HOR 10 Borough of borney REPORT ON THE HEALTH OF THE BOROUGH FOR THE YEAR 1918. BY HAROLD COATES, M.D., D.P.H., Barrister-at Law, Medical Officer of Health, Medical Superintendent of the Borough Isolation Hospital, School Medical Officer. -2- BOROUGH OF HORNSEY. Summary of Statistics. Area in acres 2,874 Rateable value (District Rate) £705,130 Population, Census, 1901 72,056 1911 84,592 ^Estimated Population 1918 (June 30th) (Civilian) 79,184 1918' ,, (General) 88,723 Number of persons pear acre, 1918 30.9 ,, ,, ,, house (Census, 1911) 5032 Estimated birth-rate per 1,000 living, 1918 11.69 Average birth-rate for previous 101 years 16.49 Estimated death-rate per 1,000 living, 1918 13.8 Average death-rate for previous 10 years 10.34 Deaths under 1 year of age, per 1,000 births, 1918 61 Average -number under 1 year of age per 1,000 births,' for previous 10 years 65.5 Death-rate from Zymotic diseases, 1918 0.38 Average death-rate from Zymotic diseases for previous 10 years 0.52 Death-rate from Phthisis 0.97 ,, ,, all forms of Tuberculosis 1.06 ,, ,, Cancer 1.64 Population.—The total population of the Borough at the middle of 1918 is estimated by the Registrar-General at 88,723, and the Civil population at 79,184. The latter figure is used for the calculation of the civilian death-rate, and the former figure for the calculation of the birth-rate. These estimates of the population are based on the assumption that the ratio between total and civilian populations is the same in Hornsey as in England and Wales as a whole. —3— On this basis the population of the Wards is as follows:— Ward. Estimated Civil Population, 1918. Estimated General Population, 1918. Census Population, 1911. Highgate 11,053 12,408 11,811 Muswell Hill 10,653 11,952 11,391 Crouch End 5,646 6,340 6,032 West Hornsey 12,132 13,634 12,951 East Hornsey 10,419 11,592 11,134 North Haringey 9,008 10,085 9,605 South Haringey 5,415 6,084 5,782 Stroud Green 8,186 9,185 8,751 Finsbury Park 6,672 7,443 7,135 Totals 79,184 88,723 84,592 There have been no new houses built in the Borough during the year, but the following table shows the number of existing houses which have been converted into Flats:— Highgate 5 Muswell Hill 0 Crouch End 3 West Hornsey 0 East Hornsey 1 North Harifigey 3 South Haringey 0 Stroud Green 0 Finsburv Park 0 Total 12 Births.—The number of Births recorded during 1918 was males 539 and females 498, making a total of 1,037. This is a decrease of 1 as compared with the number of births registered in, 1917. In the preceding twleve months (1917 compared with 1916) there was a decrease of 366 in the recorded births. Forty-two of the births were illegitimate (24 in 1917). - 4 - Thirteen of the births occurred at the Edmonton Infirmary and '26 at other Institutions and places outside the Borough. The birth-rate for the year was 1169, as compared with 113 in 1917. The following table gives the number of births and the birthrates for each quarter of the year 1918:— 1918. HORNSEY. ENGLAND & WALES. No. of Births. Birth-rate. Birth-rate. 1st Quarter 289 13.03 — 2nd ,, 245 11.04 — 3rd ,, 244 11.04 — 4th „ 259 11.7 — 1,037 11.69 17.7 The highest birth-rate occurred in the first quarter of the year. 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 1918. Birth rate. Highgate 125 10.0 Muswell Hill 106 8.9 Crouch End 62 9.8 West Hornsey 237 17.4 East Hornsey 171 14.6 North Haringey 131 12.9 South Haringey 60 9.9 Stroud Green 61 6.6 Finsbury Park 84 11.3 The Borongh 1,037 11.69 —5— Illegitimate Births.—There were 42 illegitimate birtlis recorded in 1918, and 24 in 1917, an increase of 18. The proportion of illegitimate births to the total registered births is 4'0 per cent., an increase of 1'7 as compared with last year. Thirteen of the illegitimate births occurred in the Edmonton Infirmary. Deaths.—The number of deaths registered in the Borough in 1918 was' 808, being 109 deaths more than the number registered in 1917. The yearly average number of deaths registered in the Borough during the previous ten years was 704. The death-rate calculated on these figures (gross death-rate; is 10'9 per thousand of the mean, population for the year. This is 2.5 more than in 1917. This includes only deaths actually registered in the Borough, and does not include those of Hornsey people dying elsewhere. There were 272 Hornsey people who died outside the District during 1918, via.:— 60 in the Edmonton Workhouse Infirmary. 1 in another Infirmary. 24 in the Great Northern Central Hospital. 80 in other Hospitals outside the Borough. 38 in Lunatic Asylums, and 69 in various other places. On the other hand thfere were 46 deaths registered in Hornsey of persons non-resident in the District. To get the nett deaths belonging to Hornsey we must add to the number of deatlis registered in the Borough the number (272) of Hornsey people dying outside the Borough, and deduct the number (46) of deaths registered in Hornsey of persons who normally resided in other districts. This gives the nett number of deaths belonging to Hornsey as 1,094, an increase of 188 on the corresponding number for 1917. —6— The death-rate calculated oil these figures is the nett deati. rate, and for the past 13 years is as follows:— Year. Nett Death Rate. 1906 9.57 1907 9.35 1908 9.14 1909 9.47 1910 8.77 1911 9.58 1912 9.82 1913 9.34 1914 8.80 1915 12.2 1916 11.5 1917 10.9 1918 13.8 1918 1917 The death-rate in Hornsey during the first quarter was 14.1 11.3 ,, „ „ second „ 10.0 7.4 ,, ,, ,, third „ 8.5 6.8 „ „ „ fourth „ 22.1 11.9 The ages at which deaths occurred were as follows:— 1918 1917 Under 1 week 22 21 1-2 weeks 2 0 2-3 „ 3 3 3-4 „ 1 5 Total under 1 month 28 29 1-3 months 7 10 3-6 ,, 9 14 6-9 ,, 12 15 9-12 „ 8 5 Total under 1 year 64 73 1-2 years 26 20 2-5 „ 45 13 5-15 „ 42 23 15-25 „ 64 28 25-45 „ 208 122 45-65 „ 262 248 65 and over 383 379 Total deaths 1,094 906 —7— The death-rates at various age groups are shewn below:— 1918. 1st Quarter. 2nd Quarter. 3rd Quarter. 4th Quarter. The year 1918. The year 1917. Total Deaths (Hornsey) 279 209 168 438 1094 906 Death-rate per 1,000 (Hornsey) 14.1 10.0 8.5 22.1 13.8 10.9 ,, England and Wales. — — - - 17.7 14.4 „ 96 Great Towns — — — — 17.6 14.6 Deaths under 1 year 16 17 10 21 64 73 Infantile Mortality (Hornsey) 62 65 38 81 61 70 Do. England and Wales — - — — 97 97 Do. 96 Great Towns — — - — 106 104 Deaths 1 year—65 years 122 116 99 313 650 451 Death-rate per 1,000 persons living at these ages 6.6 6.3 5.4 16.9 88 6.0 Deaths 65 years and over 141 76 62 104 383 377 Death-rate per 1,000 persons living at these ages 136.8 73.5 60.0 100.9 92.9 90.0 The actual number of deaths this year shows, an increase of 188 on the figures for 1917. Of the principal causes of death, the following diseases caused more deaths in 1918 than in 1917:- Disease. No. of Deaths in 1918. No. of Deaths in 1917. Increase. Whooping Cough 13 6 7 Diphtheria 8 6 2 Influenza 208 16 192 Phthisis 76 58 18 Cancer 130 113 17 Rheumatic Fever 6 5 1 Meningitis 6 3 3 Bronchitis and Pneumonia 124 113 11 Diarrhoea and Enteritis 10 3 7 Appendicitis 4 3 1 — 8 — The following caused fewer deaths in 1918 than in 1917:— Disease. No. of D eaths in 1918. No. of Deaths in 1917. Decrease. Measles 6 14 8 Erysipelas 0 2 2 Tubercular Meningitis 5 6 1 Other Tubercular diseases 8 19 11 Organic Heart diseases 89 117 28 Other Respiratory diseases 13 19 6 Nephritis 32 33 1 Accidents of Parturition 2 4 2 Congenital Debility 21 24 3 Syicide 8 18 10 Violence (excluding Suicide) 17 25 10 Tuberculosis.—The deaths from Phthisis numbered 76, or 18 more than in the previous year, and 19 more than the yearly average for the preceding ten years (viz., 57). Two of these 76 deaths occurred of persons, who nad been removed to the Edmonton Infirmary, 9 at Lunatic Asylums, 8 at Sanatoria, 7 at other Hospitals and 4 at other places outside the Borough. From forms of Tuberculosis other than Phthisis there were 8 deaths registered, a decrease of 17 compared with the year 1917. The total deaths from all forms of Tuberculosis were, therelore, 84, or 1 more than in the previous year. Luring! the year 357 cases of Tuberculosis were notified to me by Medical Practitioners, as compared with 290 in 1917. Of these- it was found that 132 cases had been previously notified and that 19 cases belonged not to Hornsey, but to other districts, these notifications being accordingly transferred, the new cases occurring in Hornsey, therefore, being 206. Of these, 183 were cases of Pulmonary Tuberculosis and 23 were cases of Non-Pulmonary Tuberculosis. — 9 — The following table gives the parts affected in the eases of Non-l'ulmonary Tuberculosis notified to me:— Glands 7 Boaies and Joints 5 Brain 1 Neck 1 Larynx 2 Testicle 1 Kidney 2 Peritoneum 2 Pleura 1 Bladder 1 23 Cancer.—There were 130 deaths registered as due to Cancer in 1918 as against 110 deaths from this cause in 1917, and 100 in 1911). This is an increase of '20 deaths on 1917, and of 24 deaths from the number registered in 1916. The death-rate from Cancer per thousand of the population is equal to 164, about one-eighth of the total death-rate. — 10 — Deaths from Zymotic Diseases.—The number of deaths from each disease for 1918 and preceding years is shown in the following table:— NUMBER OF DEATHS 1897-1918 FROM THE SEVEN PRINCIPAL ZYMOTIC DISEASES. 1918 1917 1916 1915 1914 913 1912 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 0 0 0 0 0 0 0 2 0 0 0 0 0 Measles 6 14 0 37 1 12 5 20 1 12 12 „ 5 18 9 18 15 7 8 4 6 14 7 Scarlet Fever 2 0 0 3 1 0 3 1 4 3 3 4 6 3 1 1 2 0 1 3 0 2 Diphtheria 8 6 11 11 6 3 2 5 8 10 9 9 13 8 7 12 9 10 14 4 11 16 Snteric Fever 0 0 1 2 1 3 2 1 3 0 2 4 5 2 2 0 5 2 6 0 4 0 Whooping Cough 13 6 5 7 4 8 2 15 10 12 11 19 4 10 17 19 9 14 18 20 8 10 Diarrhœa 1 3 8 25 29 14 16 36 1 1 9 3 30 6 24 1 1 6 9 32 15 29 Totals 30 29 25 85 42 40 30 78 27 38 46 44 76 38 69 48 35 40 52 65 52 64 There were 30 deaths from Zymotic diseases in 1918, as against 29 in 1917. — 11 — The Zymotic death-rate is equal to 0'38 per thousand of the population. Considering the Zymotic diseases in detail, it is seen that there was no death from Small Pox. There ware two 'deaths from this disease in 1902; there have been none sines that year. There were 2 deaths from Scarlet Fever. 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 8 deaths. There were no deaths from Enteric Fe.ver. There was 1 death from Infective Diarrhcea. S There were 6 deaths from Measles and 13 from Whooping Cough. Infantile Mortality.—During the year 1918 there were 64 deaths of infants under one year of age, as against 73 in 1917, and an average of 86 for the ten years 1908-1917. The infantile mortality for the year 1918, i.e., deaths u:,der one year of age per 1,000 births, is 61 in Hornsey. In 1917 the infantile mortality rate was 70 and the average rate for the twenty yeans 1898-1917 was 76, the highest being 106 in 1899, and the lowest 46 in 1916. The Infantile Mortality for England and Wales is 97, and of the 96 Great Towns, 106. The following table gives the number of infantile deaths and the mortality for each Ward of the Borough:— Number of deaths under one year. Infantile Mortality i.e., deaths under one year, per 1,000 births. Highgate 10 80 M us w ell Hill 3 28 Crouch End 3 48 West Hornsey 19 80 East Hornsey 13 76 North Haringey 6 46 South Haringey 2 33 Stroud Green 3 49 Finsbury Park 5 59 The Borough 64 61 — 12 — The number of deaths in the first tnree quarters of the year was 16, 17 and 10, and in the last quarter 21. In 1916, 7 deaths were due to dlarrhoeal diseases, in 1917, 4 deaths, and in 1918, 10 deaths were recorded from these causes. The Infantile Mortality at the four quarterly periods of 1918 was as follows:— 1918. Births. Infantile Deaths. Infantile Mortality. First Quarter 289 16 55 Second ,, 245 17 69 Third „ 244 10 41 Fourth ,, 259 21 81 The whole year 1,037 64 61 The ages at death were as follows:— Under 1 week 22 1-2 weeks 2 2-3 „ 3 3-4 1 Total under 1 month 28 1-3 months 7 3-6 ,, 9 6-9 ,, 12 9-12 ,, 8 Total deaths under 1 year 64 The principal causes of deaths among infants under one year of age were:— Premature Birth, Injury at Birth, and Equal to a death-rate per 1,000 births ol — iCongeaiital Defects 16 15.4 Bronchitis and Pneumonia 11 10.6 Atrophy, Debility, Marasmus 5 4.8 Diarrhoeal Diseases 6 5.8 Whooping Cough 6 5.8 Influenza 4 3.8 Diphtheria 1 0.9 Accident 1 0.9 Other causes 14 13.5 — 13 — Maternity and Child Welfare Centre.—The Municipal Centre at Brook Road has been open for Maternity and Child Welfare work throughout the year 1918, with the exception of Christmas, Easter and Whitsun weeks. The Centre was open for weighings and consultations twice weekly; and from June till the end of the year for three sessions a week from January to June. In addition to this, meetings were held for Mothers each week, when a short health talk, followed by a debate, was given by the Health Visitor. The Voluntary Workers supervise the sewing class, where Mothers are instructed in the making of suitable garments for their children. At the beginning of the year the old Register was revised. All names of those who had not attended for a period of three months were erased. The number on the Register at the beginning of the year was 285, and at the end 532. The total number of attendances during the year was 4,214; the highest on any one day 112; the lowest 16, and the average 598. The h'ghest number of infants seen by the Doctor on any one day was 32, and the average 22'5. The highest number of Mothers seen on any one day lias been 5 pre-natal, 14 postnatal. Extension of Work.—A steady, increase in the number of Mothers and Children attending the consultations and weighings resulted; in such numbers that it was found impossible to cope with the work in two weekly sessions, and since many of the Mothers! came from a distance it was deemed advisable on the 1st June, 1918, to open a Centre in a new area. The Harringay district was decided on, and premises were, acquired at 22, Wightman Road, which would serve the eastern and southern portions of the Borough. The attendance, here at the first session was 26, and the number on the register at the end of September was 44 It was found that the development did not decrease the work done at the original Centre in Brook Road, though it greatly enlarged the scope and efficiency of the work generally, giving evidence, of the fact proved elsewhere that it is always advantageous to decentralise, this work. — 14 — Deaths During the Year.—Amongst children who have attended during the year there has been seven deaths, 1 over one year and 6 under one year. Two only of these children were regular attendants. The following is an analysis of these deaths:— OVER ONE YEAR. Cause of Death. Treatment. Attendance. 1. Pneumonia. In Hospital. Regular. (Note on case. — Healthy child from birth. Home care good). UNDER ONE YEAR. 1. Marasmus. Whooping Cought Pneumonia In Hospital. Regular. 2. Pneumonia. At Home. 2 attendances. 3. Marasmus Twins- Hospital. 3 do. 4. do. 5. Syphilis. At Home. 1 attendance. Marasmus 6. Broncho Pneumonia. At Home. 1 do. The following are notes on these cases:— 1. Child premature; very delicate from birth. Mother suffering from advanced Pulmonary Tuberculosis. Home care excellent. 2. Child healthy. Home care fajrly good. Child referred to Hospital. 3 and 4. Marasmus. Mother unable to cope with difficulties of feeding or to carry out the numerous, instructions of authorities to whom she took the children for advice. These children should have been admitted very much earlier to hospital, but no hospital wasi able to take them in until their condition was practically hopeless. 5. This was a "nursed out." child brought to us for the first time almost moribund. It was referred back immediately to its private Doctor. 6. Mother had to support herself, being separated from her husband; the child in consequence did not receive ordinary intelligent care. Child healthy. 15 Influenza.—The first epidemic of Influenza .u June and July was not' severely felt, and did not affect the health or attendance to any extent. In September, however, the outbreak commenced in the most serious form. No deaths from Influenza occurred to children attending the Centre before the end of September. The outbreak caused a marked decrease in the attendances during the month. The Mothers stayied away either because of illness at home or for fear of infection in bringing the children together at the Centre. Summer Diarrhcea.—No case of epidemic diarrhoea occurred in children attending the Centre. This was doubtless due to some extent to climatic conditions, but as three cases only of a mild type occurred it may perhaps be assumed that the work of the Centre was partially responsible. The means taken were as follows:— (1) Every encouragement was given to breast feeding by attention to the healthi of the Mothers, supplementing the diet by fresh or dried milk. In difficult cases breast feeding was supplemented by artificial food until the establishment of lactation and then withdrawn. And here it may be noted that 78'4 per cent, of infants under nine months are breast-fed. (2) The Mothers were advised to postpone weaning until the Autumn. (3) Instructions were given to pasteurise all fresh milk. (4) Where quality of milk supply was doubtful or home conditions unsatisfactory dried milk was advised. (5) Teaching givein in general hygiene and child care was of great assistance in maintaining the general health and so avoiding predisposition to attacks. It is interesting to note here the cumulative effect of teaching given at the Centre and the result it has in forming the ideas and habits of the Mothers as a whole. The considerable time spent in teaching each Mother essential facts about child earn in general by reference to her own child in particular, appears, in looking back over a period of two years, to be time economically spent. Not only isi the knowledge permanently acquired and used by the Mother in her own home, but also one finds the teaching discussed between the Mothers themselves, and in this way a more correct standard is set up generally. 10 Free Milk under Child Wislfahh Act.—Permission was given on lllli September for the provision of free milk to necessitous mothers and. children, and marked benefit lias accrued, particularly to nureing Mothers. CO-OPERATION WITH OTHER INSTITUTIONS.—Co-oporatioil has Wen established with the following Institutions:— 1. Great Northern Hospital.—Children requiring hospital treatment are put weekly on a special list. Their names are telephoned to the Almoner of the Hospital, and the children are thus seen as far as possible by special appointment, thus saving the Mothers waiting all day, which so frequently occurs ah tha Out Patients Departments of Hospitals. The scheme has worked well in tliq majority of cases, and when it has done so is highly satisfactory. 2. Duchess of Marlborough's Maternity Hospital (under the management of the Royal Free Hospital).—Mothers who require institutional care or who are unable to make adequate provision at home for their confinements are sent to this Home. This plan was at first tried tentatively, and as it worked so satisfactorily was officially recognised by the Municipal Authorities, who undertook to subsidise it financially. M. Dental Treatment.—Children who require consultative advice have been seen by the Consulting Dentist of the Great Northern Hospital. Mothers are seen by arrangement with a private Dentist. 4. Massage has been arranged in several cases with a private Masseuse who has worked for an honorarium. 5. Two cases have been X-rayed by the invitation of the Physician in charge of the Department. COMPARISON WITH LAST YEAR'S REPORT. It is interesting to note that the percentage of Children suffering from incorrect management, this year compares favourably with that of last, year's Report: — 1916-17 Percentage incorrectly managed 34.7 1917-18 „ „ „ 29.0 1916-17 Percentage of children under nine , months breast-fed 56.0 1917-18 „ „ „ 784 — 17 — Deaths under one year of age of Illegitimate Children.—There were 42 illegitimate births registered during the year, and 4 deaths under one year of age of illegitimate children occurred. This given an infantile mortality among illegitimate children of 90. The number of illegitimate births registered wa» 995, and the number of deaths under one year ol age of legitimate children was 00. This gives an infantile mortality among legitimate children of 01. Infectious Diseases.—The eases of Infectious Disease notified during 1918 were as follows:— Scarlet Fever 89 Diphtheri 07 Enteric Fever 8 Puerperal Fever 2 Erysipelas 23 Small Pox 0 Cholera 0 Cerebro-Spinal Meningitis 1 Phthisis 187 Other forms of Tuberculosis 10 Poliomyelitis 3 Ophthalmia Neonatorum 2 Measles 790 German Measles 119 1,310 Considering the diseases now notifiable as below (Scarlet Fever, Diphtheria, Membranous Croup, Enteric or Typhoid Fever, including Paratyphoid Fever, Typhus Fever, Ttelapsing Fever, Continued Fever, Puerporal Fever, Erysipelas, Small Pox, Cholera, Plague, Measles and German Measles, Acute Poliomyelitis, Cerebro-Spinal Fever, Epidemic Cerebro-Spinal Meningitis or Spotted Fever, Ophthalmia Neonatorum, Tuberculosis, Acute Encephalitis Lethargica, Acute Polio Encephalitis) it will be seen that the cases notified to me numbered 1,110 in 1918. This is a — 18 — decrease of 1,234 as compared with 1917, when 2,344 cases were notifi ed. There was 1 case of Cerebro-Spinal Fever notified during 1918. The notifications of Tubercular Phthisis numbered 183, and other forms of Tuberculosis 23, and have already been referred to. The occurrence of the cases in the different Wards and the number notified during each quarter of the year were as follows:— Scarlet Fever. Diphtheria. Enteric Fever. Measles. German Measles. Puerperal Fever. Erysipelas. Ophth. Neon. Cerebro Spinal Fever. Polio mvelitis. Tuberculosis. Total. Phthisis. Other forms. Highgate 9 14 1 122 38 0 3 0 0 1 12 4 204 Muswel! Hill 16 13 0 96 22 0 2 0 0 0 12 0 161 Crouch End 3 3 0 26 14 0 7 1 0 0 6 2 62 West Hornsey 26 4 I 154 10 1 5 0 1 0 35 4 241 East Hornsey 15 11 I 128 3 0 3 1 0 1 43 3 209 North Haringey 8 5 0 81 12 0 0 0 0 1 25 6 138 South Haringey 3 6 3 52 4 0 0 0 0 0 22 2 92 Stroud Green 6 9 2 54 11 0 2 0 0 0 14 1 99 Finsbury Park 3 2 0 83 5 1 1 0 0 0 14 1 110 Total 89 67 8 796 119 2 23 2 1 3 183 23 1316 Scarlet Fever. Diphtheria. Enteric Fever. Measles German Measles. Puerperal Fever. Erysipelas. Ophth. Neon. Cerebro Spinal Fever. Polio Myelitis. Tuberculosis. Total. Phthisis. Other forms. 1st quarter 24 29 0 255 43 1 7 0 0 0 43 10 412 2nd quarter 19 10 5 498 61 0 4 0 0 1 51 8 657 3rd quarter 16 9 3 38 11 1 2 1 0 0 43 5 129 4th quarter 30 19 0 5 4 0 10 1 1 2 46 0 118 Total 89 67 8 796 119 2 23 2 1 3 183 23 1316 19 Scarlet Fever.— There were 89 cases of Scarlet Fever notified in 1918, as against 132 in 1917, and against a yearly average of 239 for the twenty years (1898-1917). There is, therefore, a decrease of 43 from the cases notified in 1917, and a decrease of 150 from the average number for the. preceding twenty years. The disease was mostly of a very mild type, there being only one fatal case occurring among the 89 cases, notified. The attack rate per 1,000 of the population was 1.12, and the mortality 0.0l. Seventy-nine per cent. of the oases were removed to the Isolation Hospital for treatment. Diphtheria.— There were 67 cases of Diphtheria notified in 1918, as against 66 in 1917, and against a yearly average of 107 for the twenty years. (1898-1917). There is therefore an increase of 1 over the number of cases notified in 1917, and a decrease of 40 as compared with the. yearly average for the preceding twenty years. There were 7 deaths among the 67 cases notified, as compared with 6 deaths among 66 cases notified in 1917. The attack rate was 0.85, and the mortality 0'07 per thousand of the population. Seventy-eight per cent. of the cases were removed to the Isolation Hospital. Enteric fever.— There were 8 cases of this disease notified in 1918, as compared with 4 cases, in 1917, and an average of 14 cases for the twenty years (1898-1917). The number of cases of Enteric Fever in the Borough was 4 more than in 1917 (8 against 4), and below the average for recent years. The attack rate was 0.0l. Seventy-five per cent. of the cases were removed to the Isolation Hospital. 20 INFLUENZA.— The following tables give particulars of Deaths occurring in the Borough from Influenza and from Bronchitis and Pneumonia during the year:— Week ending Influenza. Bronchitis and Pneumonia. Totals. Deaths from all causes Male. Female Male. Female Male. Female Total. January 5th ... ... 1 ... 1 5 8 13 „ 12th ... 1 2 2 5 4 17 21 „ 19th ... ... 3 3 6 12 12 24 „ 26th ... ... ... 3 3 8 13 21 February 2nd ... 1 1 ... 2 9 6 15 „ 9th ... ... ... 3 3 6 13 19 „ 16th ... l 1 1 3 9 9 18 „ 23rd ... ... 1 1 2 5 6 11 March 2nd ... ... ... 1 1 4 12 16 „ 9th ... ... 3 ... 3 6 7 13 „ 16th ... ... 1 3 4 3 9 12 „ 23rd ... ... 1 ... 1 6 7 13 „ 30th ... ... 4 2 6 14 12 26 Total for Quarter ... 3 18 19 40 91 131 222 April 6th ... ... 3 1 4 8 7 15 „ 13th ... ... 2 2 4 6 8 14 „ 20th ... ... 2 ... 2 3 2 5 „ 27th ... ... ... 1 1 5 4 9 May 4th ... ... ... ... 0 5 7 12 „ 11th ... ... ... 3 3 6 13 19 „ 18th ... 1 1 ... 2 3 8 11 „ 25th ... ... 1 1 2 5 7 12 June 1st ... ... 2 1 3 3 9 12 „ 8th ... ... ... ... 0 4 4 8 „ 15th ... ... 3 l 4 11 9 20 „ 22nd ... ... ... ... 0 9 7 16 „ 29th ... ... ... ... 0 3 4 7 Total for Quarter ... l 14 10 25 71 89 160 July 6th 1 l 1 ... 3 5 7 12 „ 13th 1 2 2 ... 5 7 6 13 „ 20th 1 3 ... ... 4 4 8 12 „ 27th ... 1 ... ... 1 4 11 15 August 3rd ... ... ... ... 0 5 4 9 „ 10th 1 ... ... 1 2 5 4 9 „ 17th ... ... 1 ... 1 2 2 4 „ 24th ... ... ... ... 0 6 5 11 „ 31st ... ... 1 ... 1 7 3 10 September 7th ... ... 2 ... 2 8 5 13 „ 14th ... ... ... 1 1 3 2 5 „ 21st ... ... ... ... 0 4 4 8 „ 28th ... ... ... 2 2 2 6 8 Total for Quarter 4 7 7 4 22 62 67 129 October 5th 2 4 1 2 9 11 10 21 „ 12th 6 2 1 3 12 19 10 29 „ 19th 12 13 1 1 27 18 27 45 „ 26th 17 27 ... 4 48 23 35 58 November 2nd 11 18 ... 4 33 16 25 41 „ 9th 6 7 3 4 20 15 14 29 „ 16th 8 11 1 3 23 15 22 37 „ 23rd 3 7 ... 1 11 10 16 26 „ 30th 5 3 2 4 14 10 12 22 December 7th 3 2 ... ... 5 10 9 19 „ 14th 1 3 1 ... 5 8 7 15 „ 21st 1 ... 2 ... 3 4 2 6 „ 28th ... ... ... 1 1 4 5 9 Total for Quarter 75 97 12 27 211 163 194 357 Total for Year 79 108 51 60 298 387 481 868 21 AGE GROUPS. Week ending. Under 1 year. 1-5 years. 5-15 years. 15-25 years. 25-45 years. 45 65 years. 65 years and over. Totals. January 5th ... ... ... ... ... ... 1 1 „ 12th 1 ... ... ... ... 1 3 5 „ 19th ... ... ... ... 1 ... 5 6 „ 26th ... ... ... ... ... 1 2 3 February 2nd ... ... ... ... ... ... 2 2 „ 9th ... ... ... ... ... l 2 3 „ 16th ... 1 ... ... ... ... 2 3 „ 23rd ... ... ... ... l l ... 2 March 2nd ... ... ... ... ... ... 1 1 „ 9th 1 1 ... ... ... ... 1 3 „ 16th ... ... ... ... ... 1 3 4 „ 23rd ... ... ... ... ... ... 1 1 „ 30th ... ... ... ... 1 ... 5 6 Total for Quarter 2 2 ... ... 3 5 28 40 April 6th 1 ... ... ... 1 1 1 4 „ 13th ... ... ... ... 1 1 2 4 „ 20th 1 ... ... ... 1 ... ... 2 „ 27th ... ... 1 ... ... ... ... 1 May 4th ... ... ... ... ... ... ... ... „ 11th ... ... ... ... ... ... 3 3 „ 18th ... ... ... ... ... 1 1 2 „ 25th 1 ... ... ... ... ... 1 2 June 1st 2 ... ... ... ... ... 2 4 „ 8th ... ... ... ... ... ... ... ... „ 15th ... 1 1 ... ... ... 1 3 „ 22nd ... ... ... ... ... ... ... ... „ 29th ... ... ... ... ... ... ... ... Total for Quarter 5 1 2 ... 3 3 11 25 July 6th ... ... ... ... 1 1 1 3 „ 13th ... ... ... ... 3 ... 2 5 „ 20th ... ... ... ... 2 ... 2 4 „ 27th ... ... 1 ... ... ... ... 1 August 3rd ... ... ... ... ... ... ... ... „ 10th ... ... ... 1 1 ... ... 2 „ 17th ... ... ... ... 1 ... ... 1 „ 24th ... ... ... ... ... ... ... ... „ 31st ... ... ... ... ... ... 1 1 September 7th ... ... ... ... ... ... 2 2 „ 14th ... l ... ... ... ... ... 1 „ 21st ... ... ... ... ... ... ... ... „ 28th 1 1 ... ... ... ... ... 2 Total for Quarter 1 2 1 l 8 1 8 22 October 5th 1 ... 1 1 6 ... ... 9 „ 12th ... 2 ... 3 6 1 ... 12 „ 19th ... 2 6 6 6 4 3 27 „ 26th 1 11 5 6 18 5 2 48 November 2nd 2 4 2 4 14 4 3 33 „ 9th 1 6 1 3 4 2 4 21 „ 16th 1 2 ... 1 12 5 2 23 „ 23rd ... 1 ... 2 5 3 ... 11 „ 30th ... 1 ... 2 2 6 3 14 December 7th ... ... ... ... 3 1 1 5 „ 14th ... ... ... 2 ... 2 ... 4 „ 21st ... 1 ... ... ... ... 2 3 „ 28th ... ... ... ... ... ... 1 1 Total for Quarter 6 30 15 30 76 33 21 211 Total for Year 14 35 18 31 90 42 68 298 22 WARDS. Week ending. Highgate. Muswell Hill. Crouch End. West Hornsey. Hast Hornsey. North Haringey. South Haringey. Stroud Green. Finsbury Park. Borough Total. January 5th ... ... ... ... ... ... ... ... 1 1 „ 12th 1 ... ... 1 ... 1 1 ... 1 5 „ 19th 1 ... 1 1 ... ... ... 2 1 6 „ 26th 1 ... ... 1 ... ... 1 ... ... 3 February 2nd ... ... ... ... ... 2 ... ... ... 2 „ 9th ... ... ... ... 1 2 ... ... ... 3 „ 16th 1 ... ... 1 ... ... ... ... 1 3 „ 23rd 1 ... ... ... 1 ... ... ... ... 2 March 2nd ... 1 ... ... ... ... ... ... ... 1 „ 9th ... ... ... 1 ... ... ... ... 2 3 „ 16th 2 ... ... 1 ... ... 1 ... ... 4 „ 23rd 1 ... ... ... ... ... ... ... ... 1 „ 30th 1 1 ... ... 1 1 ... 2 ... 6 Total for Quarter 9 2 1 6 3 6 3 4 6 40 April 6th 1 ... ... 1 1 ... 1 ... ... 4 „ 13th 1 1 ... 1 1 ... ... ... ... 4 „ 20th ... l ... ... 1 ... ... ... ... 2 „ 27th ... ... ... 1 ... ... ... ... ... 1 May 4th ... ... ... ... ...... ... ... ... ... ... „ 11th ... 2 ... ... 1 ... ... ... ... 3 „ 18th 1 1 ... ... ... ... ... ... ... 2 „ 25th 1 1 ... ... ... ... ... ... ... 2 June 1st 2 1 ... ... ... 1 ... ... ... 4 „ 8th ... ... ... ... ... ... ... ... ... ... „ 15th ... ... 1 1 ... ... ... ... 1 3 „ 22nd ... ... ... ... ... ... ... ... ... ... „ 29th ... ... ... ... ... ... ... ... ... ... Total for Quarter 6 7 1 4 4 1 1 ... 1 25 July 6th ... ... 1 ... ... ... 2 ... ... 3 „ 13th ... ... 2 2 ... ... 1 ... ... 5 „ 20th 1 1 ... 1 1 ... ... ... ... 4 „ 27th 1 ... ... ... ... ... ... ... ... 1 August 3rd ... ... ... ... ... ... ... ... ... ... „ 10th 1 ... ... 1 ... ... ... ... ... 2 „ 17th ... ... ... ... ... ... ... ... 1 1 „ 24th ... ... ... ... ... ... ... ... ... ... „ 31st 1 ... ... ... ... ... ... ... ... 1 September 7th 1 ... ... ... ... ... 1 ... ... 2 „ 14th ... ... ... 1 ... ... ... ... ... 1 „ 21st ... ... ... ... ... ... ... ... ... ... „ 28th ... ... ... l ... 1 ... ... ... 2 Total for Quarter 5 1 3 6 1 1 4 ... 1 22 October 5th 1 ... ... 4 2 2 ... ... ... 9 „ 12th ... ... ... 1 9 1 1 ... ... 12 „ 19th ... ... 3 5 12 4 1 ... 2 7 „ 26th 7 2 1 9 21 1 1 3 3 48 November 2nd 5 2 3 10 5 3 1 ... 4 33 „ 9th 4 1 2 2 4 4 1 1 2 21 „ 16th 5 2 1 3 3 2 3 2 2 23 „ 23rd 2 1 1 1 1 ... 1 2 2 11 „ 30th 2 2 1 3 2 2 ... 1 1 14 December 7th ... ... ... ... 4 ... 1 ... ... 5 „ 14th 1 ... 1 ... ... ... ... ... 2 4 „ 21st ... 1 ... 2 ... ... ... ... ... 3 „ 28th ... ... ... ... 1 ... ... ... ... 1 Total for Quarter 27 11 13 40 61 19 10 9 18 211 Total for year 47 21 18 56 72 27 18 13 26 298 23 Isolation Hospital.— As compared with the previous year there were 17 more patients admitted in 1918, viz.:—396 in 1918 and 379 in 1917. TABLE SHOWING NUMBER OF ADMISSIONS, DEATHS AND DISCHARGES AT ISOLATION HOSPITAL, 1918. Patients in Hospital Jan. 1st 54 Patients admitted during the year 396 450 Patients discharged during the year 377 Patients dying during the year 27 404 Patients remaining in Hospital Dec. 31st 46 Scarlet Fever.— The number of cases notified in Hornsey during 1918 was 89, and of these 70 (equal to 79 per cent. of the cases notified) were admitted to the Isolation Hospital. There were also 58 cases of Scarlet Fever admitted from Finchley and 35 from Wood Green. There was one death in the Hospital from Scarlet Fever during the year. Diphtheria.— here were 67 cases of Diphtheria notified in the Borough during the year, and of these 52 cases (equal to 78 per cent.of those notified) were admitted to the Isolation Hospital. There were also 68 cases of Diphtheria admitted from Finchley, 93 from Wood Green, and 1 from Friern Barnet. There were 23 deaths in the Hospital during the year from Diphtheria, giving a case mortality of 10.7 per cent. of the cases of Diphtheria under treatment. Enteric Fever.— There were 8 cases of this disease notified in the Borough during the year, and of these 6 (equal to 75 per cent. of the cases notified) were admitted to the Isolation Hospital. 24 There were also 2 cases of Enteric Fever admitted from Finchley and 1 from Wood Green. Of other diseases treated in the Isolation Hospital during the year there were:— Cerebro-spinal Fever, 1; Erysipelas, 2; Whooping Cough, 1; Puerperal Fever, 1; Poliomyelitis, 1; Influenza, 3; Influenza and Pneumonia, 1; and Pneumonia and Meningitis, 2. One patient died of Cerebro-spinal Fever and one died of Whooping Cough. Mortuary.— The following table shows the number of bodies taken to the Mortuary and the Inquests held during the year:— Bodies. Inquests. Bodies taken to Mortuary on sanitary grounds. January 5 5 - February 9 9 - March 1 1 - April 3 2 l May 2 2 — June 3 3 — July 10 10 — August & Sept. 7 7 — October 7 6 1 November 0 0 — December 3 3 — Total 50 48 2 Municipal Laboratory.— During the year 1,340 specimens were examined in the Bacteriological Laboratory from patients who were, or who. were suspected to be, suffering from the following diseases:— Disease. From Patients at Hospital. From Patients of Medical Men in Hornsey. Total. Diphtheria 891 124 1,015 Scarlet Fever 112 — 112 Enteric Fever 2 3 5 Pulmonary Tuberculosis 0 191 191 Other Diseases 1 1 2 1,006 319 1,325 Ringworm (from scholars at public elementary schools) 15 Total 1,340 Of the 124 specimens from suspected cases of Diphtheria, 25 were found to be positive; of the 191 specimens from suspected cases of Pulmonary Tuberculosis 31 proved positive. There were 96 samples of sewage and effluent analysed and reported on. 25 Diseases of Animals Acts.— By the Tuberculosis Order of 1913, made by the Board of Agriculture and Fisheries, Tuberculosis in cows was made compulsorily notifiable as from the 1st of May, 1913, but no cases have been notified in the Borough. During the year 20 cases of Parasitic Mange have occurred at Stables in the Borough. All these cases have been dealt with by the Council's Veterinary Inspector. In 14 cases the animals recovered; in 1 case a pony was slaughtered, and in 4 cases the horses affected at one stable were not clear at the 31st December, 1918. The Inspector issued certificates for the removal into the Borough of 12 pigs. He also investigated the case of several Pigs which were brought into the Borough without a licence being first obtained. This was the subject of a report presented to the Public Health Committee by the Medical Officer of Health, when it was decided that under the circumstances mentioned by the Owner of the pigs no action should be taken. The cattle siding and gangways at the Hornsey Station have been frequently inspected and were found satisfactory. Sale of Food and Drugs Acts.— Mr. S. J. Pugh, act'.ng in the absence of Mr. Richard Robinson, 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 1918:— No. of samples No. of samples taken adulterated. Milk 144 33 Coffee 3 — Miscellaneous l0 - 157 33 Number of prosecutions 8 Number of convictions 5 Dismissed on warranty 3 The figures given for adulterated samples include some adulterated informal samples In respect of which no proceedings could be taken. 26 Shops Acts.— There are 1,040 shops in the Borough, classitied according to the principal trade carried on in each shop. During the year 555 visits have been made to the shops. In a few instances it was found that the necessary notices under the Acts were not exhibited. The shopkeepers' attention was called to this, and on a further visit being made shortly after wards it was found that the requisite notices were exhibited. Factory and Workshop Act, 1901.— Register of Work shops.— The number of Workshops on the Register at the end of 1917 was 282. During the year 26 Workshops have been added and 23 taken off the Register, leaving a total of 275 Workshops on the Register at the end of 1918. 520 inspections were made and 9 written notices were served. The number of sanitary defects discovered and remedied was 9. In some instances it was found that the walls and ceilings of the workrooms required to be cleansed. On this being pointed out to the; Occupier at the time of inspection a promise was given in each case that the work would be done, and on a further inspection being made the work was found to have been carried out. In 5 cases, comparing with 6 for the previous year, the occupier was requested to cleanse, and this was immediately done. Home Work.— The number of homeworkers on the register is 149, and 297 inspections of these premises were made during the year. Lists are sent in twice yearly by employers and the Sanitary Authorities of other Districts. 487 names were entered upon these lists, 190 of which were found to refer to other districts, and were duly forwarded. Bakehouses.— There are 28 bakehouses in the Borough, 4 being underground bakehouses. Frequent inspections have been made of bakehouses, restaurant kitchens, and other business premises concerned in the preparation of food, and, speaking generally, the conditions found were satisfactory. Dairies and Milkshops numbering 30 and 1 Cowshed in the Borough have been frequently inspected. In 6 instances contravention of the bye-laws or regulations were found, and the matters were at once attended to. 27 Ice-cream.— There are 41 premises in the Borough at which ice-cream; is sold and these were frequently inspected during the summer. Rag Flock Act.— There are nine Upholsterers' premises in the Borough, but at one only is Rag Flock used. During the year frequent inspections have been made at each of these premises, and no contravention of the Act has been found. Poisons and Pharmacy Act.— Two applications have been made under the Poisons and Pharmacy Act for a licence to sell poisonous substances for agricultural and horticultural purposes, and the licence was issued in each case. Petroleum Stores.— There are 25 Petroleum Stores on the Register, and 45 inspections were made during the year. Nuisances, Drainage, &c.— One hundred and forty-eight complaints have been received during the year, classified as follows:— Obstructed or defective drains 23 Defective sanitary fittings 26 Dirty condition of premises 4 Dampness of premises 11 Defective roofs 15 Water in basement 6 Accumulation of refuse 5 Dirty condition of drinking water cistern 2 Nuisances caused by the keeping of animals, &c. 7 Want of dust-bins 7 Other nuisances 42 At seventeen premises the drains have been tested, examined, exposed, etc. On complaint 8 After infectious diseases 9 The usual intimations were issued, and where necessary statutory notices served. In no instance was it found necessary to take legal proceedings. 28 In fifteen instances the drains, etc., were re-constructed entirely, and in others the defects found were remedied and the nuisances abated. Drains unstopped and repaired 68 Waste pipes trapped 54 Rainwater pipes disconnected 33 Gutters repaired 63 New soil pipes fixed 6 Soil pipes and ventilating pipes repaired 16 Intercepting traps fixed 13 The number of premises periodically inspected during the year was 708. This number includes all premises where food is stored or prepared for sale. Preliminary notices issued numbered 630, and statutory notices 146. House-to-House Inspections.— The following tabular statement shows 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:— Premises. Houses or Tenements. Defective Drains. Sanitary Defects. Drinking-water Cisterns dirty or not properly covered. Dirty condition of Premises. Overcrowding. Other Defects. Obstructed Drains. Defective Sanitary Fittings. Defective Water closets. Rainwater Pipes, Gutters, and Roofs defective. Defective Paving. Dampness. Defective, or want of Sanitary Dustbins. St. Mary's Road 70 ... 1 2 ... 19 3 ... 7 3 22 1 25 St. James' Lane 27 ... 1 4 ... 4 ... 1 ... ... 2 ... 1 Coleridge Buildings 40 ... 1 ... ... ... ... ... ... ... 4 ... ... Springfield Cottages 23 ... ... 1 1 ... ... 1 ... ... ... ... ... Verandah Cottages 12 ... 1 1 ... 1 ... l ... ... 2 1 1 North Road Cottages 20 ... ... ... ... 1 ... ... 1 ... 2 ... ... Ward's Cottages 14 ... ... 3 ... 4 1 2 ... ... 2 ... 2 Towsend's Yard 9 ... ... 1 ... 2 1 ... ... 1 2 ... 4 Broadbent's Yard 2 ... ... 1 ... 2 ... ... ... ... ... ... 1 Kent's Yard 6 ... 1 ... ... 1 ... ... ... ... 1 ... 4 Preston's Court 4 This Property was closed by the Borough Council as unfit for human habitation. Allen's Court 4 High Street 9 29 ANNUAL REPORT OF THE MEDICAL OFFICER OF HEALTH FOR THE BOROUGH OF HORNSEY, FOR THE YEAR 1918 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 m.vde by Sanitary Inspectors or Inspectors of Nuisances. Premises. Number of Inspections. Written Notices. Prosecutions. Factories (Including Factory Laundries.) 97 0 0 Workshops (Including Workshop Laundries). 267 6 0 Workplaces (Other than Outworkers' premises included in Part 3 of this Report). 21 2 0 Total 385 8 0 2.—DEFECTS FOUND in FACTORIES, WORKSHOPS, & WORKPLACES Particulars. Number of Defects. Number of Prosecutions. Found. Remedied Referred to H.M. Intpector Nuisances under the Public Health Acts:— Want of cleanliness 5 5 0 0 Want of ventilation 1 1 0 0 Overcrowding 0 0 0 0 Want of drainage of floors 0 0 0 0 Other nuisances 3 3 0 0 †Sanitary accommodation insufficient 0 0 0 0 unsuitable or defective 0 0 0 0 not separate for sexes 0 0 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) 6 6 0 0 Other offences (Excluding offences relating to outwork which are included in Part 3 of this Report) 0 0 0 0 Total 15 15 0 0 † Public Health Acts Amendment Act, 1890, Part 3; Adopted Oct., 1890. — 30 — 3.—HOME WORK NATURE OF WORK. OUTWORKERS' LISTS, SECTION 107. OUTWORK IN UNWHOLESOME PREMISES. SECTION 108. OUTWORK IN INFECTED PREMISES, SECTIONS 109, 110. 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— (l) making, &c. 52 4 164 7 ... 15 ... ... ...... ... ... ... ... ... ... (2) cleaning and washing 4 2 ... ... ... ... ... ... ... ... ... ...... ... ... ... Household Linen ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Lace, lace curtains and nets ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Curtains & furniture hangings ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Furniture and Upholstery ... ... ... 1 ... 3 ... ... ... ... ... ... ... ... ... Electro Plate 2 6 ... ... ... ... ... ... ... ... ... ... ... ... ... File making ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Brass and Brass Articles ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Fur pulling ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Gables and Chains ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Anchors and Grapnels ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Cart Gear ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Locks, Latches and Keys ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Umbrellas, &c. ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Artificial Flowers ... ... 23 ... ... ... ... ... ... ... ... ... ... ... ... Nets, other than wire nets Tents Sacks Racquet and Tennis Balls Paper Bags and Boxes Brush making Pea Picking Feather sorting Carding, etc , of Buttons, &c. Stuffed Toys Basket making Total 58 12 187 8 0 18 0 0 0 0 0 0 0 0 0 31 4.— REGISTERED WORKSHOPS. Workshops on the Register (s. 131) at the end of the year Number. (1) (2) Dressmakers 50 Milliners 14 Bootmakers and Repairers 50 Cycle Makers and Repairers 18 Tailors 18 Laundries 11 Bakehouses 28 Miscellaneous 84 Total number of workshops on Register 273 5.— OTHER MATTERS. Class. Number. (1) (2) Matters notified to H.M. Inspector of Factories:— Failure to affix Abstract of the Factory and Workshop Act (s. 133) 6 Action taken in matters referred by H. M. Inspector as remediable under the Public Health Acts, but not under the Factory and Workshop Act (s. 5) Notified by H.M. Inspector 0 Reports (of action taken) sent to H.M. Inspector 0 Other 0 Underground Bakehouses (s. 101):— Certificates granted during the year 0 In use at the end of the year 4 32 TABLE 1. VITAL STATISTICS OF WHOLE DISTRICT DURING 1918 AND PREVIOUS YEARS. 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 per 1,000 Nett Births Number. Rate Number. Rate. Number. Rate 1 2 3 4 5 6 7 8 9 10 11 12 13 1910 83,953 1,383 1,393 16.59 626 7.45 41 152 97 69 737 8.77 1911 84,696 1,451 1,479 17.46 665 7.85 31 178 116 78 812 9.58 1912 85,522 1,367 1,385 16.19 698 8.16 44 186 105 75 840 9.82 1913 88,160 1,386 1,425 16.16 676 7.66 32 180 81 56 824 9.34 1914 89,834 1,468 1,529 17.0 624 6.94 27 194 88 57 791 8.80 1915 *82,365 1,350 1,394 15.5 790 9.6 23 240 112 80 1,007 12.2 1916 *80,547 1,353 1,404 16.0 723 8.4 31 236 64 46 928 11.5 87,673 1917 *82442 1,010 1,038 11.3 699 8.4 35 237 73 70 901 10.9 §91900 1918 *79184 998 1,037 11.69 868 10.9 46 272 64 61 1,094 13.8 §88723 * Civil Population. § General Population. Area of District in acres (land and inland water) 2,874 At Census of 1911. Total population at all ages 84,592 Number of inhabited houses 16,809 Average number of persons per house 5.032 Total families or separate occupiers 19,940 1. Institutions within the District receiving sick and infirm persons from outside the District. 2. Institutions outside the District receiving sick and infirm persons from the District. Isolation Hospital, Muswell Hill. Workhouse and Infirmary, Edmonton. Cromwell House Convalescent Home. Small Pox Hospital Summers Lane, Finchley. Santa Claus Home. Fever Hospital, Liverpool Road. All Saints' Convalescent Home. Middlesex County Asylum, Napsbury. Hornsey Cottage Hospital. Various London Hospitals. Union Workhouse not in Borough. 33 TABLE II. Cases of Infectious Disease notified during the Year 1918. Notfiable Disease. Number of Cases Notified. Total Cases notified in each Locality. Total cases removed to Hospital. At all Ages. 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 - - - - - - - - - - - - - - - - - - Cholera, Plague — — — — — — — — — — — — — — — — — — Diphtheria (including Membranous croup) 67 - 22 30 12 3 - - 14 13 3 4 11 5 6 9 2 52 Erysipelas 23 — — 1 3 12 6 1 3 2 7 5 3 — — 2 1 2 Scarlet fever 89 1 12 61 10 0 — — 9 16 3 26 15 8 3 6 3 77 Typhus fever — — — — — — — — — — — — — — — — — — Enteric fever 8 — 1 — 2 5 — — 1 — — 1 1 — 3 2 — 6 Continued fever — — — — — — — — — — — — — — — — — — Puerperal fever 2 — - — 1 1 — — — — — 1 — — - — 1 — Cerebro-Spinal Meningitis 1 — 1 - - - - - - - - 1 - - — — — 1 Poliomyelitis 3 2 — — 1 — — — 1 — — — 1 1 — — — — Ophthalmia Neonatorum 2 2 - — — — - — — 1 — 1 — — - — — Measles 796 8 203 533 43 8 1 - 122 96 26 154 128 81 52 54 83 — German Measles 119 - 19 62 25 11 2 - 38 22 14 10 3 12 4 11 5 — Pulmonary Tuberculosis 183 - 4 21 23 97 36 2 12 12 6 35 43 25 22 14 14 — Other forms of Tuberculosis 23 — 3 7 4 5 3 1 4 — 2 4 3 6 2 1 1 — Totals 1316 13 265 715 124 147 48 4 204 161 62 241 209 138 92 99 110 138 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. 34 TABLE III. Causes of, and Ages at Death during the Year 1918. 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 1094 64 26 45 42 64 208 262 383 57 Uncertified ... ... ... ... ... ... ... ... ... ... 1 Enteric Fever ... ... ... ... ... ... ... ... ... ... 2 Small-pox ... ... ... ... ... ... ... ... ... ... 3 Measles 6 ... 4 2 ... ... ... ... ... ... 4 Scarlet Fever 2 ... ... ... 1 1 ... ... ... 1 5 Whooping Cough 13 6 1 6 ... ... ... ... ... 1 6 Diphtheria and Croup 8 1 1 3 3 ... ... ... ... 23 7 Influenza 208 4 12 14 16 24 91 28 19 2 8 Erysipelas ... ... ... ... ... ... ... ... ... ... 9 Phthisis (Pulmonary Tuberculosis) 76 ... ... 1 3 13 35 22 2 ... 10 Tuberculous Meningitis 5 ... 3 1 1 ... ... ... ... ... 11 Other Tuberculous Diseases 8 ... ... 1 1 ... 2 3 1 ... 12 Cancer, malignant disease 130 ... ... ... ... ... 7 65 58 1 13 Rheumatic Fever 6 ... ... 1 ... 3 ... 2 ... ... 14 Meningitis 6 ... 1 1 1 ... 2 ... 1 2 15 Organic Heart Disease 89 1 ... 2 4 4 14 24 40 1 16 Bronchitis 55 3 2 ... ... I 2 8 39 2 17 Pneumonia (all forms) 69 8 1 8 4 6 10 13 11 18 4 18 Other diseases of Respiratory Organs 13 ... ... ... 1 ... ... 8 4 1 19 Diarrhœa and Enteritis 10 6 1 ... 1 ... ... 1 1 ... 20 Appendicitis and Typhlitis 4 ... ... ... ... 1 1 2 ... 2 21 Cirrhosis of Liver 1 ... ... ... ... ... ... 1 ... ... 21a Alcoholism ... ... ... ... ... ... ... ... ... ... 22 Nephritis and Bright's Disease 32 ... ... 1 ... ... 3 10 18 ... 23 Puerperal Fever 1 ... ... ... ... ... 1 ... ... ... 24 Other accidents and diseases of Pregnancy and Parturition 2 ... ... ... ... 1 1 ... ... ... 25 Congenital Debility and Malformation, including Premature Birth 21 19 ... ... 2 ... ... ... ... ... 26 Violent Deaths, excluding Suicide 17 ... ... 3 1 2 3 4 4 3 27 Suicide 8 ... ... ... 1 ... 1 3 3 1 28 Other Defined Diseases 304 64 26 45 43 65 210 70 175 175 29 Diseases ill-defined or unknown ... ... ... ... ... ... ... ... ... ... Totals 1094 64 26 45 42 64 208 262 383 57 Sub- Entries. included in above figures. Cerebro-spinal Meningitis ... ... ... ... ... ... 1 ... ... ... Poliomyelitis ... ... ... ... ... ... ... ... ... ... Pneumonia (other than Broncho-Pneumonia) 41 1 ... 1 2 5 13 10 9 ... 35 TABLE IV. BOROUGH OF HORNSEY. INFANT MORTALITY DURING THE YEAR 1918 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 4 Weeks. 4 Weeks and under 3 Months. 3 Months and under 6 Months. 6 Months and under 9 Months. 9 Months and under 12 Months. Total Deaths under 1 Year. All Causes Certified ... ... ... ... ... ... ... ... ... ... Uncertified ... ... ... ... ... ... ... ... ... ... Small-pox ... ... ... ... ... ... ... ... ... ... Chicken-pox ... ... ... ... ... ... ... ... ... ... Measles ... ... ... ... ... ... ... ... ... ... Scarlet Fever ... ... ... ... ... ... ... ... ... ... Whooping Cough ... ... ... ... ... ... ... 4 2 6 Diphtheria and Croup ... ... ... ... ... ... ... ... 1 1 Influenza ... ... ... ... ... ... 1 2 1 4 Erysipelas ... ... ... ... ... ... ... ... ... ... Tuberculous Meningitis ... ... ... ... ... ... ... ... ... ... Abdominal Tuberculosis (b) ... ... ... ... ... ... ... ... ... ... Other Tuberculous Diseases ... ... ... ... ... ... ... ... ... ... Meningitis (not Tuberculous) ... ... ... ... ... ... ... ... ... ... Convulsions ... ... ... ... ... 1 ... ... ... 1 Laryngitis ... ... ... ... ... ... ... ... ... ... Bronchitis ... ... ... ... ... ... ... 2 1 3 Pneumonia (all forms) 1 ... ... ... 1 1 4 1 1 8 Diarrhœa ... ... ... ... ... 1 ... ... ... 1 Enteritis ... ... ... ... ... ... 2 3 ... 5 Gastritis ... ... ... ... ... ... ... ... ... ... Syphilis 2 ... ... ... 2 ... 1 ... ... 3 Pickets ... ... ... ... ... ... ... ... ... ... Suffocation, overlying ... ... ... ... ... ... ... ... ... ... Injury at Birth 2 ... ... ... 2 ... ... ... ... 2 Atelectasis 2 ... ... ... 2 ... ... ... ... 2 Congenital Malformations(c) 1 ... ... ... 1 ... ... ... ... 1 Premature Birth 9 1 2 1 13 ... ... ... ... 13 Atrophy, Debility and Marasmus 2 ... ... ... 2 1 ... ... 2 5 Other Causes 3 1 1 ... 5 3 1 ... ... 9 Totals 22 0 3 1 28 7 9 12 8 64 Nett Births in the year legitimate, 995. illegitimate, 42. Nett Deaths in the year of legitimate infants, 60. illegitimate infants, 4.