,561 604 130 1904 84,227 1,659 690 145 1905 85,213 1,567 696 106 12,101 178 95 17 10,613 157 73 6 5,362 70 38 4 12,131 350 125 34 12,125 280 97 15 10,186 220 86 16 5,938 94 51 4 9,518 98 57 2 7,239 120 74 8 1906 86,877 1,603 767 136 12,287 198 109 17 11,524 167 71 12 5,470 100 33 8 12,697 350 141 40 12,290 247 114 25 10,208 207 101 17 5,812 105 56 4 9,530 108 66 2 7,059 121 78 11 1907 90,221 1,524 766 116 12,801 190 125 11 12,214 167 72 6 5,723 78 36 4 13,732 354 126 30 12,979 218 126 32 10,285 188 90 12 5,872 90 60 7 9,653 94 69 5 6,962 115 62 9 1908 90,814 1,485 752 95 13,100 166 102 8 12.565 160 83 7 5,782 76 48 7 14,054 351 129 28 12,842 262 112 20 10,090 196 98 13 5,753 73 39 2 9,575 95 64 1 7,053 106 77 9 1909 92,389 1,508 787 87 13.331 183 103 10 13,167 149 84 8 5,951 95 41 6 14,343 362 128 23 13,033 240 121 19 10,086 178 97 12 5,969 90 40 0 9,354 105 86 2 7,155 106 87 7 Averages of Years 1900 to 82,796 1,547 694 122 1910 94,721 1,393 737 97 13,522 163 87 9 13,720 164 87 7 6,351 73 35 5 14,499 346 128 23 13,315 217 85 12 10,340 160 92 14 5,899 78 50 4 9,791 94 86 12 7,284 98 87 11 TABLE III. Oases of Infectious Disease notified during the Year 1910. Name of District:-HORNSEY. Notifiable Disease. Cases notified in Whole District. Total Cases notified in each Locality. No. of Cases removed to Hospital from each Locality Total cases removed to Hospital. At all AgeB. At Ages -Years. 1 2 3 4 5 6 7 8 9 1 2 3 4 5 6 T 8 9 Highgate. Muswell Hill. Crouch End. West Hornsey. East Hornsey North Haringey. South Haringey. Stroud Qreen. Finsbury Park. Highgate. Muswell Hill. Crouch End. West Hornsey. East Hornsey North Haringey South Haringey. Stroud Qreen. Finsbury Park. Under i. 1 to 5 5 to 15 15 to 25 25 to 65 65 and upwards Small-pox - - - - - - - - - - - - - - - - - - - - - - - - - - Cholera - - - - - - - - - - - - - - - - - - - - - - - - - Diphtheria (including Membranous croup 105 1 20 63 9 12 9 13 6 13 34 14 7 7 2 7 9 5 10 29 13 5 1 1 80 Erysipelas 30 1 1 1 - 26 1 3 2 2 8 7 5 - 1 2 - - - - - - - - - - Scarlet fever 173 2 35 103 21 12 18 25 10 47 27 21 10 9 6 15 15 8 42 21 19 9 5 2 136 Typhus fever - - - - - - - - - - - - - - - - - - - - - - - - - Enteric fever 10 - - 1 - 9 - 2 2 - 1 1 1 2 1 - - - - - - 1 1 1 - 3 Relapsing fever - - - - - - - - - - - - - - - - - - - - - - - - - Continued fever - - - - - - - - - - - - - - - - - - - - - - - - - - Puerperal fever 1 - - - - 1 - - - - - - - 1 - - - - - - - - - - - - Plague - - - - - - - - - - - - - - - - - - - - - - - - - - Phthisis 10 - - - 1 9 - 4 1 - 3 1 1 - - - - - - - - - - - - - Totals 329 4 56 168 31 69 1 36 43 18 72 70 42 20 18 10 22 24 13 52 50 33 15 7 3 219 ISOLATION HOSPITAL -Name and Hornsey Borough Isolation Hospital, Situation) Coppett's Road, Muswell Hill. Total available beds 130 Number of diseases that can be concurrently treated 3. SCHEDULE A.—1. DISTRICT:—BOROUGH OF HORNSEY.—YEAR 1910. No. Diseases. AGES. All Ages. WARDS. High gate. Muswell Hill. Crouch End. West Hornsey. East Hornsey. North Haringey South Haringey. Stroud Green. Finsbury Park. 0- 1- 5- 10- 15- 20- 25- 35- 45- 55- 65- 75- 85- 1 Small pox (a) Vaccinated (4) Unvaccinated (c) No Statement 2 Measles ... 1 ... ... ... ... ... ... ... ... ... ... ... 1 1 ... ... ... ... ... ... ... ... 3 Scarlet Fever ... 2 1 1 ... ... ... ... ... ... ... ... ... 4 1 ... 1 1 ... ... ... 1 4 Typhus Fever 5 Epidemic Influenza 1 ... ... ... 2 ... 1 2 1 2 3 3 1 16 4 3 ... ... 1 4 1 1 2 6 Whooping Cough 3 7 ... ... ... ... ... ... ... ... ... ... ... 10 1 1 ... 5 ... ... ... ... 3 7 Diphtheria . 1 2 4 1 ... ... ... ... ... ... ... ... ... 8 1 ... ... 1 2 3 1 ... ... 8 Enteric Fever ... ... ... ... ... 1 ... ... 2 ... ... ... ... 3 ... 1 ... ... ... 1 ... 1 ... 9 Asiatic Cholera 10 Diarrhoea, Dysentery 11 Epidemic Enteritis 1 ... ... ... ... ... ... ... ... ... ... ... ... 1 ... ... ... 1 ... ... ... ... ... 12 Other Allied Diseases 13 Hydrophobia 14 Glanders 15 Tetanus 16 Anthrax 17 Cowpox 18 Syphilis 2 ... ... ... ... ... 1 1 ... ... ... ... ... 4 ... ... ... 1 1 1 ... ... 1 19 Gonorrhoea 20 Phagedena 21 Erysipelas ... ... ... ... ... ... ... 2 ... ... .. ... ... 2 ... ... ... 1 ... ... ... ... 1 22 Puerperal Fever 23 Pyaemia ... 1 ... ... ... 1 ... ... ... 1 1 ... ... 4 ... 2 ... 1 ... ... ... l ... 24 Infective Endocarditis 25 Other Allied Diseases 26 Malarial Fever 27 Rheumatic Fever ... ... ... 2 1 2 ... ... ... ... 1 ... ... 6 1 1 ... ... ... ... 2 ... 2 28 Rheumatism of Heart ... ... ... ... ... ... ... ... ... ... 1 ... ... 1 ... ... ... ... ... 1 ... ... ... 29 Tuberculosis of Brain 1 4 ... ... ... ... ... ... 1 ... ... ... ... 6 1 ... ... 3 ... 1 1 ... 30 Tuberculosis of Larynx 31 Phthisis ... ... ... ... 2 4 16 5 5 5 3 1 ... 41 4 2 4 4 7 4 3 5 8 32 Abdominal Tuberculosis 2 3 1 ... ... ... ... 1 1 ... ... ... ... 8 1 1 ... 2 1 1 1 ... 1 33 General Tuberculosis 1 1 ... ... ... ... 2 ... ... ... ... ... ... 4 ... ... 1 2 ... 1 ... ... ... 34 Other forms Tuberculosis 35 Other Infective Diseases 36 Thrush * 37 Actinomycosis 38 Hydatid Diseases 39 Scurvy 40 Other Diseases due to Altered Foid Total’s 12 21 6 4 5 8 20 11 10 8 9 4 1 119 14 12 5 22 13 17 8 9 19 No Diseases. AGES. All Ages. WARDS. Highgate. Muswell Hill. Crouch End. West Hornsey. East Hornsey. North Haringey. South Haringey. Stroud Green. Finsbury Park. 0- 1 5- 10- 15- 20- 25- 35- 45- 55- 65- 75- 85- 41 Acute Alcoholism .. .. .. .. .. .. .. .. 1 1 .. .. .. 2 .. .. 1 .. .. .. .. .. 1 42 Chronic Alcoholism .. .. .. .. .. .. .. 1 .. 1 .. 1 .. 3 .. 1 .. 1 1 .. .. .. .. 43 Chronic Industrial Poisonings 44 Oilier Chronic Poisonings 45 Osteo-arthritis .. .. .. .. .. .. .. .. .. .. .. 1 • • 1 1 .. .. .. .. .. .. .. .. 46 Gout .. .. .. .. .. .. .. .. .. 2 .. .. .. 2 1 .. .. 1 .. .. .. .. .. 47 Cancer .. .. .. .. .. .. 4 4 17 20 27 14 2 88 12 5 4 11 9 15 6 15 11 48 Diabetes Mellitus .. .. .. .. .. . 1 .. .. 1 1 ... .. 3 .. .. .. 1 1 .. 1 .. .. 49 Purpura Hatnorrhagica .. .. .. .. .. 1 .. .. .. .. .. .. .. 1 .. .. .. .. 1 .. .. .. .. 50 Haemophilia 51 Anoomia .. .. .. .. .. .. .. .. 1 3 .. .. .. 4 .. 1 1 .. .. .. 1 1 .. 52 Lymphadenoma .. .. .. .. .. .. .. .. 1 .. .. .. .. 1 .. .. .. .. 1 .. •• .. .. 53 Premature Birth 26 .. .. .. .. .. .. .. .. .. .. .. .. 26 2 2 4 1 5 4 .. 2 6 54 Injury at Birth 2 .. .. .. .. .. .. .. .. .. .. .. .. 2 .. .. .. .. .. .. 1 .. 1 55 Debility at Birth 9 1 .. .. .. .. .. .. .. .. .. .. .. 10 2 .. .. 2 1 1 1 3 .. 56 Atelectasis 1 .. .. .. .. .. .. .. .. .. .. .. .. 1 .. .. .. .. .. .. .. 1 .. 57 Congenital Defects Spinal Befida 2 .. .. .. .. .. .. .. .. .. .. .. .. 2 1 .. .. 1 .. .. .. .. .. Congenital Heart Disease 3 .. .. .. .. .. .. .. .. .. .. .. .. 3 .. .. .. 2 1 .. .. .. .. Hydro Cephalus .. 1 .. .. .. .. .. .. .. .. .. .. .. 1 .. .. .. 1 .. .. .. .. .. Obstruction of Intestine 1 .. .. .. .. .. .. .. .. .. .. .. .. 1 .. .. .. .. .. .. .. 1 .. Hydrocephalus Pyelitis .. 1 .. .. .. .. .. .. .. .. .. .. .. 1 .. .. .. .. 1 .. .. .. .. 58 Want of Breast Milk 2 .. .. .. .. .. .. .. .. .. .. .. .. 2 .. .. .. .. 1 1 .. .. .. 59 Atrophy, Debility, Marasmus 11 2 .. .. .. .. .. .. .. .. .. .. .. 13 4 1 .. 5 .. 1 .. 1 1 60 Dentition 1 .. .. .. .. .. .. .. .. 1 .. .. .. 2 .. .. 1 .. .. .. 1 .. .. 61 Rickets .. 1 .. .. .. .. .. .. .. .. .. .. .. 1 .. .. .. .. .. .. .. .. .. 62 Old Age, Senile Decay .. .. .. .. .. .. .. .. .. .. 10 41 23 74 5 12 2 10 6 9 8 11 11 63 Convulsions 1 1 .. .. .. .. .. .. .. .. .. .. .. 2 .. .. .. 2 .. .. .. .. .. 64 Meningitis 1 3 1 .. .. .. .. .. .. 1 .. .. .. 6 .. 1 1 1 .. 1 .. 1 1 65 Encephalitis .. .. .. .. .. .. .. 1 .. .. .. .. .. 1 .. .. .. .. .. 1 .. .. .. 66 Apoplexy .. .. .. .. .. .. 1 3 2 8 24 9 2 49 5 10 1 8 5 5 1 9 5 67 Softening of Brain .. .. .. .. .. .. .. .. .. 1 3 .. .. 4 .. .. .. 1 1 2 .. .. .. 68 Hemiplegia .. 1 .. .. .. .. .. 1 .. 1 .. 2 .. 5 1 1 .. 1 .. 2 .. .. .. 69 General Paralysis of Insane .. .. .. .. .. .. .. 1 2 .. .. .. .. 3 1 .. .. .. 2 .. .. .. .. 70 Other forms of Insanity .. .. .. .. .. .. .. .. 1 .. 1 .. .. 2 .. 2 .. .. .. .. .. .. .. 71 Chorea .. .. 1 .. .. .. .. .. .. .. .. .. .. 1 .. .. .. • • .. .. .. 1 .. 72 Cerebral Tumour 73 Epilepsy .. .. .. .. .. .. .. 1 .. .. .. .. .. 1 .. .. .. .. .. 1 .. .. .. 74 Laryngismus Stridulus 75 Locomotor Ataxy .. .. .. .. .. .. .. 1 .. .. .. .. .. 1 .. .. .. .. .. 1 .. .. .. 76 Paraplegia .. .. 1 .. .. 1 1 .. .. .. 5 .. .. 8 1 2 1 1 .. .. 3 .. .. 77 Other forms, Brain Diseases .. .. .. .. .. .. .. .. .. .. .. 1 .. 1 .. 1 .. .. .. .. •• .. .. 78 Otitis 79 Disease of Nose, Epistaxis 80 Diseases of Eye 81 Pericarditis .. .. 1 .. .. .. .. .. .. .. .. .. .. 1 1 .. .. .. .. .. • • .. .. 82 Endocarditis .. .. 1 1 .. 4 3 4 8 16 12 8 1 58 9 6 4 10 6 7 3 5 9 83 Hypertrophy of Heart .. .. .. .. .. .. .. 2 1 3 1 .. 7 2 1 1 1 .. 1 .. 1 .. 84 Angina Pectoris .. .. .. .. .. .. .. 1 2 .. 1 .. .. 4 .. .. .. .. .. 1 1 1 1 85 Aneurism .. .. .. .. .. .. .. 1 .. .. 1 1 .. 3 .. 1 .. l 1 .. .. .. .. 86 Senile Gangrene 87 Embolism, Thrombosis .. .. .. .. .. .. .. 2 .. .. 1 3 .. 6 .. .. 1 1 2 1 1 .. .. 88 Phlebitis 89 Varicose Veins Totals 60 11 5 1 .. 6 10 21 37 57 89 82 28 407 48 46 22 63 46 54 28 53 47 3 No. Diseases. AGES. All Ages. WARDS. Highgate. Muswell Hill. Crouch End. w est Hornsey. East Hornsey. North Haringey. South Haringey. Stroud Green. Finsbury Park. 0- 1- 5- 10- 15 20- 25- 35- 45- 55 65- 75- 85- 90 Other Diseases, Heart and Vessels Fatty Degeneration .. .. .. .. .. .. .. .. 3 3 4 .. .. 9 1 .. 1 1 3 •• 2 •• 1 Arteriosclerosis .. .. .. .. .. .. .. .. .. .. 1 2 .. 3 1 1 .. 1 .. .. .. .. .. 91 Laryngitis 92 Croup 93 Other Diseases, Larynx &• Trachea 94 Acute Bronchitis 5 .. .. .. .. .. 1 1 1 2 3 4 3 20 1 3 .. 2 2 5 3 3 1 95 Chronic Bronchitis .. .. .. .. .. .. 1 2 2 1 12 7 2 27 .. 3 .. 8 4 8 .. 2 2 96 Lobar Pneumonia .. .. .. .. .. .. 1 2 .. 2 4 .. .. 9 3 1 1 1 .. 1 .. 1 1 97 Lobular Pneumonia 6 4 .. .. 1 .. 1 1 .. 2 .. 2 .. 17 .. 1 .. 7 1 1 2 4 1 98 Pneumonia 1 .. 1 .. 1 3 5 6 1 2 4 2 1 27 4 3 4 7 2 .. 3 2 2 99 Emphysema, Asthma .. .. .. .. .. .. .. .. .. 1 2 1 .. 4 1 • • .. 2 1 .. .. .. •• 100 Pleurisy .. .. .. .. .. 1 .. .. .. .. .. 1 .. 2 .. .. .. 1 .. .. .. .. .. 101 Other Diseases, Respiratory System 102 Diseases of Mouth and Annexa 103 Diseases of Pharynx 104 Diseases of (Esophagus .. .. .. .. .. .. .. .. .. 1 .. .. .. 1 .. .. .. .. 1 .. .. .. .. 105 Ulcer of Stomach and Duodenum 1 .. .. .. .. .. 2 1 2 3 1 .. .. 10 1 2 .. 3 6 .. .. 1 .. 106 Other Diseases of Stomach 2 1 .. .. .. .. .. .. .. 1 1 .. 1 6 1 1 .. 1 .. .. 1 1 1 107 Enteritis 2 .. .. .. .. .. .. .. .. .. 2 1 .. 6 .. 1 .. .. .. 1 .. 2 1 108 Appendicitis 1 .. 1 2 .. .. 2 . 1 .. 1 .. .. 8 4 1 .. .. .. .. .. .. 3 109 Obstruction of Intestine 2 1 .. .. .. 1 .. 2 .. 1 2 .. .. 9 1 1 1 4 1 .. .. .. 1 110 Other Diseases of Intestine 111 Cirrhosis of Liver .. .. .. .. .. .. .. 1 .. 3 1 1 .. 6 2 3 .. .. 1 .. .. .. .. 112 Other Diseases of Liver .. .. .. .. .. .. .. 2 .. .. 1 1 .. 4 1 1 .. .. .. .. .. 1 1 113 Peritonitis .. .. .. .. .. .. .. .. 1 .. .. .. .. 1 .. .. .. .. 1 .. .. .. .. 114 Other Diseases, Digestive System 115 Diseases, Lymphatic System and Glands Goitre .. .. .. .. .. .. .. 1 1 .. .. .. .. 2 1 1 .. .. .. .. .. .. .. 118 Acute Nephritis 1 .. .. .. .. .. .. .. .. .. 2 .. .. 3 .. .. .. .. 1 1 .. 1 .. 117 Bright's Disease 1 .. .. .. .. 1 1 2 4 5 4 .. 1 19 2 3 1 .. 4 3 1 2 3 118 Calculus 119 Diseases of Bladder and Prostate .. .. .. .. .. .. .. .. .. 1 .. .. 2 3 .. 1 .. 1 .. .. .. 1 .. 120 Other Diseases, Urinary System 121 Diseases of Testis and Penis 122 Diseases of Ovaries 123 Diseases of Uterus & Appendages 124 Diseases of Vagina and External Genitals 125 Diseases of Breast 126 Abortion, Miscarriage 127 Puerperal Mania 128 Puerperal Convulsions .. .. .. .. .. .. 1 .. .. .. .. .. .. 1 1 .. .. .. .. .. .. .. .. 129 Placenta Preevia, Flooding Totals 22 6 2 2 2 6 15 21 15 28 45 22 10 196 25 27 8 39 25 20 12 21 19 4. No Diseases. AGES. All Ages. WARDS. Highgate Muswell Hill. Crouch End. West Hornsey. East Hornsey. North Haringey. South Haringey. Stroud Green Finsbury Park. 0- 1- 5- 10 15- 20- 25- 35- 45- 55- 65- 75- 85- 130 Puerperal Thrombosis 131 Other Diseases. Pregnancy and Childbirth 132 Arthritis, Ostitis, Periostitis 133 Other Diseases, Osseous System 134 Ulcer, Bedsore 135 Eczema 136 Pemphigus 137 Other Diseases, Integumentary System Accidents and Negligence. 138 In Mines and Quarries 139 In Vehicular Traffic ... ... ... 1 ... ... ... ... ... ... ... ... ... 1 ... ... ... 1 ... ... ... ... ... 140 On Railways 141 On Ships, Boats, &c. (not drowning) 142 In Building Operations 143 By Machinery 144 By Weapons and Implements.. 146 Burns and Scalds ... 1 ... ... ... 1 ... 1 ... ... ... ... ... 3 ... ... ... 1 ... ... 1 1 ... 146 Poisons, Poisonous Vapours ... ... ... ... ... ... ... ... ... 1 ... ... ... 1 ... ... ... ... ... ... ... 1 ... 147 Surgical Narcosis 148 Effects of Electric Shock 149 Corrosions by Chemicals 150 Drowning 151 Suffocation, Overlaid in Bed 3 ... ... ... ... ... ... ... ... ... ... ... ... 3 ... ... ... 1 ... 2 ... ... ... 152 „ Otherwise ... ... ... ... ... ... 1 ... ... ... ... ... ... 1 ... ... ... ... ... ... ... ... 1 153 Falls not specified 154 Weather Agencies 155 Otherwise not stated 156 Homicide Suicides. 157 By Poison 158 By Asphyxia 159 By Hanging and Strangulation ... ... ... ... ... ... ... 1 ... ... ... ... ... 1 ... ... ... ... ... ... ... 1 ... 160 By Drowning 161 By Shooting ... ... ... ... ... ... 1 ... ... 1 ... .. ... 2 ... 1 ... ... ... ... ... ... 1 162 By Cut or Stab ... ... ... ... ... ... ... 1 ... ... ... ... ... 1 ... ... ... 1 ... ... ... ... ... 163 By Precipitation from Elevated Places ... ... ... ... ... ... ... 1 ... ... ... ... ... 1 ... ... ... ... 1 ... ... ... ... 164 By Crushing ... ... ... ... ... ... ... ... 1 ... ... ... ... 1 ... 1 ... ... ... ... ... ... ... 165 By other and unspecified methods 166 Execution.. 167 Sudden Death, cause not ascertained 168 111 defined and unspecified causes Totals, Sheet No 4 3 1 - 1 - 1 2 4 1 2 - - - 15 - 2 - 4 1 2 1 3 2 Totals, Sheet No. 3 22 6 2 2 2 6 15 21 15 28 45 22 10 196 25 27 8 39 25 20 12 21 19 Totals, Sheet No 2 60 11 5 1 - 6 10 21 37 57 89 82 28 407 48 46 22 63 46 54 28 53 47 Totals, Sheet No. 1 12 21 6 4 5 8 20 11 10 8 9 4 1 119 14 12 5 22 13 17 8 9 19 Grand Totals 97 39 13 8 7 21 47 57 63 95 143 108 39 737 87 87 35 128 85 93 49 86 87 TABLE V. BOROUGH OF HORNSEY. INFANTILE MORTALITY DURING THE YEAR 1910. Deaths from stated Causes in Weeks and Months under One Year of Age. CAUSE OF DEATH. Under 1 Week. 1-2 Weeks. 2-3 Weeks. 3-4 Weeks. Total under 1 Month. 1-2 Months. 2-3 Months. 3-4 Months. 1-5 Months. 5-6 Months. 6-7 Months. 7-8 Months. 8-9 Months. 9-10 Months. 10-11 Months. 11-12 Months. Total Deaths under 1 Year All Causes 1 Certified 26 3 5 5 40 17 8 11 2 3 1 2 2 5 2 4 96 Uncertified 1 1 I Common Infectious Diseases 'Small-pox Chicken-pox Measles Scarlet Fever Diphtheria (including membranous Croup ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 ... 1 Whooping Cough ... ... ... ... ... ... 1 1 ... ... ... ... ... ... ... 1 3 II. Diarrhoeal Diseases Diarrhoea, all forms ... ... ... ... ... ... ... ... ... 1 ... ... ... ... ... ... 1 Enteritis, Muco-enteritis, Gastro-enteritis ... ... ... ... ... 1 1 1 ... ... ... ... ... 1 ... ... 4 Gastritis, Gastrointestinal Catarrh ... ... ... ... ... 2 ... ... ... ... ... 1 ... ... ... ... 3 III. Wasting Diseases f Premature Birth 19 ... ... ... 19 5 ... 1 ... ... ... ... ... ... ... ... 25 Congenital Defects 2 1 1 1 5 2 ... ... ... ... ... ... ... ... ... ... 7 Injury at Birth 2 ... ... ... 2 ... ... ... ... ... ... ... ... ... ... ... 2 Want of Breast-milk, Starvation ... ... ... ... ... 1 ... 1 ... ... ... ... ... ... ... ... 2 Atrophy, Debility, Marasmus J 3 l 2 2 8 4 2 2 2 2 1 ... ... ... ... ... 21 IV. Tuberculous Diseases Tuberculous Meningitis ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 1 Tuberculous Peritonitis: Tabes Mesenterica ... ... ... ... ... ... ... 2 ... ... ... ... ... ... ... ... 2 Other Tuberculous Diseases ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 ... 1 V. Other Causes Erysipelas Syphilis ... ... 1 ... 1 ... ... 1 ... ... ... ... ... ... ... ... 2 Rickets Meningitis (not Tuberculous) ... ... ... ... ... ... 1 ... ... ... ... ... ... 1 ... ... 2 Convulsions ... ... 1 ... 1 ... ... ... ... ... ... ... ... ... ... 1 2 Bronchitis ... ... ... ... ... 1 ... 1 ... ... ... 1 1 1 ... ... 5 Laryngitis Pneumonia ... 1 ... 1 2 ... ... 1 ... ... ... ... 1 2 ... 1 7 Suffocation, overlying 1 ... ... ... 1 ... 2 ... ... ... ... ... ... ... ... ... 3 Other Causes ... ... ... 1 1 1 1 ... ... ... ... ... ... ... ... ... 3 27 3 5 5 40 17 8 11 2 3 1 2 2 5 2 4 97 Registration District, Edmonton. Sub-district, Hornsey. Population, estimated to middle of 1910, 94,721. Births in the year < legitimate, 1,362. illegitimate, 31. Deaths in the year of legitimate infants, 90 illegitimate infants, 7 Deaths from all Causes at all Ages, 737. No y BOROUGH OF HORNSEY—SANITARY WORK, 1910. Name of Sanitary District Inspections. Notices. Dwelling Houses. Houses lei in Lodgings (Tenement Houses). Common Lodging Houses. CanalBoats used as Dwellings. Movable Dwell" ings, Caravans' Tents, &c. Bakehouses. Number of Premises Inspected 1 on Complaint. Number of Premises Inspected 2 in connection with Infectious Diseases. Number of Premises under Peri3 odical Inspection. Houses Inspected from House4 to-House. Total Number of Inspections 5 and re-inspections made. Cautionary or Intimation Notices given. Statutory Orders Issued. Summonses Served. Convictions Obtained. Houses, Premises, Ac., leansed, Repaired, &c. Closed as Unfit for Human Habitation (a) As result of action under H.W.C.Acts. (b) Otherwise. Re-opened after Repairs, Alterations, &c. Demolished. Illegal Underground Dwellings Vacated. Number Registered under Bye-laws. Number of Contraventions. Number Registered under Bye-laws. Number of Inspections mad Number of Contraventions. Number Registered under the Acts. Number of Contraventions of Regulations. Number Observed during the Year. Number of Nuisances therefrom Abated Number Removed from District. Number in District. Contraventions of Factory Acts. HORNSEY. 195 434 915 536 8,727 645 261 0 0 326 - - 1 - - - - - - - - - - - 43 8 Particulars as to Staff employed in Sanitary Department, specify if Inspectors are engaged in any other duties, and if so, what Medical Officer of Health ; Assistant ditto; 3 Inspectors; 2 Clerks ; 3 Disinfectors and Drain Tester*. No. 2. BOROUGH OF HORNSEY.—SANITARY WORK, 1910. Name of Sanitary District. Slaughter Houses. Cow-sheds Dairies and Milk-shops. Unsound Food. Adulterated Food. Offensive trades. Water Supply and Water Service. Number on Register. Number of Inspections made and frequency of inspection. Contraventions of Bye-laws. Number on Register. Number of Inspections made and frequency of inspection. Contraventions of Regulations. Number of Milch Cows in District. Number on Register. Number of Inspections made and frequency of inspection Contraventions of Regulations. (a) Animals seized (b) Articles or Parcels seized. Condemned by Magistrate (a&b) Articles or Parcels surrendered. Idformal Samples taken by the \ District Local Authority. Found adulterated. Number of premises in District. Number of Inspections made. Contraventions of Bye-laws. Wells. Percentage of Houses Supplied from Public Water Service. Cisterns. Draw-Taps placed on Mains. Percentage of Houses supplied on Constant System. Number of Samples obtained for analysis, a from Local Wells, b from Public Supply. New Sunk. Cleansed, Repaired, &c. Closed as Polluted. New, Provided. Cleansed, Repaired, Covered, &c. HORNSEY. 2 Carcases (Ox.) 17 cts. 2 qs. 7 lbs Fish, 1 cwt. 2 Plucks „ 3 qrs. 1 lb. Tomatoes, 8 lbs. 3 Livers „ 3 qr6. 6 lbs. Apples, 4 lbs. 9 75 - 4 21 - 62 76 201 16 - - 174 6 - - - - - 3 100% 5 165 4 100% a - Frequently Frequently Frequently b 36 No. 3. BOROUGH OF HORNSEY—SANITARY WORK, 1910. Name of Sanitary District. Drainage and Sewerage of existing Buildings. Disinfection. Dust. Sundry nuisanoes abated. Water Closets. Percentage of Houses Provided with Water ClosetF. Drains. Cesspools. Percentage of Houses Draining into Sewers. Rooms disinfected a Ordinary infectious disease, b Phthisis. Rooms Stripped & Cleansed. Articles disinfected or destroyedi a Ordinary infectious disease, b Phthisin. New bins provided. How frequently is dust removed from each house? Number of complaints of nonremoval received. Method of Disposal a Destructor, b by Tipping, c Other state method. Overcrowding. Smoke. Accumulations of refuse. Foul Ditches, Ponds, &c., and Stagnant Water. Foul Pigs and other Animals. Dampness. Yard6 repaved or repaired. Other Nuisances. Number of Water Closets Substituted for Dry Receptacles. Repaired, Supplied with Water, or otherwise Improved. Examined, Tested, Exposed,&.c Unstopped, Repaired, Trapped, &c Waste Pipes, Rain Water Pipes, Disconnected. Repaired, &c 1 New Soil Pipes or Venti ' lating Shafts fixed. Existing Soil Pipes or Ventilating Shafts repaired. Disconnecting-Traps or Chambers Inserted. Reconstructed. Rendered Impervious, Emptied, Cleansed, &c. Abolished, & Drain Connected to Sewer. Once from houses, twice from flats each week. HORNSEY. - 314 100% 335 143 302 88 34 69 91 - - 100°/° a 529 b 33 224 a 12,526 b 336 63 49 a Destructor 5 11 35 - 7 90 92 70 APPENDIX. BOROUGH OF HORNSEY. Advice to Persons Suffering FROM CONSUMPTION. 1. The safety of your family and of those with whom you associate, as well as your own chances of recovery, depend on your following these rules. 2. The material which you cough up and spit (the sputum) contains the infection of consumption. If this is allowed to become dry and to get broken into dust, such dust when inhaled will produce the disease in others, and will also cause fresh disease in your own lungs. 3. Great care must therefore be used, so that the sputum is not discharged on any spot or into any substance on which it can be dried and subsequently broken into dust. 4. It must, therefore, not be discharged on the floor or walls of any living room, workshop, meeting room, theatre, or other confined place in which people assemble. It must not be discharged into a pocket handkerchief carried in the usual manner, sinoe it readily dries in such a situation, so that not only are the clothes infected, but, when the pocket handkerchief is again used, a cloud of infective dust is scattered around you. 5. There are various ways in which this danger may be avoided. At home you should spit into a piece of paper or clean rag, carefully clean your mouth with it, and then throw the soiled rag or paper on the back of the fire. If there is on fire you should spit into a cup containing water, which must be emptied into the drains outside the house, and then thoroughly cleansed with boiling water before being again used. Outside the home you may carry a pocket spittoon charged with moistened blotting paper. This may be readily obtained at any chemists. It is essential that the lid should fit tight, and that the spittoon should be kept clean. Do not spit into a pocket handkerchief; it is better to spit over a street gulley than into an ordinary pocket handkerchief. 6. All persons who have a chronic oough and spit should carry out the above precautions. 7. Consumptives should not kiss on the lips. The eating utensils which they have used should be at once thoroughly cleansed before further use. 8. If these precautions are strictly observed a consumptive person runs 110 risk whatever of infecting others, and adds considerably to his own chances of recovery. 9. The sleeping room of a consumptive should be kept rigorously clean. If, by any chance, the pillows or bed clothes have been soiled with sputum they should be at onoe disinfected by steam, or washed with boiling water. Dust should not be allowed to accumulate anywhere in the bedroom. The room should be kept well aired and the bedroom window should, whenever possible, be kept slightly open. There is no reason why one other person should not occupy the same room, though not the same bed, if the above precautions are carefully carried out. 10. Persons who have contracted consumption, or who have a family history of the disease, should not live or sleep in a room which is damp, crowded, badly lighted, or badly ventilated. 11. It will often happen when a consumptive person's attention is first called to these rules that a considerable amount of infective dust will have oollected in the rooms which he has occupied. These must be carefully disinfected. Articles, including wearing apparel, carpets, hangings, bed clothes, and mattresses, which admit of such treatment will be disinfected at the Corporation Station free of charge, on application being made to the Medical Officer of Health. Articles which admit of washing with boiling water may be so washed. Other articles, as well as the floor, walls, and ceiling, should be thoroughly cleaned down with a disinfectant. Having once got the rooms quite clean, it becomes easy, though necessary, to keep them so. In order to effect this, the floors and skirtings of rooms used by consumptive persons should be thoroughly cleansed with soap and water at least once a week, and at all times the rooms should be kept free from dust. It is always desirable in dusting a room to moisten the floor with tea leaves or otherwise, and to use a damp duster to other parts of the room. In this way one makes sure of not scattering infectious dust in the air of the room. This is especially necessary in a room occupied by a consumptive, whose lungs are, moreover, likely to be injured by the dust left in the room. 12. The walls ought to be rubbed down with dough every three months and the dough burnt. 13. The most essential thing in preventing the spread of this disease, and in aiding the recovery of the consumptive person, is extreme cleanliness in his person and in the living and sleeping rooms used by him, with special attention to the points mentioned in this paper. Harold Coates, M.D., Medical Officer of Health. Municipal Offices, Highgate, N.