215 HoRII Borough of hornsey. REPORT ON THE HEALTH OF THE BOROUGH FOR THE YEAR 1919. 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. "Hornsey Journml " Printing Works, 86. Crouch Hill, N.4. 2 BOROUGH OF HORNSEY. Summary of Statistics. Area in acres 2,874 Rateable value (District Rate) £678,92 Population, Census, 1901 72,056 1911 84,592 Estimated Population 1919 (June 30th) (Civilian) 94,348 1919 ,, (General) 98,283 Number of persons per acre, 1919 34'2 ,, ,, ,, house (Census, 1911) 5.032 Estimated birth-rate; per 1,000 living, 1919 12.09 Average birth-rate for previous 10 years 16.06 Estimated death-rate per 1,000 living, 1919 10'5 Average death-rate for previous 10 years 10.41 Deaths under 1 year of age, per 1,000 births, 1919 64 Average number of deaths under 1 year of age per 1,000 births, for previous 10 years 65.9 Death-rate from Zymotic diseases, 1919 0.18 Average death-rate from Zymotic diseases for previous 10 years 0.51 Death-rate from Phthisis 0.69 ,, ,, other forms of Tuberculosis 0.063 all .. ,, ,. 0.76 ,, ,, Cancer 1.26 Population.—The total population .of the Borough at the middle of 1919 is estimated by the Registrar-General at 98,283, and the Civil population at 94,348. 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, 1919. Estimated General Population, 1919. Census Population, 1911. Highgate 13,061 13,619 11,811 Muswell Hill 12,710 13,118 11,391 Crouch End 6,736 7,968 6,032 West Hornsey 14,475 14,861 12,951 East Hornsey 12,431 12,723 11,134 North Haringey 10,748 11,069 9,605 South Haringey 6,460 6,676 5,782 Stroud Green 9,766 10,080 8,751 Finsbury Park 7,961 8,169 7,135 Totals 94,348 98,283 84,592 The following table shows the density of population for each Ward based on the Registrar-General's estimate of general population for the middle of 1919:— Ward. Acres. Persons to an Acre. Acres to a Person. Highgate 7095 19 .051 Muswell Hill 6635 20 .05 Crouch End ... 376 21 .048 West Hornsey 227.5 66 .015 East Hornsey 195.5 65 .015 North,' Haringey 125 88 .011 South Haringey 109 61 .016 Stroud Green. 269 37 .027 Finsbury Park 199 41 .024 The Borough 2,874 34.2 029 There have been no new houses built in the Borough during the year, but 11 houses have bean converte 1 into Flats, and one house has been converted into two houses. Births.—The number cf Births recorded during 1919 was males 590 and females 598, making a total of 1,188. This is an increase of 151 as compared with the number of births registered in 1918. In the preceding twelve months (1918 compared with 1917) there was a decrease of 1 in the recorded births. — 4 — Thirteen of the births occurred at the Edmonton Infirmary and 38 at other Institutions and places outside the Borough. Thirty-three of the births were illegitimate (42 in 1918). The birth-rate for the year was 12 09, as compared with 11.69 in 1918. The following table gives the number of births and the birth rates for each quarter of the year 1919:— 1919. HORNSEY. ENGLAND & WALES. No of Births. Birth-rate. Birth-rate. 1st Quarter 237 9.6 — 2nd ,, 272 11.7 — 3rd 299 12.2 _ 4th 380 15.4 — 1,188 12.09 18.5 The highest birth-ratal occurred in the last quarter of the year. WARD. Number of Births recorded during 1919. Birth rail . Highgate 137 10.0 Muswell Hill 138 10.5 Crouch End 74 93 West Hornsey 220 14. 8 East Hornsey 224 17.6 North Haringey 123 12.0 South Haringey 76 11.4 Stroud Green 101 10.0 Finsbury Park 85 10.4 The Borough 1,188 12.1 5 Illegitimate Births.—There were 33 illegitimate births recorded in, 1919, and 42 in 1918, a decrease of 9. The proportion of illegitimate births to the total registered births is 28 per cent., a decrease of 1.2 as compared with last year. Eleven of the illegitimate births occurred in the Edmonton Infirmary. Deaths.—The number of deaths registered in the Borough in 1919 was 772, being 96 deaths less than the number registered in 1918. The yearly average number of deaths registered in the Borough during the previous ten years was 714. The death-rate calculated on these figures (gross death-rate) is 8'2 per thousand of the mean population for the year. This is 2 7 less than in 1918. . This includes only deaths actually registered in the. Borough, and does not include those of Hornsey people dying elsewhere. There were 270 Hornsey people who died outside the District during 1919, viz.':— 96 in the Edmonton Workhouse Infirmary. 8 in another Infirmary. 15 in the Great Northern Central Hospital. 10 in the Prince of Wales' General Hospital. 61 in other Hospitals outside the Borough. 41 in Lunatic Asylums, and 39 in various other places. On the other hand there were 50 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 deaths registered in the Borough the number (270) of Hornsey people dying outside the Borough, and deduct the number (50) of deaths registered in Hornsey of persons who normally resided in other districts. This gives the nett number of deaths belonging to Hornsey as 992, a decrease of 102 on the corresponding number for 1918. 6 The death-rate calculated on these figures is the nett deathrate, and for the past 14 years is as follows: — Year. Nett. Death Hate. 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 1919 105 The ages at which deaths occurred were as follows:— 1919. 1918 . Under 1 week 23 22 1-2 weeks 9 2 2-3 " 3 3 3-4 „ 2 1 Total under 1 month 37 23 1-3 months 15 7 3-6 „ 11 9 6-9 „ 8 12 9-12 „ 5 8 Total under 1 year 76 64 1-2 years 10 26 2.5 14 45 5-15 „ 17 42 15-25 ,, 33 64 25-45 „ 143 208 45-65 ,, 256 262 65 and over 443 383 Total deaths 092 1,094 1919. The death-rate in Hornsey during the first quarter was 15.1 ,, ,, " second ,, 9.5 " ,, ,, third ,, 6.6 fourth ,, 10'8 1918. 14.1 10.0 85 22.1 7 The death-rates at various age groups are shewn below: — 1919. 1st Quarter. 2nd Quarter. 3rd Quarter. 4th Quarter. The year 1919. ear 1918.  Total Deaths (Hornsey) 356 225 156 255 992 1094 Death-rate per 1,000 (Hornsey) 15.1 9.5 6.6 108 105 13.8 „ England and Wales.. — — — — 13.8 17.7 „ 96 Great Towns — — — — 13.8 17.6 Deaths under 1 year 25 13 15 23 76 64 Infantile Mortality (Hornsey) .. 105 48 60 60 64 61 Do. England aud Wales.. — — — — 89 97 Do. 96 Great Towns — — — — 93 106 Deaths 1 year—65 years 183 93 91 159 526 650 Death-rate per 1,000 persons living at these ages 8.3 4.2 4.1 7.2 5.98 8.8 Deaths 65 years and over 148 119 50 73 390 383 Death-rate per 1,000 persons living at these ages 120.8 97.12 40.8 59.6 79.6 92.9 The actual number of deaths this year shows a decrease of 102 on the figures for 1918. Of the principal causes of death, the following diseases caused more deaths in 1919 than in 1918:— Disease. No. of Deaths No. of Deaths in 1919. in 1918. Increase. Enteric Fever l 0 l Bronchitis and Pneumonia 146 124 22 Diarrhoea and Enteritis 11 10 1 Erysipelas 1 0 1 Organic Heart Diseases 98 89 9 Other Respiratory Diseases 18 13 5 Nephritis 40 32 8 Accidents of Parturition ' 3 2 1 Congenital Debility 38 21 17 Suicide 9 8 1 8 The following caused fewer deaths in 1919 than in 1918:— Disease. No. of Deaths No. of Deaths in 1919. in 1918. Decrease Whooping Cough 0 13 13 Diphtheria 3 8 5 Intluenza 84 208 124 Phthisis 66 76 10 Cancer 119 130 11 Rheumatic Fever 5 6 1 Appendicitis 1 4 3 Measles 0 6 6 Other Tubercular Diseases 6 8 2 Tuberculosis.—The deaths from Phthisis numbered 66, or 10 less than in the previous year, and 7 more than the yearly average for the preceding ten years (viz., 59). Six of these 66 deaths occurred of persons who had been removed to the Edmonton Infirmary, 6 at Lunatic Asylums, 9 at Sanatoria, 4 at other Hospitals and 4 at other places outside the Borough. From forms of Tuberculosis other than Phthisis there were 6 deaths registered, a decrease of 2 compared with the year 1918. The total deaths from all forms of Tuberculosis were, there fore, 72, or 12 less than in the previous year. The death-rate from Phthisis per thousand of the population was 0'69, and from other forms of Tuberculosis 0'063. During the year 376 cases of Tuberculosis were notified to me by Medical Practitioners, as compared with 357 in 1918, an increase of 19. Of these it was found that 177 cases had been, previously notified, and that 6 cases belonged not to Hornsey, but to other districts, these notifications being accordingly transferred, the new cases occurring in Hornsey, therefore, being 193, a decrease of 13 on the total of 206 new cases notified in the previous year. Of these, 168 were cases of Pulmonary Tuberculosis and 25 were cases of non-Pulmonary Tuberculosis. 9 The following table gives the parts affected in the cases of Non-Pulmonary Tuberculosis notified to me: — Glands 9 Bones and Joints 5 Larynx 3 Skin 3 Hip 2 Peritoneum 1 Pleura 1 Fallopian tubes 1 • 25 Cancer.—There were 119 deaths registered as due to Cancel in 1919 as against 130 deaths from this cause in 1913 and 110 in 1917. This is a decrease of 11 deaths on 1918, and an increase of 9 deaths from the number registered in 1917. The death-rate from Cancer per thousand of the population is equal to 1.26, about one-eighth of the total death-rate. 10 Deaths from Zymotic Diseases.—The number of deaths from each disease for 1919 and preceding years is shown in the following table:— NUMBER OF DEATHS 1897-1919 FROM THE SEVEN PRINCIPAL ZYMOTIC DISEASES. 1919 1918 1917 1916 1915 1914 1913 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 0 2 0 0 0 0 0 VIeaales 0 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 2 0 0 3 1 0 3 1 4 3 3 4 6 8 1 1 2 0 1 3 0 2 Diphtheria 3 8 6 11 11 6 3 2 5 8 10 9 9 13 8 7 12 9 10 14 4 11 16 Enteric Fever 1 0 0 1 2 1 3 2 1 3 0 2 4 5 2 2 0 5 2 6 0 4 0 Whooping Cough 0 13 6 5 7 4 8 2 15 10 12 11 19 4 10 17 19 9 14 18 20 8 10 Diarrhoea 11 10 3 8 25 29 14 16 36 1 1 9 3 30 6 24 1 1 6 9 32 15 29 Totals 17 40 29 25 85 42 40 30 78 27 38 46 44 76 38 69 48 35 40 52 65 52 64 There were 17 deaths from Zymotic diseases in 1919. as against 40 in 1918. 11 The Zymotic death-rate is equal to 018 per thousand of the population. Considering the Zymotic diseases in detail, it is seen that thera was no death from Small Pox. There were two deaths from this disease in 1902; there have been none since 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 was 1 death from Enteric Fever. There were 11 deaths from Diarrhoea, and Enteritis. There were no deaths from Measles or Whooping Cough. Infantile Mortality.—During the year 1919 there were 76 deaths of infants under one year of age, as against 64 in 1918, and an average of 86 for the ten years 1909-1918. The infantile mortality for the year 1919, i.e., deaths under one year of age per 1,000 births is 64 in Hornsey. In 1918 the infantile mortality rate was 61 and the average rate for the twenty years 1899-1918 was 74, the highest being 106 in 1899, and the lowest 46 in 1916. The Infantile Mortality for England and Wales is 89, and of the 96 Great Towns 93. The following table gives the number of infantile deaths and the mortality for each Ward of the Borough:— Number of deaths under one year. nfantile Mortality, i.e. deaths under one year per 1,000 births. Highgate 7 51 Muswell Hill 6 43 Crouch End 3 41 West Hornsey 13 59 East Hornsey 17 76 North Haringey 8 60 South Haringey 5 66 Stroud Green 6 59 Finsbury Park 11 . 129 The Borough 76 64 12 The number of deaths in the first three quarters of the year was 25, 13 and. 15, and in the last quarter 23. In 1917, 4 deaths were due to diarrhoeal diseases, in 1918, 0 deaths, and in 1919, 6 deaths were recorded from these causes among infants. The Infantile Mortality at the four quarterly periods of 1919 was as follows:— 1919. Births Infantile Deaths. Infantile Mortality. First Quarter 237 25 105 Second ,, 272 13 48 Third 299 15 50 Fourth ,, 380 23 61 The whole year 1,188 76 64 The ages at death were as follows:— Under 1 week 23 1-2 weeks 9 2-3 ,, 3 3-4 2 Total under 1 month 37 1-3 months 15 3-6 „ 11 6-9 „ 8 9-12 ,, 5 Total deaths under 1 year 76 The principal causes of death among infants under one year of age were:— Equal to a death-rate per 1,030 births of— Premature Birth, Injury at Birth, and Congenital Defects 29 24.4 Bronchitis and Pneumonia 10 8.4 Atrophy, Debility, Marasmus 9 7.6 Diarrhoeal Diseases 6 5.0 Influenza 8 2.7 ]] Equal to a death-rate per 1,000 births of— Accident 2 1.7 Convulsions 1 0.84 Rickets 1 0.84 Cerebro,Spinal Fever 1 0.84 Other causes 14 11.8 76 639 Deaths under one year of age of Illegitimate Children.—There were 33 illegitimate births registered during the year, and 7 deaths under one year of age of illegitimate children occurred. This gives an infantile mortality among illegitimate children of 212. The number of legitimate births registered was 1,155, and the number of deaths under one year of age of legitimate children was 69. This gives an infantile mortality among legitimate children of 51. Infectious Diseases.— The cases of Infectious Disease notified during 1919 were as follows:— Scarlet Fever . 203 Diphtheria 87 Enteric Fever 6 Malaria 21 Dysentery 2 Measles 224 German Measles 285 Puerperal Fever 4 Erysipelas 42 Ophthalmia Neonatorum 5 Pneumonia 112 Cerebro-spinal Fever 4 Encephalitis Lethargica 2 Poliomyelitis 1 Polio Encephalitis 3 Phthisis ... 168 Other forms of Tuberculosis 25 1,194 13 14 Considering the diseases now notifiable as below (Scarlet Fever Diphtheria and Membranous Croup, Enteric or Typhoid Fever including Paratyphoid Fever, Typhus Fever, Relapsing Fever, Continued Fever, Puerperal Fever, Erysipelas, Small Pox, Cholera, Plague, Measles and German Measles, Acute Poliomyelitis, Cerebro-Spinal Fever, Epidemic Cerebro-Spinal Meningitis or Spotted Fever, Ophthalmia Neonatorum, Acute Encephalitis Lethargica, Acute Polio Encephalitis and Tuberculosis) it will be seen that the case® notified to me numbered 1,194 in 1919. This is an increase of 84 as compared with 1918, whe.n 1,110 cases were notified. There were 2 cases of Cerebro-Spinal Fever notified during 1919. The notifications of Tubercular Phthisis numbered 1G8, and other forms of Tuberculosis 25, 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 15 Scarlet Fever. Diphtheria. Enteric Fever. Malaria. Dysentery Measles. German Measles. Puerperal Fever. Erysi pelas. Ophth. Neon. Pneumonia. Cerebro Spinal Fever. Encephalitis Lethargica. Polio mvelitis. Polio Encephalitis. Tuberculosis. Total Phthisis. Other forms. Highgate 13 13 4 3 0 16 25 1 1 4 21 0 1 0 1 16 3 122 Muswell Hil 34 6 0 2 0 26 33 0 4 0 10 l 0 0 0 18 1 135 Crouch End 11 2 0 1 0 9 33 0 4 1 2 0 0 0 0 5 2 70 West Hornsey 25 16 0 3 0 80 84 2 9 0 24 1 1 0 0 32 7 284 East Hornsey 26 26 1 2 0 42 44 0 6 0 19 0 0 0 1 35 2 204 North Haringey 26 6 0 5 0 16 0 8 0 16 0 0 1 0 22 4 111 South Haringey 30 2 1 3 0 10 7 0 0 0 2 0 0 0 0 15 3 73 Stroud Green 19 11 0 1 0 18 38 1 6 0 9 0 0 0 0 15 2 120 Finsbury Park 19 5 0 1 2 7 14 0 4 0 9 2 0 0 1 10 1 75 Total 203 87 6 21 2 224 285 4 42 5 112 4 2 1 3 168 25 1194 Scarlet Fever. Diphtheria. Ent ericFever. Malaria. Dysentery. Measles. German Measles. Puerperal Fever. Erysipelas. Ophth. Neon, Pneumonia. Cerebro Spinal Fever. Encephalitis Lelhargica. Polio myelitis. Polio Encephalitis. Tuberculosis. Total Phthisis. to her forms. 1st quarter 26 26 0 1 0 38 67 0 6 0 58 0 1 0 0 33 5 261 2nd quarter 44 11 0 8 0 114 176 1 10 3 28 4 0 0 1 56 4 460 3rd quarter 41 16 4 11 2 37 25 1 13 1 4 0 0 1 1 38 7 202 4th quarter 92 34 2 1 0 35 17 2 13 1 22 0 1 0 1 41 9 271 Total 203 87 6 21 2 224 285 4 42 5 112 4 2 1 3 168 25 1194 10 Scarlet Fever.—There were 203 cases of Scarlet Fever notified in 1919, as against 89 in 1918, and against a yearly average of 235 for the twenty years (1899-1918). There is, therefore, an increase of 114 from the cases notified in 1918, and a decrease of 32 from the average number for the preceding twenty years. The disease was mostly of a very mild type, there being only two fatal cases occurring among the 203 cases notified. The attack rate per 1,000 of the population was 2'2, and the mortality 0'02. Sixty-six per cent, of the cases were removed to the Isolation Hospital for treatment. Diphtheria.—There were 87 cases of Diphtheria notified in 1919, as against 67 in 1918, and against a yearly average of 105 for the twenty years (1899-1918). There is therefore an increase of 20 over the number of cases notified in 1918, and a decrease of 18 as compared with the yearly average for the preceding twenty years. There were 3 deaths among the 87 cases notified, as compared with 7 deaths among 67 cases notified in 1918. The attack rate was 0.9, and the mortality 0.03 per thousand of the population. Sixty-eight per cent. of the cases were removed to the Isolation Hospital. Enterie Fever.—There were 6 cases of this disease notified in 1919, as compared with 8 cases in 1918, and an average of 13 cases for the twenty years (1899-1918). The number of cases of Enteric Fever in the Borough was 2 less than in 1918 (6 against 8), and below the average for recent years. The attack rate was 0.06, and the mortality 0.01 per thousand of the population. Seventeen per cent. of the cases were removed to the Isolation Hospital. Measles and German Measles.—There were 509 cases of Measles and German Measles notified during the year, as compared with 915 for 1918. There were no deaths from Measles during 1919. By an Order of the Ministry of Health these two diseases, which were made notifiable in 1915, ceased to be so as from the 31st December, 1919. \ 17 Isolation Hospital.—As compared with the previous year there were 141 more patients admitted in 1910, viz.:—537 In 1919 and 396 in 1918. TABLE SHOWING NUMBER OF ADMISSIONS, DEATHS AND DISCHARGES AT ISOLATION HOSPITAL, 1919. Patients iu Hospital Jan. 1st... 47 Patients admitted during the year 537 584 Patients discharged during the year 480 Patients dying during the year 23 — 503 Patients remaining in Hospital Dec. 31st 81 Scarlet Fever.—The number of cases notified in Hornsey during 1919 was 203, and of these 134 (equal to 66 per cent. of the cases notified) were admitted to the Isolation Hospital. There were also 73 cases of Scarlet Fever admitted from Finchley and 107 from Wood Green. The: e was one death in the Hospital from Scarlet Fever during the year, giving a case mortality of 0.32 per cent, of the 314 cases admitted to the Isolation Hospital. Diphtheria.- There were 87 cases of Diphtheria notified in the Borough during the year, and of these 59 cases (equal to 68 per cent. of those notified) were admitted to the Isolation Hospital. There were also 56 cases of Diphtheria admitted from Finchley, 79 from Wood Green, and 2 from Hendon. There were 15 deaths in the Hospital during the year from Diphtheria, giving a case mortality of 7'6 per cent. of the 196 cases of Diphtheria admitted. Enterie Fever.—There were 6 cases of this disease notified in tile Borough during the year, and of these 1 (equal to 17 per cent, of the cases notified) was admitted to the Isolation Hospital. There was also 1 case of Enteric Fever admitted from Wood Green. 18 Of other diseases treated in the Isolation Hospital during the year there were Dysentery, 6; Erysipelas, 5; Cerebro-Spinal Fever, 4; Influenza 3; Influenzal Pneumonia, 1; Puerperal Fever, 1; Meningitis, 1; Encephalitis Lethargica, 1; and Septicaemia, 1;—Total, 23. There were three deaths from Cerebro-Spinal Fever, 1 from Dysentery, 1 from Puerperal Fever, 1 from Influenza and 1 from 'Septicaemia. 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 6 6 3 February 13 10 2 March 5 3 — April 3 3 — May 7 7 1 June 2 1 — July and August 5 5 — September 5 5 — October 8 8 — November 2 2 — December 1 1 — Total 57 51 0 Municipal Laboratory.—During the year 1,631 (1,340 in 1918) 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 1,232 231 1,463 Scarlet Fever — — — Enteric Fever — 4 4 Pulmonary Tuberculosis — 157 157 Other Diseases — — — 1,232 392 1,624 Ringworm (from scholars at public elementary schools) 10 Total 1,634 19 Of the 231 specimens from suspected cases of Diphtheria, 33 were found to be positive, and of the 157 specimens from suspected cases of Pulmonary Tuberculosis 22 proved positive. There were 92 samples of sewage and effluent analysed and reported on. Diseases of Animals Acts.—By the Tuberculosis Order of 1913, made by the Board of Agriculture and Fisheries, Tuberculosis in cows was mada compulsorily notifiable as from the 1st of May, 1913, but no cases have been notified in the Borough. During the year 6 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 all cases the animals recovered. The Inspector issued certificates for the removal into the Borough of 3 pigs. The cattle siding and gangways at the Hornsey Station have been frequently inspected, and were found satisfactory. Sale of Food and Drug's Acts.—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 Hornsev during the Year 1919:— No. of Samples taken. No. of samples adulterated. Milk 133 14 Cream 2 – Miscellaneous 16 – 151 14 Number of prosecutions 4 Number of convictions 1 Summonses withdrawn 2 Dismissed on warranty 1 The figures given for adulterated samples include some adulterated informal samples in respect of which no proceedings could be taken. Shops Acts.—There are 1,102 shops in the Borough classified according to the principal trade carried on in each shop. During the year 1,022 visits have been made to the shops. 20 In a few instances it was found that the necessary noticesunder the Acts were not exhibited. The shopkeepers' attention was called to this, and on a further visit being made shortly afterwards it was found that the requisite notices were exhibited. Factory and Workshop Act, 1901.—llegister of Workshops.—The number of Workshops on the Register at the end of 1918 was 275. During the year 37 Workshops have been added and 40 taken off the Register, leaving a total of 272 Workshops on the Register at the end of 1919. 992 inspections were made and 86 written notices were served. The number of sanitary defects discovered and remedied was 86. 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 51 cases, comparing with 5 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 153, and 385 inspections of these premises were made during the year. Lists are sent in twice yearly by employers and the Sanitary Authorities of other Districts. 381 names were entered upon these lists, 199 of which were found to refer to other districts, and were duly forwarded. Bakehouses.—There are 30 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 Milksliops numbering 31 and 1 Cowshed in the Borough have been frequently inspected. In 8 instances contravention of the bye-laws or regulations were found, and the matters were at once attended to. 21 Ice-cream.—There fire 33 premises in the Borough at which ice-cream is sold, and these were frequently inspected during the summer. Rag Flock Act.—There are 16 Upholsterers' premises in the Borough, but at one only is Hag 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 the renewal of licences to sell poisonous; substances for agricultural and horticultural purposes, and the licence was issued iu each case. Petroleum Stores.—There are 35 Petroleum Stores on the Register, and 82 inspections were made during the year. Nuisances, Drainage, &c.—Two hundred and forty complaints have been received during the year, classified as follows:— Obstructed or defective drains 29 Defective sanitary fittings 22 Dirty and defective condition of premises 48 Dampness of premises 23 Defective roofs 24 Water in basement 6 Burst water pipes 9 Accumulation of refuse 5 Defective and dirty condition of drinking water cistern 5 Want of dust-bins 20 Overcrowding 2 Rats 3 Other nuisances 44 240 At 53 premises the drains have been tested, examined, exposed, etc. On complaint ... ... ... ... ... 35 After infectious diseases ... ... ... 18 53 The usual intimations were issued, and where necessary statutory notices served as follows: — 22 Preliminary intimations 619 Statutory Notices on resolution of the Council 147 In 11 cases legal proceedings were instituted against persons who had failed to comply with statutory notices to remedy defects. In each case an Order of the Court was made for the work to be done, and fines and costs amounting in all to £53 2s. wore inflicted by the Magistrates. In seventeen instances the drains, etc., were re-constructed entirely, and in others the defects found were remedied and the nuisances abated. Drains unstopped and repaired 122 Waste pipes trapped 86 Rainwater pipes disconnected 65 Gutters repaired 113 New soil pipes fixed 18 Soil pipes and ventilating pipes repaired 20 Intercepting traps fixed 13 The number of premises periodically inspected during, the year was 915. This number includes all premises where food is stored or prepared for sale. 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 Hoofs defective. Defective Paving. Dampness. Defective, or want of Sanitary Dustbins. Mount Pleasant Road 45 1 3 8 2 17 4 31 3 9 9 ... 14 Southwood Laue 7 ... ... ... ... 3 2 2 ... ... 5 ... 7 Brook Road 57 8 1 7 2 47 3 15 18 4 14 3 37 Brook Place 8 2 ... 1 ... 7 ... 1 1 5 ... ... 3 Campsbourne Road 238 3 2 22 3 67 27 40 30 12 100 4 92 St James' Lane 29 ... ... 4 ... 8 ... 5 4 3 5 1 20 Woodside Cottages 16 ... ... 7 1 8 3 9 6 1 i ... 5 Ward's Cottages 14 ... ... 3 ... 4 1 ... ... ... 2 ... 2 Boyton Road 97 1 1 11 7 60 19 51 17 6 27 2 29 Nightingale Lane 22 ... ... ... ... 27 ... ... ... ... ... ... ... Total 533 15 7 63 15 248 59 156 79 40 163 10 209 23 REPORT OX MATERNITY AND CHILD WELFARE WORK, BY DR. FLORA SHEPHERD. For the purpose of Maternity and Child Welfare work the Borough is divided into three areas—Brook Road Centre (No 1), Harringay Centre (No. 2) and Highgate. The work is carried on under the direct supervision of the Medical Officer of Health by a Medical Officer who works for six half-days weekly. No. of Sessions. New Cases Under 1 yr. Registered Over 1 yr. Total Attendances. Average per Session. Brook Road 140 176 72 4,662 32 Harringay 90 133 72 2,821 313 There are three Health Visitors, two for the poorer and more densely populated Brook Road area and one for the Harringay area. The Highgate area is not yet organised. The work of an area includes notified birth visits, still births, ophthalmia neonatorum, ante-natal visiting, weighing of infants and children at a Centre, medical consultations, lectures and sewing classes, and re-visiting all children up to the age of 5 years. Each area is autonomous and self-contained, and furnishes monthly its report of work done to the Maternity and Child Welfare Committee. The localising and concentrating of the work gives the mothers a feeling of security and continuity and the workers the stimulus of direct responsibility. Voluntary Committees.—The work of weighing and consultations is greatly facilitated by a Committee of highly-trained voluntary workers. The nuclei of these voluntary workers are those ladies who are co-opted on to the Maternity and Child Welfare Committee, and their work has been so steady and continuous that they are now a most valuable asset in the working of the Centres. 24 Percentage of Children attending Centres.—It is found that 35 per cent. of the mothers of all children visited at birth bring their children for weighing and consultation in the Brook Road area, and 52 per cent. in the Harringay area.. The more intelligent the population the higher the percentage seeking ad vice. This must be so unless the mothers are encouraged to bring their children for ailments. The whole aim of the world is, however, prevention cf illness and the raising of the health standard. To achieve this each mother must have free access to skilled advice during the upbringing of one child, and she must learn from skilled authority to recognise the abnormal and subnormal in infant and child physique. This the woman of average intelligence will learn in two years, and, having once learned it, she is a valuable asset in the scheme of prevention as unconsciously she teaches wherever she goes. Medical Consultations.—The children are seen at all medical consultations which are as follows:— 1. All new entrants. 2. All children under one year—monthly. 3. Children 1-2—quarterly. 4. Children 2-5—half-yearly. 5. Children suffering from sub-normal health and who are put by the Doctor on a special list are seen weekly or fort nightly. 6. Children discovered by Health Visitors to be in sub normal health. 7. Children making a first appearance after absence due to illness, e.g., measles, whooping cough, etc. A special report on physique is made at entrance, at seven months, at eighteen months, and at each subsequent birthday It is found that vary little attention is needed for the breast fed infants up to the time of weaning, but that in 30 per cent of these children it is necessary to give weekly medical advice during weaning. An unwise introduction to a mixed diet is frequently the cause of digestive difficulties, arrested growth dental defects and rooted dislikes and distastes for certain articles of food. I consider that for the normal child the a.ge from eight 25 to eighteen months is the most deserving of close watch and persistent digestive education. Prolonged Lactation.—I have been disappointingly unsuccessful in those children who have continued on breast milk after the age of ten months. In spite of the most careful and varied additions to their diet they have persistently remained below the normal weight line. They become peculiarly anaemic, and while they are not particularly thin their muscles lack tone, the skins dry, and there appears to be an undue laxness of ligaments. To the experienced eye their appearance is typical and can be recognised immediately; it suggests an abnormality of internal secretions. Difficult Nutrition.—With the exception of advice and education to the mother, coupled with repeated examinations of the healthy children, the greatest amount of the Medical Officer's time is taken up with cases of difficult nutrition. This difficulty is usually established in the early weeks cf life by unskilled management of breast feeding or by an injudicious management of artificial feeding. There is still a gap from birth to the end cf the first month, and this gap is wasteful cf life, time and money. Unnecessary Weaning.—It is during that first month that the most skilful advice is required both by mother and child, but the fact remains that during that month it is at present most inadequately provided for. To take one example only:—It is a common thing for me to see infants suffering from indigestion who have been weaned and who have had five different food mixtures within a few weeks; yet in no instance during my five years in Hornsey have I found in these cases an insufficient supply of milk in the mothers' breasts. The number of these cases is not small, and the amount of time which must be expended on them by the Medical Officer and Health Visitors is considerable. With skilled care they regain the normal, but the expense entailed suggests the advisability of attempting to bridge the step between ante-natal care and attendance at the Centres. 26 table of infant feeding. (159 Infants under seven months on entrance.) Breast-fed 99 Breast-fed and supplemental feeding 9 Artificial feeding 51- Cow's milk boiled 11 Full cream dried milk 17 Condensed sweetened milk 13 Malted milk 9 Boiled biscuits and water 1 51 Artificially fed Infants.—When dealing with the artificially fed infants the greatest possible freedom is given to the mothers in the choice of a food basis. They are asked what they wish to give the child as a food, and are then told its composition, and shown how to add to it in order that it may be approximated to breast milk. The dangers of not doing so are pointed out in each particular instance. The only stipulation always made is that cow's milk, which is the most popular choice, shall in every case be boiled or pasteurized at home. This method of dealing with artificial feeding takes up much more time than would be spent were simple formulae employed, but iti is so much more educative that one considers the time well spent. Scurvy.—Only three cases of Scurvy have come under my notice during the year. Two of the children were partially breastfed, and in each case the additional food was dried milk. The third child was on a mixed diet, including egg, oatmeal, crusts and boiled milk. Tuberculosis.—This condition I have found is surprisingly infrequent in young children in spite of the fact that in many cases the mothers are to my knowledge actively tuberculous. One case of tuberculosis of the testicle in child aged 3 years. One case of abdominal tuberculosis with later tubercular dactylitis, aged 11 months. Two cases of spinal caries. One case of pulmonary tuberculosis following influenza and pleurisy, child aged 5 years. 27 Three eases which can only be described as pre-tubercular pulmonary condition, as the disease cannot be discovered, while yet a constant observation of the individual cases and a process of elimination makes the diagnosis probable. In one only of these cases, and that a pre-tubercular case, was there any tubercular disease in the mother. All suspicious cases are sent for confirmation of diagnosis to the Tuberculosis Medical Officer. Syphilis.—This disease is not infrequent, and is usually diagnosed clinically and treated from the Centre. This is not ideal, but the whole question is fraught with difficulty from the point of view of mother and doctor. An attempt was made over a long period of time to have the diagnosis ratified by the Wassermann test at the nearest available hospital, but the results so seldom tallied with the clinical picture and the facts that it was discontinued, e.g.:— Infant (syphilic diagnosis at Centre). Mother apparently healthy. Father under treatment for Syphilis. At Hospital clinic:— Mother and child sent for Wassermann test. Report in each case negative. Then with regard to treatment:—Before a mother will attend hospital she must be convinced that the child is ill. If this is not obvious to her, which is by no means always the case, then the only alternative is to convince her by a full statement of fact with regard to Syphilis. This can be done, but it more frequently results in a, domestic upheaval than in anti-syphilitic treatment for mother or father or child. There has been a marked enlightenment with regard to venereal diseases in the last two years, and the position will doubtless improve, but in the meantime perhaps the best thing that can be done is treatment from the Centre. Health or 1828 Children. Normal children 1,213 Incorrect feeding and management 441 Rickets 76 Wasting 58 Syphilis 40 28 Ante-Natal Work and Provision for Maternity.— Mothers are seen ante-natally by appointment. Those who wish to go are sent to the Duchess of Marlborough's Maternity Home for confinement. The Home is under the management of the Royal Free Hospital. Every care is given to the mothers before the birth of the child, and an examination is made six weeks post partum. Where it is possible to pay the full fee they do so, but in the majority of instances part of the expenses are paid by the Council, which also provides an ambulance. This arrangement has answered admirably in the small number of cases for which it has been available. The accommodation is, however, limited, and the majority of mothers cannot leave their young families at the time of confinement. Especial investigation was made in all cases with a history of previous miscarriage. Of these there were 11 mothers, whose total living children numbered 21, and whose infants lost at or before birth numbered 26. During this year 7 of these mothers have given birth to healthy normal infants. In the 4 instances of miscarriage, 2 suffered from uterine prolapse, 1 from lead poisoning and 1 from contracted pelvis. Health of Pregnant Mother. Place of Confinement. Nature of Confinement. Teeth Sound 26 At Home 37 Normal Teeth Caries 341. Pyorrhœa 5 Dental treatment Duchess of Marlborough's Labours 35 Prematura Pulmonary Tuberculosis 4 Home 19 Birth 3 Albuminuria 1 Hospital 3 Miscarriages 8 Glycosuria 1 Infirmary 1 Instrumental Gastritis persistent 2 Labours 2 Ante partum Hæmorrhage 2 Placenta Hæmorrhoids 5 Prævia 3 Cracked Nipples 3 Lacerated Cervix 2 Insufficient Nourishment 2 Varicose Veins 5 Death-rate of Infants under two years.—The number of deaths among children who have attended the Centres has been much higher than in any previous year. This is partly due to the influenza epidemic, which accounted for five deaths, and to the fact that the number of children attending has increased to double what it was in 1917-18. 29 The causes of death were as follows:— Pneumonia 3 Influenza 4 Enteritis 2 Intestinal toxæmia 1 Congenital malnutrition 2 Marasmus 3 Appendicitis 1 Three of these infants were premature. Two were illegitimate children. Twelve were apparently normally healthy children, well cared for. Five were syphilitic. Two were twins. In two cases only was the care of the children distinctly less skilled than was desirable. Ages at Death. 1-3 months 2 3-6 „ 2 6-9 „ 2 9-12 „ 6 Over one year 4 One might sum up the yearly report by pointing to the weak links in the chain of Maternity and Child Welfare work in the Borough:— (1) Inadequate provision for maternity. (2) Lack of skilled care of the infant from birth to the end of the first month of life. (3) Failure to bring the clinical diagnosis of syphilis into line with that arrived at in the laboratory. (4) Complete failure to secure treatment of the parents of syphilitic infants. FLORA SHEPHERD. 30 ANNUAL REPORT OF THE MEDICAL OFFICER OF HEALTH FOR THE BOROUGH OF HORNSEY, FOR THE YEAR 1919 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.) 162 0 0 Workshops (Including Workshop Laundries). 525 12 0 Workplaces (Other than Outworkers' premises included in Part 3 of this Report). 27 4 0 Total 714 16 0 2.—DEFECTS FOUND in FACTORIES, WORKSHOPS, & WORKPLACES Particulars. Number of Defects. Number of Prosecutions. Found. Remedied Referred to H M. Inspector. Nuisances under the Public Health Acts:— Want of cleanliness 51 51 0 0 Want of ventilation 0 0 0 0 Overcrowding 0 0 0 0 Want of drainage of floors 0 0 0 0 Other nuisances 18 18 0 0 †Sanitary accommodation insufficient 3 8 0 0 unsuitable or defective 12 12 0 0 not separate for 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) 0 0 0 0 Other offences (Excluding offences relating to out work which are included in Fart 3 of this Report) 0 0 0 0 Total 86 86 0 0 † Public Health Acts Amendment Act, 1890, Part 3; Adopted Oct., 1890. 31 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— (1) making, &c. 54 5 125 5 ... 10 ... ... ... ... ... ... ... ... ... (2) cleaning and washing ... ... ... 1 1 ... ... ... ... ... ... ... ... ... ... Household Linen ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Lace, lace curtains and nets ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Curtains & furniture hangings ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Furniture and Upholstery 2 ... 4 ... ... ... ... ... ... ... ... ... ... ... ... Electro Plate 2 3 ... ... ... ... ... ... ... ... ... ... ... ... ... File making ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Brass and Brass Articles ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Fur pulling ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Cables and Chains ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Anchors and Grapnels ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Cart Gear ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Locks, Latches and Keys ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Umbrellas, Ac. ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Artificial Flowers 2 ... 22 ... ... ... ... ... ... ... ... ... ... ... ... 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. 60 8 151 6 l 10 0 0 0 0 0 0 0 0 0 32 4.—REGISTERED WORKSHOPS. Workshops on the Register (s. 131) at the end of the year (1) Number. (2) Dressmakers 62 Milliners 16 Bootmakers and Repairers 52 Cycle Makers and Repairers 24 Tailors 23 Laundries 18 Bakehouses 30 Miscellaneous 47 Total number of workshops on Register 272 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) 15 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 4 Reports (of action taken) sent to H.M. Inspector 4 Other 0 Underground Bakehouses (s. 101):— Certificates granted during the year 0 In use at the end of the year 4 - 33 — TABLE 1. VITAL STATISTICS OF WHOLE DISTRICT DURING 1919. 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 3 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 1,94 13.8 | §88723 1919 *94348 1,137 1,188 12.1 772 8.2 50 270 76 64 992 10.5 §98283 * Civil Papulation. § General Population. Area of District in acres (land and inland water) ,2874 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 At Census of 1911. . Institutions within the District receiving sick and infirm persons from outside the District. * Isolation Hospital, Muswell Hill. Cromwell House Convalescent Home. Santa Claus Home. All Saints' Convalescent Home. Hornsey Cottage Hospital. 2. Institutions outside the District receiving sick and inlirm persons from the Distiict. Workhouse and Infirmary, Edmonton. Fever Hospital Liverpool Road. Middlesex County Asylum, Napsbury. Various Loudon Hospitals. ,, Sanatoria. Union Workhouse not in Borough. 34 TABLE II. Cases of Infectious Disease notified during the Year 1919. Notifiable Disease. Number of Cases Notified. Total Cases notified in each Locality. 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 Qreen. 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) 87 – 17 50 16 4 – – 13 6 2 16 16 6 2 11 5 59 Erysipelas 42 – – 4 1 12 21 4 1 4 4 9 6 8 – 6 4 5 Scarlet fever 203 1 26 151 16 8 1 – 13 34 11 25 26 26 30 19 19 134 Typhus fever – – – – – – – – – – – – – – – – – – Enteric fever 6 – 1 1 3 1 – – 4 – – – 1 – 1 – – 1 Continued fever – – – – – – – – – – – – _ – – Malaria 21 – – – 3 17 1 – 3 2 1 3 2 5 3 1 1 – Dysentery 2 – – – – 2 – – – – – – – – – – 2 – Puerperal fever 4 – – – 1 3 – – 1 – – 2 – – – 1 – Cerebro-Spinal Meningitis 4 – 2 – 1 – 1 – – 1 – 1 – – – – 2 3 Poliomyelitis 1 – – 1 – – – – – – – – – 1 – – – – Ophthalmia Neonatorum 5 5 – – – – – – 4 – 1 – – – – – – – Pneumonia 112 6 13 17 9 38 22 7 21 10 2 24 19 16 2 9 9 4 Measles 224 4 36 145 30 9 – – 16 26 9 80 42 16 10 18 7 – German Measles 285 5 29 190 39 22 – – 25 33 33 84 44 7 7 38 14 – Polio Encephalitis 3 – 1 – 1 – 1 – 1 – – – 1 – – – 1 – Encephalitis Lethargica 2 – – – – 2 – – 1 – – 1 – – – – – 1 Pulmonary Tuberculosis 168 – 2 14 31 90 30 1 16 18 5 32 35 22 15 15 10 – Other forms of Tuberculosis 25 – 3 9 4 6 2 1 3 1 2 7 2 4 3 2 1 – Totals 1194 21 130 582 155 214 70 13 122 135 70 284 204 111 73 120 73 207 ISOLATION HOSPITAL Name and Situation Hornsey Borough Isolation Hospital, Coppett's Road, Muswell Hill. Total available beds 130 Number of diseases that can be concurrently treated 3. 35 TABLE III. Causes of, and Ages at Death during the Year 1919. 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 992 76 10 14 17 33 143 256 443 68 Uncertified ... ... ... ... ... ... ... ... ... ... 1 Enteric Fever 1 ... ... ... ... ... 1 ... ... ... 2 Small-pox ... ... ... ... ... ... ... ... ... ... 3 Measles ... ... ... ... ... ... ... ... ... ... 4 Scarlet Fever 2 ... ... 1 1 ... ... ... ... ... 5 Whooping Cough ... ... ... ... ... ... ... ... ... ... 6 Diphtheria and Croup 3 ... ... 2 1 ... ... ... ... 14 7 Influenza 84 6 1 2 4 7 29 22 13 1 8 Erysipelas 1 ... ... ... ... ... ... 1 ... ... 9 Phthisis (Pulmonary Tuberculosis) 66 ... ... ... 1 9 27 25 4 1 10 Tuberculous Meningitis 5 ... 1 3 ... 1 ... ... ... 1 11 Other Tuberculous Diseases 6 1 l ... l 1 2 ... ... 1 12 Cancer, malignant disease 119 ... ... ... ... 1 8 59 51 4 13 Rheumatic Fever 5 ... ... ... ... ... 2 2 1 ... 14 Meningitis 6 1 ... 1 1 ... 3 ... ... 4 15 Organic Heart Disease 98 ... ... ... ... ... 6 24 68 2 16 Bronchitis 93 1 2 ... ... ... 2 18 70 1 17 Pneumonia (all forms) 53 9 1 1 3 3 6 11 19 2 18 Other diseases of Respiratory Organs 18 ... ... 1 ... ... 2 7 8 ... 19 Diarrhoea and Enteritis 11 6 ... ... ... ... 3 1 1 1 20 Appendicitis and Typhlitis 1 ... ... ... 1 ... ... ... ... ... 21 Cirrhosis of Liver 2 ... ... ... ... ... 1 1 ... 1 21a Alcoholism ... ... ... ... ... ... ... ... ... ... 22 Nephritis and Briglit's Disease 40 ... ... ... ... 1 8 ... 18 ... 23 Puerperal Fever 1 ... ... ... ... ... 1 ... ... 1 24 Other accidents and diseases of Pregnancy and Parturition 3 ... ... ... ... 1 2 ... ... 2 25 Congenital Debility and Malformation, including Premature Birth 38 38 ... ... ... ... ... ... ... ... 26 Violent Deaths, excluding Suicide 17 2 ... ... 1 1 3 1 9 4 27 Suicide 9 ... ... ... ... ... 2 3 4 ... 28 Other Defined Diseases 310 12 4 3 3 8 35 68 177 28 29 Diseases ill-defined or unknown ... ... ... ... ... ... ... ... ... ... Totals 992 76 10 14 17 33 143 256 443 68 Sub- Entries. included in above figures. Cerebrospinal Meningitis 1 1 ... ... ... ... ... ... ... ... Poliomyelitis 6 1 ... 1 ... ... 3 ... 1 ... Pneumonia (other than Broncho-Pneumonia) 35 4 1 ... 2 3 4 10 11 ... 36 TABLE IV. BOROUGH OF HORNSEY. INFANT MORTALITY DURING THE YEAR 1919. 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 ... ... ... ... ... ... ... ... ... ... Chioken-pox ... ... ... ... ... ... ... ... ... ... Measles ... ... ... ... ... ... ... ... ... ... Scarlet Fever ... ... ... ... ... ... ... ... ... ... Whooping Cough ... ... ... ... ... ... ... ... ... ... Diphtheria and Croup ... ... ... ... ... ... ... ... ... ... Influenza ... ... ... ... ... ... 3 ... 3 6 Erysipelas ... ... ... ... ... ... ... ... ... ... Tuberculous Meningitis ... ... ... ... ... ... ... ... ... ... Abdominal Tuberculosis (b) ... ... ... ... ... ... ... ... ... ... Other Tuberculous Diseases ... ... ... ... ... ... ... 1 ... 1 Meningitis (not Tubcrculous) ... ... ... ... ... ... ... ... ... ... Convulsions ... 1 ... ... 1 ... ... ... ... 1 Laryngitis ... ... ... ... ... ... ... ... ... ... Bronchitis ... ... ... ... ... 1 ... ... ... 1 Pneumonia (all forms) 1 ... ... ... 1 4 1 3 ... 9 Diarrhœa ... 1 ... ... 1 ... 2 ... ... 3 Enteritis ... ... ... ... ... 2 ... 1 ... 3 Gastritis ... ... ... ... ... ... ... ... ... ... Syphilis ... ... ... ... ... 1 ... 1 ... 2 Rickets ... ... ... ... ... ... ... ... ... ... Suffocation, overlying ... ... ... ... ... ... ... ... ... ... Injury at Birth 1 1 ... ... 2 ... ... ... ... 2 Atelectasis 1 ... ... ... 1 1 ... ... ... 2 Congenital Malformations(c) 1 ... ... 1 2 2 ... ... ... 4 Premature Birth 14 3 2 ... 19 2 ... ... ... 21 Atrophy, Debility and Marasmus 4 2 ... ... 6 2 1 ... ... 9 Other Causes 1 1 1 1 4 ... 4 2 2 12 Totals 23 9 3 2 37 15 11 8 5 76 Nett Births in the year legitimate, 1,155. illegitimate, 33. Nett Deaths in the year of legitimate infants, 69. illegitimate infants, 7.