BOROUGH OF HORNSEY. PUBLIC HEALTH AND HOSPITAL COMMITTEE. The Mayor (Alderman Henry Ernest Cooper, J.P.) Chairman: Councillor Harold Wade. Alderman J. S. Balfour, J.P. Councillor H. E. Hill, „ W. Gaskell, „ W. J. Parkyn, „ J. H. Wilson, „ W. R. Penny, Councillor H. Boustred, „ G. A. Pidgen, „ H. B. Brackenbury, „ S. F. Stackard, „ W. Cryer, „ A. Storey, and „ G. A. Double, „ A. A. Yeatman, J.P. MEDICAL OFFICER OF HEALTH'S DEPARTMENT. Chief Sanitary Inspector Mr. W. Thorpe (Asscc. 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. A. J. Heath. 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 John M. Johnston, 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 1911. The publication of the results of the recent census revealed the fact that our population has been over estimated for several years past. In this report the figures have been corrected down to the previous taking of (he census (1901), and all the various vital statistics recalculated. The chief fact about the vital statistics of 1911, is a slight increase of the death-rate and birth-rate, of the Zymotic death-rate and infantile mortality. The increase of the mortality rates is accounted for by the comparative prevalence of Epidemic Diarrhoea, due to the hot dry summer of 1911. Nevertheless, the vital statistics are still very favourable. The number of cases of Infectious Disease notified was again very low, and it may fairly be stated that the public health of the Borough in 1911 was verv satisfactory. 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) £665,366 Population Census, 1901 72,056 1911 84,602 Estimated Population 1911 (June 30th) 94,711 Number of persons per acre, 1911 29.5 „ „ „ house, 1911 5.033 Estimated birth-rate per 1,000 living, 1911 17.4 Average birth-rate for previous 11 years 19.2 Estimated death-rate per 1,000 living, 1911 9.5 Deaths under 1 year of age, per 1,000 births, 1911 78 Average number of deaths under 1 year of age for previous 10 years 74 Death-rate from Zymotic diseases, 1911 0.92 Average death-rate from Zymotic diseases for vious 10 years 0.61 Death-rate from Phthisis 0.64 „ „ Other forms of Tuberculosis 0.92 „ „ Cancer 1.21 Population.— The publication of the results of the Census taken April 1st, 1911, shews, as was anticipated, that the estimates formed as to the number of persons living in Hornsey were far from being correct. A certain amount of error was to be expected, but it was not thought probable that the population had been over-estimated to the extent of over 10,000, as turned out to be the case. The effect of this over-estimating of the population is to render inaccurate all the vital statistics published in the report for the year 1910, and, to a less and diminishing extent, for the years preceeding that year, down to 1901. In the present report the estimates of population for the years 1901-1911 have been revised, and all the vital statistics calculated afrfsh on the basis of the revised population. The population of the Borough, as enumerated at the recent census, was 84,602. At the census taken in 1901, the population was 72,056, so that the increase of population in ten years amounted to 12,546. 4 The following table gives the population in each ward of the Borough at the census 1911, and that of 1901, with the increase or decrease of population in the intervening ten years — Ward. Population, Census 1901. Population. Census 1911. Increase in 10 years. Decrease in 10 years. Highgate 10,176 11,811 1,635 — Muswell Hill 5,833 11,391 5,558 — Crouch End 4,761 6,032 1,271 — West Hornsey 18,662 12,956 5,431 - East Hornsey 11,137 North Haringey 10,129 9,605 — 524 South Haringey 5,917 5,782 — 135 Stroud Green 9,356 8,751 — 605 Finsburv Park 7,222 7,137 — 85 The Borough 72,056 84,602 North and South Haringey, Stroud Green and Finsburv Park Wards, that is to say the wards along the Eastern boundary, all show small decreases in population. These are the parts of the Borough which have been fully built over for many years and where no further building activity is possible. In some of the wards, however, there seemed a tendency to the sub-division of houses formerly occupied by one family only, and in this way it seemed, probably, that the population of these wards might be steadily growing, in spite of the fact that no new houses were erected. It is now evident that the process of sub-letting has not progressed to the extent that seemed probable. The great increase has occurred in Muswell Hill, and East and West Hornsey Wards. Crouch End Ward has increased by about 25 per cent., and a proportionately smaller increase has taken place at Highgate. The Borough, as a whole, has increased in population by about seventeen per cent. in the ten years between the census of 1901 and that of 1911. The population for the years intervening between 1901 and 1911, in which, of course, no census was taken, have been re-estimated, and are as follows:— 5 Year. Population estimated to the middle of each year. 1901 72,865 1902 73,992 1903 75,526 1904 78,659 1905 79,193 1906 80,095 1907 81,909 1908 82,230 1909 83,034 1910 83,953 1911 84,711 In my last report the population at the middle of 1910, was estimated at 94,721, and the Registrar General's figure was 98,561. The revised estimate for the middle of 1910, as shewn above, is 83,953; a decrease of 10,768 as compared with my estimate, and a decrease of 14,608 on the Registrar General's estimate. The estimated population at the middle of 1911 is 84,711, an increase of 758 over the revised estimate for 1910. The statistical calculations of this report are based on the estimated population of 84,711. The following table shews the yearly increase per cent. for each year since the last Census:— Increase of population during the year. Increase per cent. 1901-1902 1,126 1.5 1902-1903 1,534 2.0 1903-1904 3,133 4.1 1904-1905 534 0.6 1905-1906 902 1-1 1906-1907 1,814 2.2 1907-1908 321 0.3 1908-1909 804 1.0 1909-1910 919 1.1 1910-1911 758 0.9 The rate of increase has been very irregular, but seems inclined to settle at somewhere about 1 per cent. per annum. The year 1903.4 was the year of great expansion, and smaller but still considerable increases occurred in the years 1902.3 and 1906.7. The average yearly increase in population for the last 10 years, is 1,184. The increase for the last year being 758, is considerably below the average yearly increase. The "natural increase" of population during 1911, i.e., excess of births over deaths, was 667. In the proceeding year the "natural increase " was 656, so that this year there is a slight gain in this respect. For many years past, the "natural increase "has been a diminishing quantity, owing to the great decline in the birth-rate. This year the "natural increase" accounts for almost the whole of the increase of the Borough's population. The estimated population at the end of each Quarter of 1911 was as follows :— End of first quarter 84,599 „ second „ 84,624 „ third „ 84,629 „ fourth „ 84,992 The following table shews for each Ward of the Borough, the population estimated at the middle of the year, for the years 1910 and 1911, with the increase or decrease during the 12 months. Ward. Estimated population, Estimated population. Variation during the year. 30th June, 1911, 30th June, 1910. 1911. 1910. Increase. Decrease. Highgate 11,855 11,095 160 — Muswell Hill 11,453 11,563 — 110 Crouch End 6,009 5,793 216 — West Hornsey 12,959 12,686 273 — East Hornsey 11,132 10,982 150 — North Haringey 9,610 9,500 110 - South Haringey 5,799 5,832 — 33 Stroud Green 8,756 8,657 99 — Finsbury Park 7,138 7,229 — 91 The Borough 84,711 83,953 1,008 234 West Hornsey and Crouch End shew the largest increases, and, for the first time, Muswell Hill has a small decrease in population, Highgate and East Hornsey have almost equal increases in population. In Stroud Green and North Haringey the increases are satisfactory, following those of a year ago. A loss this year in Finsbury Park replaces a gain of a year ago, and there is again a loss in South Haringey, though smaller than last year. 7 For the whole Borough there is a gross gain of 1,008 and a loss of 234, or a nett gain of 774. The population of each Ward, as enumerated at the Census, April 1, 1911, and as estimated at the middle of the year, June 30th, 1911, are shewn as follows:— Ward. Population, Census 1911. Estimated Population June 30th, 1911. Increase in ¼ year. Decrease in ¼ year. Highgate 11,811 11,855 44 — Muswell Hill 11,301 11,453 62 — Crouch End 6,032 6,009 — 23 West Hornsey 12,956 12,959 3 — East Hornsey 11,137 11,132 — 5 North Haringey 9,005 9,610 5 — South I'aringev 5,782 5,799 17 — Stroud Green 8,751 8,756 5 — Finsbury Park 7,137 7,138 1 — 84,602 84,711 — — The following table gives the revised estimated population at the middle of each year, for each Ward of the Borough :— ESTIMATED POPULATION AT THE MIDDLE OF THE YEAR Ward. 1901. 1902. 1903. 1904. 1905. 1906. 1907. 1908. 1909. 1910. 1911. Highgate 10.284 9,930 9,922 11,094 11,246 11,328 11,621 11,862 11,981 11,695 11,855 Muswell Hill 5,900 7,182 8,406 9,297 9,863 10,624 11,088 11,377 11,834 11,563 11,453 Crouch End 4,818 4,842 4,904 4,942 4,984 5,043 5,194 5,235 5,348 5,793 6,009 West Hornet 8,880 19,406 20,318 10,398 11,274 11,700 12,466 12,726 12,891 12,686 12,959 East Hornsey 11,358 11,268 11,331 11,783 11,628 11,713 10,982 11,132 North Haringey 10,235 10,185 9,938 9,625 9,466 9,411 9,337 9,136 9,065 9,500 9,610 South Haringey 5,986 6,143 6,026 5,501 5.519 5,358 5,330 5,210 5,365 5,832 5,799 Stroud Green 9,463 9,718 9,571 9,068 8,846 8,786 8,770 8,670 8,407 8,657 8,756 Finsbury Park 7,300 6,586 6,441 6,776 6,727 6,508 6,320 6,386 6,430 7,229 7,138 The Borough 72,866 73,992 75,526 78,659 79,193 80,095 81,909 82,230 83,034 83,953 84,711 8 9 Density of Population.— The total area of the Borough is 2,874 acres. With a population of 84,711, this gives us 29'5 persons per acre. Ten years ago there were 25 persons per acre in Hornsey. As is shewn in the table below, the number of persons per acre varies greatly in different parts of the district. North Haringey is the most thickly populated, having 77 persons per acre, then follow East and West Hornsey, with 57 persons per acre. Crouch End, Highgate and Muswell Hill, with 16, 16, and 17 persons per acre respectively, are yet the least densely populated areas. The following table shews the area and the density of population for each Ward of the Borough:— Ward. Area in acres. Population. Number of persons per acre. Number of persons per house. H ighgate 709.5 11,855 16 5.423 Muswell Hill 663.5 11,453 17 4.192 Crouch End 376 6,009 16 4.985 West Hornsey 227.5 12,959 57 5.201 East Hornsey 195.5 11,132 57 4.901 North Haringey 125 9,610 77 5.061 South Haringey 109 5,799 53 5.037 Stroud Green 269 8,756 32 4.703 Finsbury Park 199 7,138 35 5.869 The Borough 2,874 84,711 29.5 5.033 Births.— The number of births recorded during J911 was 1,479. This is an increase of 86 compared with the number of births registered in 1910. In the preceding twelve months (1910, compared with 1909) there was a decrease of 115 in the recorded births. Twenty-eight of the births were illegitimate (31 in 1910). Fourteen of the births occurred at the New Edmonton Infirmary. The birth-rate for the year was 17 4 as compared with 16 5 in 1910. The following table gives the number of births and the birthrates for each quarter of the year 1911 10 1911 HORNSEY. ENGLAND AND WALES. No. of Births. Birth.rate. Birth.rate. 1st Quarter 390 18.4 24.8 2nd „ 379 17.8 25 0 3rd „ 388 18.3 24.4 4th „ 322 15.2 230 1,479 17.4 24.4 As usually happens, the first three quarters do not shew much difference in the birth-rate, but a big drop occurs in the last quarter of the year. The birthrates in the great towns of England and Wales are given below:— England and Wales 24.4 77 Great Towns 25.6 London 24.8 Bristol 21.8 Croydon 22.1 Stoke-on-Trent 31.5 Wilted en 25.0 Burton-on-Trent 22.1 Hornsey 17.4 Wolverhampton 25.2 Tottenham 27.4 Walsall 28.8 West Ham 30.0 Handsworth (Staffs.) 20.9 East Ham 25.7 West Bromwich 29.9 Leyton 24.5 Birmingham 28.1 Walthamstow 24.8 King's Norton 22.1 Hastings 15.7 Smethwick 27.5 Brighton 19.7 Aston Manor 27.1 Portsmouth 25.0 Coventry 27.0 Bournemouth 15.2 Leicester 22.7 Southampton 23.9 Grimsby 28.7 Reading 21.3 Nottingham 24.5 Northampton 21.4 Derby 23.9 Ipswich 23.9 Stockport 23.4 Great Yarmouth 24.3 Birkenhead 28.6 Norwich 22.4 Wallasey 22.0 Plymouth 23.3 Liverpool 30.2 Devonport 25.7 Bootle 29.5 11 StHelen's 33.2 Sheffield 27.8 Wigan 27.3 Rotherham 29.1 Warrington 28.3 York 23.8 Bolton 22.8 Hull 28.6 Bury 20.6 Middlesborough 31.1 Manchester 26.2 Stockton-on-Tees 29.6 Salford 27.2 West Hartlepool 29.0 Oldham 23.7 Sunderland 29.9 Rochdale 20.7 South Shields 30.2 Burnley 23.3 Gateshead 30.5 Blackburn 21.5 Newcastle-on-Tyne . 26.6 Preston 23.3 Tynemouth 28.4 Barrow.in.Furness 26.6 Newport (Mob.) 27.6 Huddersfield 19.7 Cardiff 26.0 Halifax 18.5 Rhondda 35.6 Bradford 19.0 Merthyr Tydfil 31.1 Leeds 23.8 Swansea 29.1 Dewsbury 21.9 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 1911. Birth-rate. Highgate 164 13.8 Muswell Hill 170 14.8 Crouch End 76 12.6 West Hornsey 320 24.6 East Hornsey 248 22.2 North Haringey 205 21.3 South Haringey 88 15.1 Stroud Green 105 11.9 Finsbury Park 103 14.4 The Borough 1,479 17.4 The following arc the birth-rates in Hornsey for the last ten years, calculated on the revised estimated population:— 12  No. of Births registered. Birth rate per 1,000 of the population. 1901 1,511 20.55 1902 1,565 21.15 1903 1,561 20.66 1904 1,659 21.09 1905 1,567 19.79 1906 1,603 20.01 1907 1,524 18.60 1908 1,485 18.05 1909 1,508 18.16 1910 1,393 16.59 1911 1,479 1740 Illegitimate Births.— There were 28 illegitimate births recorded in 1911, and 31 in 1910, a decrease of 3. The proportion of illegitimate births of the total registered births, 1.8 per cent., as compared with 2.2 per cent. last year. Fourteen or the illegitimate births occurred in the New Edmonton Infirmary, and in the following table these have beer 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 tota births in the Ward Highgate 6 3.6 Muswell Hill 5 2.9 Crouch End 0 0 West Hornsey 3 0.9 East Hornsey 6 2.4 North Haringey 1 2.0 South Haringey 5 5.6 Stroud Green 0 0 Finsbury Park 2 1.9 28 1.8 13 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. Births. Birthrate. Births. Birth, rate. Births. Birthrate. Births. Birthrate. Highgate 34 11.4 38 12.8 52 17.5 40 13.4 164 13.8 Muswell Hill 44 15.3 39 13.6 48 16.7 39 13.6 170 14.8 Crouch End 25 16.6 21 13.9 17 11 .3 13 8.6 76 12.6 West Hornsey 86 26.5 78 24.0 91 28.0 65 20.0 320 24.6 Ea9t Hornsey 75 26.9 62 22.2 53 19.0 58 20.8 248 22.2 North Haringey 43 17.8 65 27.0 54 22.4 43 17.8 205 21.3 South Haringey 22 15.1 22 15.1 22 15.1 22 15.1 88 15.1 Stroud Green 28 12.7 31 14.1 27 12.3 19 8.6 105 11.9 Finsbury Park 33 18.4 23 12.8 24 13.4 23 12.8 103 14.4 The Borough 300 18.4 379 17.8 388 18.3 322 15.2 1,479 17.4 14 The accompanying chart, shews the Birth-rate in Hornsey for the past 28 years :— The number of births registered week by week are shewn in the following table, births occurring in public institutions outside the Borough being allocated to the Ward in which the mother resided previously. 15 WEEKLY RETURN OF BIRTHS FOR THE YEAR 1911. Week ending Highgate Muswell Hill Crouch End West Hornsey East Hornsey North „ Haringey South „ Haringey Stroud Green Finsbury Park Males Females Total 7th „ January 2 4 2 5 11 3 4 3 6 18 22 40 14th „ 3 8 1 4 6 2 1 2 1 17 11 28 21st „ 1 5 2 9 5 7 1 2 2 18 16 34 28th „ 4 — 3 5 3 3 1 1 2 12 10 22 4th „ February 4 2 1 8 2 4 2 1 3 12 15 27 11th „ 2 2 1 6 7 1 3 1 3 14 12 26 18th „ 4 4 2 8 6 3 1 2 2 17 15 32 25th „ „ 4 2 1 11 5 3 4 2 2 12 22 34 4th „ March 1 7 2 6 5 1 — 3 3 10 18 28 11th „ 2 3 — 5 4 6 2 3 4 13 16 29 18th „ ,, 1 3 4 4 5 2 1 1 2 12 11 23 25th „ 3 2 — 7 6 4 2 2 2 17 11 28 1st April 3 2 6 8 10 4 — 5 1 24 15 39 34 44 25 86 75 43 22 28 33 196 194 390 8th „ April 4 2 — 3 10 4 2 1 3 21 8 29 15th „ ,, 2 5 1 4 2 7 — 3 1 13 12 25 22nd ,, 2 3 4 11 6 3 2 2 1 21 13 34 29th „ ,, 4 2 1 7 3 8 3 3 2 15 18 33 6th „ May 5 4 — 4 9 7 4 2 2 25 12 37 13th „ ,, — 3 3 5 2 1 2 1 1 9 9 18 20th „ ,, 3 5 2 7 4 8 2 3 1 22 13 35 27th „ ,, 2 2 4 8 3 4 2 4 1 14 16 30 3rd June 5 3 1 5 5 4 1 4 4 21 11 32 10th „ ,, 4 1 2 9 5 3 2 1 2 13 16 29 17th „ ,, 3 1 2 5 5 8 — 1 — 10 15 25 24th „ ,, 2 3 1 4 5 3 — 3 4 14 11 25 1st July 2 5 — 6 3 5 2 3 1 14 13 27 38 39 21 78 62 65 22 31 23 212 167 379 8th „ July 2 4 2 5 3 5 1 2 3 19 8 27 15th „ 6 4 1 5 8 2 3 6 1 18 18 36 22nd ,, 1 2 3 7 4 6 — 1 3 14 13 27 29th „ ,, 8 2 4 7 6 4 1 1 — 13 20 33 5th „ August 3 14 1 7 5 4 — 2 2 20 18 38 12th „ 6 2 — 10 1 4 3 2 3 12 19 31 19th „ 3 2 1— 7 6 7 — 3 3 16 15 31 26th „ 2 — 1 3 — 5 3 2 1 7 10 17 2nd September 5 4 2 10 3 4 2 — 2 16 16 32 9th „ 2 4 1 7 1 2 2 — 2 15 6 21 16th „ „ 2 4 — 6 3 2 2 1 — 10 10 20 23rd „ 6 4 2 7 6 3 3 3 2 18 18 36 30th „ „ 6 2 — 10 7 6 2 4 2 24 15 39 52 48 17 91 53 54 22 27 24 202 186 388 7th „ October 3 4 2 10 4 2 1 2 2 16 14 30 14th „ 3 5 3 2 6 4 — 1 — 10 14 24 21st „ 3 2 — 6 7 3 3 2 1 13 14 27 28th „ 3 5 1 5 2 6 3 2 3 18 12 30 4th „ November 3 3 1 5 4 5 1 3 3 16 12 28 11th „ 1 2 — 4 2 6 3 1 1 11 9 20 18th „ 4 6 2 5 4 3 2 2 1 17 12 29 25th „ 3 3 2 8 5 3 3 1 2 13 17 30 2nd December 5 3 — 3 5 1 1 2 3 10 13 23 9th „ 1 2 — 6 4 2 1 2 12 6 18 16th „ 6 1 6 6 2 4 2 ] 14 14 28 23rd „ 2 — 1 2 7 4 1 — 2 8 11 19 30th „ 3 3 1 3 2 2 — — 2 9 7 16 40 39 13 65 58 43 22 19 23 167 155 322 16 Deaths.— The number of deaths registered in the Borough in 1911 was 665, being 39 deaths more than the number registered in 1910. The yearly average number of deaths registered in the Borough during the last ten years was 633. The death-rate calculated on these figures (gross death-rate) is 7.85 per thousand of the mean population for the year. This is 0.40 higher than the corresponding rate last year. This, however, includes only deaths actually registered in the Borough, and does not include those of Hornsey people dying elsewhere. There were 178 Hornsey people who died outside the district during 1911, viz.:— 64 in the Edmonton Workhouse, 22 in the Great Northern Central Hospital, 54 in other Hospitals outside the Borough, 10 in Lunatic Asylums, and 28 in various other places. On the other hand there were 31 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 (178) of Hornsey people dying outside the Borough, and deduct the number (31) 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 812, an increase of 75 over the corresponding number for 1910. The death-rate calculated on these figures is the net deathrate, and for the past 7 years is asi follows : — Year. Net death-rate 1905 8.78 1906 9.57 1907 9.35 1908 9.14 1909 9.47 1910 8.77 1911 9.58 It is only for these seven 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. 17 The net death-rate for 1911 is 0'81 higher than that of 1910. Last year, 1910, however, was the lowest death-rate on record in Hornsey. The figures for recent years have shewn very slight variations, and constitute an admirable record. The following table gives the death-rates for the " large towns" of England and Wales: — England and Wales 14.6 77 Great Towns 15.5 London 15.0 Smethwick 14.3 Croydon 11.8 Aston Manor 15.5 Willesden 11.8 Coventry 13.1 Hornsey 9.5 Leicester 13.3 Tottenham 13.1 Grimsby 14.4 West Ham 15.8 Nottingham 16.1 East Ham 12.1 Derby 14.3 Ley ton 12.1 Stockport 15.7 Walthamstow 11.6 Birkenhead 15.6 Hastings 13.6 Wallasey 12.3 Brighton 13.8 Liverpool 20.0 Portsmouth 14.1 Bootle 17.6 Bournemouth 11.4 StHelen's 18.2 Southampton 15.2 Wigan 17.9 Reading 11.8 Warrington 15.5 Northampton 13.2 Bolton 15.9 Ipswich 12.5 Bury 15.9 Great Yarmouth 14.3 Manchester 17.0 Norwich 14.1 Salford 16.7 Plymouth 17.2 Oldham 17.6 Devonport 13.4 Rochdale 15.1 Bristol 15.1 Burnley- 18.0 Stoke-on-Trent 19.9 Blackburn 16.1 Burton-on-Trent 13.2 Preston 16.9 Wolverhampton 15.8 Barrow-in-Furness 12.5 Walsall 16.2 Huddersfield 15.0 Handsworth (Staffs.) 10.3 Halifax 15.2 West Bromwich 15.8 Bradford 14.9 Birmingham 16.8 Leeds . 16.4 King's Norton 9.1 Dewsbury 17.3 18 Sheffield 16.1 Gateshead 16.1 Rotherham 16.3 Newcastle-on-Tyne 16.1 York 13.4 Tynemouth 15.4 Hull 16.7 Newport (Mon.) 13.4 Middlesbo rough 19.4 Cardiff 14.0 Stockton-on-Tees 16.5 Rhondda 15.0 West Hartlepool 15.6 Merthyr Tydfil 15.5 Sunderland 17.9 Swansea 16.2 South Shields 17.1 1910 1911 The death.rate in Hornsey during the first quarter was 9.8 10.2 ,, ,, „ second ,, 8.2 9.1 „ ,, ,, third ,, 6.1 9.6 ,, ,, ,, fourth ,, 10.9 9.3 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:— 1st Quarter. 2nd Quarter. 3rd Quarter. 4th Quarter. Death Ward. Deaths. Death. rate. Deaths. Death. rate. Deaths. Death. rate' Deaths. Death. rate. Total Deaths. per 1,000 persons living. Highgate 27 9.1 29 9.7 27 9.1 28 9.4 111 9.3 Muswell Hill 19 6.6 22 7.6 14 4.8 31 10.8 86 7.5 Crouch End 15 9.9 10 6.6 15 9.9 13 8.6 53 8.8 West Hornsey 40 12.3 37 11.4 50 15.4 36 11.1 163 12.5 East Hornsey 32 11.4 30 10.7 36 12.9 28 10.0 126 11.3 North Haringey 28 11.6 16 6.6 19 7.9 22 9.1 85 8.8 South Haringey 16 11.0 12 8.2 9 6.2 10 6.8 47 8.1 Stroud Green 15 6.8 15 6.8 14 6.3 12 5.4 56 6.3 Finsbury Park .. 25 14.0 22 12.3 20 11.0 18 10.0 85 11.9 Total deaths 217 10.2 193 9.1 204 9.6 198 9.3 812 9.5 The deaths in public institutions have been referred to the Wards from which the patients were removed on entering the public institutions. 19 Gross death-rates per 1,000 persons living 1890-1911:- 20 The Ward death.rates for the last 7 years are as follows:— Ward. Death rates per 1,000 1911. 1910. 1909 1908. 1907. 1906. 1905. Highgate 9.3 7.4 8.5 8.5 10.7 9.6 8.4 Muswell Hill 7.5 7.5 7.0 7.2 6.4 6.6 7.4 Crouch End 8.8 6.0 7.6 9.1 6.9 6.5 7.6 West Hornsey 12.5 10.0 9.9 10.1 10.1 12.0 11.0 East Hornsey 11.3 7.0 10.3 9.6 10.6 10.0 8.6 North Haringey 8.8 9.0 10.7 10.7 9.6 10.7 9.0 South Haringey 8.1 8.5 7.4 7.4 11.2 10.4 9.2 Stroud Green 6.3 9.9 10.2 7.3 7.6 7.5 6.4 Finsbury Park 11.9 12.0 13.5 12.0 9.8 11.9 11.0 The Borough 9.5 8.7 9.4 9.1 9.3 9.5 8.7 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. Muswell Hill has the most uniform death-rate, and the lowest, taking the whole period of seven years shewn in the table. The lowest. Ward death-rate for the year 1911 is that of Stroud Green Ward, viz., 6.3. The other Wards with a lower death-rate than in 1910 are South Haringey, 8.1 as against 8.5 in 1910, and Finsbury Park, 11.9 as against 12.0 in 1910. Muswell Hill has exactly the same death-rate as in 1910, viz., 7.5. All the other Wards of the Borough have higher death-rates this year than in 1910, the greater difference being in East Hornsey Ward, where a death-rate of 7 0 in 1910 has increased to one of 11.3 in 1911. Crouch End has a death-rate of 8.8 as compared with 6 0 in 1910, and West Hornsey one of 12.5 as against a death-rate of 10.0 a year ago. The remaining increases are less marked. 21 The following table shews the general and corrected rates in Hornsey for past years:. Gross death rate. Net death rate (corrected for Residents and Non.Residents). 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) 8.19 1902 8.37 1903 7.79 1904 8.38 1905 7.66 8.78 10.0 1906 8.39 9.57 10.9 1907 7.75 9.35 10.6 1908 7.95 9.14 10.4 1909 8.38 9.47 10.7 1910 7.45 8.77 9.9 1911 (Census taken) 7.85 9.59 10.9 The number of deaths occurring week by week are shewn in the following table, deaths occurring outside the Borough being allocated to the Ward in which the deceased person previously resided:— 22 WEEKLY RETURNS OF DEATHS FOR THE THE YEAR 1911. Week ending Highgate Muswell Hill Crouch End West Hornsey East Hornsey North „ Haringey South „ Haringey Stroud Green Finsbury Park Males Females Total 7th January - - 1 5 2 1 1 - 3 7 10 14th „ „ — 1 — 1 1 1 2 — 4 2 6 21st 4 1 2 5 3 1 1 2 5 11 13 24 28th „ 4 3 — 2 2 4 2 1 2 9 11 20 4th February .. 1 1 2 3 2 1 2 — — 3 9 12 11th „ 2 1 — 4 3 — 1 1 2 8 6 14 18th „ 5 1 4 3 3 4 1 1 1 11 12 23 25th „ — 1 — 2 2 3 1 2 4 6 9 15 4th „ March 2 2 — 1 — 2 2 — 3 3 9 12 11th „ 3 2 2 2 2 1 1 3 2 8 10 18 18th „ 1 4 — 7 5 4 1 — 3 11 14 25 25th „ 3 2 — 4 3 2 — 1 2 6 11 17 1st April 2 — 4 1 5 5 2 1 1 Ji 7 21 27 19 15 40 32 28 16 15 25 97 120 217 8th April 1 1 2 10 5 1 2 1 11 12 23 15th „ 2 5 — 1 3 3 — 3 1 12 6 18 22nd ,, 2 2 3 3 4 2 1 1 5 10 13 23 29th „ 6 2 — 3 2 2 4 1 1 9 12 21 6th May 2 1 — 3 5 — — 2 2 8 7 15 13th „ „ 1 1 — 2 3 3 2 1 1 8 6 14 20th „ ,, 3 1 5 2 1 — — 1 2 7 8 15 27th „ ,, 1 2 — 1 1 1 1 — 3 5 5 10 3rd June 5 1 — 2 1 — 1 1 6 7 13 10th „ ,, 4 3 — 6 1 2 1 2 11 8 19 17th „ ,, 1 — — 1 — — 2 2 4 5 9 24th „ ,, 1 2 — 2 — 1 1 1 — 4 4 8 1st July — 1 - 1 — — — 1 2 2 3 5 29 22 10 37 30 16 12 15 22 97 96 193 8th July 1 1 4 4 3 2 2 — 2 11 8 19 15th „ 2 1 — 1 2 — — 1 — 4 3 7 22nd ,, 2 — — 2 2 2 — — 1 5 4 9 29th „ 1 — 1 1 3 1 2 2 — 5 6 11 5th „ August 5 2 2 5 1 3 — 1 1 9 11 20 12th „ 1 1 1 4 — 3 — 1 4 10 5 15 19th „ 3 — — 5 2 3 1 2 2 9 9 18 26th „ 2 2 2 2 3 1 — 1 5 8 10 18 2nd September 3 1 2 13 4 1 1 2 — 11 16 27 9th „ 4 1 2 6 7 1 — 1 2 5 19 24 16th „ 2 2 — 1 4 1 1 — 1 6 6 12 23rd „ — — 1 2 4 — 1 2 1 6 5 11 30th „ 1 3 — 4 1 1 1 1 1 6 7 13 27 14 15 50 36 19 9 14 20 95 109 204 7th October 2 1 2 5 4 2 - - 3 9 10 19 14th „ 2 2 1 1 4 2 — 3 2 6 11 17 21st „ 2 6 — 2 2 — — 2 — 9 5 14 28th „ 4 2 2 4 3 2 1 1 1 8 12 20 4th November 3 2 1 1 1 1 1 1 5 6 11 11th „ 2 5 — 2 1 5 — 1 3 4 15 19 18th „ 1 2 1 5 1 1 2 1 — 4 10 14 25th „ 2 1 — 1 4 — — — 1 3 6 9 2nd December 2 2 2 3 5 1 2 1 1 8 11 19 9th „ 1 1 — 2 1 2 1 — 2 5 5 10 16th „ 4 3 1 5 2 3 1 1 1 9 12 21 23rd „ 2 3 2 5 1 3 — 1 1 11 6 17 30th „ 1 1 1 1 - — 2 — 2 6 2 8 28 31 13 37 28 22 10 12 18 87 111 198 23 The ages at which death occurred in 1911 were as follows:— Under 1 week 27 1-2 weeks 7 2-3 „ 7 3-4 „ 2 Total under 1 month 43 1-3 months 18 3-6 „ 21 6-9 „ 17 9-12 „ 17 Total under 1 year 116 1-2 years 38 2-5 23 5-15 28 15-25 „ 26 25-45 „ 109 45-65 „ 200 65 and over 272 Total deaths. 1911 812 The figures for preceding years are shewn below. Number of Deaths. Ages. 1911 1910 1909 1908 1907 1906 1905 1904 Under 1 year 116 97 87 95 116 136 106 145 1 year and under 5 years 61 39 55 52 50 55 43 66 5 years and under 15 ,, 28 21 21 19 23 32 16 24 15 „ 25 „ 26 29 27 33 16 34 24 28 25 „ 65 „ 309 261 309 295 291 269 272 203 65 years and over 272 290 288 258 270 243 235 224 Total Deaths 812 737 787 752 766 769 696 690 24 The death-rates at various age groups are shewn below. 1st Quarter. 2nd Quarter. 3rd Quarter. 4th Quarter. The year. Total Deaths 217 193 204 198 812 Death-rate per 1,000 10.2 9.1 9.6 9.3 95 „ England and Wales.. 15.9 133 15.5 13.6 14.6 „ 77 Great Towns 16.8 (77 towns). 14.7 176 15.6 16.4 Deaths under 1 year 22 27 49 18 116 Infantile Mortality 56 71 126 55 78 Do. England and Wales.. 115 91 201 113 130 Do. 77 Great Towns 115 (77 towns). 96 225 125 140 Deaths 1 year—64 years .. 94 107 111 112 424 Death.rate per 1,000 persons living at these ages 4.7 5.3 5*5 5.6 5.3 Deaths 65 years and over 101 59 44 68 272 Death.rate per 1,000 persons living at these ages 127 74 55 85 85 25 The principal causes of death are summarised in the following lists:— The following diseases caused more deaths in 1911 than in 1910:— Disease No. of Deaths in 1911. No. of Deaths iti 1910. Increase Diarrhoea 36 l 35 Measles 20 l 19 Cancer . 103 88 15 Phthisis 55 41 14 Bright's Disease 27 19 8 Dentition and Convulsions 11 4 7 Meningitis 12 6 6 Alcoholism and Cirrhosis of the Live 16 10 6 Forms of Tuberculosis other tha Phthisis 23 18 5 Whooping Cough 15 10 5 Fatty Degeneration of the Heart 14 9 5 Diabetes 6 3 3 Softening of the Brain 7 4 3 Premature Birth 28 26 2 The following diseases caused fewer deaths in 1911 than in 1910: — Disease. No. of Deaths in 1811. No. of Demths in 1910. Decrease Heart Disease 41 58 17 Infantile Atrophy and Debility 10 23 13 Pneumonia and Bronchitis 89 100 11 Apoplexy 43 49 6 Certain Diseases of Stomach and Intestines 18 30 12 Embolism, Thrombosis 1 6 5 Angina Pectoris 1 4 3 Rheumatic Fever 2 6 4 Enteric Fever 1 3 2 Diphtheria 5 8 3 Influenza 13 16 3 Scarlet Fever 1 4 3 The principal increases in the number of deaths from particular diseases are from Infectious disease in three instances, viz., 26 Measles, Epidemic Diarrhoea, and Phthisis, and the other notable increase is in the case of deaths from Cancer. Increased mortality also occurred from Alcoholism, Bright's Disease, from Whooping Cough, and from various forms of Tuberculosis other than Phthisis. As regards Measles and Epidemic Diarrhoea, regard must be paid to the fact that each of these diseases caused only one death in 1910. The deaths from Phthisis, though greater in number than in 1910, have been exceeded in some previous years. The number of Cancer deaths has shewn a big increase, and is considerably greater than in any year yet on record. The chief gains, i.e., fewer deaths recorded, were from Heart disease, Infantile wasting diseases, Lung disease, and diseases of the alimentary tract. The chief notifiable infectious diseases, Scarlet Fever, Diphtheria, and Enteric Fever, also shewed gains, as also did Influenza and Rheumatic Fever. Tuberculosis.—The deaths from Phthisis of the Lung numbered 55, or 14 more than in the previous year, and 5 more than the yearly average for the preceding 9 years. Six of these 55 deaths occurred in persons who had been removed to the Edmonton Workhouse. From forms of Tuberculosis other than Phthisis there were 23 deaths registered, an increase of 5 compared with the year 1910. The total deaths from all forms of Tuberculosis were, therefore, 78, or 19 more than in the previous year. 27 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. Number 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. 1911 55 .649 78 .921 1910 41 .488 59 .702 1909 57 .686 83 .999 1908 53 .644 69 .839 1907 50 .610 69 .842 1906 47 .586 60 .749 1905 58 .732 74 .934 1904 54 .686 77 .978 1903 45 .609 66 .874 1902 45 .608 67 .905 1901 45 .617 63 .864 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 6 0.506 7 0.590 Muswell Hill 7 0.611 8 0.698 Crouch End 2 0.332 3 0.499 West Hornsey 11 0.848 21 1.620 East Hornsey 10 0.898 14 1.257 North Haringey 9 0.936 11 1.144 South Haringey 5 0.863 6 1.036 Stroud Green 2 0.228 4 0.456 Finsbury Park 3 0.420 4 0.560 The Borough 55 0.649 78 0.920 28 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 10 years:— 1911. 1810. 1909. 1908. 1907. 1906. 1905. 1904. 1903. 1902. Phthisis 55 41 57 53 50 47 58 54 46 45 Other forms of Tuberculosis 23 13 26 16 19 13 16 23 20 22 Total 78 59 83 69 69 60 74 77 06 67 Measles 20 1 12 12 5 18 9 18 15 7 Scarlet Fever 1 4 3 3 4 6 3 1 1 2 Diphtheria 5 8 10 9 9 13 8 7 12 9 Small Pox 0 0 0 0 0 0 0 0 0 2 Enteric Fever 1 3 0 2 4 5 2 2 0 5 Whooping Cough 15 10 12 11 19 4 10 17 19 9 Diarrhœa 36 1 1 9 3 30 6 24 1 1 Total 78 27 38 46 44 76 38 69 48 35 In previous years the number of deaths from Phthisis alone has generally been greater than the number of deaths from the seven principal Zymotic diseases combined, and the deaths from all forms of Tuberculosis has nearly always been greatly in excess. Only in 1906 has the number of deaths from Tuberculosis been smaller than the number of deaths due to the chief Infectious Diseases. This year there have been 78 deaths from Tuberculosis and exactly the same number of deaths from the seven specified Infectious Diseases, but 1911 is a year in which Measles, Diarrhoea, and Whooping Cough have all been prevalent in epidemic proportions. Measles and Diarrhoea have, in fact, caused more deaths than in any previous year, and the number of deaths from Whooping Cough has exceeded the average. The following table shews the ages at death from Phthisis and from other forms of Tuberculosis:— 29 Years inclusive: AGES Under 1 year. 1-2 years. 2-5 years. 5-15 years. 15-25 years. 25-45 years. 45-65 years. 65 years & over Number of deaths from Phthisis 1 4 37 11 2 Other forms of Tuberculosis 2 6 3 5 2 2 3 All forms of Tuberculosis 2 6 3 6 6 39 14 2 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 135 deaths registered for the Borough, 41, or nearly one-third, were due to Phthisis alone. Notification of Phthisis.—The Local Government Board have made regulations which make it the duty of every Medical Practitioner to notify every case of Pulmonary Tuberculosis occurring in the course either of his public or private practice. The first step was taken in 1908, when oases of Phthisis occurring among the inmates of poor law institutions, or under the care of poor law district medical officers, were made notifiable. In March, 1911, an extension of the system of notification of Phthisis was put into effect by Regulations which provided for the notification of cases of Phthisis occurring amongst the inpatients or out-patients under treatment at Hospitals supported by voluntary contributions. At the end of 1911 the system was completed by further Regulations made by the Local Government Board making it compulsory for Medical Practitioners to notify cases of Phthisis occurring in the course of private practice. The regulations came into operation on January 1st, 1912. During 1911 I have had 11 cases of Phthisis notified to me under the Poor Law regulations, and 45 cases under the Hospital regulations. 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 or a Hospital or Sanatorium, 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, 30 Annual Death-rates from Phthisis (1896-1911) per thousand persons living 31 In April, 1911, a Conference of Representatives of the Middlesex County Council, the Borough Councils and Urban and Rural District Councils in Middlesex, was held to consider the question of the provision of a Sanatorium for Consumptives for Middlesex. The Conference was well attended, and after an interesting discussion the following resolutions were passed:— 1. That it is desirable that each Local Authority, individually or in combination, should establish and carry out the work of an anti-tuberculosis dispensary. 2. That, in connection with dispensary treatment, it is desirable that provision shall be made for the loan by Local Authorities of open-air shelters to patients for use at their homes. 3. That it is desirable that sanatorium accommodation should be provided in Middlesex for the treatment of cases of pulmonary consumption. 4. That the Local Government Board be memorialized with a view to their taking the necessary steps to compel the compulsory notification of consumption and other tuberculous diseases. As regards No. 4, as stated elsewhere, the Local Government Board have now provided for the compulsory notification of Phthisis. Cancer.—There were 103 deaths registered as due to Cancer in 1911, as against 88 deaths from this cause in 1910, and 75 in 1909. This is an increase of 15 deaths over 1910, and of 28 deaths overt the number registered in 1909. A glance at the table below shews that the deaths in 1911 greatly exceed those of any preceding year. The death-rate from cancer per thousand of the population is equal to 121, about one-eighth of the total deathrate, and much the highest from any single cause. Reference to the chart appended shews an almost continuous rise in the Cancer mortality from 1895 onwards. The following table shews the deaths from Cancer in each Ward of the Borough for the last 11 years and the death-rate from Cancer in the whole Borough for each of these years. 32 Annual Death-rate from Cancer per thousand persons living for 17 years 1895-1911. 33 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. 1911 14 8 11 18 13 11 9 9 15 103 1.21 1910 12 5 4 11 9 15 6 15 11 88 1.04 1909 9 10 4 5 11 6 4 13 13 75 .90 1908 17 16 9 5 10 7 3 9 8 84 1.02 1907 14 11 2 3 9 11 11 10 5 76 .92 1906 7 8 4 8 8 9 7 6 8 65 .81 1905 13 12 2 7 9 7 4 4 7 65 .82 1904 7 8 3 7 5 5 2 5 7 49 .62 1903 6 4 6 12 15 0 7 6 62 .82 1902 8 3 2 15 8 1 3 6 51 .68 1901 8 3 1 5 6 5 11 8 47 .63 In some cases after a death from Cancer, bedding, etc., has been disinfected or destroyed, as requested. Deaths from Zymotic Diseases.—The number of deaths from each disease for 1911 and preceding years is shewn in the following table:— Number of Deaths 1911-1897 from the seven principal Zymotic Diseases. 1911 1910 1909 1908 1907 1906 1905 1904 1903 1902 1901 1900 1899 1898 1897 Small-pox 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 Measles 20 1 12 12 5 18 9 18 15 7 8 4 6 14 7 Scarlet Fever 1 4 3 3 4 6 3 1 1 2 0 1 3 0 2 Diphtheria 5 8 10 9 9 13 8 7 12 9 10 14 4 11 16 Enteric Fever 1 3 0 2 4 5 9 2 0 5 2 6 0 4 0 Whooping Couph 15 10 12 11 19 4 10 17 19 9 14 18 20 8 10 Diarrhœa 36 1 1 9 3 30 6 24 1 1 6 9 32 15 29 Totals 78 27 38 46 44 76 38 69 48 35 40 52 65 52 64 34 The number of deaths from this group of diseases is the largest yet recorded. There were 78 deaths from Zymotic Diseases in 1911, as against 27 in 1910. The year 1907, with 76 deaths from these diseases, is the next largest total, and after that 1904 with 69 deaths and 1899 with 65. The Zymotic death-rate is equal to .92 per thousand of the population, the highest zymotic death-rate since 1897, except for the year 1906, when the zymotic death-rate (.94) was slightly greater than in this year. In reoent years our Zymotic deathrate has been exceedingly low. The table given below of Zymotic death-rates in other towns shews that high Zymotic death-rates have been general during the past year, and that Hornsey still holds a very favourable position. 35 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 1911 0.92 1910 0.32 0.99 1.23 1909 0.45 1.28 1.42 1908 0.55 1.34 1.59 1907 0.53 1.13 1.54 1906 0.94 1.73 2.24 1905 0.47 1.94 1904 0.87 1.94 1903 0.63 1.46 1902 0.47 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 36 Annual Death Rate from Zymotic Diseases per thousand of the Population, 1895-1911. 37 Considering the Zymotic diseases in detail, it is seen that there was no death from Small pox. There were two deaths from this disease in 1902; there have been none since that year. From Scarlet Fever only 1 death occurred. In recent years Scarlet Fever has not been an important cause of mortality, the highest number of deaths in any one year being 6 in 1906. Diphtheria caused 5 deaths, the smallest number in any year since 1899. Enteric Fever caused only one death. Hornsey has for many years been singularly free from Typhoid Fever. The principal causes of the increased Zymotic death-rate is the abnormally large number of deaths from Measles, Epidemic Diarrhoea, and Whooping Cough. Measles has caused 20 deaths, a larger number than in any previous year, although 1906 and 1904 are very near, with 18 deaths. There was a widespread outbreak of Measles at the beginning of the year, and the majority of the casas appeared to be of a more severe type than usual. Whooping Cough, though accounting for more deaths than in any of the three preceding years, has in several recent years been more fatal than in 1911. Epidemic Diarrhœa was the disease responsible for the greater part of the increased Zymotic death-rate. This disease caused 36 deaths in 1911, as against 1 in 1910, 9 in 1908, and 3 in 1907. The year 1906 with 30 deaths, 1904 with 24 deaths, 1899 with 32 deaths, and 1897 with 29 deaths, were all years of high Zymotic mortalities. The exceptionally long spell of hot, dry weather in the summer of 1911 is accountable for the large number of deaths from diarrhoea. Special measures were taken to counteract the climatic conditions and to minimise the incidence of the disease as far as possible. All nuisances, accumulations of refuse, dirt, and dirty conditions of houses and yards were sought out and dealt with promptly. Verbal and printed instructions as to the avoidance of conditions likely to favour the prevalence of the disease were given in the districts likely to be affected, and also information as to the care and feeding of infants, who chiefly suffer from this affection. (See Appendix.) Infantile Mortality.—During the year 1911 there were 116 deaths of infants under 1 year of age, as against 97 in 1910, and an average of 115 for each of the ten years 1902-1911. 38 The infantile mortality for the year 1911, i.e., deaths under 1 year of age per 1,000 births, is 78 in Hornsey. In 1910 the infantile mortality rate was 69, and the average rate of the 17 years 1894-1910 was 88, 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 1910. Including 1910, on only five 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 Highgate 12 73 Muswell Hill 8 47 Crouch End 8 105 West Hornsey 31 96 East Hornsey 31 125 North Haringey 9 43 South Haringey 3 34 Stroud Green 6 57 Finsbury Park 8 77 The Borough 116 78 39 Infantile Mortality (deaths under 1 year per 1,000 births) 1894-1911. 40 The Infantile Mortality at the four quarterly periods of 1911 was as follows:— 1911. Births. Infantile Deaths. Infantile Mortality. First Quarter 390 22 56 Second „ 379 27 71 Third „ 388 411 126 Fourth „ 322 18 55 The whole year 1,479 116 78 The ages at death were as follows:— Under 1 week 27 1.2 weeks 7 2.3 „ 7 3.4 „ 2 Total under 1 month 43 1.3 months 18 3.6 „ 21 6.9 „ 17 9.12 „ 17 Total deaths under 1 year 116 Thus of the 116 infants who died before completing their first year, 27, or nearly one fourth, died during the first week of life, and over one third died during the first month of life. 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 30 20.2 Atrophy, Debility, Marasmus 6 4.0 Diarrhœal Diseases 28 18.9 Bronchitis and Pneumonia 11 7.4 Convulsions 4 2.7 Meningitis 3 2.0 Whooping Cough 7 4.7 Tuberculous Diseases 2 1.3 41 The only cause of death shewing any considerable increase is Diarrhoea, a disease always unusually prevalent among infants during prolonged hot, dry weather, such as we experienced last summer. To this cause alone is due the increase in the Infantile Mortality rate. Deaths under one year of age of Illegitimate Children.—There were 28 illegitimate births regisrtered during the year, and 6 deaths under 1 year of age of illegitimate children occurred. This gives an infantile mortality among illegitimate children of 214. The number of legitimate births registered was 1,451, and the number of deaths under 1 year of age of legitimate children was 110. This gives an infantile mortality among legitimate children of 68. INFANTILE MORTALITIES IN GREAT TOWNS. England and Wales 130 77 Great Towns 140 London 128 Bristol 141 Croydon 106 Stoke-on-Trent 202 Willesden 128 Burton-on-Trent 107 Hornsey 78 Wolverhampton 135 Tottenham 125 Walsall 160 West Ham 144 Handsworth (Staffs.) 101 East Ham 121 West Bromwich 138 Leyton 109 Birmingham 164 Walthamstow 110 King's Norton 101 Hastings 105 Smethwick 141 Brighton 98 Aston Manor 167 Portsmouth 126 Coventry 107 Bournemouth 102 Leicester 132 Southampton 134 Grimsby 154 Reading 99 Nottingham 162 Northampton 128 Derby 123 Ipswich 101 Stockport 170 Great Yarmouth 123 Birkenhead 134 Norwich 135 Wallasey 108 Plymouth 145 Liverpool 154 Devonport 114 Bootle 148 42 St. Helen's 160 Sheffield 140 Wigan 193 Rotherham 157 Warrington 146 York 113 Bolton 163 Hull 155 Bury 164 Middlesborough 169 Manchester 154 Stockton-on-Tees 133 Salford 149 West Hartlepool 129 Oldham 160 Sunderland 151 Rochdale 139 South Shields 147 Burnley 210 Gateshead 136 Blackburn 188 Newcastle-on-Tyne 136 Preston 172 Tynemouth 122 Barrow-in-Furness 111 Newport (Mon.) 121 Huddersfield 132 Cardiff 135 Halifax 123 Rhondda 164 Bradford 138 Merthyr Tydfil 152 Leeds 158 Swansea 136 Dewsbury 155 INFANTILE MORTALITY. 1911 1910 1909 1908 1907 1906 1905 1904 1903 1902 1901 1900 1899 1898 1897 1896 1895 1894 Total number of Deaths under 1 year of age 116 97 87 95 116 136 106 143 130 129 127 153 156 158 138 133 144 103 „ Births registered 1,479 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 Infan tile mortality (deaths per 1,000 births) 78 69 57 63 76 84 67 86 83 82 84 102 106 117 103 102 133 86 „ England and Wales 130 106 169 121 118 133 128 146 132 133 151 154 „ 77 Great Towns 140 115 118 128 127 145 140 160 144 145 76 Great Towns 43 44 The following table gives the principal Ward statistics for 1911:— WARD. Estimated population. Birth.rate. Death.rate. Infantile mortality. Highgate 11,855 13.8 9.3 73 Muswell Hill 11,453 14.8 7.5 47 Crouch End 6,009 12.6 8.8 105 West Hornsey 12,959 24.6 12.5 96 East Hornsey 11,132 22.2 11.3 125 North Haringey 9,610 2.3 8.8 43 South Haringey 5,799 15.1 8.1 34 Stroud Green 8,756 11.9 6.3 57 Finsbury Park 7,138 14.4 11.9 77 The Borough 84,711 17.4 9.5 78 Notifications of Infectious Disease.—The notifications of the common Infectious Diseases usually notified to the Medical Officer of Health (viz.:—Scarlet Fever, Diphtheria, Enteric Fever, Puerperal Fever, Erysipelas, and Small Pox) numbered 361 in 1911, as against 319 in 1910 and 414 in 1909. The yearly average number of notifications for the past 20 years (1891.1910) is 455. The notifications received this year are therefore 42 more than in 1910; they are 53 fewer than in 1909, and 94 fewer than the yearly average number for the past 20 years. Though not quite so good as in 1910, the year under review was a year of comparatively slight prevalence of infectious disease. Reference to the mortality figures in the preceding pages shew that, in spite of the slightly more numerous cases, the deaths were much fewer than in 1910, so that the type of disease occurring was mild. NOTIFICATIONS OF INFECTIOUS DISEASE. Disease. 1911 1910 1909 1908 1907 1906 1905 1904 1903 1902 1901 1900 1899 1898 1897 1896 1895 1894 1893 1892 1891 1890 Scarlet Fever 179 173 221 239 283 411 261 197 203 261 501 186 349 168 264 530 420 189 366 234 143 139 Diphtheria 133 105 151 93 98 157 153 101 62 99 134 107 101 99 87 96 93 117 139 43 64 50 Enteric Fever 6 10 4 9 11 25 20 16 15 38 35 32 22 31 31 35 46 40 25 21 15 32 Puerperal Fever 2 1 1 3 2 1 3 5 2 0 5 2 1 0 2 5 4 6 6 8 1 0 Erysipelas 40 30 37 39 34 37 39 40 25 33 40 45 42 51 39 39 45 51 70 32 25 17 Small Pox 1 0 0 0 0 0 1 0 2 35 10 0 2 0 0 4 5 3 11 2 0 1 Cholera 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 Total 361 319 414 383 431 631 477 359 209 466 725 372 517 349 423 709 613 406 618 340 248 239 Cerebro Spinal Meningitis 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 Phthisis 56 10 16 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 Chicken Pox 38 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 Grand Total 455 329 430 383 432 631 477 359 309 466 725 372 517 349 423 709 613 406 618 340 248 239 45 46 Chicken Pox was made temporarily notifiable for three months, and 38 cases were notified. There were also 56 cases of Phthisis notified, which have already been referred to. The notifications received during each quarter of the year were as follows:— Bill. Scarlet Fever. Diphtheria. Enteric Fever. Puerperal Fever. Erysipelas. SmallPox. ChickenPox. Phthisis. 1st quarter 33 19 1 0 11 1 0 3 2nd quarter 38 19 1 0 6 0 35 24 3rd quarter 28 34 1 2 12 0 3 15 4th quarter 80 61 3 0 11 0 0 14 Total 179 133 6 2 40 1 38 56 The occurrence of the cases in the different Wards is shown below:— Scarlet Fever. Diphtheria Enteric Fever. Puerperal Fever. Erysipelas SmallPox. ChickenPox. Phthisis. Total. Highgate 20 16 2 0 5 0 4 7 54 Muswell Hill 25 16 0 0 2 0 6 3 52 Crouch End 16 10 l 0 2 0 8 6 43 West Hornsey 53 30 2 0 10 0 2 8 105 East Hornsey 18 24 0 1 8 0 4 10 65 North Haringey 12 25 1 1 1 1 1 7 49 South Haringey 8 1 0 0 3 0 3 2 17 Stroud Green 18 5 0 0 5 0 6 4 38 Finsbury Park 9 6 0 0 4 0 4 9 32 Total 179 133 6 2 40 1 38 56 455 The attack rate per 1,000 of the population for the chief of these diseases during the last eight years was as follows:— 47  1911 1910 1909 1908 1907 1906 1905 1904 1903 1902 1901 Scarlet Fever 211 206 2.66 2.90 3.45 5.13 3.29 2.50 2.68 3.52 6.87 Diphtheria 1.57 1.25 1.81 1.13 1.19 1.96 1.93 1.28 0.82 1.83 1.83 Enteric Fever 0.70 0.11 0.04 0.10 0.13 0.31 0.25 0.20 0.19 0.51 0.48 Erysipelas 0.47 0.35 0.44 0.47 0.41 0.46 0.49 0.50 0.33 0.44 0.54 Small Pox 0.01 0.0 0.0 0.0 0.0 0.0 0.01 0.0 0.02 0.47 0.13 Scarlet Fever.—There were 179 cases of Scarlet Fever notified in 1911, as against 173 in 1910, and against a yearly average of 280 for the twenty years (1891.1910). There is therefore an increase of 6 over the cases notified in 1910, but the cases notified in 1911 were 101 fewer than the average number of the preceding twenty years. The disease was mostly of a very mild type, only one fatal case occurring among the 179 cases notified. Nearly half the cases were notified in the 4th quarter of the year. Particulars as to cases notified, deaths, percentage removed to Hospital, and Mortality, for a number of years past, are given below:— SCARLET FEVER. Year. Estimated Population Total No. ofcases of Scarlet Fever notified. Attack Rate per 1,000 Population No. of Deaths Registered from Scarlet Fever. Fatality per cent. Mortality per 1,000 Population No. of Cases treated in Hospital. Percentage removed to Hospital. 1901 72,866 501 6.87 0 0 0 331 66 1902 73,992 261 3.52 2 0.76 0.02 246 94 1903 75,526 203 2.68 1 0.49 0.01 175 86 1904 78,659 197 2.50 1 0.50 0.01 133 67 1905 79,193 261 3.29 3 1.14 0.03 177 67 1906 80,095 411 5.13 6 1.45 0.07 249 60 1907 81,909 283 3 .45 4 1.41 0.04 174 61 1908 82,230 239 2.90 3 1.25 0.03 239 100 1909 83,034 221 2.66 3 1.35 0.03 173 78 1910 83,953 173 2.06 4 2.31 0.04 136 78 1911 84,711 179 2.11 1 0.55 0.01 113 63 48 Diphtheria.—There were 133 cases of Diphtheria notified in 1911, as against 105 in 1910, and against a yearly average of 105 for the twenty years (1891.1910). There is therefore an increase of 28 over the number of oases notified in 1910, and also an increase of 28 as compared with the yearly average for the preceding 20 years. There were only 5 deaths among the 133 cases notified, as compared with 8 deaths among 105 cases notified in 1910. So that the disease was of a milder type, though somewhat more prevalent in 1911 as compared with 1910. Comparatively few cases occurred in the first half of the year, viz.:—38 cases, as compared with 95 cases notified in the second half of the year. Particulars as to cases notified, deaths, percentage removed to Hospital, and Mortality, are given below:— DIPHTHERIA. 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. 1890 42,000 50 10 200 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 1894 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 64,743 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 72,866 134 10 7.4 28 1.83 20.9 0.13 1902 73,992 99 9 9.0 35 1.33 35.3 0.12 1908 75,526 62 12 19.3 35 0.82 56.4 0.15 1904 78,689 101 7 6.9 56 1.28 56.0 0.08 1905 79,193 153 8 5.2 95 1.93 62.0 0.10 1906 80,095 157 13 8.2 97 1.96 61.7 0.16 1907 81,909 98 9 9.1 70 1.19 71.4 0.10 1908 82,230 93 9 9.6 51 1.13 54.8 0.10 1909 83,034 151 10 6.6 99 1.81 65.5 0.12 1910 83,953 105 8 7.6 80 1.25 76.7 0.09 1911 84,711 133 5 3.7 106 1.57 79.6 0.05 Enteric Fever.—Only 6 cases of this disease were notified in 1911, as compared with 10 cases in 1910, and an average of 24 cases for the twenty years (1891.1910). One case of the 6 notified proved fatal. 49 The number of cases of Typhoid Fever in Hornsey has declined almost continuously for several years. Isolation Hospital.—As compared with the previous year there were 90 fewer patients admitted in 1911, viz.:—475 in 1911 and 565 in 1910. The following table shows that the diminution in the number of patients treated is due entirely to the smaller number of admissions from Wood Green. The admission of Hornsey patients was almost the same as in the preceding year, viz.:—218 in 1911, and 219 in 1910. While from Finchley 26 more cases were admitted in 1911 than in the preceding year, viz.:—139 cases in 1911, as against 113 in 1910. The Wood Green patients, however, were 113 fewer in 1911 than in 1910, the figures being 118 cases in 1911, and 231 in 1910. The following table gives particulars of the number of admissions, deaths, and discharges, during the past 7 years:— 1911 1910 1909 1908 1907 1906 1905 Patients iu Hospital Jan. 1st 88 111 68 109 105 74 53 Patients admitted during the year 475 565 673 494 594 628 419 563 676 741 603 699 702 472 Patients discharged during the year 473 562 606 518 572 567 388 Patients dying during the year 13 26 24 17 18 30 10 486 588 630 535 590 597 398 Patients remaining in Hospital Dec. 31st 77 88 111 68 109 105 74 At the beginning of the year there were 88 patients in the Hospital, viz., 30 Hornsey patients, 14 from Finchley, and 44 from Wood Green. The cases were:— Scarlet Fever. Diphtheria Enteric Fever Total. Hornsey 21 8 1 30 Finchley 5 8 1 14 Wood Green 34 8 2 44 60 24 4 88 50 During the year there 475 cases admitted, as follows. Scarlst Fever. Diphtheria. Enteric Fever. Total Hornsey 113 99 6 218 Finchley 103 35 1 139 Wood Green 56 60 2 118 272 194 9 475 There were 26 more oases admitted from Finchley, compared with 1910, one case leas admitted from Hornsey, and 113 fewer from Wood Green. At the end of the year there were 77 cases in the Hospital, viz.:— Scarlet Fever. Diphtheria. Enteric Fever. Total Hornsey 27 18 1 46 Finchley 13 7 0 20 Wood Green 6 5 0 11 46 30 1 77 The following table shews the number of cases of each disease admitted during each month of the year, and the districts from which the patients were admitted:— 51  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 4 3 18 6 3 0 9 10 4 0 14 41 February 7 4 0 11 5 2 0 7 7 6 0 13 31 March 5 5 0 10 6 6 0 12 4 7 0 11 33 April 5 3 0 8 4 3 0 7 1 4 0 5 20 May 11 4 0 15 3 4 0 7 1 3 0 4 26 June 8 2 1 11 5 0 0 5 1 4 0 5 21 July 9 4 0 13 6 1 0 7 2 4 0 6 26 August 6 7 0 13 6 0 0 6 4 1 0 5 24 September 3 14 0 17 31 6 0 37 5 3 2 10 64 October 10 20 0 30 14 0 1 15 9 9 0 18 63 November 22 18 1 41 8 5 0 13 9 10 0 19 73 December 16 14 1 31 9 5 0 14 3 5 0 8 53 Total for the year 113 99 6 218 103 35 1 139 56 60 2 118 475 52 CASES OF DIPHTHERIA ADMITTED TO THE ISOLATION HOSPITAL AND CASE MORTALITY. 1894 1895 1896 1897 189 1899 1900 1901 1902 1903 1904 1903 1906 1907 1908 1909 1910 1911 Number of cases of Diphtheria notified in sey 117 89 95 87 99 101 107 134 99 62 101 153 157 98 93 151 105 133 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.ll 0.10 0.08 0.09 0.14 0.09 0.09 0.10 0.08 0.05 Number of cases of Diphtheria admitted to the Iso lation Hospital 29 8 24 15 45 37* 45* 30* 50* 7???* 92* 127* 157* 159* 113* 201* 215* 204* Mortality per cent, of cases treated in the Hospital 24% 25% 4% 20% 13% 13% 11% 16% 14% 11% 4% 5% 8% 5% 5% 7% 7% 5% * Cases admitted to Hospital from districts outside the Borough are included in these figures. 53 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. 1911 95 „ do. The following table gives the number of cases treated of each disease, the number of cases admitted from each district, and the number of fatal cases of each disease for the past 11 years:— 54 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. 1911 272 194 9 - 475 139 - 118 218 475 0 11 l 12 2.5 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 0 24 3.2 1908 449 139 15 - 603 161 - 188 25 4 603 9 8 0 17 2.8 1907 500 181 17 l 699 127 - 261 311 609 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 0 9 3.0 1002 298 50 16 - 364 81 10 - 273 364 2 7 2 11 3.0 1901 349 31 7 - 387 2 2 - 383 387 0 5 0 5 1.3 1900 138 50 9 - 197 5 4 - 188 197 1 5 3 9 4.5 55 The cost of maintenance (provisions) per inmate (patients an< resident staff) per head per week was as follows : — in 1911 6s. 9¾d. per head per week 1910 6s. 0½d. „ „ 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 1911 was 179, and of these 113 (equal to 63 per cent. of the cases notified) were admitted to the Isolation Hospital. There were also 103 cases of Scarlet Fever admitted from Finchley and 56 from Wood Green. There was no death in the Hospital from Scarlet Fever during the year. Diphtheria.—There were 133 cases of Diphtheria notified in the Borough during the year, and of these 99 cases (equal to 74 per cent. of those notified) were admitted to the Isolation Hospital. There were also 35 cases of Diphtheria admitted from Finchley and 60 from Wood Green. There were 11 deaths in the Hospital during the year from Diphtheria, giving a case mortality of 5'6 per cent. of the cases of Diphtheria under treatment. Enteric Fever.—There were six cases of this disease notified in the Borough during the year, and all were admitted to the Borough Hospital. There was one case of Enteric Fever admitted from Finchley, and two from Wood Green. There was one death in the Hospital during the year from Enteric Fever, giving a case mortality of 11 per cent. of the cases of Enteric Fever under treatment. Municipal Laboratory.—During the year 1,635 specimens were examined from patients who were, or were suspected to be, suffering from Diphtheria. Of these 1,252 were specimens taken 56 at the Hospital, and 383 specimens were sent in by Medical men practising in the district. There were 97 specimens sent by Medical practitioners for examination from suspected cases of Tuberculosis, 22 examinations of blood for Typhoid re-action, and 4 miscellaneous specimens were received and examined. There were also 54 specimens examined from children suffering from Ringworm who were scholars at the public elementary schools. Altogether 1,812 specimens were examined in the Bacteriological Laboratory, of which 500 were received from Medical men practising in the district. Last year there were 278 specimens received from Medical practitioners. The laboratories have therefore been much more extensively used by the Medical Practitioners of the district than during the preoeding year. There were 1,756 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 was no outbreak of Glanders or Parasitic Mange during the year. Destruction of Dogs.—113 dogs were brought by their owners to be destroyed in the Lethal Chamber at the Sanitary Depot. 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 1911. No of Samples taken. No of Samples adulterated. Milk 206 13 Butter 7 2 Cream 4 — Linseed 3 — Glycerine 3 — 223 15 Number of Prosecutions 11 Number of Convictions 9 57 The figures given for adulterated samples include some adulterated informal samples in respect of which no proceedings could be taken. Shop Hours Acts, 1892-1904.—Mr. Robinscn also reports on the work done under the above Acts in the Borough of Hornsev during the twelve months ending March 31st, 1912. Number of inspections 472 Number of young persons employed 373 Number of shops where no notice exhibited 49 No case of over-employment of young persons was discovered. Seats for Shop Assistants Act, 1899.—One hundred and fifty-six inspections were made under this Act, but no infringement has been reported. 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-five 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, fish shops, and greengrocers' premises at the latter part of the week, when the stock is usually largest. At the time of inspection at slaughter-houses 1 pair of lungs (bullocks) were found to be affected with Tuberculosis; they were immediately surrendered, and destroyed by the Corporation at the Destructor. Diseased and Unsound Food.—The following articles have been destroyed at the instance of the Local Authority during the year:— Cwts Qrs. Lbs. Meat 3 23 Fish 10 15 Fruit 7 0 6 Factory and Workshop Act, 1901.—Register of Work shops. —The number of Workshops on the Register at the end of 58 1910 was 378. During the year 1911 29 workshops have been added and 30 taken off the Register, so that at the end of 1911 there were 377 workshops on the Register in Hornsey. They were as follows : — Dressmakers 63 Milliners 26 Bootmakers and repairers 48 Cycle makers and repairers 14 Tailors 24 Laundries 34 Bakers 39 Miscellaneous 129 721 inspections were made and 77 written notices were served. The number of sanitary defects discovered and remedied was 96. As in previous years, want of cleanliness is the most frequent defect to be dealt with. In 42 cases, comparing with 60 for the previous year, the occupier was requested to cleanse, and this was immediately done. In 27 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 118 persons on the list of homeworkers, an increase of 39 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. Bakehouses.—There are 39 bakehouses in the Borough, being four less than in 1910. 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 80, and 4 Cowsheds in the Borough, have been frequently inspected. In 14 instances contravention of the bye-laws or regulations have been found, and the matters were at once attended to. 59 Nuisances, Drainage, etc.—One hundred and ninety-one complaints have been received during the year, classified as follows : — Obstructed or defective drains 51 Defective sanitary fittings 26 Dirty condition of premises 10 Dampness of premises 4 Water in basement 6 Accumulation of refuse 31 Overcrowding 5 Dirty condition of drinking water cistern 2 Nuisances caused by the keeping of fowls 6 Rats on premises 3 Other causes 47 At three hundred and thirty-two premises the drains have been tested, examined, exposed, etc.— On complaint 43 After infectious diseases 75 House-to-house inspection and other causes 214 The usual intimations and statutory notices were served where defects were found. In sixty-one instances the drains, etc., were re-constructed entirely, and in the others the defects found were remedied and the nuisances abated. Drains unstopped and repaired 151 Waste pipes trapped and rainwater pipes disconnected 241 New soil pipes fixed 100 Soil pipes and ventilating pipes repaired 34 Intercepting traps fixed 87 The number of premises now on the list for periodical inspection is 980, as compared with 915 for last year, 907 for 1909, 715 for 1908, 705 for 1907, 525 for 1906, 495 for 1905, 412 for 1904, and 152 for 1903. Preliminary notices issued numbered 762, and statutory notices 134. 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. 60 Premises. Sanitary Defects. 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. Osborne Grove 18 houses .. .. 3 2 1 .. .. 3 1 7 St. Mary's Road 75 ,, 3 1 3 4 13 6 3 7 2 2 Park Road 30 ,, .. .. 2 1 .. 1 .. 2 2 6 Page's Lane 10 ,, .. 1 1 .. .. 3 .. 6 .. 2 Muswell Hill 17 ,, .. .. .. 1 .. .. .. 2 .. 3 Montague Road 14 ,, .. .. .. .. .. .. .. 1 .. .. Nelson Road 3 ,, .. .. .. .. .. .. .. 3 .. Campsbourne Gardens 6 ten'm's. .. .. 1 .. 5 .. 1 .. .. 3 Verandah Cottages 12 ,, .. 1 .. 7 1 .. .. .. .. Springfield Cottages 24 .. .. .. 1 .. .. .. .. .. Coleridge Buildings 48 ,, .. .. .. 1 14 .. .. .. .. 6 In two instances summonses were taken out against Owners who failed to abate nuisances after service of the proper notices, and Orders were made to carry out the work. Housing of the Working Classes.—The Town Council have commenced the building of additional Cottages in extension of the existing Highgate Scheme which will provide 128 independent Cottages of two classes, comprising, respectively,—Living Room and 3 bedrooms, with Scullery, Larder, Coals and W.C., and the same accommodation but with 2 bedrooms. When these are erected, the total number of independent Cottages owned by the Town Council will be 412, and there are also 24 tenement dwellings. The First Scheme at Hornsey, which comprised the erection of 108 independent Cottages, was finished in 1898. The First Scheme at Highgate, which comprised 36 independent Cottages and 24 Tenements, was finished in 1900. The Second Schema at Hornsey, which comprised 140 independent Cottages, was finished in 1904. 61 ANNUAL REPORT OF THE MEDICAL OFFICER OF HEALTH FOR THE BOROUGH OF HORNSEY, FOR THE YEAR 1911 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.) 71 4 0 Workshops (Including Workshop Laundries). 013 58 0 Workplaces (Other than Outworkers' premises included in part 3 of this Report). 108 15 0 Total 792 77 0 2.—DEFECTS FOUND in FACTORIES, WORKSHOPS, & WORKPLACES Particulars. Number of Defects. Number of Prosecutions. Found. Remedied. Referred to H. M. Inspector. Nuisanccs under the Public Health Acts :— Want of cleanliness 42 42 0 0 Want of ventilation 0 0 0 0 Overcrowding 0 0 0 0 Want of drainage of floors 8 8 0 0 Other nuisances 5 5 0 0 †Sanitary accommedation insufficient unsuitable or de 1 1 0 0 fective not separate for 24 24 0 0 sexes 2 2 0 0 Offences under the Factory and Workshop Act:— Illegal occupation of underground bakehouse (S 101) 0 0 0 0 Breach of special sanitary requirements for bakehouses (SS. 97 to 100) 14 14 0 0 Other offences 0 0 0 0 Excluding offences relating to Outwork which are included in Part 3 of this Report) Total 96 96 0 0 † Public Health Acts Amendment Act, 1890, Part 3, adopted Oct., 1890. 62 3.—HOME WORK. OUTWORKERS' LISTS. SECTION 107. OUTWORK IN UNWHOLESOME PREMISES, SECTION 108. OUTWORK IN INFECTED PREMISES, SECTIONS 109, 11 NATURE OF WORK. Lists received from Employers. 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. 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) Wearing Apparel — (1) making, &c. 38 0 125 0 0 0 0 0 0 0 0 0 0 0 0 (2) cleaning and washing 10 0 55 1 0 1 0 0 0 0 0 0 0 0 0 Household Linen Lace, lace curtains and nets Curtains & furniture hangings Furniture and Upholstery 2 0 2 0 0 0 0 0 0 0 0 0 0 0 0 Electro Plate File making Brass and Brass Articles Fur pulling Cables and Chains 0 0 0 1 0 3 0 0 0 0 0 0 0 0 0 Anchors and Grapnels Cart Gear Locks, Latches and Keys Umbrellas, &c. Artificial Flowers Nets, other than wire nets Tents Sacks Racquet and Tennis Balls Paper Bags and Boxes Brush making Pea Picking Feather sorting Carding, &c , of Buttons, &c. Stuffed Toys Basket making Total 50 0 182 2 0 4 0 0 0 0 0 0 0 0 63 4. —REGISTERED WORKSHOPS. Workshops on the Register (s. 131) at the end of the year. (1) Number. (2) Dressmakers 63 Milliners 26 Bootmakers and Repairers 48 Cycle Makers and Repairers 14 Tailors 24 Laundries 34 Bakehouses 39 Miscellaneous 129 Total number of workshops on Register 377 5.—OTHER MATTERS. Class. (1) Number. (2) Matters notified to H.M. Inspector of Factories: — Failure to affix Abstract of the Factory and Workshop Act (s. 133) 4 Notified by H.M. Inspector 4 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) Reports (of action taken) sent to H.M. Inspector 4 Other 13 Underground Bakehouses (s. 101) : — Certificates granted during the year 0 In use at the end of the year 5 64 TABLE 1. VITAL STATISTICS OF WHOLE DISTRICT DURING 1911 AND PREVIOUS YEARS. Name of District:- HORNSEY. Year. Population estimated to middle of each Year. Births. Total Deaths Registered in the District. Transferable Deaths. Nett Deaths belonging to the District. of Nonresi dents registered in the District of Residents not registered in the District under One Year of Age. at all Ages. Uncorrected Number. Nett. Number. Rate Number. Rate per 1,000 Nett Births Number. Rate. Number. Rate. 1 2 3 4 5 6 7 8 9 10 11 12 13 1906 80,095 1,597 1,603 20.01 672 8.39 20 117 136 84 769 9.60 1907 81,909 1,518 1,524 18.60 635 7.75 18 149 116 76 76G 9.35 1908 82,230 1,472 1,485 18.05 654 7.95 14 112 95 63 752 914 1909 83,034 1,508 1,508 18.16 696 8.38 36 127 87 57 787 9.47 1910 83,953 1,383 1,393 16.59 626 7.45 41 152 97 69 737 8.77 1911 84,711 1,451 1,479 17.45 665 7.85 31 178 116 78 812 9.58 Area of District in acres (exclusive of area covered by water) 2,863.5 At Census of 1911. Total population at all ages 84,602 Number of inhabited houses 16,814 Average number of persons per house 5.033 1. Institutions within the District receiving sick nnd infirm persons from outside the District. Isolation Hospital, Muswell Hill. Cromwell House Convalescent Home. Santa Claus Home. All Saints' Convalescent Home. Horusey Cottage Hospital. 2. Institutions outside the District receiving sick and infirm persons from the District. Workhouse and Infirmary, Edmonton. Small Pox Hospital Summers Lane, Finchley. Fever Hospital, Liverpool Road. Middlesex County Asylum, Napsbury. Various London Hospitals. 3. Other Institutions, deaths in which have been distributed among the several localities in the District. Union Workhouse not in borough. 65 TABLE II. Cases of Infectious Disease notified during the Year 1911. Name of District:—HORNSEY. Notifiable Disease. At all Ages. Number of Cases Notified. Total Cases notified in each Locality. Total cases removed to Hospital. At Ages—Years. 1 2 3 4 5 6 7 8 9 Highgate. Muswell Hill. Crouch End. West Hornsey. East Hornsey North Haringey. South Haringey. Stroud Green. Finsbury Park. Under 1. 1 to 5 5 to 15 15 to 25 25 to 45 45 to 65 65 and upwards. Small-pox 1 — — — — — 1 — — — — — — 1 — — — 1 Cholera — — — — — — — — — — — — — — — — — — Diphtheria (including Membranous croup) 133 3 26 81 8 14 1 — 16 16 10 30 24 25 1 5 6 106 Erysipelas 40 1 4 — 6 8 17 4 5 2 2 10 8 1 3 5 4 — Scarlet fever 179 1 27 122 20 9 — — 20 25 16 53 18 12 8 18 9 116 Typhus fever — — — — — — — — — — — — — — — — — — Enteric fever 6 — 2 1 1 2 — — 2 — 1 2 — 1 — — — 5 Relapsing fever — — — — — — — — — — — — — — — — — — Continued fever — — — — — — — — — — — — — — — — — — Puerperal fever 2 — — — — 2 — — — — — — 1 1 — — — 2 Plaeue — — — — — — — — — — — — — — — — — — Phthisis Under Tuberculosis Regulations, 1908 11 — — — 2 6 2 1 1 1 1 3 3 2 — — — — Under Tuberculosis Regulations, 1911 45 — — 1 11 25 7 1 6 2 5 5 7 5 2 4 9 — Others — — — — — — — — — — — — — — — — — — Chicken-pox 38 3 7 24 4 — — — 4 6 8 2 4 1 3 6 4 — Totals 455 8 66 229 52 66 28 6 54 52 43 105 65 49 17 38 32 230 ISOLATION HOSPITAL —Name and Hornsey Borough Isolation Hospital, Total available Number of diseases that can Situation Coppett's Road, Muswell Hill. beds 130 be concurrently treated 3. 66 TABLE III Causes of, and Ages at Death during the Year 1911. Name of District:—HORNSEY. CAUSES OF DEATH. Nett Deaths at the subjoined Ages of " Residents" whether occurring within or without the District. Total Deaths whether of " Residents " or "NonResidents " in Institutions in the District. All Ages. Under 1 year. 1 and under 2 years. 2 and under 5 years. 5 and under 15 years. 15 and under 25 years. 25 and under 45 years. 45 and under 65 years. 65 and upwards. 1 2 3 4 5 6 7 8 9 10 11 All Causes Certified 812 116 38 23 28 26 109 200 272 Uncertified Enteric Fever 1 ... ... ... ... ... 1 ... ... 1 Small-pox Measles 20 5 7 3 4 1 ... ... ... 1 Scarlet Fever 1 ... ... ... ... ... 1 ... ... Whooping Cough 15 7 3 4 1 ... ... ... ... Diphtheria and Croup 6 ... ... 2 4 ... ... ... ... 12 Influenza 13 ... ... ... ... ... 1 4 8 Erysipelas 3 ... ... ... ... ... ... 3 ... Cerebro-Spinal Fever Phthisis (Pulmonary Tuberculosis) 55 ... ... ... 1 4 37 11 2 4 Tuberculous Meningitis 11 2 4 1 2 1 1 ... ... 1 Other Tuberculous Diseases 12 ... 2 2 3 1 1 3 ... Rheumatic fever 4 ... ... ... 2 ... ... 1 1 Cancer, malignant disease 103 ... ... 1 1 1 12 48 40 7 Bronchitis 42 4 ... ... ... ... ... 11 27 Broncho-Pneumonia 23 8 4 1 ... ... 2 7 1 Pneumonia (all other forms) 24 1 1 ... ... 1 2 11 8 5 Other diseases of Respiratory Organs 9 ... 2 2 ... ... 1 3 1 Diarrhoea and Enteritis 38 28 7 1 1 ... 1 ... ... Appendicitis and Typhlitis 9 ... ... 1 1 1 3 3 ... 2 Alcoholism 4 ... ... ... ... ... 2 1 1 Cirrhosis of Liver 12 ... ... ... ... 1 1 7 3 Nephritis and Blight's Disease 27 ... ... ... ... 1 4 10 12 2 Puerperal Fever 2 ... ... ... ... ... 2 ... ... Other accidents and diseases of Pregnancy and Parturition Congenital Debility and Malformation, including Premature Birth 50 48 ... 1 ... ... 1 ... ... 1 Violent Deaths, excluding Suicide 17 ... 1 2 2 2 3 2 5 1 Suicides 9 ... ... ... ... 2 4 2 1 Other Defined Diseases 302 13 7 2 6 10 29 73 162 13 Diseases ill-defined or unknown 812 116 38 23 28 26 109 200 272 50 67 TABLE IV. BOROUGH OF HORNSEY. INFANTILE MORTALITY DURING THE YEAR 1911. Nett Deaths from stated Causes at various Ages under One Year of Age. CAUSE OF DEATH. Under 1 Week. 1-2 Weeks. 2-3 Weeks. 3-4 Weeks. Total under 1 Month. 1-3 Months. 3-6 Months. 6-9 Months. 9-12 Months. Total Deaths under 1 Year. All Causes Certified 27 7 7 2 43 18 21 17 17 116 Uncertified small-pox Chicken-pox J Measles ... ... ... ... ... ... ... 2 3 5 Scarlet Fever Diphtheria and Croup Whooping Cough ... ... ... ... ... 1 2 ... 4 7 Diarrhœa ... ... ... ... ... 1 ... ... ... 1 Enteritis ... ... ... ... ... 7 11 5 4 27 Tuberculous Meningitis Abdominal Tuberculosis Other Tuberculous Diseases ... 1 ... ... 1 ... ... 1 ... 2 Congenital Malformations Premature Birth 20 4 3 ... 27 1 ... ... ... 28 Atrophy, Debility and Marasmus ... ... 2 1 3 2 1 ... ... 6 Atelectasis 1 ... ... ... 1 ... ... ... ... 1 Injury at Birth 2 ... ... ... 2 ... ... ... ... 2 Erysipelas Syphilis ... ... ... ... .. 1 2 ... .. 3 Rickets Meningitis (not Tuberculous) ... ... ... ... 2 ... ... 1 3 Convulsions 1 ... ... ... 1 ... 1 2 ... 4 Gastritis Laryngitis Bronchitis ... ... ... 1 1 1 ... 2 ... 4 Pneumonia (all forms) ... ... ... ... ... 1 3 2 3 9 Suffocation, overlying Other Causes 3 2 2 7 1 1 3 2 14 27 7 7 2 43 18 21 17 17 116 Nett Births in the year Nett Deaths in the year of legitimate, 1,451. illegitimate, 28. legitimate infants, 110. illegitimate infants, 6. — VITAL STATISTICS OF SEPARATE LOCALITIES IN 1911 AND PREVIOUS YEARS. Names of Localities. 1.—The whole district. 2.—Highgate 3.—Uuswell 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. 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 eneh 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. 1905 79,193 1,567 696 106 11,246 178 95 17 9,863 157 73 6 4,984 70 38 4 11,274 350 125 34 11,268 280 97 15 9,466 220 86 16 5,519 94 51 4 8,846 98 57 2 6,727 120 74 8 1906 80,095 1,603 767 136 11,328 198 109 17 10,624 167 71 12 5,043 100 33 8 11,706 350 141 40 11,331 247 114 25 9,411 207 101 17 5,358 105 56 4 8,786 108 66 2 6,508 131 78 11 1907 81,909 1,524 766 116 11,621 190 125 11 11,088 167 72 6 5,194 78 36 4 12,466 354 126 30 11,783 248 126 32 9,337 188 90 12 5,330 90 60 7 8,770 94 69 5 6,320 115 62 9 1908 82,230 1,485 752 95 11,862 166 102 8 11.377 160 83 7 5,235 76 48 7 12,726 351 129 28 11,628 262 112 20 9,136 196 98 13 5,210 73 39 2 8,670 95 64 1 6,386 106 77 9 1909 83,034 1,503 737 87 11.981 183 103 10 11,834 149 84 8 5,348 95 41 6 12,891 362 128 23 11,713 240 121 19 9,065 178 97 12 5,365 90 40 0 8,407 105 86 2 6,430 106 87 7 1910 83,953 1,393 737 97 11,695 163 87 9 11,563 164 87 7 5,793 73 35 5 12,686 346 128 23 10,982 217 85 12 9,500 160 92 14 5,832 78 50 4 8,657 94 86 12 7,229 98 87 11 1911 84,711 1,479 812 116 11,854 164 111 12 11,453 170 86 8 6,008 76 53 8 12,958 320 163 31 11,132 248 126 31 9,609 205 85 9 5,798 88 47 3 8,755 105 56 6 7,137 ! 03 85 8 SCHEDULE A.—1 DISTRICT :—BOROUGH OF HORNSEY. —YEAR 1911. No Diseases. AGES. All Ages. WARDS. Highgate. Muswell Hill. Crouch End. West Hornsey. East Hornsey. North Haringey South Haringey. Stroud Green. Finsbury Park. Under 1 week 1-2 weeks 2- 3 weeks 3-4 weeks Total under 1 month 1-3 months 3 -6 months 6-9 months 9-12 months Total under 1 year 1—2 years 2-5 years 5-15 years 15—25 years 25—45 years 45—65 years 55 years and over 1 Small pox (a) Vaccinated (b) Unvaccinated (e) No Statement 2 Measles ... ... ... ... ... ... ... 2 3 5 7 3 4 1 ... ... ... 20 3 ... ... 8 5 2 ... 1 1 3 Scarlet Fever ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 ... ... 1 1 ... ... ... ... ... ... ... ... 4 Typhus Fever 5 Epidemic Influenza ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 4 8 13 4 3 1 ... 1 ... 2 1 1 6 Whooping Cough ... ... ... ... ... 1 2 ... 4 7 3 4 1 ... ... ... ... 15 ... ... ... 5 7 1 1 ... 1 7 Diphtheria ... ... ... ... ... ... ... ... ... ... 2 3 ... ... ... ... 5 ... ... ... ... 2 2 ... ... 1 8 Enteric Fever ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 ... ... 1 ... ... 1 ... ... ... ... ... ... 9 Asiatic Cholera 10 Diarrhoea, Dysentery ... ... ... ... ... 1 ... ... ... 1 ... ... ... ... ... ... ... 1 ... ... ... 1 ... ... ... ... ... 11 Epidemic Enteritis ... ... ... ... ... 7 11 5 4 27 7 1 ... ... ... ... ... 35 2 1 2 12 15 ... ... 1 2 12 Other Allied Diseases 13 Hydrophobia 14 Glanders 15 Tetanus 16 Anthrax 17 Cowpox 18 Syphilis ... ... ... ... ... 1 2 ... ... 3 ... ... ... ... ... l ... 4 1 ... 1 ... ... 1 1 ... ... 19 G onorrhœa 20 Phagedæna 21 Erysipelas ... ... ... ... ... ... ... ... ... .. ... ... ... ... ... 3 ... 3 1 ... ... ... 2 ... ... ... ... 22 Puerperal Fever ... ... ... ... ... ... ... ... ... ... ... ... ... ... 2 ... ... 2 ... .. ... ... 1 1 ... ... . 23 Pæmia ... ... ... ... ... ... ... ... ... ... 1 ... 1 ... ... 2 2 6 2 ... ... 1 2 ... ... 1 ... 24 Infective Endocarditis 25 Other Allied Diseases 26 Malarial Fever 27 Rheumatic Fever ... ... ... ... ... ... ... ... ... ... ... ... 2 ... ... ... ... 2 ... ... 1 ... ... ... ... 1 ... 28 Rheumatism of Heart ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 1 2 ... ... ... ... ... 1 ... ... 1 29 Tuberculosis of Brain ... 1 ... ... 1 ... .. 1 ... 2 4 1 2 1 1 ... ... 11 1 1 ... 3 1 2 1 2 ... 30 Tuberculosis of Larynx 31 Phthisis ... ... ... ... ... ... ... ... ... ... ... ... 1 4 37 11 2 55 6 7 2 11 0 9 5 2 3 32 Abdominal Tuberculosis ... ... ... ... ... ... ... ... ... ... 1 ... ... 1 ... ... ... 2 ... ... ... 1 1 ... ... ... ... 33 General Tuberculosis ... ... ... ... ... ... ... ... ... ... 1 2 3 ... 1 ... 10 ... ... 1 6 2 ... ... ... 1 34 Other forms Tuberculosis 35 Other Infective Diseases 36 Thrush 37 Actinomycosis ... ... ... ... ... ... ... ... ... ... ... ... ... 1 ... ... ... 1 ... ... 1 ... ... ... ... .. ... 38 Hydatid Diseases 39 Scurvy 40 Other Diseases due to Altered Food Totals ... 1 ... ... l 10 15 8 11 45 24 13 17 8 44 25 13 189 21 12 10 48 49 19 10 9 11 2. No. Diseases. AGES. All Ages. WARDS. Highgate Muswell Hill. Crouch End. West Hornsey. East Hornsey. North Haringey South Haringey Stroud Green Finsbury Park. Under 1 week 1—2 weeks 2—3 weeks 3-4 weeks Total under 1 month 1-3 months 3—6 months 6 -9 months 9-12 months Total under 1 year 1-2 years 2-5 years 5-15 years 15—25 years 25-45 years 45—65 years 65 years and over 41 Acute Alcoholism .. .. .. .. .. .. .. .. .. .. .. .. .. .. 1 .. .. 1 .. .. .. .. 1 .. .. .. .. 42 Chronic Alcoholism .. .. .. .. .. .. .. .. .. .. .. .. .. .. 1 1 1 3 .. .. .. .. .. .. 1 1 1 43 Chronic Industrial Poisonings 44 Other Chronic Poisonings 45 Osteo-arthritis .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 1 1 .. .. 1 .. .. .. .. .. .. 46 Gout .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 1 .. 1 .. .. .. .. .. 1 .. .. .. 47 Cancer .. .. .. .. .. .. .. .. .. .. .. 1 1 1 12 48 40 103 14 8 11 13 13 11 9 9 15 48 Diabetes Mellitus .. .. .. .. .. .. .. .. .. .. .. .. .. .. 2 2 2 6 1 1 1 2 .. 1 .. .. .. 49 Purpura Hæmorrhagica 50 Hæmophilia 51 Anæmia 52 Lymphadenoma .. .. .. .. .. .. .. .. .. .. .. .. .. .. 1 1 .. 2 .. .. .. .. .. 1 .. .. 1 53 Premature Birth 20 4 3 .. 27 1 .. .. .. 28 .. .. .. .. .. .. .. 28 4 4 2 4 4 3 1 3 3 54 Injury at Birth 2 .. .. .. 2 .. .. .. .. 2 .. .. .. .. .. .. .. 2 .. .. 1 .. .. 1 .. .. .. 55 Debility at Birth .. 1 1 .. 2 1 .. 1 .. 4 .. .. .. .. .. .. .. 4 .. .. .. 1 3 .. .. .. .. 56 Atelectasis 1 .. .. .. 1 .. .. .. .. 1 .. .. .. .. .. .. .. 1 .. .. .. .. .. .. .. .. .. 57 Congenital Defects 2 .. .. .. 2 .. .. .. .. 2 .. .. .. .. .. .. .. 2 .. .. .. 1 1 .. .. .. .. Atrcisa of Ocsophagus .. 1 .. .. 1 .. .. .. .. 1 .. .. .. .. .. .. .. 1 .. .. .. 1 .. .. .. .. .. Congenital Heart Disease .. .. .. .. .. .. .. .. .. .. .. .. .. .. 1 .. .. 1 .. .. .. 1 .. .. .. .. .. Tumour of Head 1 .. .. .. 1 .. .. .. .. 1 .. .. .. .. .. .. .. 1 .. .. 1 .. .. .. .. .. .. 58 Want of Breast Milk 59 Atrophy, Debility, Marasmus .. .. 2 1 3 2 1 .. .. 6 .. .. .. .. .. .. .. 6 1 .. 1 2 .. .. .. .. 2 60 Dentition .. ... .. .. .. .. .. 1 1 2 4 .. .. .. .. .. .. 6 .. .. 1 4 1 .. .. .. .. 61 Rickets 62 Old Age, Senile Decay .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 2 72 74 12 3 2 12 12 8 4 5 16 63 Convulxions 1 .. .. .. 1 .. 1 2 .. 4 .. 1 .. .. .. .. .. 5 2 .. .. 3 .. .. .. .. .. 64 Meningitis .. .. .. .. .. 2 .. .. 1 3 1 1 1 3 3 .. .. 12 3 2 1 3 1 1 .. .. 1 65 Encephalitis .. .. .. .. .. .. .. .. .. .. .. .. .. .. 1 .. .. 1 .. .. .. 1 .. .. .. .. .. 66 Apoplexy .. .. 1 .. 1 .. .. .. .. 1 .. .. .. .. 2 14 26 43 1 11 4 7 2 7 4 5 2 67 Softening of Brain .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 2 5 7 .. 1 1 2 1 2 .. .. .. 68 Hemiplegia .. .. .. .. .. .. .. .. 1 1 .. .. .. .. .. 1 5 7 2 .. .. 1 1 2 1 .. .. 69 General paralysis of Insane .. .. .. .. .. .. .. .. .. .. .. .. .. .. 3 1 .. 4 .. 1 .. .. .. 2 1 .. .. 70 Other forms of Insanity .. .. .. .. .. .. .. .. .. .. 1 .. .. .. 1 1 .. 3 2 .. .. .. .. 1 .. .. .. 71 Chorea 72 Cerebral Tumour .. .. .. .. .. .. .. .. .. .. .. .. .. .. 1 1 .. 2 2 .. .. .. .. .. .. .. .. 73 Epilepsy .. .. .. .. .. .. .. .. .. .. .. .. .. 1 .. 1 .. 2 .. .. .. .. .. .. 1 .. 1 74 Laryngismus Stridulus 75 Locomotor Ataxy .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 1 .. 1 .. .. .. .. .. 1 .. .. .. 76 Paraplegia .. .. .. .. .. .. .. .. .. .. .. .. .. .. 2 2 5 9 2 3 .. .. 1 1 1 1 .. 77 Other forms, Brain Diseases 78 Otitis 79 Disease of Nose, Epistaxis 80 Diseases of Eye 81 Pericarditis 3 g . I 3 8 82 Endocarditis .. .. .. .. .. .. .. .. .. .. .. .. 3 1 4 19 14 41 7 3 3 8 5 1 3 8 3 83 Hypertrophy of Heart .. .. .. .. .. .. .. .. .. .. .. 1 .. .. .. 1 6 8 2 .. .. 1 1 1 .. .. 3 84 Angina Pectoris .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 1 1 .. .. .. 1 .. .. .. .. .. 85 Aneurism .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 1 4 5 1 2 .. .. 1 .. .. 1 .. 86 Senile Gangrene 87 Embolism, Thrombosis .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 1 1 .. 1 .. .. .. .. .. .. .. 88 Phlebitis 89 Varicose Veins Totals 27 6 7 1 41 6 2 4 3 56 6 4 5 6 35 100 183 395 57 40 30 08 48 45 26 33 48 3. No. Diseases. AGES. All Ages. WARDS. Highgate. Muswell Hill. crouch End. West Hornsey. East Hornsey. North Haringey. South Haringey Stroud Green. Finsbury Park. Under I week 1—2 weeks 2-3 weeks 3-4 weeks Total under 1 month 1—3 months 3-6 months 6—9 months 9—12 months Total under 1 year 1—2 years 2-5 years 5- 15 years 15-25 years 25-45 years 45-65 years 65 years and over 90 Other Diseases, Heart and Vessels Fatty Degeneration of Heart .. .. .. .. .. .. .. .. .. .. .. .. .. .. 2 6 6 14 4 1 .. 1 2 .. .. 2 4 Arterio sclerosis .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 1 4 5 .. 2 .. .. .. .. 1 1 1 Athcromatus of Cor. Artries .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 1 .. 1 .. .. .. 1 .. .. .. .. .. Myocardial Degeneration .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 1 1 .. .. .. l .. .. .. .. .. 91 Laryngitis .. .. .. .. .. .. .. .. .. .. 1 2 .. .. .. .. .. 3 .. .. 2 1 .. .. .. .. .. 92 Croup .. .. .. .. .. .. .. .. .. .. .. .. 1 .. .. .. .. 1 .. .. .. .. 1 .. .. .. .. 93 Other Diseases , Larynx & Tranchae 94 Acute Bronchitis .. .. .. 1 1 1 .. 2 .. 4 .. .. .. .. .. 3 11 18 2 2 .. 3 1 5 .. 1 4 95 Chronic Bronchitis .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 8 16 24 3 1 2 2 4 4 5 1 2 96 Lobar Pneumonia .. .. .. .. .. .. .. 1 .. 1 1 .. .. .. 2 5 1 10 .. 1 .. 6 2 .. 1 .. .. 97 Lobular Pneumonia .. .. .. .. .. 1 2 1 3 7 3 1 .. .. .. 2 .. 13 1 2 1 3 4 2 .. .. .. 98 Pneumonia .. .. .. .. .. .. 1 .. .. 1 1 .. .. 1 2 11 8 24 4 4 2 5 3 2 .. 1 3 99 Emphysema, Asthma .. .. .. .. .. .. .. .. .. .. .. .. .. .. 1 2 1 4 .. 2 1 1 .. .. .. .. .. 100 Pleurisy .. .. .. .. .. .. .. .. .. .. 1 .. .. .. .. 1 .. 2 .. .. .. 1 1 .. .. .. .. 101 Other Diseases, Respiratory System 102 Diseases of Month and Annexa 103 Diseases of Pharynx 104 Diseases of Œsophagus 105 Ulcer of Stomach and Duodenum .. .. .. .. .. .. .. .. .. .. .. .. .. 2 2 3 .. 7 .. 1 1 1 1 1 l 1 .. 106 Other Diseases of Stomach .. .. .. .. .. .. .. 1 .. 1 .. .. .. .. 1 .. 2 4 1 2 .. .. .. .. .. .. 1 107 Euteritis .. .. .. .. .. .. .. .. .. .. .. .. 1 .. 1 .. 2 .. .. .. 1 1 .. .. .. .. 108 Appendicitis .. .. .. .. .. .. .. .. .. .. .. 1 1 1 3 3 .. 9 1 2 .. 3 .. 1 .. 2 .. 109 Obstruction of Intestine .. .. .. .. .. .. 1 .. .. 1 .. .. .. .. .. 2 2 5 1 .. .. .. .. 3 .. .. 1 110 Other Diseases of Intestine 111 Cirrhosis of Liver .. .. .. .. .. .. .. .. .. .. .. .. .. 1 1 7 3 12 2 1 .. 2 2 .. 2 .. 3 112 Other Diseases of Liver .. .. .. .. .. .. .. .. .. .. .. .. .. .. 1 1 1 3 .. 1 .. 1 .. .. .. .. 1 113 Peritonitis .. .. .. .. .. .. .. .. .. .. .. .. 1 .. 1 .. .. 2 .. .. 1 1 .. .. .. .. .. 114 Other Diseases, Digestive System Pancreatites .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 1 .. 1 1 .. .. .. .. .. .. .. .. Abscess Pancreas .. .. .. .. .. .. .. .. .. .. .. .. .. .. 1 .. .. 1 .. .. .. .. .. .. .. 1 .. 115 Diseases, Lymphatic System .. .. .. .. .. .. .. .. .. .. .. .. .. 1 .. .. .. 1 1 .. .. .. .. .. .. .. .. and Glands. Exophthalmic Goitre .. .. .. .. .. .. .. .. .. .. .. .. .. .. 1 1 .. 2 l l .. .. .. .. .. .. .. 116 Acute Nephritis 117 Bright's Disease .. .. .. .. .. .. .. .. .. .. .. .. .. 1 4 10 12 27 3 4 1 5 3 3 1 3 4 118 Calculus .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 1 .. 1 .. .. .. 1 .. .. .. .. .. 119 Diseases of Bladder and Prostate .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 1 1 2 .. .. .. 1 1 .. .. .. .. 120 Other Diseases, Urinary System 121 Diseases of Testis and Penis 122 Diseases of Ovaries 123 Diseases of Uterus & Appendages .. .. .. .. .. .. .. .. .. .. .. .. .. 1 .. .. 1 2 .. .. 1 .. .. .. .. .. 1 124 Diseases of Vagina and External Genitals 125 Diseases of Breast 126 Abortion, Miscarriage 127 Puerperal Mania 128 Puerperal Convulsions 129 Placenta Previa, Flooding _ Totals .. .. .. 1 1 2 4 5 3 15 7 4 4 8 23 70 70 201 25 27 12 41 26 21 11 13 25 4 No. Diseases. AGES. All Ages. WARDS. Under 1 week 1—2 weeks 2-3 weeks 3-4 weeks Total under 1 month 1-3 months 3—6 months 6-9 months 9-12 months Total under 1 year 1—2 years 2-5 years 6—15 years 15-25 years 25-45 years 45-65 years 65 years and over Highgate. Muswell Hill. Crouch End. West Hornsey. East Hornsey. North Haringey. South Haringey. Stroud Green. Finsbury Park. 130 Puerperal Thrombosis 131 Other Diseases, Pregnancy and Childbirth 132 Arthritis, Ostitis, Periostitis 133 Other Diseases, Osseous System Osteitis Deformans ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 ... 1 ... ... ... ... ... ... ... 1 ... 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 ... ... l 3 1 1 1 ... ... ... ... ... ... 140 On Railways ... ... ... ... ... ... ... ... ... ... ... ... ... ... 2 ... ...... 2 ... 1 ... ... 1 ... ... ... ... 141 On Ships, Boats, Sic. (not drowning) 142 In Building Operations 143 By Machinery 144 By Weapons and Implements 145 Burns and Scalds ... ... ... ... ... ... ... ... ... ... 1 2 1 ... ... ... ... 4 ... ... ... 3 1 ... ... ... ... 146 Poisons, Poisonous Vapours 147 Surgical Narcosis 148 Effects of Electric Shock 149 Corrosions by Chemicals 150 Drowning ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 ... 1 ... ... ... 1 ... ... ... ... ... 151 Suffocation, Overlaid in Bed 152 „ Otherwise 153 Falls not specified ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 ... 3 4 1 1 ... 2 ... ... ... ... ... 154 Weather Agencies ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 1 2 1 1 ... ... ... ... ... ... ... 155 Otherwise, not stated ... ... ... ... ... ... ... ... ... ... ... ... ... 1 ... ... ... 1 1 ... ... ... ... ... ... ... ... 156 Homicide Suicides. 157 By Poison ... ... ... ... ... ... ... ... ... ... ... ... ... 2 2 ... ... 4 1 2 ... ... 1 ... ... ... ... 158 By Asphyxia 159 By Hanging and Strangulation ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 1 ... 2 1 1 ... ... ... ... ... ... ... 160 By Drowning ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 1 1 ... ... ... ... ... ... ... ... 161 By Shooting 162 By Cut or Stab ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 ... ... 2 1 ... ... ... ... ... ... ... 1 163 By Precipitation from Elevated Places 164 By Crushing 165 By other and unspecified methods 166 Execution 167 Sudden Death, cause not ascertained 168 Ill defined and unspecified causes Totals, Sheet No. 4 - - - - - - - - - - 1 2 2 4 7 5 6 27 8 7 1 6 3 - - 1 1 Totals, Sheet No. 3 - - - 1 1 2 4 5 3 15 7 4 4 8 23 70 70 201 25 27 12 41 26 21 11 13 25 Totals, Sheet No. 2 27 6 7 1 41 6 2 4 3 56 6 4 5 6 35 100 183 395 57 40 30 68 48 45 26 33 48 Totals, Sheet No. 1 - 1 - - 1 10 15 8 11 45 21 13 17 8 44 25 13 189 21 12 10 48 49 19 10 9 11 Grand Totals 27 7 7 2 43 18 21 17 17 116 38 23 28 26 109 200 272 812 111 86 53 163 126 85 47 56 85 No 1. BOROUGH OF HORNSEY.—SANITARY WORK, 1911. Adoptive Acts and Bye-laws in force in District. Particulars as to Staff employed in Sanitary Department, specify if Inspectors are engaged in any other duties, and if so, what. Inspections. SANITARY BYE-LAWS, REGULATIONS, Etc., IN FORCE IN HORNSEY. Bye-laws have been made as follows:— Common Lodging Houses (22nd Nov., 1879). Slaughter-houses (22nd November, 1879). Management of Mortuary (6th December, 1896). Decent Conduct of Persons using Sanitary Conveniences (21st May, 1894). Houses let in Lodgings or occupied by Members of more than on Family (21st September, 1896). For Good Rule and Government of the Borough (9th May, 1904, and 13th December, 1909). Under the Employment of Children Act, 1903 (10th October, 1904, and 3rd July, 1911). Nuisances in the Borough (10th June, 1907). With respect to New Streets and Buildings in the Borough (11th May, 1908). Dairies, Cowsheds and Milkishops (19th June, 1899). Isolation Hospital (11th March, 1901). Hornsey Swine lever Regulations, 1904 (14th May, 1904). Regulations under Swine Fever Order of 1894 as to Movement of Swine (14th March, 1904, and 1st March, 1905). Regulations under the Dogs Order, 1906. Regulations as to Cleansing, etc., under Order as to Parasitic Mange in Horses, etc. Order declaring certain Trades within the Borough to be Offensive Trades (12th June, 1911). Medical Officer of Health. Assistant do. 3 Inspectors 2 Clerks 3 Disinfectors and Drain Testers. 1 Number of Premises Inspected on Complaint. 2 Number of Premises Inspected to in connection with Infectious Diseases. 3 Number of Premises under Periodical Inspection. 4 Houses Inspected from Houseto-House (H. and T.P. Act). 5 Total Number of Inspections and Re-inspections made ACTS OF PARLIAMENT ADOPTED. Adoptive Acts adopted and in operation in the Borough of Hornsey are:— Public Health Acts Amendment Act, 1890, Parts 2, 3 and 5,— by resolution of Board of 27th Oct., 1890, coming into operation 9th Dec., 1890. Public Baths and Wash-houses Acts, 1846. 1847, 1878 and 1882 -by resolution of Hornsey Urban District Council 6th July, 1896. Housing of the Working Classes Act, 1890, Part 3,-by resolution of District Council 20th July. 1896. Public Health Acts Amendment Act, 1907, sections 15 to 17. 19 to 27, 30, 31 and 33 in Part IT.. Parts III., IV., V and VI., and section 95 in Part X.-bv Order of Looal Government Board, and section 81 (modified) in Part VII.. sections 87 and 90 in Part VIII., and Part IX..by Order of the Secretary of State (Home Office). 191 963 980 207 9,054 No. 2. BOROUGH OF HORNSEY.—SANITARY WORK, 1911. Action taken (Other than under H. and T.P. Act). Dwelling Houses and Action under H. and T.P. Act, 1909. Houses let in Lodgings (Tenement Houses). Common Lodging Houses. Canal Boats used as Dwellings. Movable Dwellings, Caravans, Tents, &c. Bakehouses. Cautionary or Intimation Notices Given. Statutory Orders Issued. Summonses Served. Convictions Obtained. Number of Houses dealt with under Sect. 15. Number of Houses found to be in a state Dangerous or Injurious to Health (Reft. 17). Number of Representations made by M.O.H. (Sect. 17). Number of Houses made Habitable without Closing Orders. Number of Closing Orders made by L.A. (Sect. 17). Number of Houses closed Voluntarily. Number of Closing Orders det«-rmined after Repairs (Sect. 17). Number of Houses Demolished (a) by order of L.A. (Sect. 17), (b) Voluntarily. Illegal Underground Rooms Vacated. Number Registered under Bye-Laws. Number of Contraventions. Number Registered under Bye-Laws. Number of Inspections made. Number of Contraventions. Number Registered under the Acts. Number of Contra\entions of Regulations. Number Observed during the Year. Number of Nuisances therefrom Abated. Number Removed from District. Number in District. Contraventions of Factory Acts. 762 134 2 2 - - - - - - - - - - - - - - - - - - - 39 4 No. 3. BOROUGH OF HORNSEY.-SANITARY WORK, 1911. Slaughter Houses. Cow-sheds. Dairies and Milk-shops. Unsound Food. Adulterated Food. Offensive Trades. Number on Register. Number of Inspections made. Frequency of Inspection. Contraventions of Bye-Laws. Number on Register. Number of Inspections made. Frequency of Inspection. Contraventions of Regulations. Number of Milch Cows in DiPtrict. Number on Register. Number of Inspections made. Frequency of Inspection. Contraventions of Regulations. Animals seized. Articles or Parcels seized. Animals condemned by Magistrate. Articles or Parcels condemned by Magistrate. Articles or Parcels surrendered. Samples taken (if any) by the District Local Authority. Found adulterated. Number of Premises in District. Number of Inspections made. Contraventions of Bye-Laws. 9 85 Frequently - 4 29 Frequently - 67 80 176 1 Frequently 14 - - - - 144 lbs. Plaice. 21 lbs. Luugs (Bullocks). 67 ,, Halibut. 71 ,, Mutton. 84 „ Cod. 15 ,, Turkey. 1 Box Kippers. 13 lbs. Cherries. 777 lbs. Apples. - - - - - No. 4. BOROUGH OF HORNSEY.—SANITARY WORK, 1911. Water Supply and Water Service. Drainage and Sewerage of existing Buildings. Disinfection. Wells. Percentage of Houses Supplied j from Public Water Service. Cisterns. Draw-Taps placed on Mains. Percentage of Houses supplied on Constant System. Number of Samples obtained for analysis. Water Closets. Percentage of Houses Provided with Water Closets. Drains. Reconstructed. Cesspools. Percentage of Houses Draining into Sewers. Rooms Disinfected. Rooms Stripped and Cleansed. Articles Disinfected or Destroyed. New Sunk. Cleansed, Repaired, Ac. Closed as Polluted. New Provided. Cleansed, Repaired, Covered, &c. Number of Water Closets substituted for Dry Receptacles. Repaired, Supplied with Water, or otherwise Improved. Examined, Tested, Exposed, Ac. Unstopped, Repaired, Trapped, Ac. Waste Pipes, Rain Water Pipes Disconnected, Repaired. Ac. New Soil Pipes or Ventilating Shafts fixed. Existing Soil Pipes or Ventilating Shafts repaired. Disconnecting Traps or Chambers Inserted. Rendered Impervious, Emptied, Cleansed, Ac. Abolished, and Drain connected to Sewer. From Local Wells. From Public Supply. Ordinary Infectious Diseases. Phthisis. Ordinary Infectious Diseases. Phthisis. - - - 100% 5 92 11 100% - 36 - 243 100% 332 151 241 100 34 87 61 - - 100% 436 38 208 12,669 310 No. 5. BOROUGH OF HORNSEY.—SANITARY WORK, 1911. Dust. Sundry Nuisances Abated. Remarks as to any other matters or in explanation of previous columus. New Bins provided. How frequently is dust removed from each house? Number of Complaints of Nonremoval received. Method of Disposal. j Overcrowding. Smoke. Accumulations of Refuse. Foul Ditches, Ponds, &c., and stagnant Water. Foul Pigs and other Animals. Dampness. Yards repaved or repaired. Other Nuisances. Premises Cleansed and Repaired. Destructor. By Tipping. Other, state method. 64 Once from houses, twice from flats each week. 80 Destructor. - - 4 - 47 - 4 43 56 76 104 - Circular Letter sent to Medical Practitioners in the District. Borough of Hornsey, Health Department, Municipal Offices, Highgate, N Dear Sir, I beg to remind you of the facilities offered by the Corporation for the disinfection of dwellings, or separate rooms, and of clothing, bedding and other infected articles, during the course of the illness or after the termination of cases of Phthisis. On a request being addressed to me I shall be very glad to arrange for such disinfection as may be desired, to be carried out by the Corporation's staff free of cost and at a convenient time. In most cases disinfection is very useful in preventing the spread of infection, and it is hoped that the medical practitioners of the district will advise that disinfection be carried out in suitable cases, e.g., on a change of residence of a phthisical patient or after a death from Phthisis, or on other occasions as deemed necessary or desirable. I beg to enclose a leaflet, which may be useful to some of your patients, giving simple directions for the guidance of Phthisical persons, and I shall be glad to supply you with further copies If at any time you desire them. Yours faithfully, HAROLD COATES, Medical Officer of Health. 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, since 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 fire. If there is no 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 te 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 cough 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 no 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 once 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 collected 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 adnrit 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 bv 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. BOROUGH OF HORNSEY. information for the Use of Householders respecting Measles. Measles is too often a very fatel disease; especially is this the case where it attacks young children. The Medical Officer of Health asks the co-operation of all parents in helping to prevent the spread of this disease. It is a great mistake to regard Measles as only a trifling affection, as is too often done. During recent years Measles alone has caused on an average in England and Wales over 12,000 deaths a year! This is more than all the deaths caused by Small pox, Scarlet Fever, and Typhoid Fever put together! Moreover, as most of these deaths are in children under the age of three or four years, there is a special reason for guarding children against it during the first few years of life. GENERAL PRECAUTIONS. EARLY SYMPTOMS. These are very much those of an ordinary feverish cold. There is usually sneezing, coughing, running at the eyes and nose, heaviness, etc. Occasionally there may be vomiting, diarrhoea or shivering. The rash often does not appear till the third or fourth day, but the disease is infectious from the very beginning. Therefore, whenever there is the slightest reason for suspecting Measles, the child should be at once isolated from the other children without waiting for the rash. N.B.—Sometimes, during the interval before the rash comes out, the early symptoms almost disappear for a time, and thus may mislead as to the real nature of the illness. ISOLATION. It is very important that the sick child be kept in a room by itself, away from the other children. In the case of a small house and a large family this may not always be considered practicable, but an effort should at least be mad© to keep the younger children, and those who have never had the disease, from catching it. To deliberately put children together, in the same room, or even bed, with one suffering from Measles, with the hope that they may "catch it and have done with it," as is occasionally done, is little short of criminal, and in the event of a fatal result the person so doing is morally responsible for the death. NURSING. In all cases the child should at first be kept in bed. One oi' the chief dangers to guard against is the occurrence of lung complications. This is often due to the patient catching a chill or being allowed up too soon. The sick room should be kept warm (about 65 degrees), but not allowed to get too warm, and fresh air admitted short of causing draughts. All discharges from the mouth, nose, and eyes should be received on clean linen rags, and be at once burned. After the termination of the case everything uced by the rick should be washed or thoroughly aired. DURATION OF INFECTION. Although, in a simple case of Measles, children frequently appear to be well at the end of a week, they must in all cases be regarded as infectious until the end of four weeks, and the precautions as to isolation continued accordingly. DISINFECTION. At the termination of the illness, the Corporation will disinfect, free of charge, any room, clothing, bedding, etc., on written application being made to the Medical Officer of Health, Municipal Offices, Highgate, N. LIBRARY BOOKS. Any books belonging to Public Libraries, which have been in use in the infected house, should not be returned to the Library, but should be handed over to the officer from the Health Department to be disinfected. SCHOOL ATTENDANCE. A school child suffering from Measles must not attend school for a month after the commencement of the illness. If there are other school children living in the house, who are not suffering from the disease, they must be dealt with, as regards school attendance, as follows:— Those children who attend Infants' Schools must stay away from school for 16 days after the commencement of the last case of Measles in the house. Children attending Boys' or Girls' Departments of the Schools need not be kept away from school at all if they have already had Measles. Those who have not had Measles must be kept away from school for 16 days after the commencement of the last case of Measles in the house. Children should not be allowed to attend Sunday Schools, or children's parties, or other gatherirgs of children during the period of exclusion from the day schools. HAROLD COATES, M.D., Medical Officer of Health Health Department, Municipal Offices, Highgate, N. BOROUGH OF HORNSEY. Directions for the Feeding and Care of Infants. 1. Infants should, whenever it is at all possible, be fed at the breast for a period of six months at least; but, if that cannot be done, for as long a period as may be. Breast milk is much more wholesome for an infant than cow's milk. 2. They should have the breast not oftener than every two hours during the day, and every four hours during the night. At the end of three months they should be suckled at longer intervals. When they are fretful or suffer from indigestion, it will often be found that they are being overfed, and diminishing their diet will then put them right. 3. The mother should, in order to supply wholesome milk to her child, partake only of plain and wholesome food, avoiding intoxicating drinks such as spirit® and beer. If she suffer from sore nipples, they should be washed with warm water after the child has fed, and some glyoerine should then be applied. 4. When, from want of milk, or from an absolute neoessity of going to work, a mother cannot suckle her infant, the next best thing, as a rule, is to feed it on cow's milk, prepared as follows:— The milk should be boiled as soon as possible after it is received. The jug into which the milk is received should be placed in the coolest place available, which also must be kept scrupulously clean. After each time of using the jug should be washed out with clean cold water and then scalded out. It should then be covered over with a clean cloth until it is required. When the milk has been poured into it, the cloth should be replaced. For the sake of coolness the milk jug may be kept in a basin containing cold water. Half a pint of good fresh milk, and one pint of water, with a small teaspeonful of white sugar are mixed and boiled, and then placed in a clean jug, covered with a clean cloth. Four tablespoonfuls of this should be placed in the feeding bottle each time it is used, and after each time the child is fed the bottle should be cleansed, or a clean one used. The infant should not be fed oftener than every two hours in the day time, and every four hours during the night. This will be the diet up to the age of six weeks. When the child is at least six weeks old, one pint of cow's milk may be added to on© pint of water, and eight tablespoonfuls used to each meal, the interval between meals being increased. At the ages three to six months, two pints of cow's milk should be mixed with one pint of water, eight tablespoonfuls being used to each meal. The intervals between meals, and the quantity used at each meal, may be increased as occasion requires. But it is necessary always to bear in mind the danger of over-feeding. In all cases the mixture of milk and water should be boiled and kept in a clean jug, as before mentioned. Only a small quantity should be got ready at one time. Up to the age of six months it will generally be found better to use no other food whatever than milk. On no account should "pobbies" or other solids be given. 5. The bottle used should be one of which the teat fits directly on the neck of the bottle. Bottles fitted with a long tub© should never be used. Immediately after use the rubber teat should be turned inside out and cleaned with water containing soda, and then rinsed well in clean water, The bottle should be cleaned with scalding water every time it is used. If a brush is used, it must be washed frequently with hot water and soda. When the teat and bottle are not in use, they may be kept in a dish, containing water which has been boiled. 6. After the age of 6 months, the following diets may be used:— Diet from Six Months to Twelve Months Old.—Five meals a day. First meal, 7 a.m.—One teaspoonful of some farinaceous food to about twelve tablespoonfuls of sweetened milk, mixed and well boiled. Second meal, 11 a.m.—The same quantity of pure milk. Third meal, 1.30 p.m.—Same as first. Fourth meal, 5.30 p.m.—Same as second. Fifth meal, 10 p.m.—Same as first. Diet for a Child from 12 to 18 Months Old. First meal, 7 a.m.—Bread and milk, or oatmeal porridge, with plenty of milk. Second meal, 11 a.m.—Twelve tablespoonfuls of milk. Third meal, 1.30 p.m.—Bread crumbs and gravy, or a lightly boiled egg, and bread and butter. Fourth meal, 5.30 p.m.—Bread and milk. Fifth meal.—Milk to drink. 7. Infants should not be placed on the floor, as they are thus exposed to draughts and infectious dirt. If its hands are allowed to become dirty, the infant will suck off the dirt, and all the benefits of feeding may be destroyed. 8. They should be warmly clothed, but not with many clothes. Their clothing should not fit tight about the body, but cling loosely, so as to give free play to the lungs. The limbs should be covered equally with the body. To allow a child to be cold is as bad as to deprive it of food, while giving it all the effort of digestion. 9. Mothers are strongly warned against giving children soothing medicines to send them to sleep. 10. When an infant continues to suffer from indigestion or diarrhoea, in spite of every care in feeding it, the mother should consult a medical man, who will advise her how to act. HAROLD COATES, M.D., Medical Officer of Health. BOROUGH OF HORNSEY. Precautions against Summer Diarrhœa. 1. Infants fed by hand suffer in a far greater degree from Diarrhoea than infants fed at the breast, and it is very important that infants should be fed at the breast whenever it is possible. When they have to be fed by hand they should get only good milk, and the feeding bottle used should be of the improved boat-shaped kind (not those having a long india-rubber tube). 2. All milk should be boiled before use. 3. Children's food should be freshly prepared. When it is necessary to keep milk in the warm season it should be boiled and stood in a clean jug or dish, covered with a clean cloth. 4. All food should be kept in a clean, dry, and well-aired place. 5. Meat and fish should be carefully examined on purchase, and no tainted food should be bought. Food which his become tainted after cooking should be rejected. Fruit should be carefully selected and cleaned. 6. Overcrowding is a cause of Diarrhoea. During the warm season bedroom windows should be left open day and night, and the fireplaces should be kept open. Bedroom walls and ceilings should be limewashed early in summer. If the room is papered, the paper should be cleaned. Overcrowding should be avoided. 7. All dirt should be removed from the house. The floors should be frequently scrubbed with soap and soda. Dirty paper should be removed. If the walls under the paper are dirty or broken, the paper should be removed and the walls made good and cleansed. 8. Damp or dirty conditions about a house are conducive to Diarrhœa. 9. The paving at the rear and the front areas should be kept clean and the drains flushed with a few pails of water daily. 10. The dustbins should be kept covered and not allowed to overflow, nor should vegetable refuse be put into them. Tea leaves, cabbage leaves, fish, potato peelings, etc., should be burned in the kitchen fire. No liquid should ever be placed in the dustbin. 11. Where any offensive smell is perceived in or near a house the cause of which cannot be ascertained and removed, complaint should be made to the Public Health Department, Municipal Offices, Highgate. HAROLD COATES, M.D., Medical Officer of Health. Public Health Department, Municipal Offices, Highgate, N.