1903. FORTY-EIGHTH ANNUAL REPORT ON THE HEALTH & SANITARY CONDITION OF THE Borough of Islington. ALFRED EDWIN HARRIS MEDICAL OFFICER OF HEALTH. London: Vail & Co., Printers to the Council, 170, Farringdon Road, E C 1904. MEMBERS OF THE PUBLIC HEALTH COMMITTEE. (November 1902, to November 1903). Mayor. Alderman GEORGE SAMUEL ELLIOTT, J P. A Idermen. CUFFLIN, ROBERT S. WILLIAMS, JOHN. Councillors. 1. CADBURY-BROWN, H. 7. CHEESLEY, HY. N. 1. GANN, ROBERT J. 7. EGGETT, HARRY G. 2. WALKLEY, ALFRED 8. ELKINGTON, HENRY 3. HARPER, THOMAS WM. 9. STONELAKE, THOMAS F 3. SAINT, THOMAS W. 10. MYERS ALFRED 4. HOARE, JAMES T. 11. ANSELL, HENRY 5. GORDON, ROBERT 11. SMYTH, JOHN W. 6. CROLE-REES, CHAS. Chairman Alderman CUFFLIN. Vice-Chairman Councillor WALKLEY. OFFICERS OF THE Public Health Department. Medical Officer of Health. ALFRED EDWIN HARRIS, L.R.C.S., L.R.C.P.Edin. Solicitor. ARTHUR MELLOR BRAMALL. Public Analyst. FRANK LITHERLAND TEED, D.Sc., F.I.C., F.C.S. Superintendent of Public Health Department and Chief Sanitary Inspector. JAMES RICHARD LEGGATT. Inspector of Meat. HARGREAVES WILKINSON, Cert. Sanit. Inst. Inspector of Workshops and Bakehouses. GEORGE WEST. Inspectors of Houses let in Lodgings. JAMES JARVIS JORDAN. WILLIAM WALTER WARD. Inspector of Workshops, &c., in which Females are employed. JESSY MACDONALD STEWART GRAY, Cert. Sanit. Inst. Inspectors of Nuisances and Sanitary Inspectors. District X WILLIAM COOK, Cert. Sanit. Inst. „ 2 HARRY JAMES BICKNELL, Cert. Sanit. Inst. „ 3 ALLEN BAGSHAW, Cert. Sanit. Inst. ,, 4 CHARLES THOMAS BACON, Cert. Sanit. Inst. ,, 5 WILLIAM HOLSGROVE FLOOD, Cert. Sanit. Inst. ,, 6 CHARLES EDWIN HORSMAN, Cert. Sanit. Inst. „ 7 EDWARD ISAAC FORTUNE, Cert. Sanit. Inst. „ 8 JOHN METCALF, Cert. Sanit. Inst. „ 9 WILLIAM IRVING, Cert. Sanit. Inst. ,, 10 HARRY JOHN JAMES WATSON, Cert. Sanit. Inst. ,, 11 TOM LEONARD BURRELL, Cert. Sanit. Inst. „ 12 THOMAS WALLACE AGAR, Cert. Sanit. Inst. ,, 13 WILLIAM ROLFE. ,, 14 HARRY CALLOW, Cert. Sanit. Inst. Engineer in charge of Steam Disinfectors. JOSEPH TWIZELL. Caretaker of Shelter House. Mrs. TWIZELL. Mortuary Keeper. ARTHUR ROBINSON. Distributor of Disinfectants. JOHN REDDY. Disinfectors. JOHN WRIGHT and THOMAS DIXON. Clerical Staff. Chief Clerk GEORGE HAROLD KING. Second Clerk HENRY ANGEL. Third Clerk GEORGE JAMES ELDRIDGE. Fourth Clerk EDWARD ALBERT ABBOTT. Fifth Clerk WALTER JOSEPH WOLFE. Sixth Clerk WILLIAM GEORGE BUNCH. Junior Clerk ARTHUR R. WITTRICK. Messenger. EDWARD JOHN DURLEY. 4 INDEX. Page Adulteration of Food 235 Ages at Death 15 Annual Birth and Death-rates, and Death-rates of Children 259 Area of Borough 11 Areas and Densities of Metropolitan Boroughs 14 Bacteriological Diagnoses 154 Bakehouses 175 Baths and Washhouses 272 Births 18-23, 25-28 Cancer 78-82 Common Lodging House 222 Constitutional Diseases 77,86 Continued Fever 116 Cow Sheds 227 Deaths 29 „ from Classified Causes 39 ,, at different age periods 31, 33, 34 „ in the Quarters 37, 38, 40 „ ,, Sub-Districts 31, 35 „ ,, Wards 31, 36 ,, ,, Encircling Boroughs 42, 69, 70, 71 ,, from Zymotic Diseases 45 Deaths registered from all causes during the year 252 Deaths registered from all causes in each Quarter 255 Deaths since 1882, from specified diseases 263 Deaths in Public Institutions 87-94 Death-rates of Metropolitan Boroughs 41 Diarrhoea 63-68 Diphtheria 59 ,, Fatality from 105, 106-109 ,, Notification of 104 Diphtheria and Croup 106, 107 Disinfecting Station 162 Disinfection Work 161 District inspection 203 Duties of Sanitary Inspectors, report on 280 Dust, removal of 218 Enteric Fever 62 ,, Fatality from 111 ,, Notification of 110 5 Page Erysipelas, Fatality from 75,76,113 ,, Notification 112 Factory and Workshops Act, 1901 166-171 Fatality from Infectious Diseases 133 Food, Adulteration of 235 Food Inspection 226 Hospital Isolation of Infectious Diseases 132 Houses let in Lodgings 190-202 Ice Creams 234 Infantile Mortality 43-44 Infectious Diseases in Schools 129 Infectious Sickness in the several Wards from 1891-1903 265-270 Influenza 72-74 Inspection of Food 226 „ Kitchens of Restaurants 182 „ Slaughter Houses and Cow Houses 227 Local Government Board Returns 260, 261, 264 London County Council Returns 273-277 Margarine Act 239 Marriages 18, 23-25 Measles 52-57 Meat Inspection 230 Membranous Croup 106, 107 Milk Shops and Dairies 235 Mortality in Sub-Registration Districts 31 Mortuary and Coroner's Court 95 Notification of Infectious Diseases 98, 117 ,, „ „ „ in Registration Sub-Districts 99, 119, 120 ,, ,, „ „ in the Sanitary Inspectors' Districts 123 „ „ „ in the Wards 99, 121, 122 „ „ „ „ during the several months 124 „ „ ,, „ in the Encircling Boroughs 99, 125, 126 „ „ „ „ in Metropolitan Boroughs 127, 128 Notification of Pulmonary Consumption 33 „ „ Small Pox 100-102 Non-notifiable Infectious Diseases in Schools 130 Occupation of persons attacked with Infectious Disease 135, 138 Offensive Trades 209 Pauperism 223 Persons to an Acre 12 Phthisis 82 Places where Food is prepared 182 Population—Estimated in 1903 11 „ Sex and age Distribution 15 ,, in Sub-Districts 12 ,, and Density of Wards 13 Population, Inhabited Houses, Marriages, Births, and Deaths 258 Prosecutions, Summary of 246 Puerperal Fever 75-77 6 Page Puerperal Fever, Notification of 114 ,, ,, Fatality from 116 Pulmonary Consumption 82 Relapsing Fever 116 Registered Lodging Houses 190-202 Sanitary Inspectors' Work 213-217 Sanitary Inspectors, Duties of, report on 280 Scarlet Fever 57 „ „ Notification of 102 „ Fatality from 104 Seasonal Mortality 32, 37, 38, 40 Septic Diseases 75 Shelter House 163 Slaughter Houses 228 Small Pox, Fatality from 52 „ „ Notification of 100 Smoke Nuisances 209-213 Streets where Infectious Disease occurred 141 Summary of Sanitary Work in fourteen Districts 214 Summary of Applications for Removal of Dust 221 Trades carried on in houses where Infectious Disease has occurred 134-136 Tubercular Diseases 82-85 Typhus Fever 62, 112 Vaccination, State of 156 Whooping Cough 60 Workshop Inspectors 172-175, 181-190 Water Analysis 271 Water Supply 247 REPORT of the MEDICAL OFFICER OF HEALTH FOR THE YEAR 1903. To the Right Worshipful the Mayor, Aldermen and Councillors of the Metropolitan Borough of Islington. Gentlemen, In presenting you with my report, on the health and sanitary administration of your Borough, I am glad to be able to congratulate you on the fact that, during the year with which it deals its death-rate from all causes, its infantile mortality-rate, its zymotic death-rate, as well as its attackrate from infectious diseases were the lowest on record. The year has also been fruitful of very useful sanitary work in the underground bakehouses, which have now been made as habitable and comfortable for workers from a health point of view as it is possible to make such places. A more vigorous enforcement of the law relating to houses let in lodgings or occupied by members of more than one family has been adopted, and more houses than usual have been added to the register. Much, however, still remains to be done in this direction, and I am glad to know that your Public Health Committee are resolved that that portion of the Public Health (London) Act, 1891, dealing with tenement houses shall be firmly administered, and that an Inspector, who shall devote the whole of his time, shall be appointed to inspect houses let in the northern part of the Borough, as is already done in its southern district. 8 The late Public Health Committee before going out of office determined that the number of samples taken for analysis by your Public Analyst shall be largely increased, so that in future instead of 800 at least 1,200 shall be annually analyzed, which is none too many considering the large number of traders selling food products in Islington. I cannot conclude this introductory note without tendering on my own behalf as well as on behalf of the Public Health Department my warmest thanks to Alderman Cufflin, who for over eleven years has been Chairman of the Public Health Committee, for the great assistance he has been at all times to us, for the deep interest he has taken in the public health administration of the parish and borough, for his encouragement in times of difficulty and for the unselfish manner in which he has always placed his services at the disposal of your sanitary staff. We are glad, however, to know that, although he has retired from the Chairmanship he still remains a member of the Committee, and that his rare experience and knowledge of health and sanitary work are not to be lost to the Borough which he has served so ably and faithfully. I am, Mr. Mayor and Aldermen and Gentlemen, Your obedient Servant, Medical Officer of Health. Town Hall, Islington, May 26th, 1904. PART I. POPULATION, AREAS AND DENSITIES OF THE DISTRICTS AND OF THE BOROUGH. B 11 ]1903 REPORT OF THE Medical Officer of Health FOR THE YEAR 1903. POPULATION, AREAS, DENSITIES. Population.— The estimated population of the Borough at the middle of the year was 339,137 persons, of whom 161,246 were males and 177,891 females. This estimate has been based by the Registrar-General on the increase that took place in the decennial period 1891-1900. It is a difficult matter to decide whether or not it is correct, for undoubtedly the census that was taken in 1895 showed that the population had slightly declined. Since then, however, the difficulty that is known to have occurred, especially with the working classes, to obtain lodging accommodation, although there has been a considerable increase in the number of tenement houses, points to a further increase of the people. It is satisfactory, however, to be able to state that whether the population has or has not increased, or even slightly decreased, the error in the calculations based on the estimate cannot be falsified by a decimal point. The population, which is larger than that of any metropolitan borough, is distributed in the following manner:— Sub-Registration Districts.—Tufnell 32,838, Upper Holloway, 34,822, Tollington, 34,765, Lower Holloway, 41,537, Highbury 65,112, Barnsbury 54,278 and South-East Islington 75,785. B 2 1903] 12 Wards.—Tufnell 32,838, Upper Holloway 34,822, Tollington 34,765, Lower Holloway 41,537, Highbury 34,858, Mildmay 24,862, Thornhill 33,370, Barnsbury 20,908, St. Mary's 17,298, Canonbury 31,160 and St. Peter's 32,719. Males and Females.—There are 161,246 males and 177,891 females living in the Borough whose ages have been estimated as in Table IV. It is on all these figures that the several birth, death and infectious diseases rates have been calculated in this report. Areas.—The area of the Borough is nearly five square miles, actually 3,091.5 acres. Considerable though this area undoubtedly is, it is exceeded by the areas of at least seven metropolitan boroughs, namely, Woolwich, Lewisham, Greenwich, Wandsworth, Camberwell, Hackney and Lambeth, but their areas are not nearly all built on, which is unfortunately the case with Islington, and consequently they are not so crowded. Table I. Showing the Areas, Densities, and Estimated Populations of the Sub-registration Districts at the middle of the year 1903. Sub-Districts. Area. Acres. Acres to a person. Persons to an Acre. Estimated Population Mid-year. 1903. Tufnell 417 0.0127 78 32,838 Upper Holloway 290 0.0083 120 34,822 Tollington 320 0.0092 108 34,765 Lower Holloway 413 0.0099 IOO 4I>537 Highbury 798 0.0122 8l 65,112 Barnsbury 309 0.0057 176 54,278 South-East Islington 545 0.0072 139 75,785 The Borough 3,092 0.0091 110 339,137 13 [1903 Table II. Showing the Areas, Densities and Estimated Populations of the Wards at the middle of the year 1903. WARDS. Area in Acres. Persons to an Acre, or Density of Population. Estimated Population Mid-year, 1903. No. I—Tufnell 417 78 32,838 2—Upper Holloway 290 120 34,822 3—Tollington 320 108 34,765 4—Lower Holloway 413 100 41,537 5—Highbury 417 84 34,858 6—Mildmay 337 74 24,862 7—Thornhill 172 194 33,370 8—Barnsbury 137 153 20,908 9—St. Mary's 148 117 17,298 10—Canonbury 286 109 31,160 11—St. Peter's 155 211 32,719 The Borough 3,092 110 339,137 14 1903] Table III. Showing the Estimated Populations, Areas, Densities and Death-rates of London and of the several Metropolitan Boroughs in 1903, arranged in order of Density. Boroughs. Estimated Population, 1903. Area in Acres. (Density) Persons to each Acre. Death Rates. All Causes. Zymotic Diseases. Cols. 1 2 3 4 5 London 4,613,812 74,839 61 6 15 2 1.76 Woolwich 121,478 8.276 14.7 13.5 1.10 Lewisham 136,405 7,014 19.4 11.1 0.96 Greenwich 99,824 3,852 25.9 13.3 1.74 Wandsworth 249,678 9.129 27.3 12.4 1.61 City of London 24,539 671 36.6 14.6 0.86 Hampstead 85,197 2,265 37.6 10.0 0.58 Hammersmith 115,803 2,286 50.6 14.1 1.60 Camberwell 265,562 4,480 59.3 13.7 1.36 Stoke Newington 62,069 863 60.3 12.6 1.46 Hackney .. 224,082 3,288 68.1 13.8 1.77 City of Westminster 179,052 2,502 71.6 13.6 1.00 Deptford 112,537 1,562 72.0 14.9 2.19 Poplar 169,550 2,327 72.8 18.2 2.99 Lambeth .. .. 307,711 4,080 75.4 15.2 1.73 Kensington 178.409 2,291 77.9 13.9 1.56 Battersea 173,422 2,160 80.3 14.2 1.98 Bermondsey 129,801 1,500 86.5 18.4 2.05 Fulham .. 147,780 1,703 86.8 13.9 2.22 St. Pancras 235,716 2,694 87.5 16.1 1.90 St. Marylebone .. 131,234 1,472 89.1 16.4 1.60 Paddington 146,032 1,356 107.6 13.2 1.31 Islington 339,137 3,092 110.0 14.2 1.39 Chelsea 74,169 660 112.3 15.3 1.14 Holborn 57,845 405 142.8 18.6 1.44 Finsbury 99,717 589 169.3 20.2 2.32 Stepney 302,153 1,765 171.2 18.0 2.36 Bethnal Green 130,028 759 171.2 18.2 2.24 Shoreditch 117,513 658 178.5 19.3 2.89 Southwark 207,369 1,131 183.3 18.1 1.99 15 [1903 Table IV. Showing the Estimated Number of Persons living in Islington at the middle of 1903, at Nine Age Periods, and distinguishing Males and Females. Ages. Males. Females. Persons. 0—5 18,445 18,015 36,460 5—15 31,273 31,376 62,649 15—25 31,830 35,659 67,489 25—35 29,160 32,6l0 61,770 35—45 21,009 23,163 44,172 45—55 14,695 16,841 31,536 55—65 9,229 11,234 20,463 65—75 4,185 6,208 10,393 75 and upwards 1,420 2,785 4,205 All ages 161,246 177,891 339,137 Table V. Showing the number of Persons in the several Districts mentioned living at Nine Groups of Ages in every thousand of their populations. districts. —5 —15 —25 —35 —45 —55 —65 —75 75 and upwards England and Wales 114 210 196 162 123 89 60 33 13 Urban Districts 114 207 201 168 124 88 57 30 11 Rural „ 114 221 177 142 118 92 70 45 21 London 109 190 203 179 130 91 57 29 12 Islington 108 185 199 182 130 93 60 31 12 PART II. MARRIAGES, BIRTHS AND DEATHS. 18 1903] MARRIAGES. There were 6,106 persons married in the Borough during the year, or 201 more than the average of the preceding ten years. These marriages were equal to a rate 18.0 per 1,000 of the population, which is an increase 0.36 on that which obtained during the years 1893-1902. The variations of the marriage rate in the several quarters were very curious, for during the first quarter it was as low as 10.7 per 1,000, while in the third it was as high as 22.6. In the second quarter it was 20.9, and in the fourth only 17.4 per 1,000. BIRTHS. The births numbered 8,983, or 231 less than in 1892, and were equal to a birth rate of 26.48 per 1,000, which is the lowest hitherto recorded in Islington. The births comprised 4,653 males and 4,330 females, so that the former were in the proportion of 1,000 to every 930 of the latter. The birth-rates varied considerably in the several sub-registration districts, thus they were as high as 31.82 and 30.36 per 1,000 in Upper Holloway and Barnsbury and as low as 22.42 and 22.53 per, 1,000 in Highbury and Tufnell; while in the other sub-districts they were as follows:—24.45 in Tollington, 27.11 in Lower Holloway and 27.06 per 1,000 in Islington South-East (vide Table XIV.) In London the birth-rate was 28.5 per 1,000; in the 67 Great Towns 29.7, and in England and Wales 28.4. An examination of the birth-rates in Islington since 1841 shows that in the decade 1841-50 the rate averaged 28.65 per 1,000 of the population. This was succeeded in the next ten years (1851-60) by a rate of 34.54 per 1,000, 19 [1903 which in turn (1861-70) was followed by a rate of 37.20 per 1,000. Thence forward the birth-rate slowly decreased, for in the next decennium (1871-80) it fell to 36.60; in the ten years 1881-90 to 32.56, and in the years 1891-00 it was as low as 29.11 per 1,000. Since then three more years have passed, each of which showed that the decline in the rate still continued, for in 1901 it was 27.62 per 1,000; in 1902 26.80, and in 1903 26.48 per 1,000. Decrease in the birth-rate is not exceptional to Islington, it is general throughout this country, and has begun to cause anxiety to thinking people, who are afraid that it may prove the beginning of the national decay. One of the causes to which this is attributed is that people now marry later in life than formerly. It is exactly with nations as with families; when there are few marriages, or late marriages, there are fewer children, or longer periods between each succeeding generation. It is easily perceived that if women who married at a mean age of 30 years bore as many children as women married at 20, the annual number of births and the rate of increase will differ greatly. On the assumption that at the birth of their children the mothers' ages will advance equally—six years as an average—from the time of marriage, their mean age at the time the children are born will be 36 years and 26 years, while the intervals between the births of the mothers and the children will be respectively 36 years and 26 years ; and the intervals from marriage of the mothers to the marriage of the children will also be 36 years and 26 years. Consequently if the same number of women continue to marry, and if the fecundity of women remain unchanged, the births will be raised or depressed in the increase ratio of 36 and 26 to 30, the interval from generation to generation, from the birth of the parents to the birth of their children. If the early marriages prevailed then a generation would be reproduced every 26 years, and in the case of late marriages every 36 years. On the hypothesis laid down that the number of children born in each generation would be the same, the numbers born in a given time would differ in the ratio of the intervals which separated the generations.* There is no doubt that the age at which persons marry is now generally later than in former years, and, therefore, there has naturally been a decrease in the birth-rate. We will, therefore, examine how far this is true with respect to Islington. For this purpose the ages of married women, which are of course the great factor in procreation, at the last two censuses have been extracted, and from them the following statement has been prepared. * Farr in Registrar-General's Fourth Annual Report, p. 138. 20 1903] Table VI. Showing the proportion of Married Women at four periods of their child-bearings ages, in every 1,000 of such Married Women. Age Periods. Census Years. Increase or Decrease. 1891. 1901. 15—20 8.14 6.36 — 1.78 20—35 133.05 124.69 — 8.36 25-35 468.94 481.99 + 13.05 35—45 389.87 386.96 — 2.91 1,000 1,000 — Here it is seen that at the two earlier age periods there was a decrease in 1901 in the proportion of married women, for whereas in 1891 there were 8.14 in every 1,000 married women at the 15.20 period, there were only 6.36 per 1,000 in 1901, a decrease of 1.78; and again, in 1891 there were 133.05 in every 1,000 married women at the 20.25 period, there were only 124.69 in 1901, a decrease of 8.36. When, however, we come to the next age period, 25.35,* there were 468.94 per 1,000 married women in 1891, whereas in 1901 there were 481.99 per 1,000, or the very substantial increase of 13.05. This increase is very remarkable, particularly as it occurs at a period of life when the procreative powers are still very active. In the fourth period, 35-45, there were in 1891 389.87 married women in every 1,000, whereas in 1901 there were only 389.96, or a decrease of 2.91. Thus in the first, second and fourth periods taken together there was a decrease of 13.05, and in the third period a corresponding increase. Taking these figures into consideration one might not unreasonably have expected considerable decrease in the birth-rate. * It was not possible to sub-divide this period into two periods, 25-30 and 30-35, because the 1891 census does not give figures by which the calculation could be made. It is, therefore, possible that there was a decrease in the number of married women at the 25-30 age period. 21 [1903 If the birth-rates of the five years around the two last census years, namely 1889-93, and 1899-1903, were calculated on the number of legitimate births and number of married women living at the child-bearing ages, it would have been in the first period, 238 births per 1,000, while in the second period it would have been only 211 births per 1,000, which is a decrease of 27 per 1,000. Again, in the five years 1889-93, the average birth-rate among unmarried women at the child-bearing ages was 6.61 per 1,000, while in the five years 1899-1903 it was only 5.28, a decrease of 1.33 per 1,000. 1889-93. 1899-1903. Increase or Decrease. Average number of unmarried women and widows at child-bearing ages 45,032 47,711 + 2,689 Average number of married women at child-bearing ages 39,152 42,598 + 3,446 Births per 1,000 unmarried women and widows at child-bearing ages 6.6i 5.28 -1.33 Births per 1,000 married women at childbearing ages 237.6 211.3 -26.3 Number of Births among unmarried women and widows at child-bearing ages 1,488 1,258 -230 Number of Births among married women at child-bearing ages 46,524 45,015 -1,509 This table brings this fact clearly out that although the number of women capable of bearing children had largely increased yet the number of children borne by them had largely decreased. So far as the births among unmarried women are concerned it is most satisfactory to be able to record a decrease of 20.2 per cent, in the birth-rate. (Can it, however, be taken as a sign of the decrease of immorality) ? but it is very questionable whether the large decline of 11.1 per cent, in the birth-rate among married women can be equally considered a matter for congratulation. It is idle to speculate on the causes, which have latterly been a matter for grave consideration both in England, the Continent and the United States, and one of which was mentioned in the Report for 1902. 22 1903] Illegitimate Births.—These numbered 242 as against 248 in 1902, and an average of 261 in the ten years 1893-1902. They equalled a rate of 0.71 per 1,000 of the population, compared with a mean decennial rate of 0.78 per 1,000. This is an inaccurate, although a usual, way of expressing the illegitimate birth-rate; the more correct method would be to state it as a proportion to the unmarried women living at child-bearing ages. The birth-rate for the year, on the basis of the enumeration taken at the last census, was 5.1 per 1,000 unmarried women, aged 15-45 years, compared with a mean rate of 5.6 in the decennium 1893-1902. The illegitimate births have in actual numbers, apart from the decline in any rate proportion, been falling ever since 1871, and that despite the fact that as the population increased so too did the unmarried women at the childbearing ages become more numerous, for as we have already seen they increased from 45,032 in 1891 to 47,711 in 1901. The following figures have been gradually collected and are now published for the first time :— Table VII. Illegitimate Births during sixty-three years registered in Islington. Years. Births. Years. Births. Years. Births. Years. Births. Years. Births. Years. Births. Years. Births. 1841 * 1851 100 1861 184 1871 280 1881 380 1891 265 1901 228 1842 33 1852 100 1862 207 1872 346 1882 353 1892 298 1902 248 1843 * 1853 95 1863 224 1873 335 1883 370 1893 267 1903 242 1844 * 1854 125 1864 248 1874 344 1884 341 1894 290 1845 43 1855 126 1865 291 1875 363 1885 327 1895 286 1846 53 1856 149 1866 272 1876 361 1886 331 1896 242 1847 64 1857 151 1867 306 1877 337 1887 350 1897 269 1848 85 1858 140 1868 317 1878 303 1888 345 1898 262 1849 74 1859 174 1869 284 1879 401 1889 350 1899 279 1850 * 1860 175 1870 318 1880 359 1890 328 1900 261 6 yrs. 352 1851 to 1860 1335 1861 to 1870 2651 1871 to 1880 3429 1881 to 1890 3475 1891 to 1900 2719 1901 to 1903 718 * The births in these years could not be ascertained. 23 [1903 Birth-rates of Islington from 1841 to 1903. Year. Year. Year. 1841 25.58 1851 31.46 l86l 35.31 1842 25.28 1852 34.19 1862 34.76 1843 25.86 1853 34.81 1803 36.51 1844 27.18 1854 35.50 1864 36.84 1845 26.20 1855 35.37 1865 37.90 1846 29.13 1856 34.97 1866 38.02 1847 29.75 1857 34.89 1867 38.97 1848 30.76 1858 33.57 1868 38.86 1849 30.13 1859 35.13 1869 37.24 1850 32.96 1860 34.84 1870 36.77 Mean 28.65 Mean 34.54 Mean 37.20 1871 35.63 1881 34.87 1891 30.68 1872 36.36 1882 34.79 1892 29.68 1873 36.89 1883 34.19 1893 29.83 1874 37.16 1884 33.54 1894 28.91 1875 37.67 1885 32.45 1895 29.81 1876 37.26 1886 32.66 1896 28.87 1877 36.85 1887 31.92 1897 29.33 1878 36.28 1888 31.10 1898 28.07 1879 36.08 1889 30.79 1899 28.71 1880 35.86 1890 29.16 1900 27.55 Mean 36.60 Mean 32.56 Mean 29.11 1901 27.62 1902 26.80 1903 26.48. Table VIII. Showing the number nf Persons Married and the Marriage Rates in the Borough in 1903. No. persons married. Persons married per 1,000 inhabitants. 1st quarter 908 10.71 2nd „ 1,774 20.92 3rd „ 1,920 22.64 4th „ 1,504 17.74 The year 6,106 18.00 24 1903] Table IX. Showing the Marriages and the Marriage Rates of the Borough in the preceding ten years. Years. No. persons married. Persons married per 1000, inhabitants. 1893 5,306 16.16 1894 5,388 16.23 1895 5,360 15.97 1896 5,938 17.58 1897 6,000 17.79 1898 6,410 19.03 1899 6,508 19.35 1900 5,936 17.67 1901 5,988 I7.85 1902 6,216 18.08 Mean of 10 years 5,905 17.64 1903 6,106 18.00 Increase on mean 201 0.36 25 [1903 Table X. Showing the Marriages and Marriage Rates in the several periods mentioned. Periods Marriages. Persons married per 1,000 of the Population. 1841-50 6,109 16.03 1851-60 10,901 l8.12 1861-70 16,194 17.55 1871-80 20,889 17.06 1881-90 23.324 15.55 1891-1900 28,947 17.44 1903 6,106 18.00 Table XI. Showing the Population, Births and Birth-rates in the several Decades since 1841, and in 1903. Periods. Mean Population in each Decade. Number of Births in each Period. Birth-rates. Average Yearly Number of Births, corrected on the basis of the population of 1903. 1 2 3 4 5 1841-50 72,767 20,850 28.65 9,718 1851-60 121,353 41,915 34.54 11.713 1861-70 181,529 67,520 37.20 12,613 1871-80 244,884 89,627 36.60 12,412 1881-90 299,857 97,647 32.56 11,043 1891-1900 331,868 96,607 29.11 9.872 1903 339,137 8,983 26.48 8,983 C 26 1903] Table XII. Showing the Births (distinguishing Males and Females) and Birth-rates of Islington in 1903, and in the four quarters of the year, together with the rates in 1902 and of London and the Great Towns during the same period. Quarter. Males. Females. Total. Birth Rates. Islington, 1903. Islington, 1902. London, 1903. 76 Great Towns, 1903. 1st 1,174 1,090 2,264 26.70 28.20 29.1 30.1 2nd 1,195 1,083 2,278 26.86 25.57 29.0 30.2 3rd 1,148 1,072 2,220 26.18 27.40 28.4 29.8 4th 1,136 1,085 2,221 26.20 26.09 27.4 28.6 The Year 1903 4,653 4,330 8,983 26.48 26.80 28.5 29.7 1902 4,667 4,547 9,214 26.80 26.48 28.5 30.0 Increase or decrease on 1902 –14 –217 –231 –0.32 0.32 – 0.03 27 [1903 Table XIII. Showing the Births of Males and Females in each quarter and for the year, 1903, in the several Sub-registration Districts. Tufnell. Upper Holloway. Tollington. Lower Holloway. Highbury. Barnsbury. South-East Islington. The Borough. Males. Females. Total. Males. Females. Total. Males. Females. Total. Males. Females. Total. Males. Females. Total. Males. Females. Total. Males. Females. Total. Males. Females. Total. 1st Qr. 105 88 193 144 132 276 125 99 224 135 138 273 181 180 361 212 221 433 272 232 504 1,174 1,090 2,264 2nd „ 88 108 196 162 116 278 125 82 207 144 131 275 183 181 364 206 197 403 287 268 555 1,195 1,083 2,278 3rd „ 86 84 170 142 148 290 106 94 200 155 143 298 179 180 359 224 175 399 256 248 504 1,148 1,072 2,220 4th „ 97 84 181 138 126 264 121 98 219 130 150 280 195 181 376 199 214 413 256 232 488 1,136 1,085 2,221 Year 376 364 740 586 522 1,108 477 373 850 564 562 1,126 738 722 1,460 841 807 1,648 1,071 980 2,051 4,653 4,330 8,983 C 2 28 1903] Table XIV. Showing the Birth-rates for each quarter and for the year, of Islington, of London, and of the 76 Great Towns. Sub-Districts. 1st Quarter. 2nd Quarter. 3rd Quarter. 4th Quarter. Year. Tufnell 23.50 23.7 20.0 22.04 22.53 Upper Holloway 31.0 31.93 33.31 30.32 31.82 Tollington 25.7 23.1 23.1 25.20 24.45 Lower Holloway 26.9 26.8 28.0 26.96 27.11 Highbury 22.7 22.6 22.5 23.10 22.42 Barnsbury 31.1 29.0 29.0 30.43 30.36 Islington, S. East 26.0 29.9 26.0 25.75 27.06 The Borough 26.0 26.6 26.8 26.20 26.48 London 29.1 29.0 28.4 27.4 28.5 76 Great Towns 30.1 30. 29.8 28.6 29.7 29 [1903 DEATHS. There were 4,839 deaths registered in Islington during the fifty-two weeks which constitute, for the purposes of this report, the year 1903. These are equal to a death-rate of 14.2 per 1,000, which is the lowest rate that has been recorded here since the institution of Civil Registration. The nearest approach to it was in 1897, when the rate was 15.80 per 1,000. When the size of the borough is considered, together with the great density of its population, its lack of open spaces within its boundaries, the mixed character of its population, the crowding of its houses, and the strenuous life of its citizens, such a low deathrate must be considered almost phenomenal, and must cause the greatest gratification to every person who takes an interest in its welfare, apart altogether from those who are directly responsible for its Sanitary Administration. Decades. Death-rates. 1841-50 19.28 1851-60 21.43 1861-70 24.64 Decades. Death-rates. 1871-80 20.40 1881-90 18.60 1891-1900 17.50 Decades. Death-rate. 1901 15.9 per 1,000 1902 16.39 „ „ 1903 14.26,, „ There can be no doubt that when the complete mortality returns for the country come to be made up that it will be found that the health of the people during the year has been very satisfactory, and that the death-rate will prove to have been very low.* Nevertheless, the death toll of this borough was so small in 1903 that it would not be too much to assert that hardly any one would venture to have predicted such a good return, no matter how favourable the climatic conditions might have been, even coming as it did, after a series of years which exhibited, as we have seen in the above-mentioned returns, a steady and almost unbroken decline in the death-rate. Such a return, however, can not be expected very often, for the life of toil lead by the majority of the people living within our borders, even if no other circumstances were taken into consideration, practically forbids it. Nevertheless that which has occurred * It was only 15.4, the lowest death-rate on record. 30 1903] once may recur, and, therefore, it should be the constant aim and the strong endeavour of those responsible for the health of this populous metropolitan borough to strive with might and main to administer the sanitary laws, that that which seems attainable, may at least deserve to be attained. It has been the privilege of the Medical Officer of Health in his returns for the several quarters of the year to report that each one was in itself a record. Thus the death-rate of 16.31 per 1,000 in the first quarter had never been equalled by any previous return; so too was it with the return of 14.46 per 1,000 in the second quarter, although in the previous year the rate was almost identical with it, being 14.47; in the third quarter again the rate was only 12.16; while in the fourth quarter it was 14.26 per 1,000, which was only once approached, namely in 1894, a remarkably healthy year, when it was 14.94. The death-rate of a county taken as a whole is invariably lower than that of its populous places, but even then it is very rare to find one so low as 14.2.—the present death-rate of Islington. The latest available returns for the United Kingdom show that the lowest rate was 16.8 in 1894, and of England and Wales 16.9 in 1901; while they also record that the lowest rate of Denmark was 15.5 (1899), of Norway, a most healthy nation, 14.9 (1901), of Sweden 15.1 (1898), of Austria 24.2 (1901), of Hungary 25.4 (1901), of Switzerland 17.6 (1897 and 1899), of the German Empire 20.5 (1898), of Prussia 20.0 (1898), of the Netherlands 16.9 (1897), of Belgium 17.1 (1901), of Italy 21.9 (1897 and 1899), and of France 20.1 per 1,000 (1901) all of which death-rates but accentuate the low returns of Islington during the past year. The Borough Death-rate contrasted with that of other places.— The borough death-rate contrasted favourably with the rate of the metropolis, which was 15.2 per 1,000, or 0.9 more than it. This contrast is even better than it appears, for when both death-rates have been corrected for the difference in ages and sexes the rate for London becomes 15.9, and that of Islington 14.8, or 1.1 per 1,000 less. Compared with the Encircling Districts it had a lower death-rate than St. Pancras (16.1), Finsbury (20.2) and Shoreditch (19.3), but a higher one than Hornsey (7.9), Stoke Newington (12.6) and Hackney (13.8). In judging these rates it must not be forgotten that Islington is more densely populated than any of these places. 31 [1903 Islington stood fifteenth in order of the crude death-rate and twelfth in order of the corrected death-rate. It showed too a lower death-rate than Bristol (14.3), Birmingham (17.8), Liverpool (20.5), Manchester (19.7), Leeds (16.6) and Sheffield (18.6). The Mortality in the Sub-Registration Districts.—In each SubDistrict the returns exhibited a reduced mortality on the preceding year. Thus there were 51 fewer deaths in Tufnell registration sub-district, 70 in Upper Holloway, 90 in Tollington, 96 in Lower Holloway, 149 in Highbury, 141 in Barnsbury, and 199 in Islington South-East. T he actual record for each sub-district was as follows:— Deaths. Death Rates. Death Rates in 1902. Tufnell 440 =13.40 14.84 Upper Holloway 535 =15.36 17.23 Tollington 437 =12.57 15.03 Lower Holloway 618 =14.87 16.88 Highbury 796 =12.22 14.37 Barnsbury 899 =16.56 18.77 Islington South East 1,114 =14.70 17.03 Some of these death-rates are extraordinarily low, and all compare very favourably with those of the same districts for 1902. Mortality in the Wards.—The death-rates of the several wards varied considerably ranging from 11.86 per 1,000 in Mildmay, 12.57 in Tollington, and 12.85 in Highbury to 15.36 in Upper Holloway, 15.78 in Barnsbury, and 17.05 in Thornhill. In St. Mary's the death-rate was 13.70, in Canonbury 13.80, in Lower Holloway 14.87, and in St. Peter's 15.28. The Mortality among Males and Females.—There were 2,523 deaths among the male population, which represent a death-rate of 15.64 per 1,000, while among the female population there were 2,316 deaths, equal to a rate of 13.01 per 1,000. The Mortality at the Several Periods of Life.—The death-rate among children under 5 years of age was 45.91 per 1,000; from 5-15, 2.22; 15-25,2.98; 25-35,4.84; 35-45,8.83; 45-55,15.57; 55-65,26.04; 65-75,55.51; and among old people above 75 years of age, 127.23 per 1,000. It is noticeable that the death-rate in each period from 15-25 onwards nearly doubles itself in each succeeding period of life. (Vide Table XVI). 32 1903] The Ages at Death.—There died 1,136 infants under one year old, or 23.9 per cent. of the total mortality; between one and five years of age 538 children died, or in per cent.; between 15-25, 201, or 4.2 per cent.; between 25-35, 299, or 6.2 per cent.; between 35-45, 390, or 8.1 per cent.; between 45-55, 491, or 10.1 percent.; between 55-65, 533, or 11.0 percent.; between 65-75, 577, or 11.9 per cent.; and above 75 years of age, 535 persons died, or 11.11 per cent. of the total deaths. (Vide Table XV.) It is satisfactory to find that at every age period with the exception of from 85-95, there was a decrease in the mortality when compared with the preceding years. These differences are set out in Table XV., to which reference should be made. SEASONAL MORTALITY. It has been the good fortune of your Medical Officer of Health to be able to say in his quarterly reports that each quarter's death-rate had been under the average of all preceding quarters, and that three of them were actually the lowest hitherto recorded in the borough. The particulars for each period are as follows:— Quarters. 1903 Mean Death-rate, 1885-1902. Decrease in Death-rate. Deaths. Death-rates. First 1,383 16.31 20.65 4.34 Second 1,226 14.46 16.09 1.63 Third 1,031 12.16 16.06 3.90 Fourth 1,199 14.14 17.81 3.67 Year- 4,839 14.26 17.65 3.39 The death-rare of 16.31 in the first quarter, of 12.16 in the third, and of 14.14 in the fourth were the lowest rates hitherto recorded in the several quarters to which they relate, while that of the second quarter was only lower on one occasion, namely in 1897. Further particulars are given in Tables XVIII., XIX., XX., XXI. and XXII. 33 [1903 Table XV. Showing the Ages at Death during the Years 1893—1902 and in 1903. Years. AGES. Totals. 0–1 1–5 All under 5 yrs. 5–15 15–25 25–35 35–45 45–55 55–65 65–75 75–85 85–95 95 upwards All above 5 yrs. 1893 1,595 903 2,498 301 248 410 537 587 596 664 436 111 3 3,893 6,391 1894 1,229 885 2,114 259 231 329 388 452 485 541 389 72 3 3,149 5,263 1895 1,416 803 2,219 220 231 333 461 507 561 616 500 104 8 3,541 5,760 1896 1,490 1,008 2,498 277 228 290 465 564 493 591 385 91 2 3,386 5,884 1897 1,338 679 2,017 207 230 297 474 496 546 585 449 91 3 3,378 5,395 1898 1,504 924 2,428 161 196 292 435 497 560 585 444 105 2 3,277 5,705 1899 1,548 767 2,315 212 248 349 486 610 700 712 540 115 6 3,978 6,293 1900 1,344 612 1,956 183 233 339 480 605 664 678 469 111 3 3,765 5,721 1901 1,290 638 1,928 176 210 315 444 511 631 592 451 98 5 3,433 5,361 1902 1,219 687 1,906 198 222 339 470 571 664 656 468 141 – 3,729 5,635 Mean. 1,397 791 2,188 219 228 329 464 540 590 622 453 104 4 3,553 5,741 1903 1,136 538 1,674 139 201 299 390 491 533 577 423 112 – 3,165 4,839 Increase or Decrease – 261 –253 –514 –80 –27 –30 –74 –49 –57 –45 –30 +4 – –388 – 902 34 1903] Table XVI. Showing the, Estimated Population, together with the Deaths* and Deathrates from All Causes, at Nine Age-periods of life among Males, Females, and Persons. Males. Females Persons. Ages. Population. Deaths. Death Bates. Population. Deaths Death Rates. Population. Deaths Death Rates. 0–5 18,445 950 51.50 18,015 724 40.19 36,460 1,674 45.91 5–15 31,273 73 2.33 31,376 66 2.10 62,649 139 2.22 15–25 31,830 86 2.70 35,659 115 3.22 67,489 201 2.98 25–35 29,160 162 5.55 32,610 137 4.20 61,770 299 4.84 35–45 21,009 194 9.23 23,163 196 8.46 44,172 390 8.83 45–55 14,695 291 19.80 16,841 200 11.87 31,536 491 15.57 55–65 9,229 282 30.55 11,234 251 22.34 20,463 533 26.04 65–75 4,185 257 61.41 6,208 320 51.55 10,393 577 55.51 75 and upwards 1,420 228 160.54 2,785 307 110.24 4,205 535 127.23 All ages 161,246 2,523 15.64 177,891 2,316 13.01 339,137 4,839 14.26 *The deaths of 560 persons who had come from other districts of London for treatment in the Public Institutions of Islington are excluded from these returns, while the deaths of 627 persons who had died outside the district are included. 35 [1903 Table XVII. Showing the Deaths and Death-Rates from All Causes in the several Sub-Registration Districts. SUB-DISTRICTS. Males. Females Totals. Death Rates Tufnell 205 235 440 13.40 Upper Holloway 281 254 535 15.36 Tollington 202 235 437 12.57 Lower Holloway 333 285 618 14.87 Highbury 405 391 796 12.22 Barnsbury 489 410 899 16.56 South-East Islington 608 506 1,114 14.70 The Borough 2,523 2,316 4,839 14.26 Previous year 1902 2,840 2,795 5,635 16.39 36 1903] Table XVIII. Showing the Deaths and Death-rates from All Causes in the Wards during the Four Quarters of 1903. Wards. First Quarter. Second Quarter. Third Quarter. Fourth Quarter. Year. Deaths. Deathrates. Deaths. Deathrates. Deaths. Deathrates. Deaths. Deathrates. Deaths. Deathrates. Tufnell 107 13.04 116 14.12 110 13.40 107 13.03 440 13.40 Upper Holloway 151 17.34 138 15.85 117 13.44 129 14.81 535 15.36 Tollington 140 16.10 103 11.85 77 8.86 117 13.46 437 12.57 Lower Holloway l8l 17.43 153 14.73 137 13.19 147 14.15 618 14.87 Highbury 132 15.14 106 12.l6 96 11.01 114 13.08 448 12.85 Mildmay 84 13.51 89 14.32 54 8.69 68 10.94 295 11.86 Thornhill l6l 19.30 137 16.42 128 15.34 143 17.14 569 17.05 Barnsbury 88 16.83 84 16.07 63 12.05 95 18.17 330 15.78 St. Mary's 64 14.80 58 13.41 51 11.80 64 14.80 237 13.70 Canonbury 135 17.32 121 15.53 88 11.30 86 11.04 430 13.80 St. Peter's 140 17.11 121 14.79 110 13.44 129 15.77 500 15.28 The Borough 1,383 16.31 1,226 14.46 1,031 12.16 1,199 14.14 4,839 14.26 N.B.—The heavy figures show the healthiest Ward in the several periods to which they refer. 37 [1903 Table XIX. Shewing the Deaths and Death Rates from All Causes for each Quarter since 1885. (The Lowest Death Rates are printed in heavy type.) Years. QUARTERS. First. Second. Third. Fourth. Year. Deaths Death Rates Deaths Death Rates. Deaths Death Rates. Deaths Death Rates. Deaths Death Rates. 1885 1,551 20.83 1,445 19.40 1,392 18.68 1,352 18.15 5,740 19.3 1886 1,675 22.22 1,151 15.26 1,364 18.09 1,244 16.50 5,434 18.0 1887 1,474 19.32 1,365 17.89 1,450 19.00 1,410 18.48 5,699 18.7 1888 1,629 21.09 1,163 15.05 1,072 13.88 1,333 17.25 5,197 16.8 1889 1,440 18.42 1,186 15.17 1,101 14.07 1,308 16.73 5,035 16.1 1890 1,789 22.60 1,359 17.16 1,282 16.20 1,722 20.20 6,152 19.4 1891 1,698 21.22 1,725 21.56 1,299 16.23 1,604 20.05 6,326 19.8 1892 2,193 27.13 1,260 15.57 1,231 15.22 1,391 17.20 6,075 18.8 1893 1,597 19.53 1,485 18.16 1,558 19.06 1,751 21.41 6,391 19.5 1894 1,613 19.52 1,284 15.54 1,131 13.68 1,235 14.94 5,263 15.9 1895 1,936 23.18 1,210 14.48 1,292 15.47 1,322 15.83 5,760 17.2 1896 1,664 19.71 1,382 16.37 1,336 15.82 1,502 17.79 5,884 17.1 1897 1,421 16.85 1,081 12.82 1,335 15.83 1,558 18.48 5,395 16.0 1898 1,744 20.71 1,246 14.80 1,439 17.09 1,276 15.15 5,705 16.9 1899 1,681 19.99 1,281 15.23 1,572 18.70 1,759 20.92 6,293 18.7 1900 1,819 21.66 1,390 16.55 1,221 14.54 1,291 15.37 5,721 17.0 1901 1,411 16.83 1,253 14.94 1,216 14.50 1,481 17.66 5,361 15.9 1902 1,796 21.30 1,220 14.47 1,149 13.62 1,470 16.19 5,635 16.4 Corrected Mean 18 years 1,751 20.65 1,364 16.09 1,362 16.06 1,510 17.81 5,987 17.65 1903 1,333 16.31 1,226 14.46 1,031 12.16 1,199 14.14 4,839 14.26 Increase or Decrease –368 –4.34 –138 –1.63 -331 -3-90 -311 -3 67 -114H -3 39 38 1908] Table XX. Showing the Deaths and Death-rates from All Causes in the Four Quarters and in the Sub-districts, together with the Death-rates in the Borough during the same periods. Quarters. Tufnell. Upper Holloway. Tollington. Lower Holloway. Highbury. Barnsbury. South-east Islington. The Borough. Deaths. Death Rates. Deaths. Death Rates. Deaths. Death Rates. Deaths. Death Rates. Deaths. Death Rates. Deaths. Death Rates. Deaths. Death Rates. Deaths. Death Rates First Quarter 107 13.04 151 17.34 140 16.10 181 17.43 229 14.06 249 18.35 326 17.20 1,383 16.31 Second Quarter 116 14.12 138 15.85 103 11.85 153 14.73 217 13.33 221 16.28 278 14.67 1,226 14.46 Third Quarter 110 13.40 117 13.44 77 8.86 137 13.19 159 9.77 191 14.07 240 12.66 1,031 12.16 Fourth Quarter 107 13.03 129 14.81 117 13.46 147 14.15 191 11.73 238 17.54 270 14.25 1,199 14.14 The Year 440 13.40 535 15.36 437 12.57 618 14.87 796 12.22 899 16.56 1,114 14.70 4,839 14.26 N.B.—The figures for the healthiest quarter of each district are printed in heavy type. 39 [1908 Table XXI. Showing the Deaths and Death-rates from certain Classified Causes of Disease in the Sub-Districts and in the Borough. Classified Diseases. Tufnell. Upper Holloway. Tollington. Lower Holloway. Highbury. Barnsbury. South-East. The Borough. Deaths. Death Rates. Deaths. Death Rates. Deaths. Death Rates. Deaths. Death Rates. Deaths. Death Rates. Deaths. Death Rates. Deaths. Death Rates. Deaths. Death Rates. Miasmatic 36 1.10 32 0.92 39 1.12 68 1.64 65 0.99 93 1.71 68 0.89 401 1.18 Diarrhœal 8 0.24 11 0.31 17 0.49 19 0.47 10 0.15 17 0.31 27 0.35 109 0.32 Constitutional 97 2.95 116 3.33 99 2.85 134 3.23 180 2.76 189 3.48 255 3.36 1,070 3.15 Developmental 33 1.00 52 1.49 37 1.06 52 1.25 72 1.11 70 1.29 86 1.13 402 1.18 Nervous 31 0.94 48 1.38 25 0.72 38 0.91 63 0.96 54 0.99 89 1.17 348 1.02 Circulation 54 1.64 61 1.75 48 1.38 77 1.85 98 1.50 113 2.08 140 1.85 591 1.74 Respiration 69 2.10 82 2.35 83 2.39 108 2.60 125 1.92 178 3.28 229 3.02 874 2.58 Digestive Organs 39 1.19 37 1.06 27 0.77 31 0.74 56 0.86 51 0.94 67 0.88 308 0.91 Urinary System 17 0.51 19 0.54 15 0.43 24 0.58 28 0.43 24 0.44 25 0.33 152 0.45 Violence 14 0.42 23 0.66 15 0.43 16 0.38 23 0.35 47 0.86 52 0.68 190 0.56 Ill-defined 21 0.64 28 0.80 17 0.49 25 0.60 31 0.47 35 0.64 42 0.55 199 0.59 The heavy figures denote that these were the highest rates experienced in the several districts. 40 1903] Table XXII. Showing the Deaths (arranged in Classes) from All Causes, in the Four Quarters. Classified Causes of Death. Quarters. Year. 1st. 2nd. 3rd. 4th. I. Specific or Febrile Causes 219 155 127 75 576 1. Miasmatic Diseases 189 124 51 37 401 2. Diarrhœal ,, 10 10 65 24 109 3. Malarial ,, .. .. .. .. .. 4. Zoogenous ,, .. .. 1 .. 1 5. Venereal ,, 4 8 5 2 19 6. Septic ,, 16 13 5 12 46 II. Parasitic Diseases 1 1 .. .. 2 III. Dietic 9 3 11 11 34 IV. Constitutional Diseases 252 284 262 272 1070 V. Developmental 107 114 86 95 402 VI. Local 694 584 456 632 2,366 1. Diseases of Nervous System 98 90 68 92 348 2. ,, Organs of Special Sense 8 5 2 2 17 3. ,, Circulatory System 147 164 127 153 591 4. ,, Respiratory „ 311 188 115 260 874 5. „ Digestive „ 71 78 83 76 308 6. ,, Lymphatic „ 9 2 1 3 11 7. ,, Urinary „ 38 43 41 30 152 8. ,, Reproductive ,, 7 8 10 8 33 9. Bones and Joints 6 3 4 3 16 10. „ Integumentary System 3 3 5 5 16 VII. Violence 54 47 43 46 190 1. Accident or Negligence 41 34 26 34 135 2 Homicide 2 1 3 1 7 3. Suicide 10 12 14 10 46 4. Execution 1 .. .. 1 2 VIII. Ill-defined Causes 47 38 46 68 199 All Causes 1,383 1,226 1,031 1,199 4,839 Note.—The heavy figures denote that the diseases to which they are applied were most fatal in the Quarter to which they referred. 41 [1903 Table XXIII. Showing the Recorded and Corrected Death Rates per 1,000 persons living in London and in the Metropolitan Boroughs, arranged in order of their Corrected Death Rates. Borough. Standard Death Rate. * Factor for Correction for Sex and Age Distribution. † Crude or Recorded Death Rate 1903. Corrected Death Rate, 1903. Comparative Mortality Figure,§ 1903. London, 1,000. England and Wales 18 19 – – – – London 17.31 1.05107 15.2 15.9 1,000 Hampstead 16.19 1.12871 10.0 11.2 737 Lewisham 17.64 1.03141 11.1 11.4 750 Wandsworth 17.29 1.05228 12.4 13.0 855 Stoke Newington 17.42 1.04443 12.6 13.2 868 Greenwich 17.84 1.01984 13.3 13.6 895 Paddington 17.10 1.06398 13.2 14.0 921 Camberwell 17.53 1.03788 13.7 14.2 934 Woolwich 17.00 1.07024 13.5 14.4 947 Hackney 17.45 1.04264 13.9 14.5 954 Fulham 17.39 1.04623 13.9 14.5 954 Hammersmith 17.47 1.04144 14.1 14.7 967 Kensington 17.05 1.06710 13.9 14.8 974 Islington 17.53 1.03788 14.3 14.8 974 Battersea 16.94 1.07403 14.2 15.2 1,000 City of Westminster 15.97 1.13926 13.6 15.5 1,020 Lambeth 17.63 1.03199 15.2 15.7 1,033 Deptford 17.31 1.05107 14.9 15.7 1,033 Chelsea 17.57 1.03552 15.3 15.8 1,040 City of London 16.56 1.09867 14.6 16.0 1,052 St Pancras 17.40 1.04563 16.2 16.9 1,112 St. Marylebone 16.93 1.07466 16.4 17.6 1,158 Bethnal Green 17.98 1.01190 18.2 18.4 1,210 Stepney 17.40 1.04563 18.0 18.8 1,236 Poplar 17.61 1.03316 18.2 18.8 1,236 Southwark 17.38 1.04684 18.1 18.9 1,243 Bermondsey 17.60 1.03375 18.4 19.0 1,250 Shoreditch 17.29 1.05228 19.4 20.4 1,342 Holborn 16.39 1.11007 18.6 20.6 1,355 Finsbury 17.40 1.04563 20.3 21.2 1,395 * The Standard Death Rate signifies the death rate at all ages calculated on the hypothesis that the rates at each of the twelve-age periods in each town were the same as in England and Wales during the ten years 1891-1901; the death rate at all ages in England and Wales during that period having been 18.19 per 1,000. † The Factor for Correction is the figure by which the Crude or Recorded Death Rate should be multip'ied in order to correct for variations of sex and age distribution. ‡ The Corrected Death Rate is the Crude or Recorded Death Rate after correction has been made for variations of age and sex distribution, and may be obtained by multiplying the latter by the Factor for Correction. § The Comparative Mortality Figure represents the Corrected Death Rate in each Borough compared with the Recorded Death Rate at all ages in London in 1903. D 42 1903] Table XXIV. Showing the Death-rates from All Causes in the several under-mentioned places during the Four Quarters and during the Year. Places. First Quarter. Second Quarter. Third Quarter. Fourth Quarter, The Year 1903. England and Wales 16.8 14.9 13.9 16.2 15.4 76 Great Towns 17.3 15.3 15.1 17.3 16.3 103 other Large Towns 15.9 14.0 13.0 15.5 14.6 England and Wales less the 179 Towns 16.5 14.6 12.8 15.2 14.8 London (Registration) 16.8 14.2 13.5 16.0 15.2 Bristol 16.5 13.3 12.0 15.4 14.3 Birmingham 19.1 16.4 16.4 19.2 17.8 Liverpool 21.5 19.5 19.7 21.2 20.5 Manchester 21.4 19.5 18.4 19.6 19.7 Leeds 16.4 15.2 15.6 19.0 16.6 Sheffield 17.5 18.4 20.9 17.6 18.6 The Encircling Boroughs 16.9 14.8 13.8 16.2 15.4 St. Pancras 17.6 16.1 14.0 17.0 16.1 Stoke Newington 15.3 12.6 9.4 13.1 12.6 Hackney 14.8 13.6 12.0 15.1 13.8 Hornsey 9.1 7.8 7.1 7.5 7.9 Finsbury 23.1 18.4 19.1 20.3 20.2 Shoreditch 20.3 17.4 19.3 20.5 19.3 Islington 16.3 14.4 12.1 14.1 14.2 43 [1903 INFANTILE MORTALITY. The number of deaths among infants under one year old was 1,136, which is lower by 261 than any return of the preceding ten years; the average number having been 1,397. These deaths represented a rate of 126 per 1,000 births during the year as compared with a mean rate of 146 during the preceding ten years. Thus there has occurred the large saving of 20 lives in every 1,000 children born, which is a very considerable gain. This rate was the lowest recorded daring the last eighteen years, as may be seen from the following figures:— Years. Deaths. Deaths per 1,000 Births. 1885 1,387 144 1886 1,512 154 1887 1,517 160 1888 1,554 133 1889 1,271 132 1890 1,261 158 1891 1,488 151 1892 1,481 148 1893 1,488 163 Years. Deaths. Deaths per 1,000 Births. 1894 1,229 129 1895 1,416 143 1896 1,490 150 1897 1,338 136 1898 1,504 159 1899 1,548 160 1900 1,344 145 1901 1,290 139 1902 1,219 132 1903 1,136 Deaths = 126 per 1,000 Births. The 1,136 deaths represented 235 per 1,000 of the total deaths, which was 8 per 1,000 less than the proportion which obtained in the years 1893-1902. The decrease in the deaths among these very young children was due chiefly to a decreased mortality from Epidemic Diarrhoea and Enteritis, Bronchitis, Debility, Marasmus, Atrophy and Tabes Mesenterica, although other diseases, such as Measles, Convulsions, Tubercular Meningitis also contributed to the result in a lesser degree. There was on the other hand a slight increase in the number of deaths returned from Developmental Diseases, Gastritis and Pneumonia. The particulars respecting 21 causes of the mortality, together with a statement for the ten years 1893-1902 are fully set out in Table XXV. D 2 44 1903] Table XXV. Showing the Chief Causes of Infantile Mortality in the year 1903, and in the ten preceding years, 1893-1902. Diseases. Years. + Increase or – Decrease on mean of 10 years. 1893. 1894. 1895. 1896. 1897. 1898. 1899. 1900. 1901. 1902 Mean 10 years. 1903 Measles 28 37 37 67 12 65 27 42 37 24 38 29 – 9 Whooping Cough 70 72 34 103 58 67 66 68 38 76 65 63 – 2 Diarrhœa 189 73 144 125 138 220 208 148 143 72 146 83 – 63 Syphilis 21 14 11 6 17 12 7 17 10 I I 13 10 – 3 Tabes Mesenterica 83 45 56 64 55 48 30 25 26 25 46 20 – 26 Phthisis 28 27 28 17 15 18 27 27 18 16 22 16 – 6 Tubercular Meningitis 21 17 46 28 23 29 30 25 24 20 26 20 – 6 Premature Births 173 148 151 169 174 191 187 176 169 194 173 174 + 1 Other Developmental Diseases 48 48 37 40 39 30 21 36 48 33 38 49 + 11 Erysipelas 4 2 3 5 2 ... 6 3 2 3 3 4 + 1 Inflammation of Brain 32 19 14 21 27 25 16 19 23 16 21 18 – 3 Convulsions 75 71 63 74 60 46 62 57 68 69 64 47 – 7 Bronchitis 138 121 125 141 129 129 124 119 104 116 125 90 – 35 Pneumonia 74 88 97 129 86 87 112 118 123 134 105 109 + 4 Dentition 19 23 29 25 21 23 l6 25 24 16 22 18 – 4 Enteritis 45 40 54 62 65 105 159 67 70 43 71 46 – 25 Gastritis 4 9 11 10 8 9 13 21 21 23 13 22 + 9 Suffocation 56 56 43 51 39 48 45 43 39 51 47 35 – 12 Debility 102 71 112 68 76 76 81 53 40 65 74 38 – 36 Marasmus, Atrophy 265 161 195 174 180 168 204 168 148 127 179 145 – 34 All other Diseases 120 87 126 111 114 108 107 87 115 85 106 100 – 6 Totals 1595 1229 1416 1490 J338 I5°4 J548 :344 1290 1219 1397 1136 — 261 45 [1903 DEATHS FROM THE PRINCIPAL ZYMOTIC DISEASES. The principal Zymotic Diseases were no exception to the rule of a decreased mortality experienced in the returns from the general diseases, for they, too, showed a very considerable falling off when compared with those of preceding years. Indeed the returns were, it is believed, the lowest hitherto recorded in the borough, as they certainly were lower than any recorded since 1885. They numbered 471, as compared with 831, the corrected average for the eighteen years 1885-1902, or a decrease of more than 43 per cent. This is truly a marvellous decrease. It has not been, it must be stated, a sudden reduction, for ever since 1898, when the deaths numbered 933, they have year by year become fewer. In 1899 there were 781 in number; in 1900, 660; in 1901, 628; and in 1902, 602; and they have now fallen, as stated, to 471. A most satisfactory feature of the returns is that the reduction in the mortality has been common to all the Zymotic Diseases, and has not been, as so often happens, confined to one or two. Thus when compared with the returns of the preceding eighteen years Small Pox showed a decrease of 11 deaths, Measles 76, Scarlet Fever 28, Diphtheria 93, Whooping Cough 29, Typhus Fever 1, Enteric Fever 26, and Diarrhœal Diseases 96. (Vide Table XXVII.) The 471 deaths were equal to a death-rate of 1.39 per 1,000, the lowest rate hitherto noted, as against a mean rate of 2.45 experienced in the eighteen years 1885-1902. (Vide Table XXVI.) In England and Wales the Zymotic death-rate was 1.46 per 1,000; in the 76 Great Towns 1.89, in 103 Other Large Towns 1.41 in the Rural Districts of England 1.08, in London 1.76, in Bristol 1.07, in Birmingham 2.33, in Liverpool 2.51, in Manchester 2.55, in Leeds 1.76, and in Sheffield 3.10. Coming nearer home it is found that the Zymotic death-rate in St. Pancras was 1.90 per 1,000, in Stoke Newington 1.46, in Hackney 1.77, in Hornsey 0.65, in Finsbury 2.32, and in Shoreditch 2.89 per 1,000, the death-rate of these districts taken together being 1.91 per 1,000. From these returns we perceive that only the Rural Districts of England, and Hornsey could boast of a lower death-rate than that of your borough, and consequently the returns for the year, looked on from every aspect, must be considered exceedingly satisfactory. 46 1903] Table XXVI. Showing the Deaths from the principal Zymotic Diseases for the Eighteen years 1885 1902 and in 1903. Years. Deaths. Deathrates. Years. Deaths Deathrates. 1885 1,099 3.69 1896 1,038 3.07 1886 760 2.52 1897 638 1.89 1887 1,036 3.39 1898 933 2.77 1888 714 2.31 1899 781 2.32 1889 604 2.01 1900 660 1.96 1890 771 2.44 1901 628 1.87 1891 899 2.81 1902 608 1.77 1892 798 2.47 Corrected mean number of deaths—1885-1902 831 2.45 1893 884 2.70 1894 808 2.44 1903 471 1.39 1895 650 1.94 Table XXVII. Showing the Corrected Mean Number of Deaths from the principal Zymotic Diseases, 1885-1902, and in 1903. ses. Corrected Average, Number of Deaths 1885-1902. 1903. Increase or Decrease. Small Pox 11 .. – 11 Measles 196 120 – 76 Scarlet Fever 52 24 – 28 Diphtheria 136 43 – 93 Whooping Cough 181 152 – 29 Typhus Fever 1 .. – 1 Enteric Fever 48 22 – 26 Continued & Ill-defined Fevers 1 1 .. Diarrhœa 205 109 – 96 The Above Diseases 831 471 –360 47 [1903 Table XXVIII. Deaths from the principal Zymotic Diseases during the year 1903, inclusive of the Deaths of Borough Patients in Hospitals outside the Borough. SUBREGISTRATION DISTRICTS. Small Pox. Measles. Scarlet Fever. Diphtheria. Whooping Cough. Typhus Fever. Enteric (Typhoid Fever) Diarrhœa. TOTALS. Tufnell ... 9 4 4 12 ... *4 8 41 Upper Holloway ... 4 1 3 20 ... ... 11 39 Tollington ... 3 3 4 24 ... 2 17 53 Lower Holloway ... 22 4 14 24 ... 2 19 85 Highbury ... 22 6 2 19 ... 7 10 66 Barnsbury ... 41 5 10 24 ... 6 17 103 S. East Islington ... 19 1 6 29 ... 2 27 84 The Borough ... 120 24 43 152 ... *23 109 471 Preceding year, 1902 53 114 40 104 152 ... *46 99 608 * Including 1 Continued Fever. 48 1903] Table XXIX. Death-rates from the principal Zymotic Diseases during the Year, 1903. inclusive of Borough Patients in Hospitals outside the Borough. REGISTRATION DISTRICTS. Small Pox. Measles. Scarlet Fever. Diphtheria. Whooping Cough. Typhus Fever. Enteric (Typhoid Fever) Diarrhœa. Total Death-Rates. Tufnell ... 0.27 0.12 0.12 0.37 ... 0.12 0.25 1.25 Upper Holloway ... 0.12 0.03 0.09 0.57 ... ... 0.31 1.12 Tollington ... 0.09 0.09 0.11 0.69 ... 0.06 0.49 1.52 Lower Holloway ... 0.53 0.09 0.34 0.58 ... 0.05 0.46 2.05 Highbury ... 0.34 0.09 0.03 0.29 ... 0.11 0.15 1.01 Barnsbury ... 0.76 0.09 0.18 0.44 ... 0.11 0.31 1.89 S. East Islington ... 0.25 0.01 0.08 0.38 ... 0.03 0.36 1.11 The Borough ... 0.35 0.07 0.13 0.45 ... 0.07 0.32 1.39 Preceding year, 1902 0.15 0.33 0.12 0.30 0.44 ... 0.13 0.29 1.77 49 [1903 Table XXX. Showing the Deaths and Death Rates from the Principal Zymotic Diseases in the Wards during the Several Quarters of 1903. WARDS. First Quarter. Second Quarter. Third Quarter. Fourth Quarter. Year. Deaths. Deathrates. Deaths. Deathrates. Deaths. Deathrates. Deaths. Deathrates. Deaths. Deathrates. Tufnell 14 1.70 11 1.34 13 1.58 3 0.36 41 1.25 Upper Holloway 17 1.95 10 1.15 9 1.03 3 0.34 39 1.12 Tollington 23 2.64 9 1.03 10 1.15 11 1.26 53 1.52 Lower Holloway 26 2.50 34 3.27 18 1.73 7 0.67 85 2.05 Highbury 12 1.37 9 1.03 11 1.26 5 0.57 37 1.06 Mildmay 12 1.93 2 0.32 6 0.96 3 0.48 23 0.92 Thornhill 31 3.71 23 2.76 10 1.20 8 0.96 72 2.l6 Barnsbury 9 1.72 8 1.53 13 2.49 1 0.19 31 1.48 St. Mary's ... ... 4 0.92 3 0.69 3 0.69 10 0.58 Canonbury 11 1.41 11 1.41 9 1.15 3 0.38 34 1.09 St. Peter's 15 1.83 10 1.22 13 1.59 8 0.98 46 1.40 Totals 170 2.00 131 1.54 115 1.36 55 0.65 471 1.39 50 1903] Table XXXI. Showing the Deaths from the Principal Zymotic Diseases in the several Wards during the Year 1903. WARDS. Small Pox. Measles. Scarlet Fever. Diphtheria Whooping Cough. Typhus Fever. Enteric Fever. Continued and Ill-defined Fever. Diarrhœa. Total Zymotic Deaths. Tufnell ... 9 4 4 12 – 3 1 8 41 Upper Holloway ... 4 1 3 20 – ... – 11 39 Tollington ... 3 3 4 24 – 2 – 17 53 Lower Holloway ... 22 4 14 24 – 2 – 19 85 Highbury ... 12 3 2 8 – 5 – 7 37 Mildmay ... 6 3 ... 9 – 2 – 3 23 Thornhill ... 26 4 8 18 – 5 – 11 72 Barnsbury ... 15 1 2 6 – 1 – 6 31 St. Mary's ... 3 ... ... 5 – ... – 2 10 Canonbury ... 11 ... 2 12 – 1 – 8 34 St. Peter's ... 9 1 4 14 – 1 – 17 46 Totals ... 120 24 43 152 – 22 1 109 471 51 [1903 Table XXXII. Showing the Death-rates of the Wards from the Principal Zymotic Diseases during the Year 1903. wards. Small Pox. Measles, Scarlet Fever. Diphtheria. Whooping Cough. Typhus Fever. Enteric Fever. Continued and Ill-defined Fever. Diarrhoea. Death-rate from Zymotic Diseases. Tufnell ... 0.27 0.12 0.12 0.37 — 0.09 0.03 0.25 1.25 Upper Holloway ... 0.12 0.03 0.09 0.57 — ... — 0.31 1.12 Tollington ... 0.09 0.09 0.11 0.69 — 0.06 — 0.49 1.52 Lower Holloway ... 0.53 0.09 0.34 0.58 — 0.05 — 0.46 2.05 Highbury ... 0.34 0.09 0.06 0.23 — 0.I4 — 0.20 1.06 Mildmay ... 0.24 0.12 ... 0.36 — 0.08 — 0.12 0.92 Thornhill ... 0.78 0.12 0.24 0.54 — 0.15 — 0.33 2.16 Barnsbury ... 0.71 0.05 0.09 0.29 — 0.05 — 0.29 1.48 St. Mary's ... 0.17 ... ... 0.29 — ... — 0.12 0.58 Canonbury ... 0.35 ... 0.06 0.39 — 0.03 — 0.26 1.09 St. Peter's ... 0.28 0.03 0.12 0.43 — 0.03 — 0.52 1.41 Total ... 0.35 0.07 0.13 0.45 — 0.06 0.02 0.32 1.39 52 1903] SMALL POX. There was no death from this disease during the year although 9 cases were known. The average annual number of deaths for the previous eighteen years had been II, while in 1902 there had been 53, which was the greatest number registered since 1885, although before that date the numbers were at times very large. Years. Deaths. Years. Deaths. 1885 125 1894 3 1886 3 1895 1 1887 — 1896 1 1888 — 1897 1 1889 — 1898 — 1890 — 1899 — 1891 — 1900 1 1892 3 1901 8 1893 2 1902 53 1903 0 Death. It is very gratifying to find that this terrible scourge has not visited us with severity during the year, for at one time it seemed to be not at all improbable that the epidemic which occurred in London during the latter part of 1901 and 1902 would recrudesce in 1903. Happily, however, we were spared such an affliction. MEASLES. This disease which is so common among young children caused 120 deaths as compared with 114 in the preceding year, 151 in 1901, and with a corrected annual average of 196 in years 1885-1902. The death-rate was equal to 0.35 per 1,000 of the population, compared with a mean rate of 0.57 in the eighteen preceding years. The death-rate was also considerably less than that which obtained in the Encircling Boroughs where it was 0.64 per 1,000. Indeed the mortality was proportionately less in Islington than in any of the Encircling Boroughs except Hornsey. As usual the great secondary cause of the death of patients suffering from Measles was Pneumonia to which it was ascribed in 86 cases, 42 males and 44 females. Bronchitis followed with 17 deaths. Year after year it has been pointed out in these reports that such deaths are for the greater part entirely preventable, if persons would only keep the little patients warm, and protect them from cold and draughts. It is like flogging a dead horse to speak of these matters, until the ears of the nurses can be reached so that they may be made 53 [1903 to understand the matter fully. The extraordinary thing is that although so many children die annually from Measles great numbers of the people still look on the disease as of no consequence. (Vide Table XXXVI). The deaths from Measles in the borough during the several quinquennial periods since 1856, were as follows:— Quinquennia. Deaths. Annual Aver. No. of Deaths. Quinquennia. Deaths. Annual Aver. No. of Deaths. 1856-60 424 85 1881-85 898 179 1861-65 457 91 1886-90 924 185 1866-70 514 103 1891-95 856 171 1871-75 633 127 1896-00 1024 245 1876-80 629 126 1901-03 (3 years) 385 128 The mortality was very unevenly spread over the year, for whereas there were as many as 35 and 64 deaths respectively in the first and second quarters, there were only 17 and 4 in the third and fourth quarters. As a rule only 38 per cent. of these deaths from Measles occur in the second quarters of the year, whereas over 54 per cent. were registered in 1903. Again 18 per cent. usually are entered in the fourth quarter, whereas only slightly over 3 per cent. were noted. It is not possible to ascribe any cause for these changes, and they are merely mentioned as a matter of interest. The average percentages of deaths in the several quarters during eighteen years and in 1903, were as follows:— 1885-1902. 1903. 1st Quarters 31 per cent. 29 per cent. 2nd „ 38 „ 54 „ 3rd „ 13 „ 14 „ 4th „ 18 „ 3 „ 100 100 „ Owing to the excessive prevalence of the disease in certain schools, it became necessary to close one or more class-rooms in the infant departments of the following schools:— York Road Board School. St. John's Schools, Duncan Street. Hungerford Road Board School. St. John's Schools, Conewood Street. Westbourne Road Board School. St. Mary's Schools. Pakeman Street Board School. Montem Street Board School. Wesleyan Schools, Drayton Park. Yerbury Road Board School. Duncombe Road Board School. Richard Street Board School. St. James' Schools, George's Road. Vittoria Place Board School. Holy Trinity Schools, Cloudesley Queen's Head Board School. Street. 54 1903] Table XXXIII. Showing the Deaths from Measles in the Sub-Districts for each Quarter. Sub-Districts. 1st Quarter. 2nd Quarter. 3rd Quarter. 4th Quarter. Whole Year. Tufnell 3 4 2 .. 9 Upper Holloway 1 2 1 .. 4 Tollington 1 2 .. .. 3 Lower Holloway 2 18 2 .. 22 Highbury 9 10 2 1 22 Barnsbury 12 20 9 • • 41 Islington, South East 7 8 1 3 19 The Borough 35 64 17 4 120 Table XXXIV. Showing the Death-rates from Measles of the Sub-Districts for each Quarter. Sub-Districts. 1st Quarter. 2nd Quarter. 3rd Quarter. 4th Quarter. Whole Year. Tufnell 0.36 0.49 0.24 .. 0.27 Upper Holloway 0.11 0.23 0.11 .. 0.12 Tollington 0.11 0.23 •• .. 0.09 Lower Holloway 0.19 1.73 0.19 .. 0.53 Highbury 0.55 0.62 0.12 0.06 0.34 Barnsbury 0.88 0.47 0.66 •• 0.76 Islington, South East 0.37 0.42 0.05 0.16 0.25 The Borough 0.41 0.75 0.20 0.05 0.35 55 [1903 Table XXXV. Showing the Deaths-Rates of the Encircling Boroughs from Measles in the Four Quarters of 1903. Districts. 1st Quarter. 2nd Quarter. 3rd Quarter. 4th Quarter. Year. St. Pancras 0.83 1.93 0.42 0.09 0.82 Stoke Newington 1.23 0.61 •• .. 0.46 Hackney 0.43 1.11 0.19 0.29 0.53 Hornsey 0.15 0.56 .. .. 0.18 Finsbury 0.44 1.16 0.84 0.32 0.69 Shoreditch 0.95 1.53 0.31 0.68 0.87 The Above Districts 0.65 1.33 0.33 0.24 0.64 Islington 0.41 0.75 0.20 0.05 0.35 Table XXXVI. Showing the Secondary Causes of the Deaths from Measles. Secondary Diseases. Quarters. The Year 1903. 1 2 3 4 Males. Females. Totals. Pneumonia 26 46 10 4 42 44 86 Bronchitis 5 9 3 .. 12 5 17 Whooping Cough •• 1 •• .. 1 .. 1 Convulsions 3 2 2 .. 4 3 7 Marasmus .. .. 1 .. 1 •• 1 Laryngitis •• 1 .. .. •• 1 1 Phthisis .. 1 .. .. • • 1 1 Empyema 1 .. .. .. 1 •• 1 Malnutrition .. 1 .. .. .. 1 1 Hare Lip .. 1 .. .. 1 .. 1 Eczema .. 1 .. .. .. 1 1 Total Secondary Diseases 35 63 16 4 62 56 118 Deaths where no secondary disease was entered •• 1 1 •• 1 1 2 Total Deaths 35 64 17 4 63 57 120 56 1903] Table XXXVII. Showing the Deaths from Measles during each Week of 1903. 1st Quarter. 2nd Quarter. 3rd Quarter. 4th Quarter. Week. Deaths. Week. Deaths. Week. Deaths. Week. Deaths. 1 1 14 3 27 5 40 1 2 2 15 8 28 2 41 1 3 1 16 6 29 3 42 .. 4 2 17 3 30 1 43 .. 5 1 18 6 31 1 44 .. 6 1 19 .. 32 2 45 1 7 6 20 4 33 2 46 .. 8 5 21 5 34 .. 47 1 9 3 22 13 35 .. 48 .. 10 4 23 4 36 .. 49 .. 11 5 24 3 37 .. 50 .. 12 3 25 6 38 .. 51 .. 13 1 26 3 39 1 52 •• 13 weeks 35 13 weeks 64 13 weeks 17 13 weeks 4 57 [1903 Table XXXVIII. Showing the deaths from Measles in the Quarters, 1893 02 and 1903. Years. 1st Quarter. 2nd Quarter. 3rd Quarter. 4th Quarter. Total. 1893 25 52 31 11 119 1894 66 118 14 1 199 1895 7 36 50 42 135 1896 170 84 25 9 288 1897 15 2 8 72 97 1898 183 107 23 12 325 1899 45 53 26 31 155 1900 64 75 15 5 159 1901 7 17 27 100 151 1902 53 29 12 20 114 Corrected average number of deaths 65 58 23 30 176 1903 35 64 17 4 120 Increase or Decrease -30 + 6 -6 -26 -56 SCARLET FEVER. The deaths from Scarlet Fever numbered 24, and are equal to a death-rate of 0.07 per 1,000. These are the lowest figures hitherto known in the borough with one exception, namely in 1900, when the returns were the same as now. This rate is lower by 0.08 than the average rate in the eighteen years immediately preceding. A very large number of these deaths, 23, or nearly 96 percent., occurred in hospitals. Of the total deaths from Scarlet Fever 13, or 54.2 per cent., were those of children under five years old, who died at the rate of 0.35 per 1,000 living at that age. E 58 1903] Table XXXIX. Showing the Deaths from Scarlet Fever in the Sub-Districts for each Quarter. Sub-Districts. 1st Quar.er. 2nd Quarter. 3rd Quarter. <Hh Quarter. Whole Year. Tufnell 1 .. 3 •• 4 Upper Hollo way 1 •• •• ... 1 Tollington .. 1 •• 2 3 Lower Holloway 1 1 •• 2 4 Highbury 2 •• 4 •• 6 Barnsbury 3 •• 1 1 5 Islington, South East 1 •• •• •• 1 The Borough 9 2 8 5 24 Table XL. Showing the Death-rates from Scarlet Fever of the Sub-Districts for each Quarter. Sub-Districts. 1st Quarter. 2nd Quarter 3rd Quarter. 4th Quarter. Whole Year. Tufnell 0.12 .. 0.37 .. 0.12 Upper Holloway 0.11 .. .. .. 0.03 Tollington .. 0.11 .. 0.23 0.09 Lower Holloway 0.10 0.09 •• 0.19 0.09 Highbury 0.12 .. 0.25 •• 0.09 Barnsbury 0.22 .. 0.07 0.07 0.09 Islington, South East 0.05 .. .. .. 0.01 The Borough 0.10 0.02 0 09 0 06 0.07 59 [1908 DIPHTHERIA. The deaths referred to Diphtheria were only 43 in number or 93 less than the corrected average of 136 that obtained during the years 1885-1902. Of these deaths 21 were males and 22 females. This is a lower return than any during the last eighteen years. These deaths were equal to a death-rate of 0.13 per 1,000, which is 0.27 per 1,000 less than the average rate for the years now mentioned. Its heaviest incidence was felt in Lower Holloway, where the death-rate was 034 per 1,000 of the population. Of the 43 deaths at all ages from Diphtheria, 26, or 60.5 per cent., were under five years of age, and were equal to a death-rate of 0.71 among children living at that age. It is of happy augury that the fatality, by which is meant the percentage proportion which the deaths bear to the notified cases, has steadily decreased since 1899. This is seen in the following statement:— Years. Cases. Attack Rates. Deaths. Death Rates. Fatality Deaths per 100 Cases. 1893 885 2.70 200 0.61 22.6 1894 867 2.62 218 0.66 25.1 1895 582 1.74 144 0.43 24.7 1896 1091 3.23 257 0.76 23.5 1897 729 2.17 131 0.39 18.0 1898 544 1.62 93 0.27 17.1 1899 705 2.1O 128 0.38 18.2 1900 633 1.89 106 0.32 16.7 1901 911 2.72 134 0.40 14.7 1902 878 2.55 104 0.30 11.8 Corrected Mean 792 2.34 153 0.45 19.3 1903 455 1.34 43 0.13 9.4 Decrease 337 1'00 110 0.32 9.9 E 2 60 1903] Table XLI. Showing the Deaths from Diphtheria in the Sub-Districts for each Quarter. Sub-Districts. 1st Quarter. 2nd Quarter. 3rd Quarter. 4th Quarter. Whole Year. Tufnell 1 1 1 1 4 Upper Holloway 1 •• • • 3 Tollington 2 1 1 •• 4 Lower Holloway 8 4 1 14 Highbury 1 .. •• 1 2 Barnsbury 5 2 3 .. 10 Islington, South East 1 2 .. 3 6 The Borough 20 11 6 6 43 Table XLII. Showing the Death-rates from Diphtheria of the Sub-Districts for each Quarter. Sub-Districts. 1st Quarter. 2nd Quarter. 3rd Quarter. 4th Quarter. Whole Year. Tufnell 0.12 0.12 0.12 0.12 0.12 Upper Holloway 0.23 0.11 •• •• 0.09 Tollington 0.28 0.1l 0.11 •• 0.11 Lower Holloway 0.77 0.39 0.10 0.09 0.34 Highbury 0.06 •• •• 0.06 0.03 Barnsbury 0.37 0.15 0.22 •• 0.18 Islington, South East 0.05 0.11 •• 0.16 0.08 The Borough 0.24 0.13 0.07 0.07 0.13 WHOOPING COUGH. The deaths attributed to this disease during the year numbered 152 at all ages, equal to a death-rate of 0.45 per 1,000 of the population, and were fewer by 29 than the average, after correction for increase of the population had been 61 [1903 made during the eighteen years 1885-1902. Of these deaths 148, or 97.3 per cent., were under five years old, of whom 72 were boys and 76 girls. The deathrate among children living at this period of life was 0.40 per 1000. By a coincidence the mortality was identical with that of 1902. The death-rate was above the average for the borough in Upper Holloway, Tollington and Lower Holloway, but below it in Tufnell, Highbury, Barnsbury, and Islington South East. Table XLIII. Showing the Deaths from Whooping Cough in the Sub-Districts for each Quarter and for the Year. Sub-Districts. 1st Quarter. 2nd Quarter. 3rd Quarter. 4th Quarter. Whole Year. Tufnell 5 6 1 .. 12 Upper Holloway 13 6 1 •• 20 Tollington 18 5 •• 1 24 Lower Holloway 14 7 2 1 24 Highbury 11 2 3 3 19 Barnsbury 17 5 1 1 24 Islington, South East 10 11 7 1 29 The Borough 88 42 15 7 152 Table XLIY. Showing the Death-rates from Whooping Cough of the Sub-Districts for each Quarter. Sub-Districts. 1st Quarter. 2nd Quarter. 3rd Quarter. 4th Quarter. Whole Year Tufnell 0.61 0.73 0.12 .. 0.37 Upper Holloway 1.50 0.69 0.11 .. 0.57 Tollington 2.07 0.58 .. 0.11 0.69 Lower Holloway 1.35 0.67 0.19 0.09 0.58 Highbury 0.68 0.12 0.18 0.19 0.29 Barnsbury 1.26 0.37 0.07 0.07 0.44 Islington, South East 0.53 0.58 0.37 0.05 0.38 The Borough 1.04 0.50 0.18 0.08 0.45 62 TYPHUS FEVER. No death from Typhus Fever was recorded, nor indeed has any been registered since 1898, when a very doubtful return was entered. ENTERIC FEVER. Twenty-two deaths were ascribcd to Enteric Fever, also known as Typhoid Fever, which is 26 fewer than the corrected average for the preceding eighteen years. The return is the lowest of which any record can be found. These deaths represent a death-rate of 0.07 per 1,000 of the population. The deaths occurred at the following age periods: — 0-5 1 or 0.03 per 1,000 living at this age 5-15 3 „ 0.04 „ „ 15-25 5 ,, 0.07 „ „ 25-35 6 „ 0.09 „ „ 35-45 4 „ 0.09 „ „ 45-55 2 „ 0.06 „ „ 55 and upwards 1 „ 0.03 „ „ Among males there were 13 deaths, equal to a death-rate of 0.08 per 1,000 cf that sex, and among females 9 deaths equal to a rate of 0.05 per 1,000. The death-rate was slightly above the average of the year in Tufnell, Highbury and Barnsbury, and below it in the other wards. Table XLV Showing the Deaths from Enteric Fever in the Sub-Districts for each Quarter. Sub-Districts. 1st Quarter. 2nd Quarter. 3rd Quarter. 4th Quarter . Whole Year. Tufnell .. .. 1 2 3 Upper Holloway •• .. .. •• •• Tollington •• .. .. 2 2 Lower Holloway 1 •• 1 •• 2 Highbury 3 2 .. 2 7 Barnsbury 2 •• 1 3 6 Islington, South East 1 .. 1 •• 2 The Borough 7 2 4 9 22 83 [1903 Table XLVI. Showing the Death-rates from Enteric Fever of the Sub-Districts for each Quarter. Sub-Districts. 1st Quarter. 2nd Quarter. 3rd Quarter. 4th Quarter. Whole Year. Tufnell .. .. 012 0.24 0.12 Upper Holloway .. .. .. .. .. Tollington •• .. .. 0.23 0.06 Lower Holloway 0.10 .. 0.10 .. 0.05 Highbury 0.18 0.12 .. 0.12 0.11 Barnsbury 0.15 .. 0.07 0.22 0.11 Islington, South East 0.05 •• 0.05 .. 0.03 The Borough 0.08 0.02 0.05 0.11 0.07 DIARRHCEAL DISEASES. For the second consecutive year the return of deaths from these diseases, mainly of infancy, has been below the corrected average. The number now to be recorded is 109 as compared with an average of 205 in the eighteen years immediately preceding. These deaths are equal to a death-rate of 0*32 per 1,000 as compared with a mean death-rate of o'6o which obtained in the years just indicated. The number registered in the first quarter was 10, in the second 10, in the third 65, and in the fourth 24. In the third quarter the disease generally assumes an epidemic form, and it is then usually called Epidemic Diarrhoea. As customary it began to assume this aspect in the early part of July, when there were 7 deaths registered, increasing in intensity in August when there were 16 deaths, and reaching its height in September when 42 deaths occurred. The decreased mortality was without doubt due, in a considerable measure, to the meteorological conditions which prevailed, as the disease is greatly influenced by temperature of the air, temperature of the ground, and rainfall; 64 1908] low temperatures and excess in the rainfall tending to control it, and the opposite characteristics to favour its increase. It is not proposed to enter into these matters now because they have been discussed frequently in the reports of your Medical Officer of Health; besides their relationship to the disease is fairly well known and defined. It may, however, be stated once more that the sanitary state of houses, and the conditions of their yards, have more than a passing effect on the disease, for it is just in those premises that are most neglected that it is most constant. The milk that infants are fed on is also a considerable factor, for according as it is clean or dirty so will it be wholesome or unwholesome, always supposing it is diluted to suit the infant, and this milk also will be good or bad according as the cowkeeper and purveyor practices cleanliness, and as it is protected from dirt and dust in the homes of the people. It is difficult to say positively how many deaths occur annually in England from polluted or unclean milk alone, but they must number many thousands. This may seem an alarmist statement, but it must not be forgotten that diarrhœal diseases cause annually in England and Wales nearly 13,000 deaths (between 1891 and 1900 they actually were accountable for 126,841); therefore to say that it causes many thousands of deaths is only to assert what every medical man knows to be a fact. Dirty cowsheds and dirty cows, and dirty milkers and dirty cans, create an abnormal number of bacteria, these bacteria set up fermentation, which means sour milk, sour milk creates Diarrhcea, and Diarrhoea causes death. Recently a magistrate was so surprised, when it was stated in court that several thousand deaths could be attributed annually to such uncleanliness of milk as that which has just been mentioned, that he requested the press to suppress such an alarming statement. It is an alarming statement, but it is a true one based on knowledge, and known to the medical profession, especially to that portion engaged in preventive medicine. Many years ago your Medical Officer of Health, in company with the late Dr. Ballard, of the Local Government Board, and formerly Medical Officer of Health of this parish, investigated many hundreds of cases of Diarrhcea in Sunderland, and again and again, and yet again, it was demonstrated that the cause of the disease was the souring of the milk, intended for the childrens' food. The causes of this souring was not as well understood then as now, for now we know that the chief of them is undoubtedly the dirty conditions under which the milk is drawn from the cow. It is not by suppressing these truths, but by letting the people, whose health and lives, and whose children's health and lives are at stake, know them, that reformation will come, as come it will, and perhaps sooner than may be expected, for it is not to be supposed that once they understand this question that they will long tolerate a grave and insidious danger to the public health. 65 [1903 Table XLVII. Showing the Deaths from Diarrhoea in the Sub-Districts for each Quarter. Sub-Districts. 1st Quarter. 2nd Quarter. 3rd Quarter. 4th Quarter. Whole Year. Tufnell 3 .. 5 .. 8 Upper Holloway .. 1 7 3 11 Tollington 2 •• 9 6 17 Lower Holloway •• 4 12 3 19 Highbury •• •• 9 1 10 Barnsbury 1 4 8 4 17 Islington, South East 4 1 15 7 27 The Borough 10 10 65 24 109 Table XLVIII. Showing the Death-rates from Diarrhoea of the Sub-Districts for each Quarter. Sub-Districts. 1st Quarter. 2nd Quarter. 3rd Quarter. 4th Quarter. Whole Year. Tufnell 0.37 .. 0.61 .. 0.25 Upper Holloway • • 0.11 0.81 0.34 0.31 Tollington 0.23 • • 1.04 0.69 0.49 Lower Holloway .. 0.39 1.15 0.29 0.46 Highbury • • • • 0.55 0.06 0.15 Barnsbury 0.07 0.29 0.60 0.30 0.31 Islington, South East 0.21 0.05 0.80 0.37 0.36 The Borough 0.12 0.12 0.77 0.28 0.32 66 1903] Table XLIX. Showing the Deaths from Diarrhcœl Diseases and from those classed under Enteritis and its sub-headings, arranged in quarterly periods, and at three groups of ages. Ages. 1st Quarter. 2nd Quarter. 3rd Quarter. 4th Quarter. The Year. Diarrhœa. Enteritis, etc. Totals. Diarrhoea. Enteritis, etc. Totals Diarrhœa Enteritis, etc. Totals. Diarrhœa. Enteritis, etc. Totals. Diarrhœa. Enteritis, etc. Totals. Under 1 year 6 20 26 5 12 17 55 22 77 17 14 31 83 68 151 1 to 5 years 4 3 7 2 2 4 7 1 8 6 3 9 19 9 28 Over 5 years — 5 5 3 4 7 3 7 10 1 6 7 7 22 29 Totals 10 28 38 10 18 28 65 30 95 24 23 47 109 99 208 67 [1903 Table L. Showing the Diarrhœal Death in the Third Quarter, 1903. 1903. Deaths. Death-Rate. Meteorology. Week Ending. Tuf. U.H. Toll. L.H. H. B. S.E. Total. Tuf. U.H. Toll. L.H. H. B. S.E. Total. Mean temperature of air in degrees. Departure from mean temperature. Temperature j of the earth 3 feet below surface. Rainfall in inches. No. of days on which rain fell. July 11th .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 63.6 +1.5 60.58 0.00 2 „ 18th 1 .. .. .. 1 . . 2 4 1 58 .. .. .. 0.80 .. 1.37 0.61 60.7 -2.3 61.64 0.57 4 25th.. .. .. .. .. .. 1 .. 1 .. .. .. .. .. 0.96 .. 0.15 60.5 -2.3 61.39 3.18 7 Aug. 1st.. .. .. .. .. .. .. 2 2 .. .. .. .. .. .. 1.37 0.30 58.6 -3.7 61.07 1.52 7 1 .. .. .. 1 1 4 7 0.39 •• •• •• 0.20 0.24 0.68 0.27 60.8 -1.7 61.17 5.37 20 August 8th .. .. .. .. .. .. 1 1 .. .. .. .. .. .. 0.68 0.15 61.2 -1.1 60.70 0.35 3 „ l5th .. 2 .. .. .. .. 3 5 .. 2.99 .. .. . . .. 2.06 0.76 59.5 -2. 9 60.87 2.11 4 ,, 22nd .. 1 1 1 .. .. 3 6 .. 1.49 1.50 1.25 .. .. 2.06 0.92 58.3 -3.1 60.49 1.11 5 „ 29th •• 2 .. .. .. 1 1 4 •• 2.99 .. .. .. 0.96 0.68 0.61 58.1 -2.6 59.83 1.23 5 •• 5 1 1 .. 1 8 16 •• 1.87 0.37 0.31 .. 0.24 1.37 0.61 59.3 -2.4 60.47 4.80 17 Sept. 5th 1 1 .. 2 5 1 .. 10 1.58 1.49 .. 2.51 4.00 0.96 .. 1.53 62.9 +3.2 60.69 0.86 5 „ 12th .. .. 3 2 2 .. 1 8 .. .. 4.50 2.51 1.60 .. 0.68 1.23 53.7 -4.8 60.53 0.55 6 „ 19 th 2 .. 3 3 1 1 2 12 3.17 .. 4.50 3.76 0.80 0.96 1.37 1.84 51.7 -5.7 57.98 0.01 1 „ 26th 1 .. 1 2, .. .. 1 5 1.58 .. 1.50 2.51 .. .. 0.68 0.76 59.3 + 3.9 57.87 0.22 4 Oct. 3rd .. 1 1 2 • • 1 2 7 .. 1.49 1.50 2.51 •• 0.96 1.37 1.07 59.3 + 5.0 58.72 0.61 5 4 2 8 11 8 3 6 42 1.27 0.59 2.40 2.76 1.28 0.57 0.82 1.29 57.4 +0.3 59.16 2.25 21 3rd Quarter 5 7 9 12 9 5 18 65 0.61 0.80 1.03 1.15 0.55 0.37 0.95 0.77 59.2 -1.2 60.27 12.32 58 68 1903] Table LI. Showing the Mean Temperature of the Air and the Earth, and the Rainfall, for each week of the Third Quarter, 1903, together with those of the corresponding periods in 1902, and also the Deaths from Diarrhoea in the same periods. Weeks of Quarter. Mean Air Temperature. Earth Temperature at 3 feet. Rainfall in inches. Diarrhoeal Deaths. 1902. 1903. Diflerence between 1902 and 1903. 1902. 1903. Difference between 1902 and 1908. 1902. 1903. 1902. 1903 Difference. ° ° ° ° ° ° July 11 621 63.6 +1.5 59.01 60.58 +1.57 0.58 0.00 .. .. .. ,, 18 62.8 60.7 -2.1 60.62 61.64 +1.02 0.35 0.57 2 4 +2 .. 25 64.0 60.5 -3.5 61.09 61.39 +0.30 0.01 3.18 3 1 -2 Aug. 1 57.1 58.6 +1.5 60.27 61.07 +0.80 0.21 1.52 2 2 .. July 61.5 60.8 -0.7 60.25 61.17 +0.92 1.15 5.27 7 7 .. Aug. 8 58.1 61.2 +3.1 60.02 60.70 +0.68 0.29 0.35 .. 1 +1 15 59.1 59.5 +0.4 59.94 60.87 +0.93 0.44 2.11 4 5 +1 „ 22 58.5 58.3 -0.2 59.34 60.49 +1.15 0.17 1.11 3 6 +3 ,, 29 60.7 58.1 -2.6 59.79 59.83 +0.04 1.43 1.23 4 4 .. Aug. 59.1 59.3 +0.2 59.77 60.47 +0.70 2.33 4.80 11 16 +5 Sept. 5 60.4 62.9 +2.5 59.92 60.69 +0.77 0.24 0.86 6 10 +4 .. 12 60.8 53.7 -7.1 60.28 60.53 +0.25 0.68 0.55 6 8 +2 .. 19 56.4 51.7 - 4.7 60.09 57.98 -2.11 1.45 0.01 10 12 +2 .. 26 52.9 59.3 +6.4 58.35 57.87 -0.48 0.06 0.22 11 5 -6 Oct. 3 55.9 59.3 +3.4 57. 16 58.72 +1.56 0.00 0.61 12 7 -5 Sept. 57.3 57.4 -0.1 59 16 59.15 -0.01 2.43 2.25 45 42 -3 3rd Qrtr. 59.3 59.2 -0.1 59 73 60.27 +0.54 5.91 12.32 63 65 +2 In this table the thick figures denote that the temperatures, rainfall or deaths, were higher in the year to which they refer than in that with which they are contrasted. They are printed in this manner in order that comparison may be more readily made. 69 [1903 Table LII. Showing the Deaths occurring in Islington and, in the several Encircling Sanitary Boroughs from All Causes, from the principal Zymotic Diseases, and from Phthisis in the year 1903. THE ENCIRCLING BOROUGHS. Estimated Populations, 1903. Total Deaths from All Causes. Total Zymotic Deaths. Small Pox. Deaths from principal Zymotic Diseases. Diarrhoea. Deaths from Phthisis. Deaths of infants under 1 year of age. Deaths under 1 year to 1,000 Births. Measles. Scarlet Fever. D iphther a. Whooping Cough. Typhus. Enteric Fever. Simple and Undefined Fevers. 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 St. Pancras 235,716 3,805 448 — 193 23 37 91 — 14 — 90 428 841 133 Stoke Newington 52,069 655 76 — 24 — 7 19 — 5 — 21 64 130 119 Hackney 224,082 3,099 397 — 113 21 48 67 — 36 — 112 283 736 119 Hornsey 78,386 619 51 — 14 1 10 20 — — — 6 44 136 82 Finsbury 99.717 2,017 231 — 69 11 11 54 — 10 — 76 228 498 135 Shoreditch 117,513 2,273 340 — 102 7 22 44 — 13 — 152 272 669 171 The above Boroughs 807,483 12,468 1,543 — 515 63 135 295 — 78 — 457 1,319 3,010 132 Islington 339,137 4,839 471 — 120 24 43 152 — 22 1 109 492 1,136 126 70 1903] Table LIII. Showing the Death Rates of Islington and of the several Encircling Sanitary Boroughs from All Causes, from the principal Zymotic Diseases, and from Phthisis in the the year 1903. THE ENCIRCLING BOROUGHS. Estimated Populations, 1903. Total Deathrates from All Causes. Total Zymotic Death-rates. Death-rate from principal Zymotic Diseases. Death-rates from Phthisis. Deaths under 1 year to 1,000 Births. Small Pox. Measles. Scarlet Fever. Diphtheria. Whooping Cough. Typhus. Enteric Fever. • Simple and Undefined Fevers. Diarrhœa. I 2 3 4 5 6 7 8 9 10 11 12 13 14 15 St. Pancras 235,716 16.14 1.90 ... 0.82 0.09 0.16 0.39 ... 0.06 ... 0.38 1.82 133 Stoke Newington 52,069 12.6O 1.46 ... 0.46 ... 0.13 0.37 ... 0.10 ... 0.40 1.23 119 Hackney 224,082 13.83 1.77 ... 0.50 0.09 0.22 0.30 ... 0.16 ... 0.50 1.26 119 Hornsey 78,386 7.89 0.65 ... 0.18 0.01 0.13 0.26 ... ... ... 0.07 0.56 82 Finsbury 99,717 20.22 2.32 ... 0.70 0.11 0.11 0.54 ... 0.10 ... 0.76 2.29 135 Shoreditch 117,513 19.34 2.89 ... 0.87 0.06 0.196 0.37 ... 0.11 ... 1.29 2.31 171 The above Boroughs. 807,483 15.44 1.91 ... 0.64 0.08 0.17 0.36 ... 0.09 ... 0.57 1.63 132 Islington 339,137 14.26 1.39 ... 0.35 0.07 0.13 0.45 0.06 0 02 0 32 1.45 126 71 [1903 Table LIV. Showing the Death.rates from All Causes, from the principal Zymotic Diseases, together with the Infantile Mortality, in the Country, in the Populous Towns, in Towns whose Populations exceed 300,000 inhabitants, the Encircling Boroughs, and in Islington. All Causes. Principal Zymotic Diseases (Cols. 3.9). Small-Pox. Measles. Scarlet Fever. Diphtheria. Whooping Cough. Fever. Diarrhœa. Deaths under 1 Year to 1,000 Births. Cols. 1. 2. 3. 4. 5. 6. 7 8. 9. 10. England and Wales 15.4 1.46 0.02 0.27 0.12 0.18 0.27 0.10 0.50 132 76 Great Towns 16.3 1.89 0.03 0.36 0.14 0.20 0.33 0.12 0.71 144 103 Other Large Towns 14.6 1.41 0.02 0.29 0.12 0.16 0.28 0.11 0.43 135 England and Wales less the 179 Towns 14.8 1.08 0.02 0.17 0.10 0.17 0.22 0.09 0.31 118 London 15.2 1.77 0.03 0.44 0.07 0.16 0.35 0.08 0.64 131 Bristol 14.3 1.07 0.01 0.03 0.15 0.35 0.19 0.06 0.28 116 Birmingham 17.8 2.33 0.02 0.36 0.27 0.26 0.18 0.13 1.10 159 Liverpool 20.5 2.51 0.19 0.18 0.27 0.23 0.43 0.23 0.98 159 Manchester 19.7 2.55 0.05 0.63 0.17 0.24 0.39 0.17 0.89 169 Leeds 16.6 1.76 0.05 0.28 0.25 0.15 0.27 0.13 0.63 153 Sheffield 18.6 3.10 0.00 0.79 0.22 0.09 0.61 0.11 1.27 182 St. Pancras 16.1 1.90 .. 0.82 0.09 0.16 0.39 0.06 0.38 133 Stoke Newington 12.6 1.46 .. 0.46 •• 0.13 0.37 0.10 0.40 119 Hackney 13.8 1.77 .. 0.50 0.09 0.22 0.30 0.16 0.50 119 Hornsey 7.9 0.65 •• 0.19 0.01 0.13 0.26 .. 0.07 82 Finsbury 20.2 2.32 .. 0.70 0.11 0.11 0.54 0.10 0.76 135 Shoreditch 19.3 2.89 .. 0.87 0.06 0.19 0.37 0.11 1.29 171 Encircling Boroughs 15.4 1.91 .. 0.64 0.08 0.17 0.36 0.09 0.57 132 Islington 14.2 1.39 .. 0.35 0.07 0.13 0.45 0.06 0.32 126 72 1903] INFLUENZA. To this cause were referred 40 deaths, which is a decrease of 51 on the average, corrected for the increase of population, during the preceding ten years. They are also below any return made during these years. These deaths represent a death-rate of 0.11 per 1,000 of the population. As many as 30 out of the total number of deaths from Influenza occurred in the first quarter, while only 3, 1, and 6 were respectively entered in the three remaining quarters. The early part of the year has invariably been the period when this disease has been most fatal, although occasionally, as in 1893 and 1897, the greatest number of deaths have occurred in the fourth quarter. It was not until 1890, after a lapse of very many years, that Influenza, so well known on the continent as La Grippe, became epidemic here. Indeed, from 1856 to 1889 only 40 deaths altogether were registered in Islington, since which time, fourteen years, 1,307 deaths have occurred. Of the 40 deaths during the year, 22 were males and 18 females; 4 were referred to Tufnell, 4 to Upper Holloway, 2 to Tollington, 2 to Lower Holloway, 6 to Highbury, 5 to Barnsbury, and 11 to Islington South East sub-registration districts. The ages at death were as follows:— Under 5 3 55-65 8 5-15 1 65-75 6 15-25 2 75-85 3 25-35 3 35-45 5 Total ... 40 45-55 9 73 [1903 Table LV. Showing the Deaths from Influenza in the Quarters of the Year 1903, together with those of the corresponding periods 1893-02. Years. Quarters. Totals. First. Second. Third. Fourth. 1893 31 23 9 60 123 1894 31 3 4 13 51 1895 137 29 4 9 179 1896 13 5 6 9 33 1897 14 11 4 18 47 1898 41 13 4 7 65 1899 52 25 4 45 126 1900 122 17 3 7 149 1901 18 13 4 11 46 1902 45 15 5 18 83 Corrected Average 51 15 5 20 91 1903 30 3 1 6 40 Increase or Decrease -21 -12 -4 -14 -51 F 74 1903] Table LVI. Shewing the Secondary Causes of Death from Influenza in the Four Quarters of the Year 1903. Tufnell. Upper Holloway. Tollington. Lower Holloway. Highbury. Barnsbury. South-East Islington. Totals for Year. Quarters. Quarters. Quarters. Quarters. Quarters. Quarters. Quarters. 1st. 2nd 3rd. 4th. 1st 2nd. 3rd 4th. 1st. 2nd. 3rd. 4th. 1st. 2nd 3rd. 4th. 1st. 2nd. 3rd. 4th 1st. 2nd. 3rd 4th. 1st. 2nd. 3rd. 4th. Bronchitis 2 .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 2 Pneumonia .. .. .. .. 3 .. .. .. 1 .. .. .. 1 .. .. .. 2 .. .. .. 1 .. .. 1 6 2 .. .. 17 Pleurisy .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Phthisis .. .. .. .. .. .. .. .. .. .. .. .. .. 1 .. .. .. .. .. .. .. .. .. .. .. .. .. .. 1 Meningitis .. .. .. .. 1 .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 2 .. .. 1 .. .. .. .. 4 Nephritis .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Pyæmia .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 1 .. .. .. .. .. .. .. .. .. .. .. 1 Diabetes Mellitus .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 1 .. .. .. .. .. .. .. .. .. .. .. 1 Paraplegia .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 1 .. .. .. .. .. .. .. 1 Endocarditis .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Cystitis .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 1 .. 1 Heart Disease, etc. 1 .. .. .. .. .. .. .. .. .. .. 1 .. .. .. .. 2 .. .. 2 1 .. .. .. 1 .. .. .. 8 Sloughing Prostitis .. .. .. .. .. .. .. .. 1 .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 1 Peritonitis .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Tubercular Meningitis 1 .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 1 Dentition .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 1 .. .. .. .. .. .. .. .. 1 All Secondary Causes 4 .. .. .. 4 .. .. .. 2 .. .. 1 1 1 .. .. 6 .. .. 3 5 .. .. 2 7 2 1 .. 39 No Secondary Causes .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 1 .. .. .. 1 Totals .. 4 .. .. .. 4 .. .. .. 2 .. .. 1 1 1 •• .. 6 .. .. 3 5 •• .. 2 8 2 1 .. 40 75 [1903 SEPTIC DISEASES. Erysipelas. —To this disease only 9 deaths were referred, 4 being of males and 5 of females, and representing a death-rate of 0.02 per 1,000 inhabitants. One of the deaths occurred in a public institution situated within the borough. This return is the lowest, with one exception, since 1891. To each of the sub-districts of Toliington, Barnsbury, and Islington South East, 2 deaths were credited; to Tufnell, Lower Holloway and Highbury 1 death; and to Upper Holloway none. (Vide Tables LVII. and LVIII.) Puerperal Fever.—Nine deaths of women were attributed to this disease of child-bed compared with an average of twelve in the preceding twelve years. The mortality was in the proportion of 1.0 to every 1,000 children born within the year. This rate is considerably less than that which usually obtains in England. All the deceased women were between 25 and 35 years of age ; and 3 of the deaths occurred in hospitals. (Vide Tables LIX. and LX.) Table LVII. Deaths from Erysipelas in the Sub-Districts during the Year 1903. Deaths. Death Rates. Tufnell 1 0.03 per 1,000 inhabitants. Upper Holloway ... ... ,, ,, Tollington 2 0.06 „ ,, Lower Holloway 1 0.02 „ ,, Highbury 1 0.01 ,, „ Barnsbury 2 0.03 „ ,, Islington, South-East 2 0.02 ,, ,, The Borough 9 002 76 1903 Table LVIII. Deaths from Erysipelas during the preceding Ten Years. Deaths. Death Rates. 1893 34 0.10 per 1,000 inhabitants. 1894 15 0.04 ,, ,, 1895 16 0.05 ,, ,, 1896 16 0.05 „ „ 1897 11 0.03 „ „ 1898 8 0.02 ,, ,, 1899 16 0.04 ,, ,, 1900 17 0.05 „ „ 1901 15 0.04 „ „ 1902 13 0.04 ,, ,, Corrected Average 16 1.05 ,, ,, 1903 9 0.02 ,, ,, Table LIX. Showing the Deaths from Puerperal Fever in the Sub-Districts for each Quarter and the Year 1903. Sub-Districts. 1st Quarter. 2nd Quarter. 3rd Quarter. 4th Quarter. Whole Year. Tufnell 1 .. .. .. 1 Upper Holloway 1 2 .. .. 3 Tollington .. .. .. .. .. Lower Holloway 1 .. .. 1 2 Highbury .. 1 .. 1 2 Barnsbury .. .. .. .. .. Islington, South East .. 1 .. .. 1 The Borough 3 4 .. 2 9 77 1903 Table LX. Showing the Deaths from Puerperal Fever per 1,000 Births in the Sub-Districts for each Quarter and the Year 1903. Sub-Districts. 1st Quarter. 2nd Quarter. 3rd Quarter. 4th Quarter. Whole Year. Tufnell 518 .. .. .. 1.35 Upper Holloway 3.62 7.19 .. .. 2.71 Tollington .. .. .. .. .. Lower Holloway 3.66 .. .. 3.57 1.78 Highbury .. 2.75 .. 2.66 1.37 Barnsbury .. .. .. .. .. Islington, South East .. 1.80 .. .. 0.49 The Borough 1.32 1.76 .. 0.90 1.00 CONSTITUTIONAL DISEASES. This is a large group of diseases comprising within it such ailments as Rheumatism, Rheumatic Fever, Rickets, Cancer, Tubercular Diseases such as Phthisis, Tabes Mesenterica, Tubercular Meningitis, Scrofula, Purpura, Anaemia and Diabetes. Altogether they caused 1,070 deaths as compared with an average of 1,078 in the preceding ten years, while the death-rate was equal to 3.15 per 1,000 as contrasted with a mean decennial rate of 3'22. These deaths were referred to the quarters as follows :— 1st Quarter 252 = 2.97 per 1,000 2nd „ 284 = 3.35 3rd „ 262 = 3.09 4th ,, 272 = 3.21 Total 1,070 = 3.15 78 1903 Cancer or Malignant Disease. This disease stands almost alone in showing a persistently increasing mortality. In the report for 1902 it was deplored that the return for that year, 326, was the highest hitherto recorded. That return is, however, now only second to the return for 1903, when as many as 350 deaths, equal to the high rate of 1.03 per 1,000, occurred. Everywhere the tendency of the disease has been to steadily increase, and locally its deathrate has risen from 6.8 per 10,000 in 1891 to 10.3 per 10,000 in 1903. Although the figures given below were presented last year, they are again printed for general information, for unfortunately there are few people who are not directly or indirectly interested in this disease, a cure for which they are loudly calling. Years. 1891 1892 1893 1894 1895 1896 1897 Deaths. 218 219 238 239 266 291 304 Deaths per 10,000 Pop. 6.8 6.8 7.3 7.2 7.9 8.5 9.0 Years. 1898 1899 1900 1901 1902 1903 Deaths. 283 270 303 289 326 350 Deaths per 10,000 Pop. 8.4 8.0 9.9 8.6 9.5 10.3 This is a truly alarming return, which becomes not less so when it is known that the death-rate among males is 9.61 per 10,000 and 10.96 per 10,000 among females. The death-rate in England and Wales as given in the last published report of the Registrar-General is 6.91 per 10,000 among males and 9.85 per 10,000 among females. These death-rates, which relate to the year 1901, are the highest on record. The returns of these deaths are so important that the following table showing the relative frequency of the organs attacked has been prepared, and the dread fact may be gathered from it that very few of them escape its attack, although the female generative organs, the breast and the womb, suffer the most frequently. 79 1903 Table LXI. Mortality from Cancer during the Year 1903. ORGANS AFFECTED. Sex. Age at Death. Males. Females. Totals. 0—5 —16 —26 —36 —45 —65 —66 —75 — 85 upwards. Diseases of Nervous System— Brain M. .. .. .. .. .. 1 .. .. .. 1 .. 3 F. .. .. .. 1 .. .. 1 .. .. .. 2 Organs of Special Sense — Eye (Orbit) M .. .. .. 1 .. .. .. .. .. 1 .. 1 F. .. .. .. .. .. .. .. .. .. .. .. .. Nose M. .. .. .. .. .. 1 .. .. .. 1 .. 1 F. .. .. .. .. .. .. .. .. .. .. .. .. Diseases of Heart, etc.— Endocarditis M. .. .. .. .. .. .. .. .. .. .. .. .. F. .. .. 1 .. .. .. .. .. .. .. 1 1 Respiratory System— Larynx M. .. .. .. .. 1 1 3 1 .. 6 .. 6 F. .. .. .. .. .. .. .. .. .. .. .. .. Lung M .. 1 .. .. .. .. .. 2 .. 3 .. 9 F. .. .. .. .. .. .. 3 3 .. .. 6 Throat M. .. .. .. .. 1 1 1 .. .. 3 .. 3 F. .. .. .. .. .. .. .. .. .. .. .. .. Digestive System — Rectum M. .. .. .. .. 2 2 7 5 .. 16 .. 29 F. .. .. 1 .. .. 4 2 5 1 .. 13 Pylorus M .. .. .. .. 1 2 .. .. .. 3 .. 7 F. .. .. .. .. 1 1 2 .. .. .. 4 Pancreas M. .. .. .. .. .. .. 1 .. .. 1 .. 2 F. .. .. .. .. .. 1 .. .. .. .. 1 Liver M 2 .. .. .. 3 5 3 6 3 22 .. 45 F. .. .. .. .. 1 6 7 4 5 .. 23 Ventriculi M. .. .. .. .. 1 .. 1 .. .. 2 .. 2 F. .. .. .. .. .. .. .. .. .. .. .. .. Œsophagus M. .. .. .. .. 3 6 4 4 2 19 .. 19 F. .. .. .. .. .. .. .. .. .. .. .. .. Stomach M. .. .. .. .. 4 6 9 4 1 23 .. 55 F. .. .. .. 1 4 a 6 9 4 .. 32 Spleen M. .. .. .. .. .. .. .. .. .. .. .. .. F. .. .. .. .. .. .. 1 1 .. .. 2 2 Tongue M. .. .. .. .. .. 2 5 4 1 12 .. 12 F .. .. .. .. .. .. .. .. .. .. .. .. Mouth M. .. .. .. .. .. .. .. 2 .. 2 .. 2 F. .. .. .. .. .. .. .. .. .. .. .. .. Caecum M. .. .. .. .. .. .. .. 1 .. 1 .. 2 F. .. .. .. .. .. .. 1 .. .. .. 1 Gall Bladder M. .. .. .. .. .. .. .. .. .. .. .. .. F. .. .. .. .. .. .. 1 .. .. .. 1 1 Abdomen M. .. .. .. .. .. .. 1 .. .. 1 .. 1 F. .. .. .. .. .. .. .. .. .. .. .. .. Anus M. .. .. 1 .. .. .. .. .. .. 1 .. 1 F. .. .. .. .. .. .. .. .. .. .. .. .. Peritoneum M .. .. .. .. .. 1 .. .. 1 2 .. 4 F. .. .. .. .. .. .. 1 1 .. .. 2 Colon M. .. .. .. .. .. 1 .. 2 .. 3 .. 8 F. .. .. .. .. .. .. 2 2 1 .. 5 Pelvis M. .. .. .. .. .. .. .. .. .. .. .. .. F. 1 .. .. .. 1 .. .. 2 .. .. 4 4 Jaw M. .. .. .. .. .. 1 2 .. .. 3 .. 3 F. .. .. .. .. .. .. .. .. .. .. .. .. Intestines (parts not specified) M. .. .. .. .. .. .. 1 .. 1 2 .. 14 F. .. .. .. .. .. 4 5 2 1 .. 12 Tonsils M .. .. .. .. .. 1 .. .. .. 1 .. 1 F. .. .. .. .. .. .. .. .. .. .. .. .. 80 1903 Table LXI.—continued. ORGANS AFFECTED. Sex. Age at Death. Males. Females. Totals. 0—6 —15 —26 —36 —45 —66 —65 —76 —85 upwards. Lymphatic System— Parotid Glands M. .. .. .. .. .. .. .. .. 1 1 .. 1 F. .. .. .. .. .. .. .. .. .. .. .. .. Thyroid M. .. .. .. .. .. .. .. .. .. .. .. .. F. .. .. 1 .. .. .. .. .. .. .. 1 1 Mediastinum M. .. .. .. .. .. 1 .. .. .. 1 .. 2 F. .. .. .. .. .. 1 .. .. .. .. 1 Groin M. .. .. .. .. .. 1 .. .. .. 1 .. 1 F. .. .. .. .. .. .. .. .. .. .. .. .. Urinary System— Kidney M. .. .. .. .. .. 1 .. .. .. 1 .. 3 F. .. 1 .. .. .. .. .. .. 1 .. 2 Bladder M. .. .. .. .. .. .. 1 1 2 4 .. 6 F. .. .. .. .. .. .. .. 1 1 .. 2 Prostate M. .. .. .. .. .. .. 1 1 1 3 .. 3 F. .. .. .. .. .. .. .. .. .. .. .. .. Generative System — Breast M. .. .. .. .. .. .. .. .. .. .. .. .. F. .. .. .. .. 9 4 7 7 3 .. 30 30 Uterus M. .. .. .. .. .. .. .. .. .. .. .. .. F. .. .. .. 2 7 9 11 9 2 .. 40 40 Vagina M. .. .. .. .. .. .. .. .. .. .. .. .. F. .. .. .. .. 1 .. .. .. .. .. 1 1 Ovary M. .. .. .. .. .. .. .. .. .. .. .. .. F. .. .. .. .. .. 1 .. .. 1 .. 2 2 Testicle M. .. .. .. .. 1 .. .. .. .. 1 .. 1 F. .. .. .. .. .. .. .. .. .. .. .. .. Organs of Locomotion— Neck M. .. .. .. .. .. 1 2 1 .. 4 .. 4 F. .. .. .. .. .. .. .. .. .. .. .. .. Thigh M. .. .. .. .. .. .. 1 .. .. 1 .. 2 F. .. 1 .. .. .. .. .. .. .. .. 1 Leg M. .. .. .. .. .. .. 1 .. .. 1 .. 2 F. .. .. 1 .. .. .. .. .. .. .. 1 Spine M. .. .. .. .. .. 1 .. .. .. 1 .. 1 F. .. .. .. .. .. .. .. .. .. .. .. .. Bones and Joints— Cheek M. .. .. .. .. 1 .. .. 1 .. 2 .. 2 F .. .. .. .. .. .. .. .. .. .. .. .. Periosteal (Parietal bone) M. 1 .. .. .. .. .. .. .. .. 1 .. 1 F. .. .. .. .. .. .. .. .. .. .. .. .. Bones M. .. .. .. .. .. .. .. .. 1 1 .. 1 F. .. .. .. .. .. .. .. .. .. .. .. .. Skull M. .. .. 1 .. .. .. .. .. .. 1 .. 1 F. .. .. .. .. .. .. .. .. .. .. .. .. Unspecified M. .. .. 1 .. .. .. .. 1 .. 2 .. 7 F. .. .. .. .. 1 1 1 1 1 .. 5 Total Males and Females for Year M. 3 1 3 1 18 35 44 36 14 155 .. F. 1 2 4 4 25 40 51 47 21 .. 195 Total Deaths 4 3 7 5 43 75 95 83 35 155 195 350 * Certified as " Pressure on Cardiac Nerve." 81 1903 The disease seems to become more fatal as life advances, for while between 1-5 it has been returned as 1.1 per 10,000, it becomes 97 per 10,000 in the period between 35-45, increasing to 23.8 in the next decade, further advancing to 46.4 per 10,000 in the years 55-65, whence it jumps to 79.8 per 10,000 in the 65-75 period, until finally it reaches the very high rate of 83.2 per 10,000 among persons who are 75 years old and upwards. Males. Females. Persons. Ages. Deaths. Deaths per 10,000 living at the age. Deaths. Deaths per 10,000 living at the age. Deaths. Deaths per 10,000 living at the age. O-25 25-35 35-45 45-55 55-65 65-75 75 & up All Ages 7 1 18 35 44 36 14 155 0.86 0.34 8.57 23.81 47.68 86.03 98.60 9.61 7 4 25 40 5i 47 21 195 0.82 1.23 1.08 23.75 45.40 75.71 75.40 10.96 14 5 43 75 95 83 35 350 0.84 0.81 9.73 23.80 46.42 79.87 83.24 10.32 82 1903 The distribution of the disease throughout the year, and in the subregistration districts, was as stated in the following Table. Table LXII. Showing the Deaths from Cancer or Malignant Disease in the several Sub-Districts during the Quarters and the Year 1903. Quarters. Tufnell. Upper Holloway. Tollington. Lower Holloway. Highbury. Barnsbury. Islington. South-East. The Borough. 1st 6 9 10 7 19 16 23 90 2nd 6 7 10 7 17 17 18 82 3rd 12 10 5 12 20 15 23 97 4th 9 9 6 4 15 18 20 81 The Year 33 35 31 30 71 66 84 350 TUBERCULAR DISEASES. Tuberculosis of the Lungs or Phthisis, Tuberculosis of the Brain, Tuberculosis of the Larynx, Tuberculosis of the Abdomen or Tabes Mesenterial, and General T uberculosis. These diseases are generally known as the Tubercular Diseases, and taken in the aggregate, they caused 632 deaths, as compared with 672 in the preceding year, and were equal to a death-rate of 1.85 per 1,000 of the population; they also represented over 13 per cent. of the mortality from all causes, they form, therefore, a considerable factor in the annual death returns. They have, of late years, become of more consequence, because they are known to proceed from a well-defined cause, namely, the Bacillus Tuberculosis, or as it is frequently called, after its discoverer, the Bacillus of Koch. Phthisis or Tuberulosis of the Lungs.—This disease, commonly known as Consumption, caused 493 deaths, or slightly over 10 per cent. of the mortality from all causes, and showed a decrease of 64 deaths when compared with the corrected average of the preceding ten years. It is satisfactory to find that during the last four years there has been a steady, although not a considerable, decline in the recorded deaths. For instance, in 1900 they numbered 602, falling to 545 in 1901, and still further declining to 515 in 1902; while in the year under consideration they dropped to 492. Of these deaths 291 occurred among males and 201 among females; while 29 were those of children under 5 years of age, and 463 of persons above that age. 83 1903 The particulars for each period of life were as follows:— Age periods. Deaths. Deaths per 1,000 at each age. Age periods. Deaths. Deaths per 1,000 at each age. 0-5 29 0.79 55-65 50 2.44 5-15 13 0.21 65-75 21 2.02 15-25 66 0.98 75-85 2 0.47 25-35 110 1.78 35-45 106 2.40 Total 492 1.45 45-55 95 3.01 It will be noticed that the deaths among persons in the prime of life, that is to say between 25 and 55 years of age, are numerous, causing no less than 311. Such a large number as this is a distinct reproach, now that it is widely known that Phthisis is a preventable disease. Islington is not doing its duty with respect to its prevention, and the Council did not act with its usual wisdom when they rejected the scheme of voluntary notification recommended by the Public Health Committee, although the Medical Officer of Health is not without considerable hope that before very long they will reconsider the subject and that then the Borough will join the ranks of the many boroughs and sanitary authorities throughout the Kingdom in pursuing an active crusade against its spread. The death-roll for the last ten years is an interesting but melancholy record. It is as follows:— Phthisis. Proportion of Deaths from Phthisis per 100 Deaths from All Causes. Death rates from All Causes per 1,000 inhabitants. Deaths. Death rates per 1,000 inhabitants. 1893 560 1.71 8.76 19.5 1894 539 1.63 10.24 15.9 1895 568 1.70 9.86 17.2 1896 530 1.54 9.01 17.1 1897 520 1.54 9.64 16.0 1898 527 1.56 9.24 16.9 1899 583 1.73 9.'26 18.7 1900 602 1.79 10.52 17.0 1901 545 1.62 10.16 15.9 1902 515 1.50 9.14 16.4 Corrected mean 556 1.64 9.56 17.1 1903 492 1.45 10.16 14.2 84 1603 Table LXIII. Showing the Deaths from Phthisis in the Sub-Districts during the Four Quarters of the Year 1903. Quarters. Tufnell. Upper Holloway. Tollington. Lower Holloway. Highbury. Barnsbury. South-East. Borough. 1st 8 11 13 15 15 15 31 108 2nd 12 12 9 23 24 20 28 128 3rd 16 17 12 16 13 17 26 117 4th 11 18 9 18 18 33 32 139 The Year 47 58 43 72 70 85 117 492 Tabes Mesenterica or Tuberculosis of the Abdomen.—This form of Tuberculosis was responsible for 40 deaths, mainly among children under five years old, of whom 35 died. These deaths were equal to a rate of 0.12 per 1,000 of the population at all ages, while the death-rate among children, who had not passed their fifth year, was 0.96 (nearly ro) per 1,000. Tuberculosis of the Brain or Tubercular Meningitis was credited with 71 deaths, the greater number of which, namely 56, occurred among children under five years old, the death-rate among them being 1.54 per 1,000. Tuberculosis of the Larynx, which is very fatal to those whom it attacks, was fortunately only responsible for 7 deaths. General Tuberculosis was given as the cause of 19 deaths, 11 of which occurred among children under five years, and 8 among persons above that age. Other forms of Tuberculosis, which include Lupus and Caries, were responsible for 3 deaths. 85 [1903 Table LXIV. Showing the Deaths from the Tubercular Diseases during 1903. Diseases. Ages. Sex. Districts. Total Deaths. Death Rates. 0—1 1—5 Over 5 M. F. Tuf. U.H. Toll. L.H. H. B. S.E. 0—5 5—15 All Ages. Phthisis 16 13 463 291 201 47 58 43 72 70 85 117 492 0.79 0.21 1.45 Tabes Mesenterica 20 15 5 19 21 2 6 8 2 4 6 12 40 0.96 0.01 0.12 Tubercular Meningitis 20 36 15 41 30 6 3 3 17 13 14 15 71 1.54 0.16 0.21 Tuberculosis of the Larynx — — 7 6 1 1 — 1 — 2 1 2 7 — 0.01 0.02 General Tuberculosis 4 7 8 12 7 2 5 3 3 2 2 2 19 0.30 0.06 0.06 Other Forms of Tuberculosis — 1 2 2 1 — — — 2 — — 1 3 0.03 0.03 0.00 All Tubercular Diseases 60 72 500 371 261 58 72 58 96 91 108 149 632 3.62 0.49 1.86 86 1903 Table LXV. Showing the Deaths from the several Constitutional Diseases during the Years 1893 1902, also the Corrected Mean Number of Deaths for these Years, together with the Deaths in 1903. 1893. 1894. 1895. 1896. 1897. 1898. 1899. 1900. 1901. 1902. Average 189302. 1903. creas or De creas Rheumatic Fever 18 14 9 17 20 22 26 16 9 17 17 16 - 1 Rheumatism 18 8 12 12 4 12 8 10 12 15 11 21 +10 Gout 7 7 9 15 9 7 4 7 7 11 8 6 - 2 Rickets 9 10 17 12 17 19 25 13 19 17 16 9 - 7 Cancer 238 239 266 291 304 283 270 303 289 326 281 350 + 69 Tabes Mesenterica 113 69 80 81 71 65 50 36 38 43 65 40 -25 Tubercular Meningitis 75 62 108 103 82 87 89 69 80 77 83 71 -12 Phthisis 560 539 568 530 520 527 583 602 545 515 549 492 -57 Other Tubercular and Scrofulous Diseases 10 3 7 16 16 7 7 3 14 37 12 29 + 17 Purpura 4 2 2 .. 2 1 4 2 2 2 2 1 - 1 Anxmia, Chlorosis, Leucocythæmia 8 13 10 9 12 11 11 12 9 7 10 8 - 2 Diabetes 20 23 16 19 13 18 20 28 33 28 22 26 + 4 Other Diseases 4 .. 1 3 3 .. 3 3 5 2 2 1 - 1 Totals 1,084 989 1,105 1,108 1,073 1,059 1,100 1,104 1,062 1,097 1,078 1,070 - 8 87 1903 DEATHS IN PUBLIC INSTITUTIONS. The record of the mortality of the Borough would not be complete without a statement as to the places where the deaths occurred. The tables in the following pages have, therefore, been prepared, and they show that out of the 4,839 deaths, registered during the year 1903, no less than 1,539, or 31.'8 per cent., died in Public or Charitable Institutions. This is a most serious fact, for few people, it is ventured to be asserted, could have had any idea that so many persons sought medical relief in their last illnesses. The figures for London are not available for 1903, but in the Registrar-General's Report for 1901, they show that as many as 39.1 per cent. of the total deaths occurred in Metropolitan Public or Charitable Institutions, while the same report a'so indicates that the proportion in England and Wales, in the same year, was only 15.1 per cent. Within the Borough.—1,467 persons died in the Public and Charitable Institutions of Islington during the year, of whom only 912 could be described as belonging to this borough, the remaining 555 having come here for treatment or relief, and are therefore, not included in the deaths proper to Islington, but have been referred by the Registrar-General to Holborn and other places. Among the latter were 407 persons who died in the Holborn Infirmary, and 83 who died in the Great Northern Central Hospital. Of the 912 deaths of inhabitants, 654 occurred in the Islington Workhouse Infirmary, 101 in the Islington Workhouses, and 122 in the Great Northern Central Hospital. The proportion which the 912 deaths bore to the borough mortality was i8'9 per cent. Without the Borough.—627 deaths of persons belonging to Islington were registered as occurring in Public Institutions of London situated outside the borough. They included, amongst others, 54 in the North-Eastern Fever Hospital, 26 in University Hospital, 38 in the Childrens' Hospital, Great Ormond Street, 74 in St Bartholomew's Hospital, 31 in the Middlesex Hospital, 49 in the Royal Free Hospital, and 26 in the Colney Hatch Asylum. 88 1903 The 627 deaths represented 12.9 per cent. of all the deaths registered in the year. Within and Without the Borough.—These deaths of Islingtonians numbered 1,539, and were equal to 31.8 per cent. of the total deaths registered during the year. Fatal Accidents or Sudden Deaths outside the Borough.— Thirty-two inhabitants died from accidental deaths, or suddenly, in places outside Islington. It may be of interest to contrast the foregoing figures with those of preceding years:— Years. Total Deaths in Local Institutions cols. 3 and 4). Inhabitants of Islington in Local Institutions, NonInhabitants of Islington in Local Institutions. Inhabitants in Islington Infirmary. Inhabitants of Islington in G.N.C. Hospital. Inhabitants of Islington in Institutions outside the Borough. Total Deaths of Inhabitant in all Institutions (cols. 3 and 7). Proportion per 100 deaths from all causes (col. 8). 1 2 3 4 5 6 7 8 9 1895 - 1,180 686 494 539 82 524 1,210 21.0 1896 - 1,299 779 520 584 109 658 1.437 24.4 1897 - 1,260 729 531 569 93 566 1.295 24.0 1898 - 1,365 820 545 656 95 517 1.337 23.4 1899 - 1,672 993 679 772 136 593 1,586 25.2 1900 - 1.564 990 574 779 124 553 1.543 26.9 1901 - 1.394 903 491 603 124 630 1.533 28.6 1902 - 1,531 909 622 587 130 737 1,646 29.2 Average - 1,408 851 557 636 111 597 1,448 25.3 1903 - 1,467 912 555 654 122 627 1,539 31.8 89 1903 Table LXVI. Showing the Deaths of Inhabitants in Public and Charitable Institutions situated within the Borough distributed to their respective Sub-registration Districts. Also the Deaths of Non-Inhabitants in the same Institutions during the Year 1903. PUBLIC INSTITUTION. Tufnell. Upper Holloway. Tollington. Lower Holloway. Highbury. Barnsbury. Islington, South East. Total Inhabitants. NonInhabitants. Islington Infirmary 78 77 68 101 80 115 135 654 14 Islington Workhouses 5 25 10 11 11 21 18 101 5 Workhouse Schools — — — — — — — — — Gt. Northern Hospital 17 36 22 14 20 7 6 122 83 Holborn Infirmary — 3 — 1 — — — 4 407 Aged Pilgrims' Asylum — 2 — — — — 1 3 5 St. Pelagias' Creche 3 — — — — 1 — 4 6 Aged Blind Home — — — — 1 — — 1 4 Medical and Surgical Home — — — — — — — — — Children's Nursing Home — — — — — — — — — St. John's Nursing Institute — — — — — — — — — Kingsdown Orphanage — — — — — — — — — Alexandra Orphanage — — — — — — — — — Whittington College — — — — — — — — 1 Tufnell Park Nursing Institution 1 — — — — — 1 — H.M. Prison, Holloway 4 — — — — — 1 5 4 H.M. Prison, Pentonville — — — 3 — — — 3 4 Drovers' Almshouses — — — 1 — — — 1 London Fever Hospital — 1 — — — — — 1 6 Memorial Cottage Hospital — — — — 5 — — 5 5 Invalid Home, Aubert Park — — — — — — — — Invalid Home, Highbury Terrace — — — — — — — — 1 Bookbinders' Asylum — — — — — — — — 2 Metropolitan Benefit Societies' Asylum — — — 4 — — 4 3 Bricklayers' and Tilers' Almshouses — — — — — — — Dyers' Almshouses — — — — — — — — 1 Pennefather Memorial Home — — — — — — — — — Clothworkers' Almshouses — — — — — — 3 3 Totals 108 144 100 131 121 144 164 912 *551 * There were also 9 deaths at places not mentioned in list. 90 1903] Table LXVII. Showing the Deaths of Inhabitants of Islington in Public Institutions situated outside the Borough distributed to their respective Sub-Registration Districts during the Year 1903. Sub-Registration Districts. First Quarter. Second Quarter. Third Quarter. Fourth Quarter. Whole Year. Males. Females. Total. Males. Females. Total. Males. Females. Total. Males. Females. Total. Males. Females. Total. Tufnell 5 6 11 3 5 8 11 6 17 3 1 4 22 18 40 Upper Holloway 11 17 28 8 7 15 13 6 19 11 6 17 43 36 79 Tollington 3 8 11 2 4 6 1 .. 1 5 6 11 11 18 29 Lower Holloway 14 16 30 8 7 15 6 4 10 11 6 17 39 33 I 72 Highbury 10 12 22 14 12 26 17 11 28 22 6 28 63 41 104 Barnsbury 19 15 34 36 11 47 19 11 30 21 12 33 95 49 144 South-East Islington 20 16 36 23 11 34 25 15 40 28 21 49 96 63 159 Borough 82 90 172 94 57 151 92 53 145 101 58 159 369 258 627 91 1903 Table LXVIII. Showing the Deaths of Inhabitants in Public and Charitable Institutions situated without the Borough, during the Year 1903. Institutions. 1st Quarter. 2nd Quarter. 3rd Quarter. 4th Quarter. Year. Middlesex Hospital 6 9 7 9 31 Friedenheim (Home of Peace), N.W. .. 1 1 2 4 North Western Fever Hospital 2 .. 2 1 5 University College Hospital 6 5 9 6 26 Eastern Fever Hospital 4 .. 1 2 7 Children's Hospital, Gt. Ormond Street 10 12 8 8 38 Banstead Asylum 3 2 3 4 12 Manor Asylum (Epsom) .. .. 1 .. 1 Darenth Asylum 1 1 .. .. 2 Hanwell Asylum 7 .. 1 4 12 Convent Hospital .. .. .. .. .. St. Mary's Hospital 1 1 .. .. 2 Hospital of St. John and St. Elizabeth .. .. .. 2 2 Hospital for Women (Euston Road) 1 3 1 2 7 Metropolitan Hospital 3 6 7 1 17 German Hospital 2 1 3 6 12 St. Bartholomew's Hospital 13 26 17 18 74 Royal Chest Hospital 2 1 3 4 10 King's College Hospital 1 3 5 .. 9 Guy's Hospital 3 2 1 2 8 Colney Hatch Asylum 14 6 4 2 26 North Eastern Fever Hospital 25 9 9 11 54 Leavesden Asylum 2 1 .. 1 4 St. Thomas's Hospital 1 1 1 1 4 Cane Hill Asylum 4 2 1 3 10 Paddington Infirmary .. .. .. .. .. Royal Free Hospital 10 15 13 11 49 London Temperance Hospital 2 1 5 .. 8 Cancer Hospital (Chelsea) 3 .. 1 2 6 London County Asylum (Dartford) 3 1 .. 4 8 London Hospital 4 .. 2 2 8 St. Anne's House, Stoke Newington .. .. .. .. .. Maternity Home, Hackney .. .. .. .. .. Mildmay Hospital .. .. 1 3 6 Grove Hall Asylum .. .. .. .. .. Westminster Hospital .. .. .. .. .. Homœpathic Hospital, Gt. Ormond Street .. 3 .. 1 6 Clayburn Asylum .. 4 3 5 18 Homerton Hospital .. .. 1 .. 1 Children's Hospital (Paddington Green) .. .. 1 .. 1 St. George's Hospital .. 1 1 1 3 North Eastern Hospital (Haggerston) .. .. .. .. .. Hackney Infirmary .. 1 1 2 5 Middlesex Asylum .. .. .. .. .. Queen Charlotte Hospital .. 1 .. .. 1 Ilford Asylum .. . . .. .. .. French Hospital .. .. .. .. 2 Pancras Workhouse .. 5 1 1 7 Invalid Asylum (Stoke Newington) .. .. .. .. .. St. Peter's Home .. 2 1 2 5 Brompton Hospital .. 1 1 1 4 West London Hospital .. .. 1 .. 1 City of London Lying-in Hospital .. 1 .. 1 7 Peckham House Asylum .. 2 .. .. 2 Poplar Hospital .. .. .. .. .. South Western Fever Hospital .. .. .. .. .. G 2 92 1903 Table LXVIII.—continued. Institutions. 1st Quarter. 2nd Quarter. 3rd Quarter. 4th Quarter. Year. Camberwell House Asylum 1 .. .. .. 1 Wine and Beer Sellers Asylum, Nunhead .. .. .. .. .. Hospital Ship "Castalia" .. .. .. .. .. Hospital Ship "Atlas" .. .. .. .. .. Bethnal Green Infirmary .. .. .. .. .. City of London Asylum (Stone) .. .. 1 .. 1 Hoxton House Asylum .. .. 1 .. 1 Charing Cross Hospital .. .. .. 2 2 Royal Hospital for Women and Children .. .. .. .. .. Home Hospital, 16, Fitzroy Square .. .. .. .. .. Hampstead Home Hospital .. .. .. .. .. School for Indigent Blind (Southwark) .. .. .. .. .. Hostel of God .. 1 .. .. 1 North West London Hospital .. .. 1 2 3 Bethlem House .. .. .. .. .. Poplar and Stepney Sick Asylum .. .. .. .. .. Northern Fever Hospital .. .. .. .. .. National Hospital .. 1 .. 1 2 Bethnal House Asylum 2 .. 1 l 4 St. Luke's House .. .. .. 1 1 City Infirmary, Bow .. .. .. .. .. City of London Chest Hospital .. .. 1 2 2 South-Eastern Fever Hospital .. .. .. .. .. Butchers' Almshouses .. .. .. 1 1 Central London Throat and Ear Hospital .. 1 .. .. l Gresham Almshouses, Brixton .. .. .. .. .. Italian Hospital .. .. .. .. .. St. Mark's Hospital .. .. .. .. .. Holborn Workhouse, Hoxton .. 4 1 2 7 Lewisham Infirmary .. .. .. .. .. St. Olave's Infirmary .. .. .. .. .. St. Giles Infirmary .. .. .. .. .. Surgical Home, 24, Devonshire Street, Marylebone .. .. .. .. .. Shoreditch Infirmary .. 1 .. .. 1 Samaritan Free Hospital .. .. .. .. .. Horton Asylum (Epsom) 3 4 2 4 13 Throat Hospital, Golden Square .. .. .. .. .. Chest Hospital, Chelsea .. .. .. .. .. Heart Hospital, Soho Square .. .. .. .. .. Hospital for Women, Soho 1 .. .. 1 2 Gore Farm Hospital .. .. .. .. .. Royal Hospital for Incurables .. .. .. .. .. South Wharf Shelter .. .. .. .. .. Samaritan Free Hospital .. .. .. .. .. Chelsea Hospital for Women .. .. .. .. .. British Lying-in Hospital, Endell Street .. .. .. .. .. Royal London Ophthalmic Hospital .. .. .. .. .. Licensed Victuallers' Asylum 1 .. 1 .. 2 Childrens's Hospital, Shadwell 1 .. .. l 2 North Eastern Children's Hospital 2 .. 2 l 5 Metropolitan Ear and Throat Hospital 1 .. .. .. 1 Throat Hospital, Golden Square 1 .. .. .. 1 Hospital for Incurable Children, Maida Vale 1 .. .. .. 1 Tooting Bec Asylum .. 1 1 .. 2 City of London Asylum, Stone .. 1 .. .. 1 London County Asylum, Norwood .. 2 .. .. 2 H. M. Hospital, 19, Stepney Causeway .. 1 1 .. 2 St. Pancras Infirmary .. .. 2 .. 2 Surgical Home, 45, Devonshire Street, W. .. .. 1 .. 1 St. Elizabeth's Home, Mortimer Street, W. .. .. 1 .. 1 Mount Vernon Consumption Hospital .. .. .. 1 1 St. George-in-the-East Infirmary .. .. .. l 1 Caterham Asylum .. .. .. l 1 166 147 135 147 595 93 1903 Table LXVIII.—continued. Places where deaths occurred. 1st Quarter. 2nd Quarter. 3rd Quarter. 4th Quarter. Year. Accidental and other Deaths:— At 115, Shaftesbury Avenue, W.C. 1 .. .. .. 1 At 10, Southwold Road, Clapton 1 .. .. .. 1 At 33, Beaumont Street, W. 1 .. .. .. 1 Regent's Canal, Great Northern Goods Yard Basin 1 .. 1 .. 2 At 5, Beaumont Street, W. 1 .. .. .. 1 At 30, Wood Street, City 1 .. .. .. 1 At 10, Greville Place, W. .. 1 .. .. 1 At Upper Tulse Hill, S.E. .. l .. .. 1 At 72, Sheep Lane, Hackney .. l .. .. 1 On Railway, near Shoreditch .. l .. .. 1 In Seal Street, Shacklewell .. .. 1 .. 1 No. 3 Pond, Parliament Hill .. .. l .. 1 No. 1 Pond, Hampstead Heath .. .. l .. 1 In Goods Yard, King's Cross, Great Northern Railway .. .. l .. 1 At 14, Pembridge Square, Kensington .. .. l .. 1 In River Thames (St. Saviour's) .. .. l .. 1 In City Road (St. Luke) .. .. l .. 1 In Hampstead Road, N.W. .. .. l .. 1 In Van on Great Central Railway, Marylebone .. .. l .. 1 In Foreign Flower Market, Covent Garden .. .. .. 1 1 At 15, Graham Street, Belgravia .. .. .. l 1 At Middle Heath, Hampstead .. .. .. l 1 In Pond, Vale of Health, Hampstead .. .. .. l 1 At 11, Percival Street, Clerkenwell .. .. .. l 1 In Goodge Street, W. .. .. .. 1 1 At 161, Camden Road, N.W. .. .. .. l 1 On Metropolitan Railway, King's Cross .. .. .. l 1 At 115, Queen Victoria Street, E.C. .. .. .. l 1 In Basement of 19, Princes Gardens .. .. .. l 1 At 37, Ball's Pond Road .. .. .. l 1 In Cab, near Royal Free Hospital .. .. .. l 1 Totals 172 151 145 159 627 94 1903] Table LXIX. Showing the Deaths of Inhabitants and Non-Inhabitants in Public and Charitable Institutions situated within the Borough during the Four Quarters and in the Year, 1903. PUBLIC INSTITUTIONS. Inhabitants. Non-Inhabitants. Totals. 1st qr. 2nd qr. 3rd qr. 4th qr. Year. 1st qr. 2nd qr. 3rd qr. 4th qr. Year. 1st qr. 2nd qr 3rd qr. 4th qr. Year. Islington Infirmary 168 177 151 158 654 3 1 7 3 14 171 178 158 161 668 Islington Workhouses and Schools 24 26 25 26 101 .. 3 1 1 5 24 29 26 27 106 Great Northern Central Hospital 21 37 34 30 122 14 21 26 22 83 35 58 60 52 205 Holborn Inrfimary 1 .. 3 .. 4 136 81 92 98 407 137 81 95 98 411 St. John's Nursing Institute .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Tufnell Park Nursing Institution .. 1 .. .. 1 .. .. .. .. .. .. 1 .. .. 1 London Fever Hospital .. 1 .. .. 1 .. 3 2 1 6 .. 4 2 1 7 Aged Pilgrims' Asylum .. .. 1 2 3 3 1 1 .. 5 3 1 2 2 8 St. Pelagia's Creche 1 .. .. 3 4 4 2 .. .. 6 5 2 .. 3 10 Memorial Cottage Hospital 2 3 .. .. 5 1 1 .. 3 5 3 4 .. 3 10 Nursing Home, H ungerford Road .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Aged Blind Home .. .. 1 .. 1 .. .. 3 1 4 .. .. 4 1 5 Medical and Surgical Home .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Invalid Home, Aubert Park .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. H M. Prison, Holloway 1 1 2 1 5 1 .. 2 1 4 2 1 1 2 9 H.M Prison, Pentonville .. 1 .. 2 3 l 2 1 .. 4 1 3 1 2 7 Children's Nursing Home .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Kingsdown Orphanage .. .. .. .. .. .. .. .. .. .. .. .. .. .. Nursing Home, Turle Road .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Whittington College .. .. .. .. .. .. .. .. 1 1 .. .. .. 1 1 Metropltn. Benefit Societies' Asylum 2 2 .. .. 4 .. .. .. 3 3 2 2 .. 3 7 Winifred House .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Alexandra Orphanage .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Drover's Almshouses 1 .. .. .. 1 .. .. .. .. .. 1 .. .. .. 1 Bookbinder's Asylum .. .. .. .. .. .. .. .. 2 2 .. .. .. 2 2 Invalid Home, Highbury Terrace .. .. .. .. .. .. .. .. 1 1 .. .. .. 1 1 Royal Caledonian Asylum .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Dyers' Almshouses .. .. .. .. .. .. .. .. 1 .. 1 .. .. 1 Highbury Truant School .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Bricklayer's and Tiler's Almshouses .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Clothworkers' Almshouses 1 1 .. 1 3 .. .. .. .. .. 1 1 .. 1 3 St. Andrew's Nursing Home .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Totals 222 250 217 223 912 163 116 135 137 551 385 366 352 360 1463 95 1903 INQUESTS AND MORTUARY. During the year 681 bodies were received into the Mortuary, one being taken there because the deceased had suffered from infectious disease. The is the lowest since 1889 when 613 bodies were removed thither. The coroner found it necessary to hold 393 inquests as compared with 458 in 1902, and with an average of 438 in the ten years immediately preceding. Bodies received into Mortuary. Inquests. 1893 820 445 1894 685 382 1895 742 412 1896 757 463 1897 708 443 1898 712 402 1899 807 467 1900 754 475 1901 693 431 1902 745 458 Average 742 438 1903 681 393 The following table gives a return of the bodies received into the Mortuary and the inquests held by the Coroner during the years 1902 and 1903. 1902. No. of bodies received. Daily Average. No. of Inquests held. 1903. No. of bodies received. Daily Average. No. of Inquests held.[/##] 1st Quarter 225 2.5 141 1st Quarter 166 1.8 110 2nd „ 182 2.0 104 2nd „ 179 1.9 104 3rd „ 155 1.7 94 3rd „ 174 1.9 80 4th „ 183 2.0 119 4th „ 162 1.7 99 Total for Year 745 20 458 Total for Year 681 1.8 393 PART III. THE NOTIFICATION, ISOLATION, FATALITY, AND PREVENTION OF DISEASE. 98 1903 THE NOTIFICATION OF INFECTIOUS DISEASES. Small Pox, Scarlet Fever, Diphtheria, Membranous Croup, Enteric (or Typhoid) Fever, Erysipelas, Puerperal Fever, Continued Fever, Relapsing Fever, Cholera. The return for 1903 was a record one, because since the notification of these infectious diseases became compulsory, there have not been so few in any one year; and not only that but the cases of each disease were below the corrected average for the preceding ten years, while the number of notifications of several of them, namely Scarlet Fever, Diphtheria and Membranous Croup, Enteric Fever and Erysipelas, was the smallest that had hitherto been known in a year. Years. 1891 1892 1893 1894 1895 1896 1897 1898 1899 1900 1901 1902 1903 Cases. 2,059 = 3,318 = 4,853 = 3,121 = 2,841 = 3,822 = 2,906 = 2,418 = 2,943 = 2,276 = 2,852 = 3,164 = 1,707 Attack-rates. 6.43 per 1,000 inhabitants. 10.26 „ „ 14.84 ,, ,, 9.44 ,, ,, 8.50 „ „ 11.32 ,, ,, 8.62 „ ,, 7.18 ,, ,, 8.75 ,, ,, 6.78 „ „ 8.50 „ „ 9.20 ,, ,, 5.03 ,, ,, When comparison is made with the preceding ten years it is found that the 1,707 cases, the number notified during the year, were 1,453 below the average after correction had been made for the increase in the population, and that the attack-rate of 5.03 per 1,000 was 4.28 below the mean decennial rate. London.—The general health of London was very good, as the attack-rate was only 6.oo per 1,000 inhabitants, but notwithstanding this fact only five of the metropolitan boroughs were so free from infectious diseases as Islington, namely Kensington, Westminster, HamDstead. Stoke Newington, and Greenwich. 99 1903 The Encircling Boroughs (St. Pancras, Stoke Newington, Hackney Hornsey, Finsbury and Shoreditch) exhibited a mean attack-rate of 6.30 per 1,000, or 1.27 in excess of the local rate. Hornsey and Stoke Newington alone of these communities showed a lower rate than that of Islington, while the attack-rates in St. Pancras (6.48), Hackney (8.00), Finsbury (5.89), and Shoreditch (5.68), were not so good as it. The Sub-registration Districts.—The incidence of these diseases varied from 4.15 per 1,000 of the population in Islington South East to 7.03 per 1,000 in Lower Holloway. The return for each sub-district was as follows:— Tufnell Upper Holloway Tollington Lower Holloway Highbury Barnsbury Islington South East - Cases. 158 = 169 = 197 = 292 = 330 = 246 = 315 = Attack-rates. 4.81 per 1,000 inhabitants. 4.85 ,, ,, 5.66 ,, ,, 7.03 ,, ,, 5.07 ,, ,, 4.53 ,, ,, 4.15 ,, ,, Wards—Of the above-mentioned sub-registration districts the four firstmentioned are also separate wards, the remaining three are, however, split up into seven wards, the particulars for each of which appear in the following statement:— Highbury Mildmay Thornhill Barnsbury St. Mary's Canonbury St. Peter's Cases. 200 = 111 = 169 = 77 = 65 = 118 = 151 = Attack-rates. 5.74 per 1,000 inhabitants. 4.46 ,, ,, 5.06 ,, ,, 3.68 „ „ 3.76 ,, ,, 3.78 ,, ,, 4.61 ,, ,, In the Quarters. -In the first quarter 437 cases were notified and the attack-rate was 5.15, in the second 402, equal to an attack-rate of 474, in the third 472 or an attack rate of 5.56, and in the fourth 396 representing an attackrate of 4.67. 100 1903 Fatality.—By this is meant the percentage of deaths to cases. In proportion to the cases the deaths were fewer than hitherto known, for out of a total of 1,707 cases there were only 108 deaths, or a fatality of 6.3 per cent. The lowest fatality previously recorded was 7.1 per cent. in 1898, while the average fatality for thirteen years was 8'9 per cent. Years. 1891 1892 1893 1894 1895 1896 1897 1898 1899 1900 1901 1902 1903 Cases. 2,059 3.318 4.853 3.121 2,841 3,822 2,906 2,418 2.943 2,276 2,852 3,167 1,707 Deaths. 258 291 383 339 266 390 258 173 238 202 250 268 108 Fatality. 12.5 8.7 7.9 10.8 9.3 10.2 8.8 7.1 8.1 8.8 8.7 8.4 6.3 Total 38,283 3,424 8.9 Hospital Isolation.—Out of 1,709 cases (2 of which were not notified) 1,241, or 72.6 per cent., were removed to hospital, of whom 69, or 5.5 per cent., died, as against 6.3 per cent. of the cases retained for treatment at home. SMALL POX. There were only 9 cases reported during the year, 1 of which was notified in June, 3 in July, 1 in August, 1 in September, and 3 in November, compared with 276 in the previous year, and with a corrected average of 63 in the ten years 1893-1902. Three of the attacks occurred in Tufnell Sub-district, 1 in Upper Holloway, 2 in Lower Holloway, and 3 in Islington South-East. In London 416 cases were known, and these equalled an attack-rate of 0.09 per 1,000 of the population as against 0.03 in this borough. In Westminster, Lambeth, and Battersea the greatest incidence of the disease was felt, the attack-rates being respectively 0.25, 0.24, and 0.21 per 1,000 of their populations. Showing the rise and fall of Small-Pox for each week in 1903, and the averages for the corresponding weeks in the ten years 1893-1902. 101 [1903 In the Encircling Boroughs only 41 cases were notified, namely 31 in St. Pancras, 2 in Stoke Newington, 4 in Hackney, 2 in Hornsey, 2 in Finsbury, and 0 in Shoreditch. Fatality.—No case of Small Pox was fatal. Hospital Isolation.—All the cases were removed to hospital. Table LXX. Showing the Sickness from Small Pox in the Sub Districts for each Quarter and for the Year. Sub-Districts. 1st Quarter. 2nd Quarter. 3rd Quarter. 4th Quarter. Whole Year. Tufnell .. .. 2 1 3 Upper Holloway .. .. .. 1 1 Tollington .. .. .. .. .. Lower Holloway .. .. 2 .. 2 Highbury .. .. .. .. .. Barnsbury .. .. •• .. .. Islington, South East .. 1 1 1 3 The Borough .. 1 5 3 9 Table LXXI. Showing the Attack Rates from Small Pox of the Sub-Districts for each Quarter and for the Year. Sub-Districts. 1st Quarter. 2nd Quarter. 3rd Quarter. 4th Quarter. Whole Year. Tufnell .. .. 0.24 0.12 0.09 Upper Holloway .. .. .. 011 0.03 Tollington .. .. .. •• .. Lower Holloway .. .. .. 0.19 • • 0.05 Highbury .. .. .. .. .. Barnsbury .. .. .. .. .. Islington, South East .. 0.05 0.05 0.05 0.04 The Borough .. 0.01 0.06 0.03 0.03 1903] 102 Table LXXII. Showing the Fatality from Small Pox. (Deaths to 100 cases of Sickness). Sub-Districts. 1st Quarter. 2nd Quarter. 3rd Quarter. 4th Quarter. Whole Year. Tufnell .. .. .. .. .. Upper Holloway .. .. .. .. .. Tollington .. .. .. .. .. Lower Holloway .. .. Nil ..Return. .. .. Highbury .. .. .. .. .. Barnsbury .. .. .. .. .. Islington, South East .. .. .. .. .. The Borough .. .. .. .. .. SCARLET FEVER. There were only 865 cases of this disease notified, which is the smallest number that has been known since its notification became compulsory. This was a reduction of 780 on the corrected annual average for ten years, while the attack rate was 2.55 per 1,000 of the population compared with a mean decennial rate of 4.85 per 1,000. An examination of the accompanying chart shows that in only two weeks, namely the first and twelfth, were the cases above the average of the corresponding weeks in ten years. In London there were 12,531 cases known, which are equal to an attack rate of 2.72 per 1,000, or 0.17 below the local rate. In the Encircling Boroughs 2,178 cases were notified, representing an attack rate of 2.70, which is 0.15 above that of Islington. Hospital Isolation.—756, or 87.4 per cent., of the 856 known cases were removed to hospital. This return is even higher than that of 1902, which was up to then the highest on record. It is most gratifying to find that the public so highly appreciate the great advantages which the Metropolitau Asylums Board Hospitals afford them for the isolation and treatment of their children. Fatality.—The fatality was extremely small, for there were only 24 deaths among the 865 cases, or 2.7 per cent. Showing the rise and fall of Scarlatina for each week in 1903, and the averages for the corresponding weeks in the ten years 1893-1902. 103 [1903 Table LXXIII. Showing the Sickness from Scarlet Fever in the Sub-Districts for each Quarter and for the Year. Sub-Districts. 1st Quarter. 2nd Quarter. 3rd Quarter. 4th Quarter. Whole Year. Tufnell 19 18 14 25 76 Upper Holloway 17 22 29 10 78 Tollington 26 19 41 27 113 Lower Holloway 31 16 54 28 129 Highbury 51 73 56 27 207 Barnsbury 26 20 46 38 130 Islington, South East 29 25 42 36 132 The Borough 199 193 282 191 865 Table LXXIV. Showing the Attack Rates from Scarlet Fever of the SubDistricts for each Quarter and for the Year. Sub-Districts. 1st Quarter. 2nd Quarter. 3rd Quarter. 4th Quarter. Whole Year. Tufnell 2.31 2.19 1.71 3.85 2.32 Upper Holloway 1.95 2.53 3.33 1.15 2.24 Tollington 2.99 2.19 4.72 3.11 3.25 Lower Holloway 2.99 1.54 5.20 2.70 3.11 Highbury 3.13 4.49 3.44 1.66 3.18 Barnsbury 19. 2 1.48 3.39 2.80 2.40 Islington, South East 1.53 1.32 2.22 1.90 1.74 The Borough 2.35 2.28 3.33 2.25 2 .55 1903] 104 Table LXXV. Showing the Fatality from Scarlet Fever. (Deaths to 100 cases of Sickness). Sub-Districts. 1st Quarter. 2nd Qua..rter. 3rd Quarter. 4th Quarter. Whole Year. Tufnell 5.3 .. 21. 4 .. 5.3 Upper Holloway 6.0 .. .. .. 1.3 Tollington .. 5.3 .. 7.4 2.6 Lower Holloway 3.2 62 .. 7.1 3.1 Highbury 4.0 •• 7.1 •• 2.9 Barnsbury 11.5 .. 2..2 2.6 3.8 Islington, South East 3.4 •• .. .. 0.7 The Borough 4.5 1.0 2.8 2 6 2-77 DIPHTHERIA. This disease, inclusive of Membranous Croup, also showed a very large decrease in the cases reported, as altogether only 455 were known as against an annual corrected average of 793. They represented an attack rate of 1.34 per 1,00c, which is a decrease of ro per 1,000 on the decennial rate. On only eight occasions during the year was the weekly return above the average of the corresponding periods of the ten years immediately preceding, namely in its 2nd, 4th, 12th, 17th, 22nd, 26th and 27th weeks. In London the attack rate was 1.68, and in the Encircling Boroughs r8o per 1,000, each of which are above the local rate. Hospital Isolation.—Cases of this disease were also largely isolated, for out of 455, 337, or 74.0 per cent., were removed to hospital, of which 30, or 8.9 per cent., died, as against 1 ro per cent. among those who remained at home. Showing the rise and fall of Diphtheria for each week in 1903, and the averages for the corresponding weeks in the ten years 1893-1902. 105 [1903 Fatality.—There were 43 deaths among 455 cases, which represent 9.4 percent. This is the lowest rate yet recorded in Islington, and speaks very highly for the manner in which this disease is now treated. The fatality among hospital cases was 8.9 per cent., and among home cases 11.0 per cent. The decline in this fatality is so marked that the rates for years 1891-1903 are appended for the purposes of comparison. Year. Fatality. Year. Fatality. Year. Fatality. 1891 23.5 1896 23.5 1901 14.7 1892 23.0 1897 18.0 1902 11.8 1893 22.6 1898 17.1 1903 9.4 1894 25.1 1899 18.1 1895 24.7 1900 16.7 Table LXXVI. Showing the Sickness from Diphtheria in the Sub-Districts for each Quarter and for the Year. Sub-Districts. 1st Quarter. 2nd Quarter. 3rd Quarter. 4th Quarter. Whole Year. Tufnell 13 8 13 9 43 Upper Holloway 17 14 7 7 45 Tollington 16 15 9 7 47 Lower Holloway 47 49 15 10 121 Highbury 13 20 11 14 58 Barnsbury 14 12 15 11 52 Islington, South East 26 21 17 25 89 The Borough 146 139 87 83 455 H 1903] 106 Table LXXVII. Showing the Attack Rates from Diphtheria of the Sub-Districts for each Quarter and for the Year. Sub-Districts. 1st Quarter. 2nd Quarter. 3rd Quarter. 4th Quarter. Whole Year. Tufnell 1.58 0.98 1.58 1.10 1.31 Upper Holloway 1.95 1.61 0.80 0.80 1.29 Tollington 1.84 1.73 1.04 0.81 1.35 Lower Holloway 4.53 4.62 1.44 0.96 2.91 Highbury 0.80 1.23 0.68 0.86 0.89 Barnsbury 1.03 0.88 1.03 0.81 0.96 Islington, South East 1.32 1.11 0.90 1.32 1.17 The Borough 1.72 1.64 1 02 0.98 1.34 Table LXXVIII. Showing the Fatality from Diphtheria, including Membranous Croup. (Deaths to 100 cases of Sickness). Sub-Districts. 1st Quarter. '2nd Quarter. 3rd Quarter. 4th Quarter. Whole Year. Tufnell 7.7 12.5 7.7 11.1 9.3 Upper Holloway 12.0 7.1 .. .. 6.7 Tollington 12.5 6.6 11.1 •• 8.5 Lower Holloway 17.0 8.3 6.6 10.0 11.6 Highbury 7.7 .. .. 7.1 3.4 Barnsbury 35.7 16.6 21.4 .. 19.2 Islington, South East 4.0 10.0 .. 12 .0 6.7 The Borough 13.7 7.9 6.9 7.2 9.4 107 [1903 Table LXXIX. Showing the Cases and Deaths from Diphtheria together with the Fatality and the Departure from the Mean Fatality during the ten years 1893-1902, and 1903. Year. Cases. Deaths. Fatality. Diphtheria. Membranous Croup. Total of Diphtheria and Membranous Croup. Diphtheria. Membranous Croup. Total of Diphtheria and Membranous Croup. Deaths to 100 cases of Diphtheria and Membranous Croup. Departure from Average Fatality of 10 years. 1893 855 30 885 189 11 200 22.6 + 1.0 1894 843 24 867 208 10 218 25.1 + 3.5 1895 564 18 582 137 7 144 24.7 + 3.1 1896 1,069 24 1,093 247 10 257 23.5 + 1.9 1897 700 29 729 115 16 131 18.0 - 3.6 1898 531 13 544 90 3 93 17.1 - 4.5 1899 688 17 705 120 8 128 18.1 - 3.5 1900 624 9 633 100 6 106 16.7 - 4.9 1901 902 9 911 124 10 134 14.7 - 6.9 1902 871 7 878 101 3 104 11.8 - 8.8 1893-02 7,647 180 7,827 1,431 84 1,515 19.4 - 2.3 1903 452 3 455 41 2 43 9 4 - 10 0 H 2 1903] 108 Table LXXX. Showing the Cases, Deaths and Fatality from Diphtheria at Home and in Hospital. Quarter. Cases Nursed at Home. Cases Nursed at Hospital. Cases. Deaths. Percentage Fatality. Cases. Deaths. Percentage Fatality. 1 2 3 4 5 6 1St 31 3 9.6 115 17 14.8 2nd 32 6 18.7 107 5 4.7 3rd 25 3 12.0 62 3 4.8 4th 30 1 3.3 53 5 9.4 Year 118 13 11.0 337 30 8.9 Note.— In comparing columns 3 and 6 it must not be forgotten that it is only the mildest cases as a rule which are retained at home, The worst cases are invariably hurried off to hospital. 109 [1903 Table LXXXI. Showing the Fatality from Diphtheria* at each year of life up to 15 years of age, and at each decennial period after that age. Ages. First Quarter. Second Quarter. Third Quarter. Fourth Quarter. The Year. Cases. Deaths. Deaths to 100 Cases. Cases. Deaths. Deaths to 100 Cases. Cases. Deaths. Deaths to 100 Cases. Cases. Deat1s. Deaths to 100 Cases. Cases. Deaths. Deaths to 100 Cases. 0— 1 8 1 12 2 2 100 1 ... ... 2 1 50 13 4 31 1— 2 10 2 20 12 2 17 3 ... ... 6 1 17 31 5 16 2— 3 7 1 14 10 1 10 9 2 22 7 1 14 33 5 15 3— 4 20 2 10 18 3 17 14 1 7 3 1 33 55 7 13 4— 5 24 3 12 17 1 6 18 1 5 12 ... ... 71 5 7 5— 6 13 2 15 14 1 7 4 1 25 9 ... ... 40 4 10 6— 7 9 3 33 8 ... ... 3 ... ... 7 ... ... 27 3 11 7— 8 12 2 17 6 ... .. 4 ... ... 3 1 33 25 3 12 8— 9 5 1 20 7 ... 14 ... ... ... 4 ... ... 16 2 12 9—10 4 ... ... 7 ... ... 2 ... ... 1 ... ... 14 ... ... 10—11 3 ... ... 3 ... ... 8 ... ... 4 1 25 18 1 5 11—12 5 ... ... 3 ... ... 3 ... ... 1 ... 12 ... ... 12—13 2 ... ... 4 ... ... 3 ... ... 3 ... ... 12 ... ... 13—14 2 ... ... 1 ... ... 2 ... ... 2 ... ... 7 ... ... 14—15 5 1 20 1 ... ... 2 ... ... 4 ... ... 12 1 8 15—25 7 1 14 15 ... ... 5 ... ... 9 ... ... 36 1 3 25—35 5 1 20 5 ... ... 3 ... ... 4 ... ... 17 1 6 35-45 4 ... 3 ... ... 1 ... ... 2 ... ... 10 ... ... 45-55 1 ... ... 2 ... ... 1 ... ... ... ... ... 4 ... ... 55—65 ... ... 1 ... ... 1 1 100 ... ... ... 2 1 50 65 upwards ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Totals 146 20 14 139 11 8 87 6 7 83 6 7 455 43 9 * Inclusive of Membranous Croup. 1903] 110 ENTERIC FEVER. The decrease in the number of cases of Enteric Fever was very remarkable, being more than 54 per cent. below the corrected average of ten years. The actual number of separate notifications was only 130, as against a decennial average of 258, and were equal to an annual attack-rate of 0.38, as compared with 0.76 per 1,000 in the ten years 1892-1902. In London the rate was 0.5 per 1,000, and in the Encircling Boroughs 070. Hospital Isolation.—100 cases, or 76.9 per cent., were isolated, and of these only 11, or 11 per cent., died; while of 30 cases kept at home 11,or 36.7 per cent., died, or more than three times the fatality of the hospital cases. There is no disease which it is so essential should be treated in hospital as Enteric Fever. It may be said without fear of contradiction that in the ordinary working class, or even lower middle class, homes it is impossible to treat Enteric Fever as it should be treated, for neither the means nor the nursing staff are available. Nursing is more than half the battle, but it is not obtainable because of the cost. Fatality.—22 cases, or 16.9 per cent., were fatal, which is slightly under the average of thirteen years. Table LXXXII. Showing the Cases of Enteric Fever in the Sub-Districts for each Quarter and for the Year. Sub-Districts. 1st Quarter. 2nd Quarter. 3rd Quarter. 4th Quarter. Whole Year. Tufnell 2 .. 2 5 9 Upper Holloway 1 2 4 6 13 Tollington 2 1 3 8 14 Lower Holloway 1 1 8 1 11 Highbury 6 6 7 10 29 Barnsbury 3 3 15 7 28 Islington, South East 8 1 6 11 26 The Borough 23 14 45 48 130 Showing the rise and fell of Enteric Fever for each week in 1903, and the averages for the corresponding weeks in the ten years 1893-1902. 111 [1903 Table LXXXIII. Showing the Attack Rates from Enteric Fever of the Sub-Districts for each Quarter and for the Year. Sub-Districts. 1st Quarter. 2nd Quarter. 3rd Quarter. 4th Quarter. Whole Year. Tufnell 0.24 .. 0.24 0.61 0.27 Upper Holloway 0.12 0.23 0.46 0.69 0.37 Tollington 0.23 0.12 0.34 0.92 0.40 Lower Holloway 0.09 0.09 0.77 0.10 0.27 Highbury 0.37 0.37 0.43 0.61 0.45 Barnsbury 0.22 0.22 1.11 0.52 0.51 Islington, South East 0.42 0.05 0.32 0.58 0.34 The Borough 0.27 0.16 0.59 0.57 0.38 Table LXXXIV. Showing the Fatality from Enteric Fever. (Deaths to 100 cases of Sickness). Sub-Districts. 1st Quarter. 2nd Quarter. 3rd Quarter 4th Quarter. Whole Year. Tufnell .. .. 50.0 40.0 33.3 Upper Holloway .. •• .. .. •• Tollington .. .. .. 25.0 14.3 Lower Holloway 100.0 .. 12.5 ' •• 18.2 Highbury 50.0 33.3 .. 20.0 24.1 Barnsbury 66.6 .. 6.6 42.8 21.4 Islington, South East 12.5 .. 16.6 .. 7.7 The Borough 30.4 14.3 8.1 18.7 16.9 1903] 112 TYPHUS. No case was notified, although 22 cases occurred in the Metropolis, of which 16 were credited to Bermondsey, 1 case to Paddington, 2 to Bethnal Green, and 1 to Stepney. ERYSIPELAS. Erysipelas was responsible for 227 cases, which is a decrease of 142 on the corrected average of the preceding ten years. It was also the smallest number hitherto recorded in a year. On only three occasions during the twelvemonths did the notifications exceed the weekly decennial average, namely in the 3rd, 13th and 24th weeks. The attack-rate was 0.67 per 1,000, or 0.42 below the mean rate 1893-1902, and as compared with 0.95 per 1,000 in London, and 1.00 in the Encircling Boroughs. Hospital Isolation.—Only 34 cases, nearly all of which occurred in hospitals, were isolated, or 15 per cent., as against 193, or 85 per cent., that remained at home. Fatality.—There were 9 deaths, which were equal to a rate of 3.9 per cent. Table LXXXV. Showing the Sickness from Erysipelas in the Sub-Districts for each Quarter and for the Year. Sub-Districts. 1st Quarter. 2nd Quarter 3rd Quarter. 4th Quarter. Whole Year. Tufnell 9 6 4 4 23 Upper Holloway 9 5 6 8 28 Tollington 5 3 6 8 22 Lower Holloway 6 6 5 8 25 Highbury 9 10 6 6 31 Barnsbury 11 9 7 8 35 Islington, South East 11 9 16 24 63 The Borough 63 48 50 66 227 Showing the rise and fall of Erysipelas for each week in 1903, and the averages for the corresponding weeks in the ten years 1893-1902. 113 [1903 Table LXXXVI. Showing the Attack Rates from Erysipelas of the Sub-Districts for each Quarter and for the Year. Sub-Districts. 1st Quarter. 2nd Quarter. 3rd Quarter. 4th Quarter. Whole Year. Tufnell 1.10 0.73 0. 49 0.48 0.70 Upper Holloway 1.03 0.57 0 .70 0.92 0.80 Tollington 0.57 0.34 0.69 0.92 0.63 Lower Holloway 0.58 0.58 0 .48 0.77 0.60 Highbury 0.55 0.51 0.37 0. 37 0.48 Barnsbury 0.81 0.66 0.52 0.59 0.64 Islington, South East 0.74 0.48 0.84 1.27 0.84 The Borough 0.74 0.57 0.59 0.78 0.67 Table LXXXVII. Showing the Fatality from Erysipelas. (Deaths to 100 cases of Sickness). Sub-Districts. 1st Quarter. 2nd Quarter. 3rd Quarter. 4th Quarter. Whole Year. Tufnell 11.1 .. .. .. 4.3 U pper Holloway • • .. • • .. • • Tollington • • .. 16.6 12.5 9.1 Lower Holloway 16.6 .. .. .. 4.0 Highbury .. .. • • 16.6 3.2 Barnsbury • • • • • • 25.0 5.7 Islington, South East •• 11.1 •• 4.1 3.2 The Borough 3.2 2.0 2.0 7.6 3.97 1903] 114 PUERPERAL FEVER. This disease, so fatal to women, was responsible for 19 cases, which are 7 below the average of ten years, and are equal to a rate of 2.11 per 1,000 women delivered of children during the year; compared with a rate of 2.72 during the preceding ten years. In London the rate was 1.78 per 1,000 births and in the Encircling Boroughs rg2. Hospital Isolation.—Out of 21 cases only 4, or 10.6 per cent., were removed to hospital. Fatality.—There were 9 deaths, or 42.8 per cent. of the cases. In 1902 the rate was 54.5 per cent. Table LXXXVIII. Showing the Sickness from Pueperal Fever in the Sub-Districts for each Quarter and for the Year. Sub-Districts. 1st Quarter. 2nd Quarter. 3rd Quarter. 4th Quarter. Whole Year, Tufnell 1 .. .. 2 3 Upper Holloway 1 2 1 •• 4 Tollington •• 1 •• •• 1 Lower Holloway 2 •• 1 1 4 Highbury •• 2 1 2 5 Barnsbury .. 1 •• •• 1 Islington, South East •• 1 •• •• 1 The Borough 4 7 3 5 19 115 [1903 Table LXXXIX. Showing the Attack Rates from Puerperal Fever per 1,000 registered Births of the Sub-Districts for each Quarter and for the Year. Sub-Districts. 1st Quarter. 2nd Quarter. 3rd Quarter. 4th Quarter. Whole Year. Tufnell 5.2 .. .. 11.0 4.05 Upper Holloway 3.6 10.2 5.9 • • 3.61 Tollington • • 4.8 • • • • 1.18 Lower Holloway 7.0 • • 3.3 3.57 3.55 Highbury • • 5.5 2.7 5.32 3.42 Barnsbury •• 2.4 • • • • 0.61 Islington, South East .. 1.8 •• •• 0.49 The Borough 1.77 3.07 1.35 2.25 2.11 i903] 116 Table XC. Showing the Fatality from Puerperal Fever. Deaths to 100 cases of Sickness. Sub-Districts. 1st Quarter. 2nd Quarter. 3rd Quarter. 4th Quarter. Whole Year. Tufnell 1000 ,, a. 33 3 Upper Holloway 1000 1000 •• 750 Tollington • • 000 •• •• Lower Holloway 500 0 00 1000 500 Highbury •• 500 500 400 Barnsbury •• 000 •• •• Islington, South East •• 1000 •• 1000 The Borough 750 57 1 400 47 3 CONTINUED FEVER. Two cases were notified, which is a decrease of 3 on the corrected average of ten years. Hospital Isolation.—One case was removed. Fatality.—One case died, or 50 per cent. RELAPSING FEVER. Nil return. CHOLERA. Nil return. 117 [1903 Table XCI. Showing the number of Cases of the several Notifiable Infectious Diseases which occurred during each Ten Years 1893-02, and in 1903. DISEASES. YEARS. Corrected average number of cases. Increase or Decrease. 1893. 1894. 1895. 1896. 1897. 1898. 1899. 1900. 1901. 190?. 1893-02. 1903. Small Pox ... Il8 90 25 50 3 ... 3 2 50 276 63 9 —54 Scarlet Fever 2880 1493 1692 2031 1577 1336 1494 ro74 1286 1372 1645 865 —780 Diphtheria ... 855 843 564 I06/ 700 531 688 624 902 871 775 452 —323 Membranous Croup.. 30 24 18 24 29 13 17 9 9 7 18 3 — 15 Enteric Fever 2SI 245 184 229 256 237 353 259 281 257 258 130 —128 Typhus Fever I I 5 ... ... 2 1 2 ... I ... —1 Erysipelas ... 672 395 320 385 312 279 35o 285 285 357 369 227 —142 Puerperal Fever 38 23 22 30 27 19 33 16 34 19 26 19 —7 Continued Fever ... 7 7 9 6 I 1 2 6 3 5 5 2 —3 Relapsing Fever ... ... 2 ... ... ... ... ... ... ... ... ... Cholera 1 ... ... ... I ... 3* ... ... ... ... ... ... Totals 4853 3121 2841 3822 2906 2418 2943 2276 2852 3164 3160 1707 —1453 • English Cholera. 1903] 118 Table XCII. Showing the Attack Rates arising from the several Notifiable Infeotious Diseases which occurred during the Ten Years 1893-1902 and in 1903. DISEASES. YEARS. Mean Attack Rates. Attack Rate. Increase or Decrease. 1893. 1894. 1895. 1896. 1897. 1898. 1899. 1900. 1901. 1902. 1893-02. 1903. Small Pox 0.36 0.27 0.07 0.15 O.OO O.OO O.OO o.oo 0.I5 o.8o 0.18 0.03 0.15 Scarlet Fever 8.81 4.52 5-06 6.02 4.68 3.97 4.44 3.20 3.84 3.99 4.85 2.55 2.30 Diphtheria 2.6I 2.55 1.69 3.16 2.08 1.58 2.05 1.86 2.69 2.53 2.29 1.33 0.96 Membranous Croup 0.09 0.07 0.05 0.07 0.09 0.04 0.05 0.03 0.03 0.02 0.05 0.01 0.04 Enteric Fever 0.77 0.74 0.55 0.68 0.76 0.70 1.05 0.77 0.84 3.75 O.76 0.38 0.38 Typhus Fever O.OO o.oo 0.01 ... ... 0.00 ... 0.00 O.OO 3.00 o.oo 0.00 ... Erysipelas 2.06 1.20 0.96 1.14 0.93 0.83 1.04 0.85 0.85 0.14 1.09 0.67 0.42 •Puerperal Fever 3.90 2.42 2.23 3.02 2.74 2.86 3.42 1.73 3.67 2.06 2.72 2.11 o.61 Continued Fever 0.02 0.02 0.03 O.O1 o.oo 0.00 o.oo 0.02 0.00 O.O1 0.01 0.00 0.01 Relapsing Fever ... ... ... ... ... ... ... ... ... ... ... ... Cholera 0.00 ... ... ... o.oo ... 0.00 ... ... ... ... ... ... Totals 14.84 9.44 8.50 11.32 8.62 7.18 8.75 6.78 8.50 9.20 9.31 5.03 4.28 * These figures are calculated as per 1,000 Registered Births. 8061] 611 TABLE XCIII. Showing the number of Cases of Infectious Diseases notified in the Sub-Registration Districts during 1903. Sub-Registration District. Small Pox. Scarlet Fever or Scarlatina. Diphtheria Membranous Croup. Enteric (Typhoid) Fever. Typhus Fever. jErysipelas. Puerperal Fever. Continued Fever. Relapsing Fever. Cholera. Totals. Rate per 1,000 of the Population. Tufnell 3 76 43 ... 9 ... 23 3 1 ... ... 153 4.81 Upper Holloway 1 78 45 ... 13 ... 28 4 ... ... ... 169 4.85 Tollington ... 113 47 ... 14 ... 22 1 ... ... ... 197 5.66 Lower Holloway 2 I29 120 1 11 ... 25 4 ... ... ... 292 7.03 Highbury ... 20 7 58 ... 29 ... 31 5 ... ... ... 330 5.07 Barnsbury ... 130 51 1 28 ... 35 1 ... ... ... 246 4.53 Islington South East 3 132 88 1 26 ... 63 1 1 ... ... 315 4.15 The Borough 9 865 452 3 130 ... 227 19 2 ... ... 1707 5.03 (All Duplicates have been deducted). 1908] 120 TABLE XCIV. Showing the attack rates from Infectious Diseases notified in the Sub-Registration Districts during 1903. Sub-Registration Districts. Small Pox. Scarlet Fever or Scarlatina. Diphtheria. Membranous Croup. Enteric (Typhoid) Fever. Typhus Fever. Erysipelas. Puerperal* Fever. Continued Fever. Relapsing Fever. Cholera. Rate per 1,000 of the Population. Tufnell 0.09 2.32 I.3I .. 0-27 070 4'°5 0*03 ... 4'8i Upper Holloway 0.03 2.24 I"29 ... 0'37 o'8o 3-61 ... 4*85 Tollington ... 3.25 I-35 ... 0*40 0*63 V17 ... 5-66 Lower Holloway 0.05 3.11 2'8g 0'02 0'2 7 o'6o 3'55 ... ... 7*°3 Highbury 3.I8 0*89 ... 0*45 0*48 3'42 ... 5*°7 Barnsbury ... 2.40 0-94 0*02 I*5I 0*64 o'6i ... 4'53 Islington, South East 0.04 1.74 ri6 O'OI o"34 0*84 0-49 O'OI ... 4-I5 The Borough 0.03 2.55 1 "33 O'OI 0-38 ... 0*67 2*11 O'OO ... ... 5"°3 * Per 1,000 Registered Births. 121 [1903 TABLE XCV. Showing the number of Cases of Infectious Disease notified in the Wards during the year 1903. (N.B.—Duplicate notifications have been deducted). WARDS. Estimated Population. 1903. Small Pox. Scarlet Fever or Scarlatina. Diphtheria. Membranous Croup. Enteric (Typhoid) Fever Typhus Fever. Erysipelas. Puerperal Fever. Continued Fever. Relapsing Fever. Cholera. Totals. Cases Notified per 1,000 of Population. I 2 3 4 5 6 7 8 9 10 11 12 13 14 15 Tufnell 32,838 3 76 43 ... 9 ... 23 3 1 ... ... 158 4.81 Upper Holloway 34,822 1 78 45 ... 13 ... 28 4 ... ... ... 169 4.85 Tollington 34,765 ... 113 47 ... 14 ... 22 1 ... ... ... 197 5.66 Lower Holloway 41.537 2 129 120 1 11 ... 25 4 ... ... ... 292 7.03 Highbury 34,858 ... 130 37 ... 13 ... 16 4 ... ... ... 200 5.74 Mildmay 24,862 ... 70 17 ... 13 ... 10 1 ... ... ... 111 4.46 Thornhill 33,370 ... 88 34 ... 21 ... 25 ... ... ... ... 169 5.06 Barnsbury 20,908 ... 42 17 ... 7 ... 10 1 ... ... ... 77 3.68 St. Mary's 17,298 ... 28 21 ... 4 ... 12 ... ... ... 65 3.76 Canonbury 31,160 1 36 36 ... 13 ... 31 ... 1 ... ... 118 3.78 St. Peter's 32,719 2 75 35 1 12 ... 25 1 ... ... ... 151 4.61 Totals 339,137 9 865 452 3 130 ... 227 19 2 ... ... 1707 5.03 1901 335,325 5o 1286 902 9 281 2 ... 285 34 3 ... ... 2852 8.50 1902 337,268 276 1372 871 7 257 357 19 5 .. ... 3164 9.20 1903] 122 Table XCVI. Showing the Attack-Rates arising from the Infectious Diseases notified in the Wards during the Year 1903. WARDS. Small Pox. Scarlet Fever or Scarlatina. Diphtheria. Membranous Croup. Enteric (Typhoid) Fever. Typhus Fever. Erysipelas. Puerperal Fever. Continued Fever. Relapsing Fever. Cholera. Total CaseRates. Tufnell 0.09 2.32 1.31 ... 0.27 ... 0.70 0.09 0.03 ... ... 4.81 Upper Holloway 0.03 2.24 1.29 ... 0.37 ... 0.80 0.12 ... ... ... 4.85 Tollington ... 3.25 1.35 ... 0.40 ... 0.63 0.03 ... ... ... 5.66 Lower Holloway 0.05 3.11 2.89 0.02 0.27 ... 0.60 0.09 ... ... ... 5.03 Highbury ... 3.73 1.06 ... 0.37 ... 0.46 0.12 ... ... ... 5.74 Mildmay ... 2.82 0.68 ... 0.52 ... 0.40 0.04 ... ... ... 4.46 Thornhill ... 2.64 1.02 0.03 0.63 ... 0.74 ... ... ... ... 5.06 Barnsbury ... 2.01 0.81 ... 0.34 ... 0.48 0.04 ... ... ... 3.68 St. Mary's ... 1.62 1.21 ... 0.23 ... 0.70 ... ... ... ... 3.76 Canonbury 0.03 1.15 1.15 ... 0.42 ... 1.00 ... 0.03 ... ... 3.78 St. Peter's 0.06 2.29 1.07 0.03 0.37 ... 076 0.03 ... ... ... 4.61 Totals 0.03 2.55 1.33 0.01 0.38 ... 0.67 0.06 0.00 ... ... 5.03 123 [1903 Table XCVII. Showing the Number of Cases of Infectious Diseases which were investigated by the several Sanitary Inspectors during the Year 1903. Sanitary Inspectors. Number of the Sanitary District. Small Pox. Scarlet Fever or Scarlatina. Diphtheria. Membranous Croup. Enteric (Typhoid) Fever. Typhus Fever. Erysipelas. Pueperal Fever. Continued Fever. Relapsing Fever. Cholera. Total. Mr. Cook 1 3 60 26 ... 5 ... 16 2 1 ... ... 113 ,, Bicknell 2 1 78 45 ... 13 ... 29 4 ... ... ... 170 ,, Bagshaw - 3 ... 25 J9 ... 7 ... 9 ... ... ... ... 60 „ Bacon 4 ... 115 45 10 ... 14 I ... ... ... 185 ,, Flood 5 ... 45 94 1 8 ... 14 4 ... ... ... 168 „ Horsman - 6 ... 73 30 ... 6 ... 13 ... ... ... ... 122 „ Fortune 7 ... 93 15 ... 8 ... 11 3 ... ... ... 130 ,, Metcalf 8 ... 67 12 ... 12 ... 10 1 ... ... ... 102 „ Irving 9 ... 66 37 ... 17 ... 22 2 ... ... ... 144 ,, Watson 10 ... 32 26 ... 12 ... 21 ... ... ... 92 „ Burrell 11 ... 41 29 1 13 ... 22 1 ... ... ... 108 „ Agar 12 ... 69 24 1 10 ... 16 ... ... ... 120 „ Rolfe ,, Callow 13 2 43 58 14 36 ... 6 3 ... 14 16 1 ... ... ... 78 115 Totals ... 9 865 452 3 130 ... 227 19 2 ... ... 1,707 1903] 124 Table XCVIII. Showing the Cases of Infectious Disease which were notified, in the several Months during the Year 1903. n.b.—(Duplicate Notifications have been deducted.) Month. Small Pox. Scarlet Fever or Scarlatina. Diphtheria. Membranous Croup. Enteric (Typhoid) Fever. Typhus Fever. Erysipelas. Puerperal Fever. Continued Fever. Relapsing Fever. Cholera. Total each month. January ... 61 56 ... 12 ... 21 2 ... ... ... 152 February ... 55 44 ... 6 ... 19 1 1 ... ... 126 March ... 83 45 1 5 ... 23 1 1 ... ... 159 April ... 46 42 ... 2 ... 18 3 ... ... ... 111 May ... 61 38 7 ... ii 3 ... ... ... 120 June 1 86 58 1 5 ... 19 1 ... ... ... 171 July 3 96 36 ... 9 ... 17 2 ... ... ... 163 August 1 71 28 1 12 ... 12 ... ... ... ... 125 September 1 115 22 24 ... 21 1 ... ... ... 184 October ... 70 27 ... 24 ... 19 1 ... ... ... 141 November 3 59 20 ... 11 ... 22 1 ... ... ... Il6 December ... 62 36 ... 13 ... 25 3 ... ... ... 139 Total 9 865 452 3 130 ... 227 19 2 ... ... 1,707 125 [1903 Table XCIX. Showing the Cases of Infectious Disease notified, during the Year 1903 in Islington and in the Encircling Boroughs. The Encircling Boroughs. Estimated Populations, 1903. Small Pox. Scarlet Fever or Scarlatina. Diphtheria (including Membranous Croup. Enteric (Typhoid) Fever. Typhus Fever. Erysipelas. Puerperal Fever. Continued Fever. Relapsing Fever. Cholera. Total Cases. St. Pancras 235,7I6 31 659 522 88 ... 224 4 ... ... ... 1,528 Stoke Newington 52,069 2 87 40 36 ... 30 3 ... ... ... 198 Hackney 224,082 4 667 545 271 ... 281 20 5 ... ... 1.793 Hornsey 78,386 2 213 62 13 ... 25 2 ... ... ... 317 Finsbury 99,717 2 293 129 52 ... 104 8 ... ... ... 588 Shoreditch 117.5I3 ... 259 154 99 ... 147 7 1 ... ... 667 The Encircling Boroughs 807,483 41 2,178 1,452 559 130 ... 811 44 6 ... ... 5.091 Islington 339,137 9 865 455 ... 227 19 2 ... ... 1,707 [1903 126 Table C. Showing the Attack Raton per 1,000 inhabitants arising from the Infectious Diseases furtt/ud durng the Year 1903 in Islington and in the Enciroiing Boroughs. Tha Encircling Boroughs. Estimated Populations. 1903. Small Pox. Scarlet Fever or Scarlatina. i'iphtlu-na (including Membranous) Croup. Enteric (T vphoid) Fever. Typhus Fever. Erysipelas. I'Merperal Fever.* Continued Fever. Relapsing Fever. Cholera Total Case Kates. 1 2 3 4 5 6 7 8 9 10 11 12 13 St. Pancras 235.716 013 2.80 2.22 0.37 ... 0.95 0.01 ... ... ... 6.48 Stoke Newington 52,069 0.04 1-67 °77 0-69 ... 0.57 0.06 ... ... ... 3.80 Hackney 224,082 0.02 2.98 2.43 1.21 ... 1.25 0.09 0.02 ... ... 8.00 Hornsey 78,386 0.02 2.72 0.79 0.17 ... 0.32 0.02 ... ... ... 4.04 Finsbury 99.717 0.02 2.94 1.29 0.52 ... 1.04 0.08 ... ... ... 5.89 Shoreditch 117.5I3 ... 2.21 1.31 0.84 ... 1.25 0.06 0.01 ... ... 5.68 The Encircling Boroughs 807,483 0.05 2.70 1.80 0.70 ... 1.00 0.05 0.00 ... ... 6.30 Islington 339,137 0.03 2 .55 1.34 038 ... 0.67 0.06 0.00 ... ... 5.03 Increase or Decrease ... -0.02 -0.15 -0.46 0.32 ... -0.33 +0.01 ... ... ... .1 27 *Per 1,000 of the population. 127 [1908 Table C1. Showing the Cases of Infection Diseases notified in the several Metropolitan boroughs during the year 1903. Citizen and Boroughs. Estimated populations in the middle of 1903. Kminnti G*st,s or Unenov* Pimw, Small pox. Scarlet Fever Diphtheria.* Typhus Perot. ??? Fever Other continued Fever ??? Frver ??? Cholera. Total. london 4,013,812 416 12,531 7,73S 22 2,339 40 233 1,372 •• 27,691 West Districts. Paddington 146,032 5 417 150 1 44 3 4 119 .. 743 Kensington 178,409 5 335 180 .. 66 2 4 177 .. 769 Hammersmith 115, 803 7 316 106 .. 59 1 6 109 .. 664 Fulham 147,780 11 446 294 .. 80 .. 19 116 .. 926 Chelsea 74,169 7 200 98 .. 13 .. 6 55 .. 388 City of Westminster 179,052 45 352 186 .. 71 2 111 111 .. 772 North Districts. St. Marylebone 131,234 4 414 228 .. 67 4 7 177 •• 901 Hampstead 85,197 1 174 86 .. 29 .. 1 41 .. 332 St Pancras 235,7116 31 658 522 .. 88 .. 5 224 .. 1,528 Islington 339,137 9 865 455 .. 130 2 19 227 .. 1 707 Stoke Newington 52,069 2 87 40 .. 35 1 3 30 .. 197 Hackney 224,082 4 667 545 .. 271 5 21 281 .. 1,794 Central Districts. .. .. Holborn 57,845 2 144 52 .. 54 2 4 90 .. 348 Finsbury 99,717 2 293 129 .. 52 .. 8 106 • • 590 City of London 24,539 .. 73 27 •• 14 .. 1 10 •• 125 East Districts. .. .. Shoreditch 117 513 .. 259 154 .. 99 1 7 147 .. 667 Bethnal Green 130,028 3 392 242 2 59 1 6 214 •• 919 Stepney Poplar 302,153 169,550 26 28 878 450 543 425 1 .. 199 93 .. .. 10 8 376 144 .. .. 1.148 South Districts. Southwark 207,369 40 512 354 .. 122 .. 13 239 .. 1,280 Bermondsey 129,801 7 401 174 16 76 .. 9 182 .. 865 Lambeth 307,711 73 745 346 .. 136 7 18 231 .. 1 Battersea 173,422 37 474 314 .. 89 .. 8 149 .. 1,071 Wandsworth 249.678 29 821 532 .. 101 3 13 235 .. 1.734 Camberwell 265,562 19 666 365 .. 103 2 6 233 .. 1,394 Deptford 112,537 2 502 456 2 31 1 6 134 .. 1,134 Greenwich 99,824 4 164 208 .. 44 • • 7 73 .. 500 Lewisham 136,405 1 463 278 .. 49 .. 8 82 .. 88l Woolwich 121,478 6 390 184 •• 42 3 2 58 .. 685 Port of London .. 3 2 2 •• 22 •• •• 1 •• 30 *Including Membranous Croup. 1903] 128 Table CII. Showing the Attack Rates of Cases of Infectious Diseases notified in the several Metropolitan Cities and Boroughs during the year 1903. Cities and Boroughs. Estimated Population 1903. Small Pox. Scarlet Fever. Diphtheria. Typhus Fever. Enteric Fever. Other Continued Fevers. Puerperal Fever. Erysipelas. Cholera. Total Attack Rate. County of London 4,613,812 0.09 2.72 1.68 0 00 0.51 0.00 0.05 0.95 .. 6.00 West Districts. Paddington 146,032 0.03 2.86 1.03 0.00 0.30 0.02 0.03 0.82 .. 5.09 Kensington 178,409 0.03 1.88 1.01 .. 0.37 0.01 0.02 0.99 .. 4.31 Hammersmith 115,803 0.06 2.73 1.43 .. 0.51 0.01 0.05 0.94 .. 5.73 F ulham 147,780 0.07 2.75 1.99 .. 0.54 .. 0.13 0.79 .. 6.27 Chelsea 74,169 0.09 2.82 1.32 .. 0.18 .. 0.08 0.74 .. 5.23 City of Westminster 179,052 0.25 1.97 1.04 .. 0.39 0.01 0.03 0.62 .. 4.31 North Districts. St. Marylebone 131,234 0.03 3.16 1.74 .. 0.51 0.03 0.05 1.35 .. 6.87 Hampstead 85,197 0.01 2.04 1.01 .. 0.34 .. 0.01 0.48 .. 3.89 St. Pancras 235.716 0.13 2.80 2.22 .. 0.37 .. 0.01 0.95 .. 6.48 Islington 339,137 0.03 2.55 1.34 .. 0.38 0.00 0.05 1.00 .. 5.03 Stoke Newington.. 52,069 0.04 1.67 0.77 .. 0.69 .. 0 06 0.57 .. 3.80 Hackney 224,082 0.02 2.98 2.43 .. 1.21 0.02 0.09 1.25 .. 8.00 Central Districts. Holborn 57.845 0.03 2.49 0 .90 .. 0.93 0.03 0.07 1.56 .. 6.01 Finsbury 99,717 0.02 2.94 1.29 .. 0.52 .. 0 08 1.04 .. 5.89 City of London 24,539 .. 2.98 1.10 .. 0.57 .. 0.04 0.40 .. 5.09 East Districts. .. .. Shoreditch 117,513 0.00 2.21 1.31 .. 0.84 0.01 0.06 1.25 .. 5.68 Bethnal Green 130 028 0.02 3.02 1.86 0.01 0.45 0.01 0.05 1.65 .. 7.07 Stepney 302,153 0.08 2.91 1.80 0.00 0.66 .. 0.03 1.25 .. 6.73 Poplar 169,550 0.16 2.65 2.51 .. 0.55 .. 0.05 0.85 .. 6.77 South Districts. Southwark 207,369 0.19 2.47 1.71 .. 0.59 .. 0.06 1.15 .. 6.17 Bermondsey 129,801 0.05 3.09 1.34 0.12 0.59 .. 0.07 1.40 .. 6.66 Lambeth 307,711 0.24 2.42 1.12 .. 0.44 0.02 0.06 0.75 .. 5.05 Battersea 173.422 0.21 2.73 1.81 .. 0.51 .. 0.05 0.86 .. 6.17 Wandsworth 249,678 0.12 3.29 2.13 .. 0.40 0.01 0.05 0.94 .. 6.94 Camberwell 265,562 0.07 2.51 1.37 .. 0.39 0.00 0.02 0.88 .. 5.24 Deptford 112 537 0.02 4.46 4.06 0.02 0.28 0.00 0.05 1.19 .. 10.08 Greenwich 99,824 0.04 1.64 2.08 .. 0.44 .. 0.07 0.73 .. 5.00 Lewisham 136,405 0.00 3.40 2.04 .. 0.36 .. 0.06 0.60 .. 6.46 Woolwich 121,478 0.05 3.21 1.52 .. 0.35 0.02 0.01 0.48 .. 5.64 Port of London Table CIII. Showing the cases of Notifiable Infectious Diseases occurring in Public Elementary Schools during the Year 1908. NAME OF SCHOOL. Scholars attacked. Non-Scholars attacked who livcu in houses from which children attended the several Schools. Small Pox. Measles. Scarlet Fever. Diphtheria. Whooping Cough. Enteric Fever. Other Feve.s Total. Small Pox. Measles. Scarlet Fever. Diphtheria. Whooping Cough. Enteric Fever. Other Fevers. Total. 1 Yerbury Road, B.S. .. .. 20 4 .. .. .. 24 .. .. 8 6 .. 8 1 23 2 St. John's, Hoiloway Road, C.S. .. .. 3 1 .. .. .. 4 .. .. 2 .. .. 2 .. 4 3 St. Joseph's, R.C.S. .. .. .. .. .. .. .. .. .. .. .. 1 .. .. .. 1 4 Hargrave Park, B.S. .. .. 5 3 .. .. .. 8 1 .. 1 4 .. .. .. 6 5 Burleigh Road, B.S. .. .. 7 5 .. .. .. 12 .. .. 3 1 .. 1 .. 5 6 St. Mark's, Grove Road, C.S. .. .. 8 1 .. .. .. 9 .. .. 1 2 .. .. .. 3 7 Cottenham Road, B.S. .. .. 11 4 .. 1 .. 16 .. .. 3 4 .. 1 2 10 8 Grafton Road, B.S. .. .. 9 13 .. 1 .. 23 .. .. 2 1 .. 4 .. 7 9 Duncombe Road, B.S. .. .. 13 6 .. .. .. 21 .. .. 1 5 .. .. .. 6 10 Whittington, B.S. .. .. 25 2 .. .. .. 27 .. .. 4 5 .. .. 2 11 11 Montem Street, B.S. .. .. 12 2 .. 1 .. 15 .. .. 12 6 .. 1 .. 19 12 Forster, B.S. .. .. 26 .. .. 3 .. 29 .. .. 4 2 .. .. 4 10 13 Poole's Park, B.S. .. .. 10 7 .. 2 .. 19 .. .. 11 2 .. 1 4 18 14 Hornsey Road, B.S. .. .. 18 5 .. .. .. 24 .. .. 3 4 .. l 4 12 15 Hungerford Road, B.S. .. .. 10 16 .. .. .. 26 .. .. 2 11 .. .. 1 14 16 Brecknock,B.S. .. .. 3 29 .. 1 .. 34 .. .. 4 14 .. l .. 19 17 Pakeraan Street, B.S. .. .. 5 7 .. .. .. 12 .. .. 3 1 .. l 1 6 18 St. James', C.S. .. .. .. 6 3 .. 1 .. 10 .. .. 3 .. .. l .. 4 19 Catholic School, Eden Grove, R.C.S... .. .. 11 .. .. 1 .. 12 .. .. 1 .. .. .. .. 1 20 Caledonian Road, B.S. .. .. 4 3 .. .. .. 7 .. .. 6 .. .. .. .. 6 21 Westbourne Road, B.S. .. .. 13 5 .. .. .. 18 .. .. 6 4 .. .. .. 10 22 Chapel-of-Ease, C.S. .. .. 9 2 .. .. 1 12 .. .. 10 1 .. .. .. 11 23 Blackstock Road, B.S. .. .. 17 2 .. .. 1 20 .. .. 1 4 .. .. .. 5 24 Gillespie Road, B.S. .. .. 31 3 .. 2 .. 36 .. .. 10 6 .. 3 .. 20 25 Drayton Park, W.M.S. .. .. 9 6 .. .. .. 15 .. .. 1 1 .. .. .. 2 26 St. John's, Conewood Street, C.S. .. .. 17 1 .. 1 .. 19 .. .. 2 2 .. 1 .. 5 27 St. Jude's, C.S. .. .. 6 .. .. 1 .. 7 .. .. 3 .. .. .. .. 3 28 Newington Green, B.S. .. .. 2 1 .. 1 .. 4 .. .. 4 2 .. 2 .. 12 29 Ambler Road, B.S. .. .. 5 .. .. .. .. 5 .. .. 2 1 .. .. .. 3 30 York Road, B S. .. .. .. 10 2 .. 1 .. 13 .. .. 8 3 .. 1 .. 12 31 Gifford Street, B.S. .. .. 3 6 .. 2 .. 11 .. .. 7 5 .. 4 1 17 32 St. Thomas', C.S. .. .. 2 4 .. .. .. 6 .. .. 6 2 .. 1 2 11 33 St. Clement's, C.S. .. .. 4 .. .. 1 .. 5 .. .. 4 2 .. .. .. 6 34 Blundell Street, B.S. .. .. 7 8 .. .. .. 15 .. .. 6 6 .. 1 .. 13 35 St. Paul's, Dorset Street, C.S. .. .. 6 .. .. .. .. 6 .. .. 1 .. .. 1 3 5 36 Ecclesbourne Road, B.S. .. .. 10 11 .. .. .. 21 .. .. .. .. .. 2 3 5 37 Tottenham Road, B.S. .. .. 6 3 .. .. .. 9 .. .. 5 1 .. 1 1 8 38 Queen's Head Street, B.S. .. .. 12 4 .. .. .. 18 .. .. 5 3 .. 1 2 11 39 Popham Road, B.S. .. .. 1 7 .. .. .. 8 .. .. 7 2 .. .. 2 11 40 St. Philip's, B.S .. .. .. 4 .. .. 1 .. 5 .. .. .. .. .. 6 .. 6 41 Shepperton Road, B.S. .. .. 3 .. .. .. 1 4 .. .. 1 1 .. 2 1 5 42 Rotherfield Street, B.S. .. .. 9 3 .. l 3 16 .. .. 8 3 .. 3 2 16 43 Buckingham Street, B.S. .. .. 20 8 .. 5 .. 33 .. .. 5 8 .. 1 4 18 44 Winchester Street, B.S. .. .. 6 4 .. 1 l 12 .. .. 2 .. .. .. .. 2 45 All Saint's, C.S. .. .. 4 1 .. .. .. 5 .. .. 2 .. .. 1 .. 3 46 Vittoria Place, B.S. .. .. 7 2 .. .. .. 9 .. .. 8 3 .. 2 .. 12 47 Holy Trinity, C.S. .. .. 3 .. .. .. .. 7 .. .. 1 2 .. 1 3 7 48 Richard Street, B.S. .. .. 20 4 .. .. .. 24 .. .. 9 .. .. .. 2 11 49 Station Road, B.S. .. .. 8 1 .. .. .. 9 .. .. 3 3 .. .. 2 8 50 Thornhill Road, B.S. .. .. 21 3 .. .. .. 25 .. .. 3 1 .. 7 2 13 51 St. Matthew's, City Road, C.S. .. .. 7 .. .. .. .. 7 1 .. 2 1 .. .. 1 5 52 St. John's, Duncan Terrace, R.C S. .. .. 5 .. .. .. .. 6 .. .. 2 2 .. .. .. 4 53 Hanover Street, B.S. .. .. 9 2 .. 1 1 13 .. .. 2 1 .. .. 1 4 54 Canonbury Road, B.S. .. .. 1 9 .. .. 2 12 .. .. .. 3 .. 2 3 8 55 St. Mary's, C.S. .. .. 4 2 .. l .. 7 .. .. 3 .. .. 2 1 6 Total .. .. 507 216 .. 35 16 774 2 .. 213 142 .. 67 60 484 129 [1903 INFECTIOUS DISEASES IN THE PUBLIC ELEMENTARY SCHOOLS. The infectious diseases included under this heading are those which are notifiable under the provisions of the Public Health (London) Act, as well as others which are not so notifiable, and which comprise Measles, Chicken Pox, Whooping Cough and Mumps. Notifiable Infectious Diseases. Cases among Scholars.—774 cases occurred among scholars who were in attendance at the public elementary schools. Cases in Scholar's Homes.—484 cases occurred in the homes of scholars, or in houses in which they resided. Small Pox.—In no instance was the patient attending school. Scarlet Fever.—507 cases, or 157 less than in the previous year, occurred among school children. The Board Schools in which the largest number of cases occurred were Montem Street 25 cases, Forster 26, Hornsey Road 18, Blackstock Road 17, Gillespie Road 31, Buckingham Street 20, Richard Street 20, and Thornhill Road 21. There were 213 cases in the homes of scholars who had been in attendance at school. Diphtheria.—216 cases of this disease were discovered among scholars, as against 405 in 1902. 13 were referred to Grafton Road, 16 to Hungerford Road, and 29 to Brecknock Road Board Schools. 1903] 130 There were 142 cases in the homes or houses in which scholars resided. Enteric Fever.—35 cases were scholars, and 67 were cases in scholars' homes or houses. Non-notifiable Infectious Diseases. The number of cases notified by teachers amounted to 2,298, which is only 9 less than the number notified in the previous year. Measles was known to have attacked 1,049 children, and was most prevalent in the infant classes of the following schools: Montem Street (99), Canonbury Road (48), Buncombe Road (38), Drayton Park (42), Ecclesbourne Road (36), Gillespie Road (49), Hungerford Road (47), Newington Green (37), Pakeman Street (40), Popham Road (56), Rotherfield Street (72), Shepperton Road (39), St. Paul's, Dorset Street (55), and St. Philips' (50). The number of schools invaded was 45. Chicken Pox.—206 cases, or 276 less than last year were reported, the largest number (26) coming from Westbourne Road School, and 20 from Richard Street School. While 16 occurred in Gillespie Road School, and 15 in Hanover Street School. There were 32 schools invaded. Whooping Cough was notified in 277 instances, from 28 schools. Mumps and other Diseases were notified in 766 instances. It is satisfactory to note that the teachers were, as in the preceding year, anxious to assist the Public Health Department in dealing with these diseases, and it is still more satisfactory to find that the Medical Officer of the School Board has kept a very watchful eye on the schools, and has in many instances closed class-rooms even before information had reached your Medical Officer of Health that disease had occurred in them. This is an improvement on the practice of previous years 131 [1903 Table CIV. Showing the Infectious Diseases notified during the year 1903 by the Teachers of Public Elementary Schools under the provisions of Regulation 148, sec. Hi., of the London School Board Code. School. Measles. Chicken Pox. Whooping Cough. Other Diseases. Totals. Ambler Road 1 1 2 2 6 Brecknock Road 1 2 ... ... 3 Blackstock Road 1 1 5 2 9 Blundell Street 3 1 9 29 42 Buckingham Street 27 ... ... 11 38 Canonbury Road 48 7 4 12 71 Caledonian Road 14 1 ... 7 22 Chapel of Ease 4 3 ... 2 9 Duncombe Road 38 ... ... 4 42 Drayton Park 42 1 1 9 53 Ecclesbourne Road 36 2 4 24 66 Grafton Road 9 ... 4 1 14 Gillespie Road 49 16 12 37 114 Gifford Street 7 8 ... 6 21 Hargrave Park .. ... ... 1 1 Hungerford Road 47 4 ... 8 59 Hanover Street 5 15 2 6 28 Montem Street 99 7 5 125 236 Newington Green 37 5 6 25 73 Poole's Park 3 1 24 25 53 Pakeman Street 40 ... ... ... 40 Popham Road 56 12 10 22 100 Queen's Head Street 4 ... ... ... 4 Risinghill Street. 3 4 ... 1 8 Rotherfield Street 72 11 31 79 193 Richard Street 19 20 33 14 86 Shepperton Road 39 3 2 2 46 Station Road 17 .. 16 43 76 St. Mark's, Grove Road 1 ... ... ... 1 St. Barnabas .. ... ... 2 2 St. James' 21 ... ... 1 22 St. John's, Conewooc Street 21 2 1 ... 24 St. John's, Duncan Ter race 17 ... ... ... 17 St. Thomas' 5 3 2 1 11 St. Paul's, Dorset Street 55 5 15 8 83 St. Bartholomew's .. ... ... 2 2 St. Philip's 50 2 2 18 72 St. Matthew's, City Road 8 ... 2 ... 10 Thornhill Road 3 ... ... ... 3 Tottenham Road 6 ... ... ... 6 Upper Hornsey Road 24 5 1 10 40 Vittoria Place 24 10 7 ... 41 Whittington 16 8 10 27 61 Wenlock Street 4 ... 1 2 7 Westbourne Road 21 26 23 14 84 Winchester Street 21 12 8 6 47 Yerbury Road 19 2 35 169 225 York Road 12 6 ... 9 27 Total 1049 206 277 766 2298 1903] 182 ISOLATION OF INFECTIOUS DISEASES IN HOSPITALS. Altogether 1,241 cases were removed to hospital for isolation and treatment, of which 1,150, or 92 Q per cent., were admitted into the hospitals of the Metropolitan Asylums Board, and of these 66, or 57 per cent., died. The North Eastern Hospital, as usual, received the greatest number of the Borough's patients, namely 942 (of whom 54 died), as against 1,134 in the preceding year. The Eastern Hospital received 104 patients, of whom 8 died, and the North Western 73, of whom 4 died; 2 were sent to the Western Hospital, 15 to the South Western, 1 to the Grove, 1 to the South Eastern and 12 to the Small Pox Hospital. Table CV. Showing the number of Cases of Infectious Disease removed from Islington to the Metropolitan Asylums Board's Hospitals for treatment and isolation during 1903. Metropolitan Asylums Board's Hospitals. Small Pox. Scarlet Fever. Diphtheria. Enteiic Fever. Typhus Fever. Other Diseases. Total Admissions. Total Deaths. Eastern •• 39 32 18 •• 15 104 8 North Eastern •• 618 190 36 •• 98 942 54 North Western •• 39 27 1 •• 6 73 4 Western •• 1 • • •• 1 2 •• South Western •• 7 6 .. •• 2 15 •• The Grove .. •• 1 •• .. •• •• 1 •• South Eastern •• • • •• 1 •• •• 1 •• Northern •• .. •• •• •• •• •• Small Pox 12 •• •• •• •• 12 •• Totals 12 705 255 56 •• 122 1,150 66 Table CVI. Summary of Infectious Sickness and of the Deaths arising therefrom, distinguishing the Cases treated at Home and in Hospitals; and showing the percentages of notified Cases removed to Hospitals, together with the Fatality among cases treated at Home and in Hospitals. Notified Cases Treated. Percentages of Notified Cases Treated. Deaths Occurring. Percentages of Deaths Occurring. In Hospitals. At Home. Total. In Hospital. At Home. In Hospital. At Home. Total. In Hospital. At Home. Total. Small Pox 9 •• 9 100.0 •• .. .. .. .. • • Scarlet Fever 756 109 865 87.4 12.6 23 1 24 3.0 0.9 2 8 Diphtheria 337 118 455 74.0 26.0 30 13 43 8.9 11.0 9.4 Enteric (Typhoid Fever) 100 30 130 76.9 23.1 11 11 22 11.0 36.7 16.9 Typhus Fever .. .. •• .. .. •• .. •• •• •• •• Erysipelas 34 193 227 15.0 85.0 1 8 9 2.9 4.1 3.9 Puerperal Fever *4 17 21 10 6 89.4 4 5 9 100.0 29.4 42.8 Continued Fever 1 1 2 50.0 50.0 •• 1 1 •• 100.0 50.0 Relapsing Fever •• .. .. •• .. •• •• •• •• •• Cholera •• •• •• .. •• •• •• •• .. .. •• Total *1,241 468 1.709 72 6 27.4 69 39 108 5.5 8.3 6.3 *Including 2 cases which had not been notified. 1903] 184 INFECTIOUS DISEASES ON BUSINESS PREMISES. If the notification of infectious diseases needed any justification at this time it would surely be found in the fact that it enables sanitary authorities to discover if any trades are being carried on in the houses in which they have broken out and if the goods manufactured under such circumstances are likely to convey infection to outsiders. The Factory and Workshop Act particularly recognizes the danger, and by its 109th section enacts that " If the occupier of a factory or workshop or of any place " from which any work is given out, or any contractor employed " by any such occupier, causes or allows wearing apparel to be made, " cleaned or repaired in any dwelling-house or building occupied " therewith, whilst any inmate of the dwelling-house is suffering from " scarlet fever or small-pox, then unless he proves that he was not " aware of the existence of the illness in the dwelling-house, and " could not reasonably have been expected to become aware of it, he " shall be liable to a fine not exceeding ten pounds." Trades carried on in Invaded Premises.—Altogether 184 premises, in which a trade or business was carried on were discovered, and of these, ior were infected with Scarlet Fever, 46 with Diphtheria, 13 with Enteric Fever, and 24 with Erysipelas. Scarlet Fever was found in homes where the following businesses, among many others, were conducted: Butcher, Bootmaker, Baker, Confectioner, Dressmaker, Dairy, Draper, Fishmonger, General Dealer, Greengrocer, Laundry, Mangling, Mantlemaker, Milkshop, Newsagent, Publican, Schools, Tailor. Diphtheria invaded the premises where the following businesses were conducted: Butcher, Bootmaker, Boxmaking, Confectioner, Dressmaking, Draper General Dealer, Grocer, Laundry, Milkshop, Newsagent, Publican and Tailor, 185 [1903 One can so easily appreciate how readily goods from many of these premises might convey infection to the public that it is unnecessary to enlarge on the subject. There is, however, another view of the question, and that is the danger to persons calling at the business premises, because of the fact that many a mother or woman attendant acts at a time of illness in the dual capacity of shop-attendant and nurse; and even where she does not so act, but proposes only to look after the business, it is found that she is constantly backwards and forwards between the sick room and the shop. Of course she is ! Her maternal or womanly feelings compels her, so that even if she would, she could not, keep away from the patient. In such cases as these the best, indeed the only, place for the patient is the hospital, and therefore every energy is strained by the Public Health Department to induce the parents or guardians to permit his removal thither. This has generally been satisfactorily accomplished ; although at times it requires great persuasion and even entreaty before they will give their consent. One of the greatest objections to the removal, apart from parental feelings, is that the public might see the ambulance at the door, and that consequently their business would suffer. (Vide Table CVII.) Occupations of Persons Attacked.—The occupations of the persons attacked have been noted during the year as usual. The full statement is given in Table CVIII. The list is instructive. Small Pox infected a Barman, a Boxmaker, a Factory Hand, a Laundress, a Metal Worker, and a Packer. Scarlet Fever attacked persons, besides very many children, following the undermentioned occupations:—Accountant, Bookkeeper, Butcher, Barmaid, Bootmaker, Clerk, Carman, Clergyman, Grocer, Labourer, Messenger, Nurse, Porter, Pork Butcher, Postman, Packer and Solicitor. Diphtheria was noted among Butchers, Bootmakers, Boxmakers, Confectioners, Dressmakers, Drapers, General Dealers, Hairdressers, Laundresses, Manglers, Milk Dealers, Newsagents, Stablemen and Tobacconists, in addition to many other tradespeople. Enteric Fever attacked 13 persons following various occupations. Erysipelas infected 24 persons engaged in various employments. 1903] 186 Table CVII. List of Trades and Businesses carried on in Houses wherein Infectious Diseases have occurred during 1903. TRADES AND BUSINESSES. Small Pox. Scarlet Fever or Scarlatina. Diphtheria. Memb. Croup. Enteric (Typhoid Fever). Typhus Fever. Erysipelas. Puerperal Fever. Cholera. Total. Agency Artificial Florists ... ... ... ... ... ... 1 ... ... I Butchers ... 3 ... ... ... ... ... ... ... 8 Builders ... 2 1 ... 1 ... ... ... ... 4 Boot Makers ... 4 ... ... ... ... 1 ... ... 7 Bakers ... 3 1 ... ... ... 1 ... ... 5 Beerhouse ... 1 ... ... 1 ... ... ... ... 2 Box Making ... ... ... ... ... ... ... ... ... 3 Brush Manufacturing ... 1 1 ... ... ... ... ... ... 2 Boot Repairing ... 2 1 ... ... ... ... ... ... 3 Boarding House ... ... 1 ... ... ... ... ... ... 1 Confectioners ... 1 ... ... ... ... ... ... ... 3 Club ... 1 ... ... ... ... ... ... ... 1 Chimney Sweeps ... ... ... ... ... ... 1 ... ... 1 Cornchandlers ... 1 ... ... ... ... ... ... ... 1 Chemists ... 2 ... ... ... ... ... ... ... 2 Coal Dealers ... ... ... ... ... ... 1 ... ... 1 Dressmaking ... 6 ... ... ... ... 1 ... ... 10 Dairy ... 2 1 ... ... ... 1 ... ... 3 Drapers ... 2 ... ... ... ... ... ... ... 4 Dining Rooms ... 2 ... ... ... ... 1 ... ... 3 Dyers and Cleaners ... 1 ... ... ... ... ... ... ... 1 Furriers ... 1 ... ... ... ... 1 ... ... 2 Furniture Dealers ... 1 ... ... 1 ... ... ... ... 4 Fishmonger ... 2 ... ... 1 ... ... ... ... 3 Fruiterer ... 1 ... ... ... ... ... ... ... 1 General Dealer ... 7 ... ... ... ... ... ... ... 9 Grocers ... 6 1 ... 2 ... ... ... ... 9 Greengrocers ... 4 ... ... 1 ... 3 ... ... 8 Glass Case Maker ... ... ... ... 1 ... ... ... ... 1 Hairdressing ... ... 1 ... ... ... 1 ... ... 2 Lodging House ... ... 1 ... ... ... ... ... ... 1 Laundry ... 3 1 ... 2 ... 2 ... ... 8 Lamp Shade Makers ... ... 1 ... ... ... ... ... ... 1 Mangling ... 5 1 ... ... ... 1 ... ... 7 Milk Shop ... 1 1 ... ... ... ... ... ... 2 Mantle Making ... 1 ... ... ... ... 1 ... ... 2 Nursing Home ... 2 ... ... ... ... ... ... ... 2 Newsagent ... 5 ... ... 1 ... ... ... ... 9 Oilman ... 2 1 ... 1 ... ... ... ... 4 Orphanage ... 1 ... ... ... ... ... ... ... 1 Off License ... 1 ... ... ... ... ... ... ... 1 Public House ... 2 1 ... ... ... ... ... ... 3 Plumbers ... ... 1 ... ... ... ... ... ... 1 137 [1903 Table CVII.—continued. TRADES AND BUSINESSES. Small Pox. Scarlet Fever or Scarlatina. Diphtheria. Memb. Croup. Enteric (Typhoid Fever). Typhus Fever. Erysipelas. Puerperal Fever. Cholera. Total. Picture Frame Makers ... 1 ... ... ... ... ... ... ... 1 Printers ... 1 ... ... ... ... ... ... ... 1 Poulterers ... ... ... ... ... ... 1 ... ... 1 Pianoforte Makers ... 1 ... ... ... ... ... ... ... 1 Provision Dealers ... 1 ... ... ... ... ... ... ... 1 Sweets ... 3 ... ... ... ... 2 ... ... 5 Sadlers ... ... ... ... ... ... 1 ... ... 1 Stablemen ... 1 ... ... ... ... ... ... ... 4 School ... 5 ... ... ... ... ... ... ... 5 Stationers ... 1 ... ... ... ... ... ... ... 1 Tobacconists ... 1 1 ... ... ... ... ... ... 2 Tailors ... 3 2 ... ... ... 2 ... ... 7 Tie Making ... ... ... ... ... ... 1 ... ... 1 Tinsmith ... ... 1 ... ... ... ... ... ... 1 Tool Maker ... ... ... ... ... ... 1 ... ... 1 Wine and Spirit Stores ... ... ... ... ... ... ... ... ... 1 Watchmakers ... 1 ... ... ... ... ... ... ... 1 Waistcoat Making ... 1 ... ... ... ... ... ... ... 1 Wood Turners ... 1 ... ... ... ... ... ... ... 1 Totals ... 101 46 ... 13 ... 24 ... ... 184 1903] 138 OCCUPATION OF PERSONS ATTACKED WITH INFECTIOUS DISEASE. An interesting table (CVIII.) showing the occupations of 1,068 persons who were attacked with one or the other of the several notifiable diseases is given below. Table CVIII. Showing the Occupations of Patients suffering from the several Infectious Diseases during the year 1903. occupations. Small Pox. Scarlet Fever. Diphtheria Merab. Croup. Typhoid Fever. Typhus Fever. Erysipelas. Puerperal Fever. Cholera. Total. Apprentice ... 3 ... ... ... ... ... ... ... 3 Artificial Florist ... ... ... ... 1 ... ... ... ... 1 Artist ... ... ... ... 2 ... 1 ... ... 3 Accountant ... 1 ... ... ... ... ... ... ... 1 Bookkeeper ... 1 ... ... 1 ... ... ... ... 2 Basket Maker ... ... ... ... 1 ... ... ... ... 1 Butcher ... ... ... ... ... ... ... ... ... 1 Brickmaker ... ... ... ... 1 ... ... ... ... 1 Baker ... ... ... ... ... ... 1 ... ... 1 Barman ... ... ... ... ... ... ... ... ... 1 Barmaid ... ... ... ... ... ... ... ... ... 1 Box Maker ... ... ... ... 2 ... ... ... ... 4 Bookbinder ... ... ... ... 1 ... 3 ... ... 4 Bootmaker ... 1 ... ... 1 ... 1 ... ... 3 Clerk ... 9 ... ... 4 ... 3 ... ... 16 Compositor ... ... ... ... ... ... 1 ... ... 1 Cashier ... ... ... ... 1 ... 1 ... ... 3 Carman ... ... ... ... 6 ... 1 ... ... 9 Carpenter ... ... ... ... 1 ... 1 ... ... 2 Chemist ... ... ... ... 1 ... 1 ... ... 3 Costermonger ... ... ... ... ... ... 1 ... ... 1 Clergyman ... ... ... ... ... ... ... ... ... 1 Cornchandler ... ... ... ... 1 ... ... ... ... 1 Charwoman ... ... ... ... 2 ... 4 ... ... 7 Cabman ... ... ... ... ... ... 1 ... ... 2 Cabinet Maker ... ... ... ... 1 ... ... ... ... 1 Cattle Drover ... ... ... ... ... ... 1 ... ... 1 Chapel Keeper ... ... ... ... ... ... 1 ... ... 1 Costumier ... ... ... ... ... ... 1 ... ... 1 Coach Painter ... ... ... ... ... ... 1 ... ... 1 Carrier ... ... ... ... ... ... 1 ... ... 1 Dustman ... ... 1 ... ... ... ... ... ... 1 Diamond Setter ... ... ... ... ... ... ... ... ... 1 Dressmaker ... ... 2 ... ... ... 2 ... ... 4 Electro Plater ... ... 1 ... ... ... ... ... ... 1 Errand Girl ... ... 1 ... ... ... ... ... ... 1 Errand Boy ... 4 1 ... ... ... 1 ... ... 6 Electric Lamp Maker ... 1 ... ... ... ... ... ... ••• 1 139 [1903 Table CVIII.—continued. occupations. Small Pox. Scarlet Fever. Diphtheria Merab. Croup. Typhoid Fever. Typhus Fever. Erysipelas. Puerperal Fever. Cholera. Total. Engine Driver ... ... ... ... ... ... 1 ... ... 1 Electrician ... ... ... ... ... ... 1 ... ... 1 Furriers ... 1 ... ... ... ... 2 ... ... 3 Factory Hand 1 ... ... ... ... ... 2 ... ... 3 Flreman ... ... ... ... ... ... 1 ... ... 1 French Polisher ... ... ... ... 1 ... ... ... ... 1 Fancy Worker ... ... ... ... ... ... ... ... ... 1 Flower Seller ... ... 1 ... ... ... ... ... ... 1 Glass Case Maker ... ... ... ... 1 ... ... ... ... 1 Grocer ... 2 ... ... ... ... ... ... ... 2 Housewife 1 7 8 ... 1 ... 24 16 ... 57 Horsekeeper ... 2 2 ... 1 ... 1 ... ... 6 Hatter ... ... 1 ... ... ... ... ... ... 1 Iron Founder ... ... ... ... 1 ... ... ... ... 1 Ironer ... ... 1 ... 1 ... 1 ... ... 3 Labourer ... 5 ... ... 6 ... 8 ... ... 19 Laundress 1 ... 2 ... ... ... 1 ... ... 4 Lead Pipe Worker ... ... ... ... 1 ... ... ... ... 1 Lady's Help ... ... ... ... ... ... 1 ... ... 1 Lift Attendant ... ... ... ... ... ... 1 ... ... 1 Messenger ... 1 2 ... 2 ... 1 ... ... 6 Milliner ... ... ... ... 1 ... ... ... ... 1 Metal Worker 1 ... ... ... ... ... 1 ... ... 2 Meat Carrier ... ... ... ... 1 ... ... ... ... 1 Machinist ... 1 ... ... ... ... ... ... ... 1 Manageress ... 1 ... ... ... ... 1 ... ... 2 Mantle Maker ... ... 1 ... ... ... ... ... ... 1 Nurse ... 1 4 ... ... ... 1 ... ... 6 Needle worker ... ... ... ... ... ... 1 ... ... 1 Organ Builder ... ... 1 ... ... ... ... ... ... 1 Oil Color Merchant ... ... 1 ... 1 ... ... ... ... 2 Porter ... 1 ... ... 1 ... 3 ... ... 5 Paper Stainer ... 1 ... ... ... ... ... ... ... 1 Pork Butcher ... 1 ... ... ... ... ... ... ... 1 Policeman ... ... ... ... 1 ... 2 ... ... 3 Postman ... 2 ... ... ... ... 1 ... ... 3 Painter ... ... 1 ... ... ... ... ... ... 1 Professor of Music ... ... ... ... ... ... 1 ... ... 1 Pianoforte Maker ... 1 ... ... 1 ... 1 ... ... 3 Post Office Official ... ... ... ... ... ... 2 ... ... 2 Packer 1 4 ... ... ... ... ... ... ... 5 Platelayer ... ... ... ... ... ... 1 ... ... 1 K 2 140 1903] Table CVIII.—continued. occupations. Small Pox. Scarlet Fever. Diphtheria. Memb. Croup. Typhoid Fever. Typhus Fever. Erysipelas. Puerperal Fever. Cholera. Total. Rag Sorter ... ... ... ... ... ... 1 ... ... 1 Scholar 1 495 214 ... 30 ... 17 ... ... 757 Servant ... 3 6 ... ... ... 2 ... ... 11 Shop Assistant ... 2 2 ... 3 ... ... ... ... 7 Soldier ... 1 ... ... ... ... ... ... ... 1 School Teacher ... 2 ... ... ... ... ... ... ... 2 Signwriter ... 1 ... ... ... ... ... ... ... 1 Stockbroker ... ... ... ... 1 ... ... ... ... 1 Solicitor ... 1 ... ... ... ... ... ... ... 1 Sorter (G.P.O.) ... ... 1 ... ... ... ... ... ... 1 Salesman ... ... 1 ... ... ... ... ... ... 1 Surgeon ... ... 1 ... ... ... ... ... ... 1 Sleeping Car Attendant ... ... ... ... ... ... 1 ... ... 1 Silver Smith ... ... ... ... ... ... 1 ... ... 1 Straw Hat Maker ... ... ... ... ... ... 1 ... ... 1 Second Hand Furniture Dealer ... ... ... ... ... ... 1 ... ... 1 Sawyer ... ... ... ... ... ... 1 ... ... 1 Slaughterman ... ... ... ... ... ... 1 ... ... 1 Scavenger ... ... ... ... ... ... 2 ... ... 2 Telephone Assistant ... 1 ... ... ... ... ... ... ... 1 Traveller ... 2 ... ... ... ... 2 ... ... 4 Tram Driver ... ... ... ... ... ... 1 ... ... 1 Tailor ... 1 ... ... ... ... 1 ... ... 2 Telegraphist ... 1 ... ... ... ... ... ... ... 1 Turncock ... 1 ... ... ... ... ... ... ... 1 Tie Maker ... ... ... ... ... ... 1 ... ... 1 Ticket Sorter ... ... ... ... 1 ... ... ... ... 1 Telegraph Instrument Maker ... ... ... ... ... ... 1 ... ... 1 Upholsterer ... ... ... ... ... ... ... ... 1 Van Boy ... ... 1 ... ... ... 1 ... ... 2 Warehouseman ... ... ... ... 1 ... ... ... ... 1 Waitress ... ... 1 ... ... ... 1 ... ... 2 Waiter ... ... ... ... ... ... 1 ... ... 1 Wood Turner ... ... ... ... ... ... 1 ... ... 1 Totals 8 569 262 ... 85 ... 128 16 ... 1068 141 [1903 Table CIX. Showing the Streets in which the several cases of Infections Disease occurred during 1903. The large figures denote the number of cases and the small figures the number of infected houses. NAME OF STREET. Small Pox. Scarlet Fever. Diphtheria. Memb. Croup. Enteric Fever. Typhus Fever. Erysipelas. Puerperal Fever. Continued Fever. Totals. Arlington Street ... 22 11 ... 21 ... ... ... ... 51 Albion Grove ... ... ... ... ... ... 11 ... ... 11 Arlington Square ... 11 11 ... ... ... ... ... ... 22 Albert Place ... 11 ... ... ... ... ... ... ... I1 Alexander Road ... 11 ... ... ... ... ... 11 ... 22 Anson Road ... ... 11 ... 11 ... ... ... ... 22 Arvon Road ... ... 11 ... ... ... 11 ... ... 22 Aberdeen Place ... 21 22 ... ... ... ... ... ... 43 Arundel Place, Offord Road ... 21 ... ... ... ... ... ... ... 21 Albion Street ... 11 ... ... ... ... ... ... ... 11 Alwyne Road ... ... 11 ... ... ... ... ... ... 11 Alsen Goad ... 22 22 ... ... ... 11 ... ... 55 Alexandra Orphanage ... ... 3 ... ... ... ... ... ... 3 Almington Street ... 11 ... ... ... ... ... ... ... 11 Almeida Street ... ... ... ... 11 ... ... ... ... 11 Annesley Road ... ... ... ... ... ... 11 ... ... 11 Alfred Street ... 33 ... ... ... ... 11 ... ... 44 Alma Terrace ... ... 11 ... ... ... ... ... 11 Almorah Road ... ... 11 ... ... ... 11 ... ... 22 Aberdeen Park Mews ... ... 11 ... ... ... ... ... ... 11 Alma Grove ... 11 ... ... ... ... ... ... ... 11 Asliby Road ... 11 ... ... ... ... ... ... ... 11 Aberdeen Park ... ... ... ... 11 ... ... ... ... 11 Ashburton Grove ... ... 11 ... ... ... ... ... ... 11 Adelaide Square ... 11 ... ... ... ... 11 ... ... 21 Andover Road ... 33 11 ... ... ... 11 ... ... 5s Athelstane Road ... 32 ... ... ... ... ... ... ... 32 Archway Road ... 22 11 ... ... ... ... ... ... 38 Anatola Road 21 22 ... ... 11 ... ... ... ... 54 Avenell Road ... 22 ... ... 11 ... 11 11 ... 55 Ambler Road ... 22 ... ... ... ... ... ... ... 22 Aberdeen Road ... ... ... ... 11 ... ... ... ... 11 Ardilaun Road ... 11 ... ... ... ... ... ... ... 11 Ashmount Road ... 11 ... ... ... ... ... ... ... 11 All Saints' Street ... 22 ... ... ... ... ... ... ... 22 Arundel Square ... 23 ... ... ... ... ... ... ... 22 Albany Place ... ... ... ... ... ... 11 ... ... 11 Astey's Row ... ... 22 ... ... ... ... ... ... 22 142 1903] Table CIX.—continued. NAME OF STREET. Small Pox. Scarlet Fever. Diphtheria. Memb. Croup. Enteric Fever. Typhus Fever. Erysipelas. Puerperal Fever. Continued Fever. Totals. Arundel Road ... ... ... ... ... ... 11 ... ... 11 Ann Street 11 ... ... ... ... ... ... ... ... 11 Archibald Road ... ... ... ... ... ... ... 11 ... 11 Arundel Grove ... ... ... ... 11 ... ... ... ... 11 Alma Road ... ... 11 ... ... ... ... ... ... 11 Brewery Road ... 53 38 ... ... ... ... ... ... 86 Brecknock Road ... ... 43 ... ... ... ... ... ... 43 Bemerton Street ... 33 31 ... 33 ... 11 11 ... 118 Bracey Street ... 11 11 ... 11 ... ... ... ... 33 Bickerton Road ... 33 ... ... ... ... 11 ... ... 44 Barbara Street 11 22 ... ... ... ... ... ... ... 33 Bedford Terrace ... 33 ... ... ... ... ... ... ... 33 Bride Street 11 99 32 ... ... ... ... ... ... 1312 Bingfield Street ... 22 33 ... 11 ... ... ... ... 66 Beaconsfield BUILDINGS ... 11 55 ... 11 ... ... ... ... 77 lioleyn Road ... ... ... ... 11 ... ... ... 11 Brandon Road ... ... 11 ... ... ... ... ... ... 11 Barnsbury Road ... 44 ... ... ... ... 11 ... ... 55 Birnam Road ... 22 ... ... 11 ... ... ... ... 33 Balfour Road ... 43 ... ... ... ... ... ... ... 43 Benwell Road ... 52 ... ... ... ... ... ... ... 52 Bardolph Road ... ... ... ... ... ... 22 ... ... 22 Bismarck Road ... 11 ... ... ... ... ... ... ... 11 Battledean Road ... 11 ... ... ... ... 22 ... ... 33 Brook Road ... ... ... ... ... ... 11 ... ... 11 Barnsbury Street ... ... ... ... ... ... 11 ... ... 11 Brooksby Street ... 11 11 ... ... ... ... 11 ... 33 Brunswick Road ... ... 11 ... ... ... ... ... ... 11 Balls Pond Road ... 11 ... ... ... ... ... ... ... 11 Beacon Hill ... 22 ... ... ... ... ... ... ... 22 Blackstock Road ... 32 ... ... ... ... ... ... ... 32 Baring Street ... ... 22 ... ... ... ... ... ... 22 Beresford Road ... 11 ... ... ... ... ... 11 ... 22 Belitha Villas ... 11 ... ... ... ... ... ... ... 11 Blundell Street ... 33 ... ... ... ... 22 ... ... 54 Britannia Row ... ... 11 ... ... ... ... ... ... 11 Burghley Stables, Parkhurst Road ... ... 11 ... ... ... ... ... ... 11 Buckingham Street ... ... ... ... 11 ... ... ... ... 11 Bishops Grove ... 11 11 ... ... ... ... ... ... 22 Barnsbury Park ... ... 21 ... ... ... ... ... ... 21 Bryantwood Road ... 11 11 ... ... ... ... ... ... 22 Brand street ... ... 11 ... ... ... ... ... ... 11 Bovay Street ... 11 ... ... ... ... ... ... ... 11 143 [1908 Table CIX.—continued. NAME OF STREET. Small Pox. Scarlet Fever. Diphtheria. Memb. Croup. Enteric Fever. Typhus Fever. Erysipelas. Puerperal Fever. Continued Fever. Totals. Barnsbury Grove ... 22 ... ... ... ... ... ... ... 22 Broadway, Highbury Park ... 11 ... ... ... ... ... ... ... 11 Bryan Place ... ... 11 ... ... ... ... ... ... 11 Barnsbury Square ... ... 11 ... ... ... ... ... ... 11 Brunswick Street ... 11 ... ... ... ... ... ... ... 11 Baxter Road ... 22 ... ... ... ... 11 ... ... 33 Blenheim Road ... ... 11 ... ... ... ... ... ... 11 Church Road ... 31 ... ... ... ... ... ... ... 31 Cottenham Road ... 33 32 ... 11 ... 33 ... ... 109 Citizen Road ... 22 11 ... ... ... 11 ... ... 44 Crouch Hill ... 11 11 ... ... ... 11 ... ... 33 Copenhagen Street ... 97 11 ... 11 ... 44 ... ... 1513 Corbyn Street ... 11 43 ... 11 ... 11 ... ... 76 Caledonian Road ... 1413 33 ... 11 ... 44 11 ... 2321 Crossley Street ... 32 ... ... ... ... ... ... ... 32 Carleton Road ... ... 22 ... ... ... ... ... ... 22 Corinne Road ... ... 22 ... ... ... 11 ... ... 33 Chatterton Road ... 83 ... ... ... ... ... ... ... 83 Courtney Road ... 11 ... ... ... ... ... ... ... 11 Caledonian Cresccnt ... ... ... ... ... ... 11 ... ... 11 Caledonia Street ... ... ... ... 11 ... ... ... ... 11 Calverley Grove ... 11 ... ... ... ... ... ... ... 11 Corinth Road ... ... 43 ... ... ... ... ... ... 43 Carleton Terrace, Halton Road ... 11 ... ... ... ... ... ... ... 11 Canonbury Avenue ... ... ... ... ... ... 11 ... ... 11 Crayford Road ... ... 11 ... ... ... ... ... ... 11 Camden Dwellings ... 11 42 ... 11 ... ... ... ... 64 Cheverton Road ... 43 11 ... ... ... ... ... ... 54 Cumberland Street ... 21 ... ... ... ... 11 ... ... 32 Cromwell Road ... 43 33 ... ... ... ... ... ... 76 Celia Road ... 11 ... ... ... ... ... ... ... 11 Corporation Street ... ... 73 ... ... ... 11 ... ... 84 Compton Road ... ... 32 ... ... ... ... ... ... 32 Cloudesley Road ... 64 31 ... ... ... 11 ... ... 106 Charteris Road ... 53 11 ... ... ... ... ... ... 63 Cardale Street ... 32 ... ... ... ... 11 ... ... 43 Campbell Road ... 43 65 ... 11 ... 22 11 ... 1410 Compton Avenue ... ... 11 ... ... ... 11 ... ... 21 Charles Street, Westbourne Rd. ... 11 22 ... ... ... ... ... ... 33 Charlotte Street ... 22 ... ... ... ... ... ... ... 22 City Road 11 22 ... ... ... ... 11 ... ... 44 C mpton Street ... 11 ... ... ... ... 11 ... ... 22 Church Lane ... 11 42 ... ... ... ... ... ... 53 Canonbury Street 11 11 ... ... ... ... ... ... ... 22 144 1908] Table CIX.—continued. NAME OF STREET. Small Pox. Scarlet Fever. Diphtheria. Memb. Croup. . Enteric Fever. Typhus Fever. Erysipelas. Puerperal Fever. Continued Fever. Totals. Crescent Avenue ... ... ... ... 11 ... ... ... ... 11 Colebrooke Row ... 11 22 ... ... ... ... ... ... 33 Camden Road ... 32 11 ... ... ... ... ... ... 43 Canonbury Park South ... ... ... ... ... ... 11 ... ... 11 Cross Street ... 11 ... ... ... ... 11 ... ... 22 City Arms Buildings ... 11 11 ... ... ... ... ... ... 22 Chalfont Road ... 32 ... ... 11 ... ... ... ... 48 Canterbury Road ... ... 22 ... ... ... ... ... ... 22 Cutlers Terrace, Balls Pond ... 11 ... ... ... ... ... ... ... 11 Conewood Street ... 11 11 ... 11 ... ... ... ... 38 Charlesworth Street ... ... ... ... 11 ... ... ... ... 11 Canning Road ... 32 ... ... 32 ... ... ... ... 64 Canonbury Road ... 11 ... ... ... ... 22 ... ... 33 Cleveland Road ... 11 ... ... ... ... 11 ... ... 22 Cardozo Road ... ... 11 ... ... ... ... ... ... 11 Crescent Street ... 11 ... ... ... ... ... ... ... 11 City Garden Row ... ... 22 ... ... ... ... ... ... 22 Clayton Street ... ... ... ... ... ... 11 ... ... 11 Canonbury Square ... ... 11 ... ... ... ... ... ... 11 Cornwallis Road ... 11 ... ... 11 ... 11 ... ... 33 Canterbury Place ... 11 11 ... ... ... ... ... ... 21 Carlsbad Street ... 32 ... ... ... ... ... ... ... 32 Crane Grove ... 21 11 ... ... ... ... ... ... 32 Clarence Street ... ... ... ... ... ... 11 ... ... 11 Camden Street ... 11 ... ... ... ... ... ... ... 11 Charlton Crescent ... 11 ... ... ... ... ... ... ... 11 Canal Terrace ... 21 ... ... ... ... ... ... ... 21 Coleridge Road ... 11 ... ... ... ... ... ... ... 11 Dresden Road ... 42 32 ... ... ... ... ... ... 74 Dame Street ... 11 ... ... ... ... 11 ... ... 22 Dennis Street ... 22 21 ... 11 ... 11 ... ... 64 Dunford Road ... 11 ... ... ... ... ... ... ... 11 Despard Road ... 11 22 ... ... ... ... ... ... 33 Dartmouth Park Hill ... 11 ... ... ... ... ... ... ... 11 Drayton Park ... 62 ... ... ... ... ... ... ... 62 Dibden Street ... ... 22 ... ... ... ... ... ... 22 Duncan Terrace ... 31 ... ... ... ... 22 ... ... 53 Dalmeny Road ... 51 11 ... ... ... ... ... ... 62 Denmark Road ... ... 22 ... ... ... ... ... ... 22 Denmark Grove ... 22 ... ... ... ... ... ... ... 22 Downham Road ... ... ... ... ... ... 22 ... ... 22 Devonshire Road ... 52 52 ... ... ... 11 ... ... 115 Durham Road ... 31 86 ... ... ... ... ... ... 117 Danbury Street ... ... 11 ... ... ... ... ... ... 11 145 [1903 Table CIX.—continued. NAME OF STREET. Small Pox. Scarlet Fever. Diphtheria. Menito. Croup. Enteric Fever. Typhus Fever. Erysipelas. Puerperal Fever. Continued Fever. Totals. Dagmar Terrace ... 21 11 ... ... ... ... ... ... 31 Dalmeny Avenue ... 11 11 ... ... ... ... ... ... 22 Devonshire Street ... 11 22 ... ... ... ... ... ... 33 Delhi Street ... 32 ... ... ... ... ... ... ... 32 Dorset Street ... ... ... ... 22 ... ... ... ... 22 Duncombe Road ... 11 ... ... 11 ... 11 ... ... 33 Davenant Road ... 11 ... ... ... ... ... ... ... 11 Duncan Street ... 21 ... ... ... ... ... ... ... 21 Denmark Street ... ... 11 ... ... ... ... ... ... 11 Dean Street ... ... ... ... 11 ... 11 ... ... 22 Douglas Road ... ... 11 ... ... ... ... ... ... 11 Eden Grove ... 105 11 ... ... ... 22 ... ... 138 Elmore Street ... 33 53 ... ... ... 22 ... ... 107 Elfort Road ... 22 11 ... ... ... ... ... ... 33 Essex Road 11 11 21 ... ... ... 44 ... ... 87 Elthorne Road ... 22 22 ... 22 ... ... 11 ... 77 East Street ... ... 11 ... 42 ... ... ... ... 52 El wood Street ... 72 ... ... 22 ... ... ... ... 94 Edinburgh Cottages, Essex Rd. ... ... 33 11 ... ... ... ... ... 43 Edinburgh Place, Brewery Rd. ... ... 22 ... ... ... ... ... ... 22 Edwards Cottages, Canonbury Road ... ... 11 ... ... ... ... ... ... 11 Elliott's Place ... 11 ... ... 21 ... ... ... ... 32 Everleigh Street ... 11 ... ... ... ... ... ... ... 11 Eddington Street ... 11 ... ... ... ... ... ... ... 11 Elphinstone Street ... 11 ... ... ... ... ... ... ... 11 Englefield Road ... ... 11 ... ... ... 11 ... ... 22 Elder Walk, Essex Road ... ... ... ... ... ... 11 ... ... 11 Ellington Street ... 22 ... ... ... ... 11 ... ... 33 Edwards Square ... 33 11 11 ... ... ... ... ... 55 Enkel Street ... ... 21 ... ... ... ... ... ... 21 Ecclesbourne Road ... ... 11 ... ... ... 11 ... ... 22 Eaton Grove, Wedmore Street ... 11 ... ... ... ... ... ... ... 11 Ferntower Road ... ... ... ... ... ... 11 ... ... 11 Freeling Street ... 22 ... ... 11 ... ... ... ... 33 Francis Street ... 11 ... ... I1 22 Fortnam Road ... 31 22 ... 22 ... ... ... ... 75 Fontliill Road ... 44 ... ... 22 ... 22 ... ... 88 Fairbridge Road ... 11 11 ... ... ... ... ... ... 22 Freegrove Road ... 11 11 ... ... ... ... ... ... 22 Florence Street ... 11 ... ... ... ... ... ... ... 11 Foxham Road ... 22 11 ... ... ... ... 11 ... 43 Frederick Street ... 33 63 ... ... ... 22 ... ... 118 Fakenham Street ... ... 11 ... 11 ... ... ... ... 22 146 1903] Table CIX.—continued. NAME OF STREET. Small Pox. Scarlet Fever. Diphtheria. Memb. Croup. Enteric Fever. Typhus Fever. Erysipelas. Puerperal Fever. Continued Fever. Totals. Frome Street ... 11 ... ... ... ... ... ... ... 11 Furlong Road ... 31 i1 ... ... ... ... ... ... 42 Fife Terrace ... i1 ... ... ... ... ... ... ... 11 Great Northern Hospital ... ... 51 ... ... ... ... ... ... 51 George's Road ... 42 i1 ... 11 ... 22 ... ... 86 Gifford Street ... ... ... ... 11 ... 11 ... ... 22 Gillespie Road ... 138 11 ... ... ... ... 11 ... 1510 Gibson Square ... 32 ... ... ... ... 22 ... ... 54 Goodinge Road ... 76 2012 ... 11 ... 33 ... ... 3121 Gerrard Street ... 22 11 ... ... ... 11 ... ... 44 Grovedale Road ... 11 33 ... ... ... 11 ... ... 55 Graham Street ... 22 22 ... ... ... ... 11 ... 55 Gloucester Road ... 11 ... ... 11 ... 11 ... ... 33 Girdlestone Road ... 32 11 ... ... ... 11 ... ... 53 Grenville Road ... ... 11 ... ... ... ... ... ... 11 Gordon Place ... ... ... ... ... ... 11 ... ... 11 Grove Road ... 94 ... ... ... ... 21 ... ... 115 Goldsmith's Place ... 11 ... ... ... ... ... ... ... 11 Grafton Road 11 11 ... ... ... ... ... ... ... 22 Garden Villas ... ... ... ... ... ... 11 ... ... 11 Gladsmuir Road ... ... 11 ... ... ... 11 ... ... 22 Giesbach Road ... 11 ... ... ... ... ... ... ... 11 Gainford Street ... ... ... ... ... ... 11 ... ... 11 Grove Street ... 31 21 ... ... ... ... ... ... 52 Goodwin Street ... ... ... ... ... ... 11 ... ... 11 Grosvenor Street ... ... 11 ... ... ... ... ... ... 11 Gresley Road ... ... 11 ... ... ... ... ... ... 11 Grosvenor Road ... ... ... ... 11 ... ... ... ... 11 Gordon Street ... 11 ... ... ... ... ... ... ... 11 Hungerford Road ... 43 54 ... ... ... ... ... ... 96 Hilldrop Crescent ... ... 11 ... ... ... ... ... ... 11 Hornsey Road ... 86 32 ... 22 ... 22 11 ... 1612 Highbury New Park ... 44 ... ... ... ... ... ... ... 44 Harvist Road ... 11 11 ... ... ... ... ... ... 22 Holloway Road ... 127 86 ... 22 ... 22 ... ... 2415 Hornsey Lane ... 11 ... ... ... ... ... ... ... 11 Highbury Hill ... 108 11 ... ... ... 43 ... ... 1512 Huntingdon Street ... 42 22 ... ... ... 11 ... ... 75 Half Moon Crescent ... 11 ... ... 11 ... ... ... ... 22 Hazellville Road ... 42 11 ... 11 ... 22 ... ... 86 Hanley Road ... 22 11 ... 11 ... ... ... ... 43 Halse Street 21 62 42 11 ... ... ... ... ... 134 Hargrave Road ... 38 ... ... ... ... ... ... ... 33 Harberton Road ... 11 ... ... ... ... 11 ... ... 22 147 [1903 Table CIX.—continued. name OF street. Small Pox. Scarlet Fever. Diphtheria. Memb. Croup. Enteric Fever. ! Typhus Fever. Erysipelas. Puerperal Fever. Continued Fever. Totals. Hargrave Park ... 22 11 ... ... ... 11 ... ... 44 Hercules Road ... 11 ... ... ... ... ... ... ... 11 Huddlestone Road ... 33 22 ... ... ... ... ... ... 55 Highbury Grange ... 11 11 ... ... ... ... ... ... 22 Hilldrop Road ... 22 11 ... ... ... ... ... ... 32 H.M. Prison, Holloway ... ... 11 ... ... ... 3 ... ... 41 Hatley Road ... 11 11 ... ... ... 11 ... ... 33 Hercules Place ... 11 ... ... ... ... 11 ... ... 22 Hamilton Road ... 21 22 ... ... ... ... ... ... 43 Halliford Street ... 11 22 ... ... ... ... ... ... 33 Hemingford Road ... 54 11 ... ... ... ... ... ... 65 Hampden Road ... 22 11 ... ... ... 11 11 ... 54 Havelock Street ... ... 22 ... ... ... 11 ... ... 33 Herrick Road ... 65 11 ... ... ... ... ... ... 76 Hawthorn Street ... 11 ... ... ... ... ... ... ... 11 Hardinge Street ... ... ... ... 11 ... ... ... ... 11 Highbury Quadrant ... 22 11 ... ... ... ... ... ... 32 Hornsey Street ... ... ... ... 11 ... 11 ... ... 22 Hollingsworth Street ... 32 ... ... ... ... ... ... ... 32 Hope Street ... 11 ... ... ... ... 11 ... ... 22 High Street ... 11 11 ... ... ... ... ... ... 22 Henry Place ... 11 ... ... ... ... ... ... ... 11 Heathville Road ... 11 ... ... ... ... ... ... ... 11 Hartliam Road ... 11 ... ... ... ... ... ... ... 11 Highgate Hill ... 41 11 ... ... ... ... ... ... 51 Halton Road ... 11 ... ... ... ... ... ... ... 11 Isledon Road ... 22 21 ... ... ... ... ... ... 43 Islington Workhouse ... ... ... ... 11 ... 71 ... ... 81 Islington Green ... 32 11 ... ... ... ... ... ... 48 Islington Infirmary ... ... ... ... ... ... 51 ... ... 51 Ingleby Road ... ... 22 ... ... ... ... ... ... 22 James Street ... ... 11 ... 11 ... 11 ... ... 33 Junction Road ... 22 ... ... ... ... ... ... ... 22 King Edward Street ... 38 ... ... ... ... ... ... ... 33 Kingsdown Road ... 11 33 ... 11 ... ... ... ... 66 Kelvin Road ... 22 ... ... ... ... ... ... ... 22 Kelvin Mews ... ... 11 ... ... ... ... ... ... 11 King Henry Street ... 11 11 ... ... ... 11 ... ... 38 Kingsbury Road ... ... 11 ... 11 ... ... ... ... 22 Liverpool Road ... 43 41 ... ... ... 44 ... ... I 211 Lofting Road ... 11 ... ... ... ... ... ... ... 11 Lonsdale Square ... 11 ... ... ... ... 11 ... ... 22 Lidyard Road ... 11 ... ... ... ... 11 ... ... 22 Little Cross Street ... ... 32 ... ... ... ... ... ... 32 148 1903] Table CIX.—continued. NAME OF STREET. Small Pox. Scarlet Fever. Diphtheria. Memb. Croup. Enteric Fever. Typhus Fever. Erysipelas. Puerperal Fever. Continued Fever. Totals. Luard Street ... 11 ... ... ... ... ... ... ... 11 Lady Margaret Road ... ... 11 ... ... ... ... ... ... 11 Lambton Road ... 11 11 11 ... 11 ... ... 44 Langdon Road ... 54 33 ... ... ... 22 ... ... io8 Liverpool Buildings ... 11 11 ... 11 ... 11 ... ... 44 Lesly Street ... 22 ... ... ... ... ... ... ... 22 Lennox Road ... 11 ... ... 11 ... ... ... ... 22 Lyon Street ... ... ... ... ... ... 11 ... ... 11 Little Cumming Street ... 11 ... ... ... ... 11 ... ... 21 Landseer Road ... 11 ... ... ... ... ... ... ... 11 London Fever Hospital ... 1 2 ... ... ... ... ... ... 31 Leconfield Road ... 11 11 ... 11 ... ... ... ... 33 London Street ... 11 21 ... ... ... ... ... ... 32 Loraine Road ... 22 ... ... 11 ... ... ... ... 38 Liberia Road ... 11 ... ... ... ... ... ... ... 11 Mayton Street ... 48 ... ... ... ... 11 ... ... 54 Middleton Road ... ... 21 ... ... ... ... ... ... 21 Milner Square ... ... ... ... 11 ... 11 ... ... 22 Mercers Road ... ... 11 ... ... ... ... ... ... 11 Mildmay Grove ... 54 ... ... 11 ... ... ... ... 65 Mildmay Park ... 22 11 ... ... ... ... ... ... 33 Marquess Road ... 11 ... ... ... ... ... ... ... 11 Mildmay Street ... 11 ... ... 11 ... 38 ... ... 55 Magdala Road ... 21 ... ... ... ... ... ... ... 21 Marriott Road ... 32 22 ... ... ... ... ... ... 53 Mildmay Road ... 33 ... ... ... ... 11 ... ... 44 Middlesex Street ... 32 ... ... ... ... ... ... ... 32 Marlboro' Road ... 44 44 ... 11 ... 21 ... ... 118 Mildmay Memorial Hospital ... ... ... ... 21 ... ... ... ... 21 Marcellus Road ... 33 22 ... ... ... ... ... ... 55 Mitford Road ... 11 ... ... ... ... ... ... ... 11 Myrtle Street ... 54 ... ... 11 ... ... ... ... 65 Monnery Road ... 11 11 ... ... ... ... ... ... 22 Mayville Stree ... 11 ... ... ... ... 11 ... ... 29 Mountgrove Road ... 11 ... ... ... ... ... ... ... 11 Monsell Road ... ... ... ... ... ... 11 ... ... 11 Monte Christo Mansions ... ... 11 ... ... ... ... ... ... 11 Matthias Road ... 21 ... ... ... ... 22 ... ... 48 Marylebone Street ... 11 ... ... ... ... ... ... ... 11 Moray Road ... 44 22 ... ... ... ... ... ... 66 Maygood Street ... 11 ... ... ... ... 11 ... ... 22 Montem Street ... 22 ... ... ... ... ... ... ... 22 Muriel Street ... ... 11 ... 11 ... ... ... ... 22 Medina Road • •• 22 ... ... ... ... ... ... ... 22 149 [1908 Table CIX.—continued. NAME OF STREET. Small Pox. Scarlet Fever. Diphtheria. Memb. Croup. Enteric Fever. Typhus Fever. Erysipelas. Puerperal Fever. Continued Fever. Totals. Milton Grove ... 11 22 ... ... ... ... ... ... 32 Mildmay Avenue ... ... ... ... 11 ... 11 ... ... 22 Morton Road ... ... ... ... 11 ... ... ... ... 11 Myddelton Buildings ... ... 11 ... ... ... ... ... ... 11 Matilda Street ... 11 ... ... ... ... ... ... ... 11 Noel Street ... 11 22 ... ... ... ... ... ... 33 North Road ... ... 44 ... ... ... ... ... ... 44 North Avenue ... 11 ... ... ... ... ... ... ... 11 Nicholay Road ... ... 32 ... 11 ... 11 ... ... 54 North Street ... 11 22 ... ... ... ... ... ... 33 Northolme Road ... 32 ... ... ... ... ... ... ... 32 Newington Green ... 22 ... ... ... ... ... ... ... 22 Nelson Place ... ... ... ... 11 ... ... ... ... 11 Nailour Street ... ... 11 ... ... ... ... ... ... 11 Newington Green Road ... ... 22 ... ... ... ... ... ... 22 New North Road ... 11 42 ... ... ... ... ... ... 52 Napier Terrace ... 11 ... ... ... ... ... ... ... 11 Norfolk Road ... 11 ... ... ... ... ... ... ... 11 Nelson Terrace ... .. 11 ... ... ... ... ... ... 11 Oakley Road ... 11 ... 11 ... 38 ... ... 55 Ockendon Road ... 32 ... ... ... ... 21 ... ... 53 Outram Street ... 33 11 ... ... ... 11 ... ... 55 Oxford Road ... ... ... ... 11 ... 22 ... ... 33 Oiford Road ... 22 ... ... 11 ... ... ... ... 33 Oxford Terrace, St. Peter's Street ... 11 ... ... ... ... ... ... ... 11 Orpingley Road ... 11 ... ... ... ... 22 ... ... 32 Orchard Cottages, James Street, Essex Road ... 11 ... ... ... ... ... ... ... 11 Pulteney Terrace ... 11 32 ... 11 ... ... ... ... 54 Pembroke Street ... ... 22 ... 22 ... 11 ... ... 87 Popham Street ... 11 ... ... ... ... ... ... ... 11 Plimsoll Road ... 42 11 ... 11 ... 11 11 ... 86 Poet's Road ... 11 ... ... 11 ... ... ... ... 22 Pentonvillc Cottages ... 11 ... ... ... ... ... ... ... 11 Petherton Road ... 11 ... ... ... ... ... ... ... 11 Popham Road ... 11 ... ... ... ... 22 ... ... 33 Palmerston Road ... 116 43 ... 11 ... 33 ... ... 1913 Pickering Street ... ... 11 ... 11 ... 11 ... ... 33 Parolles Road ... 22 ... ... ... ... ... ... ... 22 Pleasant Buildings, York Road ... 11 ... ... ... ... 11 ... ... 21 Prebend Street ... 68 ... ... ... • •• 11 ... ... 74 Parkhurst Road ... 11 ... ... 22 ... ... ... ... 33 150 1903] Table CIX.—continued. NAME OF STREET. Small Pox. Scarlet Fever. Diphtheria. Memb. Croup. Enteric Fever. Typhus Fever. Erysipelas. Puerperal Fever. Continued Fever. _ Totals. Premier Buildings ... 22 ... ... ... ... 22 ... ... 44 Packington Street ... 76 ... ... ... ... ... ... ... 76 Penn Road Villas ... ... ... ... ... ... 11 ... ... 11 Palmerston Buildings, City Garden Row ... 42 11 ... ... ... ... ... ... 53 Pemberton Terrace ... 11 ... ... ... ... 11 ... ... 21 Pyrland Road ... ... 11 ... ... ... 11 ... ... 22 Peabody Buildings ... 11 11 ... 11 ... 22 ... ... 55 Prah Road ... 11 ... ... ... ... ... ... ... 11 Pooles Park ... 11 ... ... ... ... 11 ... ... 22 Pemberton Gardens ... 32 ... ... ... ... ... ... ... 32 Prospero Road ... 11 ... ... ... ... ... ... ... 11 Poynings Road ... 11 11 ... ... ... ... ... ... 22 Pleasant Place, Halton Cross street ... ... 11 ... ... ... ... ... ... 11 Quinn Buildings ... 55 22 ... 11 ... 11 ... ... 99 Queensland Road ... 22 11 ... 43 ... ... ... ... 76 Queen's Square ... 11 ... ... ... ... ... ... ... 11 Queen's Arms Buildings ... ... 33 ... ... ... ... ... ... 33 Queensbury Street ... 11 11 ... ... ... 11 ... ... 38 Queen's Cottages ... 22 ... ... ... ... ... ... ... 22 Queen Margaret's Grove ... ... ... ... ... ... 11 ... ... 11 Quadrant Road ... ... ... ... ... ... 11 ... ... 11 Rotherfield Street ... ... 54 ... ... ... 11 ... ... 66 Richmond Crescent ... 41 ... ... ... ... ... ... ... 41 Riversdale Road ... 117 11 ... ... ... ... ... ... 128 Roman Road ... 106 ... ... 11 ... ... 11 ... 128 Richmond Road ... 22 ... ... 11 ... ... ... ... 33 Rupert Road ... 11 11 ... ... ... ... ... 11 33 Roden Street ... 22 ... ... 11 ... ... ... ... 44 Russell Road ... ... 11 ... ... ... ... ... ... 11 Railway Street ... ... 11 ... ... ... ... ... 11 11 Rosemary Street ... ... 11 ... ... ... ... ... ... 22 Royal Caledonian Asylum ... 2 ... ... ... ... ... ... ... 21 Rock Street ... 11 ... ... ... ... ... ... ... 21 Rhodes Street ... 43 ... ... ... ... ... ... ... 43 Randall's Road ... 11 ... ... ... ... ... ... ... 11 Rayner Place, Queensbury Street ... ... ... ... ... ... 11 ... ... 11 Remington Street ... 42 ... ... ... ... ... ... ... 42 Regina Road ... 11 ... ... ... ... ... ... ... 11 Rhodes Place ... 11 ... ... ... ... ... ... ... 11 Ringcroft Street ... 11 ... ... ... ... ... ... ... 11 151 [1903 Table CIX.—continued. NAME OF STREET. Small Pox. Scarlet Fever. Diphtheria. Memb. Croup. Enteric Fever. Typhus Fever. Erysipelas. Puerperal Fever. Continued Fever. Totals. Rufford Street ... ... ... ... ... ... 11 ... ... 11 Stanmore Street ... 32 ... ... 11 ... 22 ... ... 65 St. James' Road ... 11 11 ... 11 ... 11 ... ... 44 Sussex Road ... 53 ... ... ... ... ... ... ... 53 Southampton Street ... 22 ... ... ... ... 11 ... ... 32 St. John's Road ... 33 ... ... 11 ... 11 ... ... 55 St. Paul's Road ... 43 11 ... ... ... 11 ... ... 65 St. John's Park ... ... 11 ... ... ... ... ... ... 11 Stanley Road ... 11 ... ... ... ... ... ... ... 11 Slaney Place ... 21 ... ... ... ... ... ... ... 21 Sebbon Place ... 11 ... ... ... ... 11 ... ... 22 St. Thomas' Road ... 86 11 ... ... ... ... ... ... 97 Shaftesbury Road ... ... ... ... ... ... 11 ... ... 11 Storey Street ... 43 ... ... ... ... 11 ... ... 51 St. Peter's Street ... 22 11 ... ... ... 22 ... ... 54 Sudeley Street ... ... ... ... ... ... 11 ... ... 11 Scholefield Road ... ... 22 ... ... ... 11 ... ... 33 Seven Sisters Road ... 11 22 ... ... ... 11 ... ... 44 Surr Street ... ... 84 ... ... ... ... ... ... 84 St. Philip Street ... 31 ... ... ... ... ... ... ... 31 Sonning Street ... 22 22 ... ... ... ... ... ... 44 Spencer Street ... 11 11 ... 11 ... ... ... ... 32 St. Paul's Place ... 21 ... ... ... ... ... ... ... 21 Salisbury Road 11 41 ... ... ... ... ... ... ... 55 St. Clement's Street ... 11 ... ... ... ... ... ... ... 22 Sunnyside Road ... 11 11 ... ... ... 11 ... ... 38 Sotheby Road ... 11 ... ... ... ... ... ... ... 11 Shelburne Road ... 22 ... ... ... ... ... ... ... 22 Sutterton Street ... ... 11 ... ... ... 11 ... ... 22 Shepperton Road ... 22 33 ... 11 ... 11 ... ... 76 St. John's Park Mansions ... ... ... ... 11 ... ... ... ... 11 St John's Villas ... 11 ... ... ... ... ... ... ... 11 South Street ... ... ... ... 11 ... ... ... ... 11 Southgate Road ... 22 ... ... 21 ... ... ... ... 43 Southern Street ... ... 11 ... ... ... ... ... ... 11 Station Houses, Cumberland Street ... ... ... ... 11 ... ... ... ... 11 Sherbourne Street ... ... ... ... 22 ... 11 ... ... 32 St. John Street ... ... ... ... 11 ... ... ... ... 11 Sebbon Street ... ... ... ... ... ... 11 ... ... 11 Stock Orchard Crescent ... 11 ... ... ... ... ... ... ... 11 St. Peter's Road ... 11 ... ... ... ... ... ... ... 11 St. Jude Street ... ... 11 ... ... ... ... ... ... 11 152 1908] Table CIX.—continued. NAME OF STREET. Small Pox. Scarlet Fever. Diphtheria. Memb. Croup. Enteric Fever. Typhus Fever. Erysipelas. Puerperal Fever. Continued Fever. Totals. St. George's Avenue ... ... 11 ... ... ... ... ... ... 11 Theberton Street ... 11 ... ... ... ... ... ... ... 11 Tabley Road ... 22 11 ... ... ... ... ... ... 33 Torrens Buildings ... 41 ... ... 11 ... ... ... ... 52 Tollington Road ... 22 11 ... ... ... ... ... ... 33 Thornhill Houses, Offord Road ... ... ... ... 11 ... 11 ... ... 22 Tollington Park ... ... ... ... 11 ... ... ... ... 11 Travers Road ... 11 ... ... ... ... ... ... ... 11 Thornhill Road ... 22 ... ... 11 ... 11 ... ... 43 Tiber Street ... 33 22 ... ... ... 11 ... ... 66 Trinity Street ... 11 ... ... ... ... 11 ... ... 22 Tytherton Road ... 22 ... ... ... ... ... ... ... 22 Tufnell Park Road ... 11 11 ... ... ... 11 ... ... 33 Thane Villas ... ... 11 ... 11 ... ... ... ... 22 Thornhill Square ... 11 ... ... ... ... 11 ... ... 22 Thornhill Crescent ... 11 11 ... ... ... ... ... ... 22 Twyford Street ... 32 11 ... ... ... ... ... ... 43 Tibberton Square ... ... 11 ... ... ... ... ... ... 11 Tile Yard Road ... ... 11 ... ... ... ... ... ... 11 Tavistock Mews ... ... 11 ... ... ... ... ... ... 11 Upper Street ... 64 ... ... 11 ... 22 ... ... 97 Upper Park Street ... 11 ... ... ... ... ... ... ... 11 Union Road ... ... ... ... ... ... 11 ... ... 11 Union Square ... ... ... ... ... ... 11 ... ... 11 Vincent Terrace ... 11 ... ... ... ... ... ... ... 11 Vorley Road ... 11 22 ... ... ... ... ... ... 33 Victoria Street ... 21 11 ... ... ... ... ... ... 32 Victoria Villas, Sonderberg Road ... 11 ... ... ... ... ... ... ... 11 Victoria Road ... 11 22 ... ... ... ... ... ... 33 Victoria Place ... 11 11 ... ... ... ... ... ... 22 Victor Road ... ... ... ... ... ... 11 ... ... 11 Windsor Road ... 44 11 ... ... ... 11 ... ... 66 Westbourne Road ... 44 ... ... ... ... 11 ... ... 55 Wilton Square ... 11 ... ... 11 ... ... ... ... 22 Wharfdale Road ... 33 ... ... ... ... 22 ... ... 55 Whistler Street ... 41 21 ... ... ... ... ... ... 65 Winchester Street ... ... 11 ... ... ... 11 ... ... 22 Wellington Road ... 11 32 ... ... ... ... ... ... 43 Wray Crescent ... 42 ... ... ... ... ... ... ... 42 Windsor Street ... ... 11 ... 11 ... 11 ... ... 33 Williamson Street ... ... ... ... ... ... 11 ... ... 11 Wolsey Road ... 11 ... ... ... ... ... ... ... 11 Warner Street ... 44 22 ... ... ... 11 ... ... 77 153 [1908 Table CIX.—continued. NAME OF STREET. Small Pox. Scarlet Fever. Diphtheria. Memb. Croup. Enteric Fever. Typhus Fever. Erysipelas. Puerperal Fever. Continued lever. Totals. Wall Street ... 22 ... ... ... ... ... ... ... 22 Workhouse Schools ... 33 ... ... ... ... ... ... ... 331 Wyatt Road ... 43 ... ... ... ... ... ... ... 43 Witherington Road ... 11 ... ... ... ... ... ... ... 11 Wilton Street ... 21 ... ... ... ... ... ... ... 21 Wedmore Gardens ... 11 ... ... ... ... ... ... ... l1 Woodville Grove ... 11 ... ... ... ... 11 ... ... 22 Waterloo Terrace ... ... 11 ... ... ... ... ... ... 11 Weymouth Villas, Moray Road ... ... 11 ... ... ... ... ... ... 11 Whitehall Mansions, Archway Road ... ... 11 ... 11 ... ... ... ... 22 William Street, Barnsbury ... ... 11 ... ... ... ... ... ... 11 William Street, St. Peter's St. ... ... 11 ... ... ... ... ... ... 11 Wiiittington College ... ... ... ... ... ... 11 ... ... 11 Whitehall Park ... 11 ... ... ... ... ... ... ... 11 Wedmore Street ... ... ... ... 11 ... ... ... ... 11 Wynford Road ... 11 ... ... ... ... ... ... ... 11 Warrender Road ... ... ... ... 11 ... ... ... ... 11 Yonge Park ... 33 38 ... ... ... ... ... ... 66 York Road ... ... 1813 ... ... ... ... 33 ... 2116 Yerbury Road ... 33 33 ... ... ... ... ... ... 66 154 1903] BACTERIOLOGICAL DIAGNOSIS OF DIPHTHERIA, ENTERIC FEVER AND PHTHISIS. The examination of sputum and blood to enable medical men to arrive at an early, or a more certain diagnosis of these diseases, is now generally undertaken by the Sanitary Authorities of London and of the chief cities of the Kingdom. Indeed many of them have extended their operations, and, having set up bacteriological departments of their own, with fully qualified bacteriologists at their head, now examine large quantities of food, particularly of milk. No doubt the time will come when Islington will follow suit, nay, will be compelled to do so, for the science of bacteriology has placed a powerful weapon in the hands of those engaged in public health work for the protection of the public. Look at what was done during the last eighteen months with respect to oysters, cockles, shell fish and watercress ! how Enteric Fever was traced to them, and how bacteriology enabled the investigators to declare which were the polluted beds. This science is doing a great work at the present time in enabling medical men to detect Phthisis in its early stage, and if it never accomplished anything more it would deserve the very highest enconiums for its usefulness in this direction. But for it many persons, now hale and strong, would have drifted into being incurable consumptives; they are also the mainstay of their families, who, otherwise, might have been greatly reduced in circumstances or thrown on the parish for relief. In Islington the services of the Lister Institute are retained for the examination of the sputum of persons suspected to be suffering from Phthisis and Diphtheria, and of the blood of patients who are supposed to have been attacked with Enteric Fever. During the year 283 specimens from patients suspected to be suffering from one or other of these diseases were examined, with the result that they were diagnosed in 69 instances. The particulars for each disease are as follows:— Diphtheria.—The bacillus of this disease was found in 14 out of 78 examinations, or in 17.9 per cent. Enteric Fever.—69 examinations of blood were made, and in 15, or 21.7 per cent., this fever was detected. Phthisis.—The sputa of 136 persons were examined, resulting in the bacilli of tuberculosis being discovered in 40, or in 29.4 per cent. The examinations of the specimens from patients suspected to be suffering from Diphtheria and Enteric Fever decreased considerably in number, but this was solely due to the fact that there was an abnormal decrease in the attacks of these diseases during the year. 156 [1903 The case was the reverse with respect to Phthisis, for the examinations increased from 122 in 1902 to 136. This number is not, however, nearly so many as might have been expected, although it may be partly explained by the fact that many medical men get examinations made privately, either by the Lister or other Institutes. Table CX. Showing the result of the Bacteriological Examinations made for the Diagnosis of Diphtheria, Enteric Fever and Phthisis, 1898 1903. Periods. Diphtheria. Entbric Fevpr. Phthisis. Positive Results. Negative | Results. Total Examined. Positive Results. Negative Results. Total Examined. Positive Results. Negative Results. Total Examined. Totals. 3rd Quarter 3 6 9 9 8 17 • • • • • • 26 4th 8 14 22 22 9 31 • • • • • • 53 1898 11 20 31 31 17 48 • • • • • • 79 1st Quarter 12 16 28 4 7 11 7 6 13 52 2nd ,, 10 7 17 1 9 10 16 19 35 62 3rd ,, 10 14 24 6 19 25 4 9 13 62 4th ,, 15 13 28 14 16 30 9 9 18 76 1899 47 50 97 25 51 76 36 43 79 252 1st Quarter 10 14 24 8 8 16 14 17 31 71 2nd „ 8 11 19 4 17 21 7 10 17 57 3rd „ 14 14 28 4 14 18 8 8 16 62 4th „ 11 23 34 17 6 23 6 9 15 72 1900 43 62 105 33 45 78 35 44 79 262 1st Quarter 13 17 30 7 12 19 8 13 21 70 2nd „ 14 18 32 7 12 19 7 12 19 70 3rd ,, 21 22 43 30 9 39 6 4 10 92 4th ,, 32 33 65 22 13 35 7 14 21 121 1901 80 90 170 66 46 112 28 43 71 353 1st Quarter 19 18 37 9 22 31 12 27 39 107 2nd ,, 15 17 32 6 9 15 9 16 25 72 3rd ,, 15 15 30 14 19 33 7 19 26 89 4th „ 3 20 23 16 19 35 11 21 32 90 1902 52 70 122 45 69 114 39 83 122 358 1st Quarter 5 17 22 2 12 14 10 17 27 63 2nd ,, 1 15 16 0 12 12 10 29 39 67 3rd ,, 5 16 21 3 17 20 13 30 43 84 4th ,, 3 16 19 10 13 23 7 20 27 69 1903 14 64 78 15 54 69 40 96 136 283 Totals 247 356 603 215 282 497 178 309 487 1,587 L 2 156 1903] THE STATE OF VACCINATION. The return relating to vaccination is always more than twelve months late, because it is not possible for the vaccination officers to obtain a large number—perhaps the largest number—of the certificates of successful vaccination until after a period of six months has elapsed from the birth of the infant. The complete return for 1902 has only just been made available, and when it is compared with those of the seven years immediately preceding, it may be considered a favourable one. Albeit there is nothing to go into ecstasies over, for it is most regrettable to find that 20 per cent. of the infants born during that year had not been vaccinated. The return shows that out of 9,055 births of infants, of whom 818 died before they had been vaccinated, 6,593, or 80.0 per cent., were successfully vaccinated, as against 75.8 per cent. in 1901 It would have been pleasant to think that this increase had come about through a growing belief, on the part of the parents, in the protective powers ot vaccination against small pox, but the fact cannot be denied that during 1902 this disease was unusually prevalent, and that, consequently, special efforts were made to induce parents to get their children vaccinated; and also that, in all probability, fear of the disease, which affects even the professing antivaccinator, was a potent factor in effecting the same object. The returns since 1880 show that from that year down to 1895 the vaccinations per 100 births, less infants who had died unvaccinated, were never below 84 per cent., and on several occasions were 90 per cent., while they have beep as h|igh as gri per cent. Years. Vaccinations per 100 births, less infants who died unvaccinated. Years. Vaccinations per 100 births, less infants who died unvaccinated. 1880 89.8 1891 87.4 l88l 90.8 1892 85.5 1882 91.1 1893 85.0 1883 90.4 1894 84.0 1884 90.5 1895 70.9 1885 90.6 1896 73.9 1886 90.8 1897 73.3 1887 90.4 1898 64.9 1888 88.4 1899 66.4 1889 89.0 1900 67.9 1890 89.3 1901 75.8 1902 80.0 157 [1903 The Returns for 1903 (first six months).—So far as the returns for the first six months of 1903 are available they show, when compared with the corresponding returns for 1902, a very considerable decrease, for whereas in the latter period 81.7 per cent of the infants, less those that had died prior to the time fixed for the operation to be performed, had been vaccinated, there were in the former period only 38.4 per cent. This is an enormous decrease. It will, however, be very considerably altered before the final returns for the year are made up, but that the proportion of successful vaccinations will be as large as in 1902 your Medical Officer of Health has grave doubts. He trusts that this may not be so, and he would earnestly urge on those who have neglected up to now to fulfil their legal obligation, to get their children vaccinated. The subject is one on which he feels strongly, because he has seen with his own eyes the results of such neglect. He has seen one of his dearest friends, exposed to similar infection to himself, carried off, and he has seen the father of that friend die soon after of a broken heart, because he had not only failed to have his son vaccinated, but had also inculcated into his mind the heresy that vaccination was a myth and a sham. Your Medical Officer of Health has heard another gentleman, whom he knew intimately, bewail the loss of two children, and he has heard him in the Health Committee of a great northern borough, accuse himself of being their murderer, because he had failed to carry out his manifest duty. Again, he has seen in the hospitals, of which he has had charge, every member of the staff pass scatheless through two epidemics, while an unvaccinated woman, who on one occasion only gained momentary access as far as the kitchen of the building was stricken. He has seen all his sanitary inspectors and his disinfectors, with one exception, emerge in safety from several epidemics, and that one had lied, for he signed a written statement that he had been recently re-vaccinated, when such had not been the case. He has seen young vaccinated children escape, while the young unvaccinated have been attacked and died, or only escaped with their life, greatly disfigured. He has seen the adult who was vaccinated in infancy generally recover from an attack of small pox, while the unvaccinated adult has generally perished. He has seen the disease in the one case generally assume a modified form, while in the other it has been generally either confluent or malignant. His study of hospital statistics, in addition to his own experience as a hospital superintendent, tells him very forcibly that vaccination exercises a great controlling influence over this terrible disease. These statistics tell the tale in such a manner that, unless people believe they are a tissue of falsehoods, they must be convinced. But such a belief is preposterous, unless, indeed, they also believe that a great conspiracy has been entered into, not only by the Medical Profession of England but of the civilized world, to foist on the public information that had no foundation in fact. The Prussians are an eminently practical race, and they, seeing the good that would accrue to their nation, 158 1903] adopted compulsory vaccination and revaccination, with the result that smallpox is a rare disease now in their country. The diagram given on the opposite page depicts more plainly than words can do, what has been effected in Prussia, and ought to convince those who doubt that vaccination and revaccination are a great, if not a complete, protection against small-pox. Well might Professor Martens, of Rostock, with the facts which this diagram describes, before him say, "That terrible pestilence, small pox, has almost completely disappeared from among us; not because we have discovered and destroyed the exciting cause of small pox—which, indeed, is still unknown— and have thus prevented its spread in the world, but solely because we have succeeded in making every individual personally proof against this pestilence." He further explains the presence of the very few cases that arise as follows: "Cases of small pox which occur now and again have always been traced to infection brought from abroad, especially from Russia, where compulsory protective inoculation (vaccination and revaccination) against small-pox has not been introduced." Since these words were put in type, the Local Government Board have issued a report, written by one of their Medical Inspectors (Dr. R. Bruce Low), "On the arrangements made in Germany for the isolation of Small " Pox cases." This report shows that he visited ten towns where he found that the usual custom was to treat patients on the sites of the infirmaries used for general diseases; and that, with one or two exceptions, "the small pox pavilion is shut "off in no way from the rest of the hospital." His concluding observations convey so great a lesson as to the efficacy of vaccination and re-vaccination that they are quoted. They are as follows :— " From the account above given of the methods employed in " Germany for isolating Small Pox, it will be obvious that the general " plan followed differs markedly from that employed in this country. " Almost always, in Germany, small pox cases are isolated on the " site of the general hospital, and, as often happens when the occur" rence of Small Pox in a given place is rare, the small pox pavilion " is not allowed to stand empty, but is used for the accommodation " of other cases, infectious or non-infectious. Untoward results to " other persons, from bringing Small Pox to the site of the general " hospital for purposes of isolation and treatment have been seldom " observed, and this, in Germany, is with one consent attributed to " the protection which is conferred on the population by statutory " vaccination and re-vaccination. Without these the German method, " it is unanimously admitted, would break down. 159 [1903 " It has been asserted in England by persons who have little or " no faith in the value of vaccination as a prophylactic against " Small Pox, that the comparative immunity of the German nation " from that disease is due, not to statutory vaccination and re-vacci" nation, but to the strict system of isolation of Small Pox which is " carried out in Germany. But the evidence given to me by the " eminent medical men with whom I have personally conferred, " entirely refutes this assertion; and one and all joined in the repre" sentation that compulsory vaccination and re-vaccination were " Germany's great protectors against Small Pox. " The description which I have given of the position of the " small pox pavilion at each of the hospitals visited in Germany " shows conclusively that there is not in that country 'strict system " ' of isolation of Small Pox' in the sense as we in England under" stand it. With one or two exceptions the pavilion is shut off in no " way from the rest of the hospital, and there is no limitaition in the " number of persons residing within the several zones around the " hospital. " Nor is the administration of the small pox pavilion entirely " separate from the general administration of the hospital establish" ment. The German nation, therefore, by the agency of compulsory " vaccination and re-vaccination is able to dispense with separate " small pox hospitals altogether. " It is not necessary there to provide for Small Pox a separate " site nor separate administration. Germany is in this way freed " from "great expense, not to speak of the suffering and the incon" venience which fall upon the English nation. But all this could " not be achieved in Germany unless the Law of Compulsory Vacci" nation and Re-vaccination were thoroughly carried out." Contrast with these facts the regulations of the Local Government Board under which small pox hospitals are built in England. "Hospitals for Small Pox.—In view of the frequently demonstrated " liability of small pox hospitals to disseminate that disease to neigh" bouring communities, and in order to lessen the risk of such " occurrence, the Board require the following conditions to be " complied with in the case of small pox hospitals provided by means " of loans sanctioned by the Board :— " 1st. The site must not have within a quarter of a mile of it either " a hospital, whether for infectious diseases or not, or a workhouse, " asylum or any similar establishment, or a population of as many " as 200 persons. 160 1903] " 2nd. The site must not have within half a mile of it a population of as " many as 600 persons, whether in one or more institutions, or in " dwelling houses. " 3rd. Even where the above conditions are fulfilled, a hospital must not be " used at one and the same time for the reception of cases of Small Pox " and of any other class of disease." The contrast between the practice in England and in Germany is truly great, and the contrast between the results are as marvellous. Germany rigidly practices vaccination and re-vaccination, incurs no special expenditure on hospitals, and is practically free from Small Pox ; while England plays with vaccination, altogether neglects re-vaccination, builds expensive hospitals, provides the necessary staff of doctors and nurses, and Small Pox is hardly ever absent from the country. These facts speak for themselves. They require no comment to drive their moral home, just as good wine requires no bush. From these remarks it is plainly seen that England has not yet done her duty with respect to this disease, although she is slowly moving in the right direction, and until she shall have there can be no hope of stamping out this loathsome and filthy sickness. Table CXI. Showing the State of Vaccination in Islington, 1880-1903, also in London and England and Wales, 1880-99. Years. No. of Births. Successfully Vaccinated. Insusceptible to Vaccination. Died Unvaccinated. No. of exemption certificates. Postponed by nedical certificate. Remaining. Cases (cols. 6, 7, & 8), not finally vaccinated per 100 births. In London. Rest of England. 1 2 3 4 5 6 7 8 9 10 11 1880 9,931 8,123 26 885 Not granted for years previous to 1897. 118 779 9.0 7.0 4.5 1881 9,993 8,339 21 812 83 730 8.2 5.7 4.3 1882 10,000 3,360 22 819 155 644 8.0 6.6 4.5 1883 9,950 8,192 25 890 194 644 8.4 6.8 4.9 1884 9,892 8,121 47 924 191 601 8.0 6.8 5.3 1885 9,683 7,874 41 991 157 617 8.0 7.0 5.5 1886 9,844 7.944 39 1,091 148 622 7.8 7.8 6.1 1887 9,732 7,769 44 1,133 171 615 8.1 9.0 6.7 1888 9,620 7,522 39 1,112 219 728 9.8 10.3 8.2 1889 9,638 7,581 22 1,120 198 717 9.5 11.6 9.6 1890 9,239 7,250 19 1,117 122 731 9.2 13 9 10.9 1891 9,823 7,584 33 1,145 131 930 10.8 16.4 12.9 1892 9,626 7,221 28 1,182 127 1,018 12.2 18.4 14.3 1893 9,757 7,251 38 1.222 132 1,114 12.7 18.2 15.7 1894 9,574 7,151 39 1,067 101 1,215 13.7 20.6 19.0 1895 9,959 7,079 50 975 237 1,620 18.7 24.9 19.8 1896 9,752 6,575 46 854 223 2,054 23.4 26.4 22.3 1897 9,878 6,539 30 954 14 220 2,135 24.0 29.1 21.6 1898 9,478 5,422 44 1,068 103 251 2,693 32.2 33.0 21.5 1899 9,631 5,69s 81 1,048 101 333 2,370 29.1 27.7 17.2 1900 9,316 5,777 30 812 127 298 2,399 30.3 Not Not 1901 9,266 6,382 29 852 106 107 1,896 22.7 available available. 1902 9,055 6,593 39 818 73 98 1,507 18.5 1903 4,484 1,550 14 347 53 81 2,492 58.6 „ „ (6 m'ths) Note.—The figures n Column 8 are obtained by adding together the numbers given in Columns 3, 4, 5 and 7 and deducting the total from the number in Column 2. The figures in Column 9 are percentage statements, obtained by adding together the numbers given in Columns 6, 7 and 8 and applying them to the numbers in Column 2. 101 [1903 DISINFECTION. Disinfection of Rooms.—2,021 rooms were disinfected with formaldehyde gas or with formalin solution, used in the form of a spray, or with both. These methods of disinfection have been practised in Islington for some time past, and have been found to give most excellent results. Since their use the practice of stripping the papers from the walls of rooms has ceased, with certain reservations. Cleansing and Stripping of Rooms.—136 rooms were cleansed and their papers stripped from the walls. This is, however, 1178 less than the number dealt with in the preceding year, owing to the decrease in cases of infectious sickness during 1903. Disinfection of Schools.—In addition to the usual disinfection of houses after infectious diseases, the Infants' Departments, or certain class rooms thereof, were disinfected in consequence of Measles, Chicken Pox, or Diphtheria having appeared amongst the scholars. Amongst these were:— Board Schools.—York Road, Hungerford Road, Westbourne Road, Pakeman Street, Hornsey Road, Montem Street, Yerbury Road, Duncombe Road, Richard Street, Upper Hornsey Road, Vittoria Place, and Queen's Head Street. Other Schools.—Wesleyan Schools, Drayton Park; St. John's, Duncan Street; St. John's, Conewood Street; St. Mary's, Cross Street; St. James' Schools, George's Road; Workhouse Schools, Hornsey Road; and Holy Trinity Schools, Cloudesley Street. Other Places—Children's Nursery, Gifford Street; Caledonian Asylum, and Alexandra Orphanage. Table CXII. Showing the Disinfection of Rooms after Infectious Disease, in the Sanitary Inspectors' Districts, during the year 1903. Sanitary Inspectors' Districts. 1 2 3 4 5 6 7 8 9 10 11 12 13 14 Total 1903. 1902 1st Q'rter 30 37 29 39 59 28 20 38 35 27 40 30 19 43 474 975 2nd do. 29 36 19 76 75 29 43 52 35 43 68 45 23 27 598 756 3rd do. 21 44 25 36 36 44 40 43 36 30 50 42 43 37 527 731 4th do. 32 26 33 26 30 22 24 36 30 22 41 40 22 38 422 688 Year 110 143 100 177 200 123 127 169 136 122 199 157 107 145 2021 3150 162 1903] Table CXII1. Showing the Cleansing and Stripping of Rooms after Infectious Disease in the Sanitary Inspectors' Districts, during the year 1903. Sanitary Inspectors Districts. 1 2 3 4 5 6 7 8 9 10 11 12 13 14 Total 1903. 1902 1st Q'rter .. .. 8 .. .. 11 2 14 .. .. .. .. .. .. 35 872 2nd do. .. .. .. .. 9 .. 3 6 1 .. .. 1 .. 10 30 150 3rd do. 14 .. .. .. 21 .. 2 .. .. .. .. .. .. 8 45 102 4th do. 1 1 .. .. 5 .. .. .. 1 1 9 5 3 .. 26 190 Year 15 1 8 .. 35 11 7 20 2 1 9 6 3 18 136 1314 WORK DONE AT DISINFECTING STATION. The work done at this station was, in consequence of the few cases of sickness from infectious disease, much less than in the previous year, yet 23,748 separate articles, including many bundles containing small clothes, were disinfected. The two machines were used alternately week about, so that there was never any delay caused by the necessity for repairs. Since 1895, when the machines were erected, 240,056 large articles, apart from the small ones, have been disinfected without any appreciable damage to the clothing, and consequently with very little expense in compensation to the borough. TABLE CX1V. Summary of the chief articles of Clothing, Bedding, &c., disinfected during the year 1903 and also in the preceding year. 1st Quarter. 2nd Quarter. 3rd Quarter. 4th Quarter. The Year 1903 1902. Beds 414 387 450 350 1,601 3,121 Blankets 735 4,306 611 625 6,277 4,705 Bolsters 278 265 309 247 1,099 2,093 Carpets 124 115 8l 63 383 678 Chair Bed Cushions 113 97 103 70 383 510 Mattresses 266 213 213 197 889 1,556 Palliasses 286 322 349 312 1,269 2,496 Pillows 708 714 72 633 2,779 4,862 Quilts 345 323 312 275 1,255 2,294 Sheets 646 624 6 77 571 2,518 4,386 Other Articles 1,339 1,316 1,612 1,028 5,295 10,071 Totals 5,254 8,682 5,441 4,371 23,748 36,772 163 [1903 The following is a record of the work performed by the Steam Disinfectors during the past nine years :— 1895 17,240 articles. 1896 42,258 1897 28,302 „ 1898 20,172 „ 1899 25,378 1900 19,136 „ 1901 27,050 ,, 1902 36,772 ,, 1903 23,748 „ Total 240,056 ,, Disinfectants distributed and used.—The following statement gives the quantity of disinfectants distributed by the Sanitary Authority, and used in cleansing rooms : — How disposed of. Carbolic Powder. Carbolised Creosote. Clear Carbolic Acid. To Householders Tons. 3 cwts. 5 Gallons. 805 Gallons. Disinfection of Premises — — 5 SHELTER HOUSE. Under the provisions of the Public Health (London) Act, 1891, every Sanitary Authority shall provide, free of charge, temporary shelter with any necessary attendants for the members of any family in which any dangerous infectious disease has appeared, who have been compelled to leave their dwellings for the purpose of enabling such dwellings to be disinfected by the Sanitary Authority. Nine families consisting of 18 persons were received into the Shelter House during the year. Four of these families came there owing to Small Pox having appeared in their houses, and remained until the disinfection, cleansing and stripping of the walls had been completed. The clothing of two verminous men was disinfected, while at the same time they were provided with baths. The following table gives the particulars as to the number of persons accommodated. 164 1903] Table CXV. Families accommodAcd in the Shelter House. Date of Admittance. Address. Number in Family Cause. 1903: 6th April 1 Verminous Person. 2nd july 91, Arlington Street 2 Scarlet Fever. 18th ,, 35, Halse Street 4 Small Pox. 18th ,, 115, York Road I Puerperal Fever. 21st 26, Halton Road I Verminous Person. 25th „ 35, Halse Street 3 Small Pox. 1st Aug. 129, St. James Road 3 Scarlet Fever. 4th September 11, Anatola Road 1 Small Pox. 5th November 1, Ann Street 1 ,, 19th 50, Archway Road 2 Diphtheria. 20th „ 22, „ 1 Puerperal Fever. PART IV. SANITATION. ADMINISTRATION OF THE FACTORY AND WORKSHOP ACT, 1901. INSPECTION OF WORKSHOPS, WORKPLACES, LAUNDRIES AND BAKEHOUSES. HOUSES LET IN LODGINGS. DISTRICT INSPECTIONS. DUST REMOVAL. COMMON LODGING HOUSES. STATE OF PAUPERISM. 166 1903] FACTORY AND WORKSHOPS ACT, 1901. This Act, which consolidated and amended all previous Acts relating to factories and workshops, made considerable alterations and additions to the duties of Sanitary Authorities in regard to factories, workshops and such places, and under these circumstances it has been deemed advisable to set before you those features which affect local authorities in London. Definitions.—Factories are classed in two categories— (1) All places in which mechanical power is used in aid of the manufacturing processes; and (2) All places, whether mechanical power is used or not, in which certain specified industries are carried on, that is to say, print works, bleaching and dyeing works, earthenware works, lucifer match works, percussion cap works, cartridge works, paper staining works, fustian cutting works, blast furnaces, copper mills, iron mills, foundries, metal and india rubber works, paper mills, glass works, tobacco factories, letterpress printing works, bookbinding works, flax scutch mills, electrical stations. Workshops are defined to be any premises or places named in Part Two of the Sixth Schedule of the Act, which are not a factory. They include— (1) Hat works, rope works, bakehouses, lace warehouses, shipbuilding yards, quarries, pit banks of metalliferous mines, dry cleaning works and bottle washing works, unless mechanical power is used. (2) Any other premises (not being factories) in which manual labour is exercised by way of trade, or for purposes of gain, in, or incidental to, the making, altering, repairing, or ornamenting, finishing or adapting for sale of any article, and to or over which the employer of the persons working there has the right of access or control. (3) Any workplace (termed in the Act " tenement workshop") in which, " with the permission of or under agreement with the owner or occupier, two or more persons carry on any work which would constitute the workplace or workshop of the persons working therein, were in the employment of the owner or occupier." Laundries do not come within the definition of "factory" or "workshop;" but under sect. 103 are, so far as sanitation and means of escape from fire are concerned, to be treated as factories, if mechanical power is used, and as workshops if mechanical is not used. 167 [1908 Workplaces are not defined in the Act, but the term is used in the Public Health (London) Act, 1891, sec. 38, where the words " factory, workshop and workplace" occurs, and it was held in a case (Bennett v. Harding) that the word "workplace" is not to be limited to places where something is being manufactured or made, but includes " any place where work is done permanently, and where people assemble together to do work permanently of some kind or other.'''' It is, therefore, a word of wider signification than " workshop." In the case mentioned a stable and stable yard where men were employed as cab cleaners and horse keepers were held to be a workplaces. Since then the Secretary of State has been advised that the kitchens of restaurants, etc., though they are not workshops, come within the meaning of the term "workplace." Duties of the Borough Council.—Factories.—The chief duty with respect to factories is the enforcement of the 38th section of the Public Health (London) Act, 1891, which requires that every factory, workshop or workplace shall be provided with sufficient and suitable accommodation in the way of sanitary conveniences. Workshops and Workplaces.—The Borough Council has important duties with respect to these places: (1) As to their sanitary conditions; (2) As to special sanitary regulations for bakehouses; (3) As to home work. (1) "Sanitary Conditions."—The Council is made responsible for the sanitary condition of the workshops and workplaces, while the Factory Inspector is responsible for the sanitary condition of factories. Sanitary conditions include (a) Cleanliness; (b) Air space; (c) Ventilation, and (d) Drainage of the floors. (a) Cleanliness.—(Sec. 2). Every workshop and workplace must be kept in a cleanly state and free from effluvia arising from any drain, privy earth closet, water closet, urinal or other nuisance ; and if they be not so kept the Council may deal with them under sec. 2 (g. i) of the Public Health London Act, 1891. (b) AirSpace.—(Sees. 2-3). Workshops and workplaces must not be over-crowded so as to be dangerous or injurious to the health of the persons employed, and if they are in this condition the Council is empowered to deal with them as a nuisance under sec. 2 (iii) of the Public Health (London) Act, 1891. Under sec. 3 (1) of the Factory and Workshop Act, a workshop is overcrowded, " if the number of cubic feet of space in any room therein bears to the number of persons employed at one time in the room a proportion less than two hundred and fifty, or, during any period of overtime, four hundred, 168 1903] cubic feet of space to every person." By sec. 3 (3) of the Act the Secretary of State has power to alter this amount in the case of a workshop, not being a domestic workshop, " which is occupied by day as a workshop and by night as a sleeping apartmentand by his Order of the 17th January, 1902, the amount in such cases has been increased to 400 cubic feet. The Act requires (sec. 3 (4)) a notice " specifying the number of persons who may be employed in each room," to be affixed in every workshop. (c Ventilation (sees. 2, 7).—Every workshop and workplace must be ventilated in such a manner as to render harmless as far as practicable any gas, vapours, dust, or other impurities generated in the course of the work, that are a nuisance or injurious to health ; and any such place may be dealt with under sec. 2 (ii) of the Public Health (London) Act, 1891. This provision is supplemented by a special requirement (sec. 7 (i) of the Factory and Workshop Act), that " in every room in any factory or workshop sufficient means of ventilation shall be provided, and sufficient ventilation shall be maintained," and when a standard has been presented by the Secretary of State, which he has power to make under the succeeding subsection for any class of workshops, that standard must be observed. By section 157 of the Act, men's workshops, that is to say, workshops conducted on the system of not employing any woman, young person or child are excluded from the operation of this requirement. In workshops where dust, gas, or impurities are generated, and inhaled by the workers, the Factory Inspector may direct that a fan or other mechanical means be provided, if he thinks that thereby such inhalation can be prevented ; and the Home Office recommends that " if in any case the Council are of opinion that this power could be usefully employed, they should refer it to the Inspector of the District." (d) Drainage of Floors (sec. 8).—This is a provision which requires that adequate means shall be provided for draining off the wet in every workshop or part of a workshop in which any process is carried on which renders the floor liable to be wet. A workshop not so drained may be dealt with as a nuisance under sec. 2 of the Public Health (London) Act, 1891. This section does not apply to men's workshops, or to domestic factories or workshops, but it does to laundries, which are practically the only places affected in Islington. Sanitary Accommodation (sec. 9).—This section does not apply to London, but it enacts that every factory and workshop must be provided with sufficient 169 [1903 and suitable accommodation in the way of sanitary conveniences, and where both sexes are employed separate accommodation must be provided. In London proceedings must be taken under sec. 38 of the Public Health (London) Act, 1891, which contains similar provisions. Bakehouses.—The duties of the Borough Council with respect to bakehouses were fully stated in the Annual Report of the Medical Officer of Health for 1902, pp. 170 and 171 ; and, therefore, it will not be necessary to recapitulate them, especially as the Town Clerk has sent to each member of the present Council a copy of that report, which is bound up with his own annual report. Home Work (sees. 107-115).—The Council possesses important powers of controlling the conditions under which certain classes of work are done, and which are dangerous to the health of the persons working therein; homework is prohibited in unwholesome and infected dwellings; and the Council may make an order prohibiting any work being given out to any person living or working there. In case of urgency this power may be exercised by any two or more members of the Council acting on the advice of the Medical Officer of Health. This provision is analagous to the powers given to sanitary authorities with respect to schools under the " Government Code of Regulations for Day Schools." Outworkers' Lists (sec. 107).—Formerly outworkers' lists had to be sent to the Factory Inspectors only, but were to be open to the inspection of the Council. Now, however, they must be sent instead twice every year to the Council. These lists must also be sent in on a prescribed form, which shows the names and addresses of all persons employed by the occupiers of factories or workshops. It is the duty of the Council to have these lists examined, and if the place of employment is in another district to furnish the name and place of employment to the Council of that district. In Islington the outworkers are for the most part females, engaged in making clothing for local, city, or west end employers. Register of Workshops.—The Council must keep a register of all workshops in Islington. Medical Officer of Health (sec. 132).—A new and onerous duty is placed on the Medical Officer of Health, who in his annual report to the Council " shall report specifically on the administration of this Act in workshops and workplaces, and he shall send a copy of his annual report, or so much of it as deals m 170 1903] with this subject, to the Secretary of State." The Memorandum of the Local Government Board as to Annual Reports of Medical Officers of Health lays down that the chief points to be reported on by him are :— (1) Sanitary conditions of workshops and workplaces, including (a) Cleanliness. (6) Air space. (c) Ventilation. (d) Drainage of floors on which wet processes are carried on. (e) Provision of suitable and sufficient sanitary conveniences. (2) Special sanitary regulations for bakehouses. (3) Home-work. Under this heading comes the prevention of homework being carried on in dwellings which are injurious or dangerous to the health of the workers through overcrowding, want of ventilation, or other sanitary defect, or in dwellings in which infectious disease exists. (4) The keeping of the lists of outworkers in certain branches of industry which are to be furnished by employers, and the transmission of the name and place of employment of any such outworker, who does not reside in the district to the Council of the district in which he works. (5) The keeping of a register of workshops. It may be convenient to state here that sec. 102 of the Act, which deals with the enforcement of the law as to retail bakehouses, enacts that "for the purposes of this section, the medical officer of health of the district council shall have and may exercise all the powers of entry, inspection, taking legal proceedings, and otherwise of an inspector "—i.e., of a Factory Inspector. It is also the duty of the Medical Officer of Health, under sec. 133 of the Act, to inform the District Inspector of Factories if he finds any woman, young person or child employed in a workshop in which no abstract of the Act is posted up. Default of Council (Sec. 4).—In the event of the Council failing to administer the provisions of the Act, or of the law relating to public health in so far as it affects factories, workshops or workplaces, the Secretary of State may by Order authorise a Factory Inspector during such time as may be mentioned in the Order, to enforce these provisions, and the Factory Inspector shall be entitled to recover from the Council any expenses incurred by him which are not recovered from any other person. 171 [1903 Information by Factory Inspectors (Sec. 5).—Where a Factory Inspector finds " any act, neglect, or default, in relation to any drain, water closet, earth closet, privy, ashpit, water supply, nuisance, or other matter in a factory or workshop, is punishable or remediable under the law relating to public health " but not under the Factory and Workshop Act, he shall give the Council notice in writing. Having so far explained the duties of the Council and the general scope of the Act, it becomes the duty of your Medical Officer to report on its administration. Administration of the Act. It may safely be asserted that the administration of this Act in Islington has been satisfactory, and that all its requirements have been faithfully carried out, a fact which will become apparent as each particular subject is reported on. When the Act came into force, Islington, unlike many boroughs, had been enforcing the provisions of the Public Health Act, 1891, as well as of the former Factory and Workshops Acts, with the assistance of two special inspectors, so that when new and increased duties were cast on the Council, in addition to those which they and their predecessors were already administering, they too were promptly enforced. That this was really so is made apparent by the ensuing table which shows some of the work which has been done during and since 1896. This work relates to the abatement of overcrowding, the provision of ventilation, the cleansing of dirty rooms, the amendment of drains, the erection of suitable and efficient w.c. accommodation, the supply of water for drinking purposes, the provision of surface drains in laundries and work places where water flowed on the floors (chiefly laundries), and to the cleansing of workshops. During these years also Islington stood almost alone among Metropolitan Boroughs in examining lists of outworkers and in sending the names and addresses of persons living out of the borough to the Medical Officers of Health of those places where they resided, while the lists which were received in return were few and far between. The work done by the Inspectors during those years entailed over forty-one thousand inspections and visits, from which it may be judged that it was continuous and energetic. It has been regularly reported on by your Medical Officer of Health and by the Inspectors themselves, to whom, let it be stated, every credit is due for the manner of its performance. Formerly it was the rule that hardly a day passed that anonymous or signed complaints were not received from workers, now it is the exception ; and, indeed, they are practically unknown, while on the other hand testimony has been given of the great improvement that has been effected in every direction. m 2 172 1903] Inspection and Visits.—There are two inspectors engaged in the work of inspection, namely, Miss Gray, who visits all workshops where women are employed, and Mr. George West, who undertakes the inspection of those places where males work. During the year they made 3,979 separate inspections of work places, which entailed 3,867 subsequent visits, making altogether 7,846 visits, a return which compares favourably with the average return of the preceding seven years of 7,102. 1896 5,996 inspections and re-visits. 1897 6,761 „ „ 1898 6,882 „ ,, 1899 7,233 „ „ 1900 7,411 „ „ 1901 7,371 „ „ 1902 8,060 „ „ Average 7,102 1903 7,846 The inspections during the year included 209 tailors' workshops, 297 shoemakers' workshops, 100 pianoforte workshops, 54 cycle makers' workshops 213 bakehouses, 375 restaurant kitchens, and 869 miscellaneous places, which were visited by Inspector West. Among the places inspected by Miss Gray were 149 kitchens of restaurants, 511 homeworkers' premises, and 1,095 miscellaneous workshops, a complete list of which is given in her report on page 185. Altogether Mr. West inspected 2,117 premises and Miss Gray 1,862. 1896 1897 1898 1899 1900 1901 1902 1903 Total Overcrowding 26 12 15 14 22 14 4 13 120 Ventilation 14 13 2 5 4 3 5 8 54 Dirty rooms 311 195 109 99 217 218 231 423 1,803 Drains 554 458 375 313 216 177 90 50 2,233 W.C.'s 420 325 341 355 411 375 154 161 2,542 Water supplies 79 41 35 20 19 13 83 54 344 Surface drains 79 109 37 51 78 81 2 53 540 Cleansing 412 375 393 424 437 387 558 441 3,427 173 [1903 Register —At the end of the year there were on the register 2,279 workshops, workplaces, laundries and bakehouses, with 3,506 rooms. That portion of the register kept by Mr. West was at the beginning of the year rather in arrear, chiefly due to the fact that he had not entered the workshops until they had been measured. He, however, made strenuous efforts to complete it, as far as possible, with the result that, while at the end of the first quarter there were 1,707 on the register, there were 2,213 at the end of the second, 2,245 at the end of the third, and 2,279 at the end of the fourth. Of these 2,279 workplaces women were employed in 1,083 and men in 1,196. The register is kept on the card principle, which has been found the readiest for reference, as well as for the removal or addition of workplaces. It also avoids the use of heavy and cumbersome books. Additions to and Removals from the Register.—During the year 612 workshops, of which 214 were newly discovered, were added to the register, and in 186 of these women were employed ; while 172, were removed from it. Sanitation. Cleanliness.— The workshops and workrooms were generally found in an improved condition when compared with previous years. As a rule very little difficulty has been experienced in getting the owners to cleanse them, although now and again some pleaded that the exigencies of their business would prevent them carrying out the notices served on them. It was, however, pointed out that as cleanliness was most desirable where the greatest number of hands were employed, it was essential that the work should be done speedily, and they accordingly executed it at once. In 127 instances workrooms wherein women were employed were found in a dirty state, and these with the addition of 3 others, were cleansed. On the other hand 296 workshops where men were employed were discovered to require cleansing, and the requisite limewhiting was carried out, in addition to 15 others, which the owners cleansed voluntarily. Effluvium Nuisances.—No nuisances of this character came under observation. Air Space.—It is satisfactory to find that in only 13 workplaces, in all of which women were employed, was overcrowding discovered, and immediately, on attention being called to the fact, the nuisance was abated. One reason assigned for this by your Inspector (Miss Gray) is that in most of the workshops the number of persons employed has been smaller than usual owing to the 174 1903] depression in trade. In any case a great improvement has taken place in recent years, especially since the late Vestry commenced to distribute cards to the owners of workshops for hanging up in the workrooms, showing the cubic capacity of the rooms and the number of persons who can be legally employed in them. During the year 339 of these cards were distributed. Ventilation.—Only 13 workshops, apart from bakehouses, were discovered with insufficient ventilation. At the end of the year, however, 11 of these places had been put into a satisfactory state. With respect to bakehouses a great deal has been done under the supervision of your Medical Officer of Health and your Chief Inspector. At the beginning of the year there was not a single underground bakehouse that was satisfactorily ventilated, while many of them were dependant on such ventilation as windows provide. At the present time there is not one of these bakehouses, and they are 117 in number, that is not provided with independent inlet and other ventilators. That they will be always kept at work is another matter, for shortly after they had been erected it was discovered that in several instances the inlet ventilators had been occluded, and in most cases without the slightest justification for the action. The overground bakehouses are at present engaging attention, and it is hoped that in every case where a ventilator, independent of windows, is required that it will be provided. Drainage of Floors. —Theworkshops in Islington which require drainage of floors are laundries, bottle washing, pickle making and gut scraping workshops. In no other places are any wet processes used in which women are employed with men, and it is in only such cases that the law is applicable. Such of the laundries as are workshops were all attended to in previous years. Sanitary Accommodation.—In 30 instances it was discovered that factories or workshops were without sufficient sanitary accommodation, but after the service of notice on the owners the deficiency was in every case made good. In 5 instances this accommodation was required in workshops where women were employed, and in 25 instances where only men worked. In 6 instances the accommodation was unsuitable, and had to be replaced by new sanitary conveniences, and in 5 instances separate accommodation was provided. 175 [1903 The inspectors report that, in addition to the defective w.c. accommodation, they found the following, among other, sanitary defects :— Female. Inspector. Male. Inspector. Totals. Water cisterns dirty or defective 18 13 31 Dustbins wanting or defective 41 51 92 Drains defective in joints 8 26 34 „ unventilated or untrapped 16 ... 16 W.c.'s defective or dirty 53 108 161 Miscellaneous 76 243 319 Vide also Tables CXVI. and CXVII., which fully set out the various matters dealt with by your Inspectors. Bakehouses.—There are in Islington 266 bakehouses, of which 108 are overground and 117 underground, in addition to 4 which are not in use. Underground Bakehouses.—During the year the underground bakehouses received very special attention in consequence of the clause of the Factory and Workshop Act which requires that (1) " an underground bakehouse shall not be used as a bakehouse unless it was so used at the passing of this Act" {i.e., August 17th, 1901). (2) " Subject to the foregoing provision, after the xst day of January, 1904, an underground bakehouse shall not be used unless certified by the district council to be suitable for this purpose." (3) " An underground bakehouse shall not be certified unless the district council is satisfied that it is suitable as regards construction, light, ventilation, and in all other respects." The Public Health Committee, on whom fell the duty of reporting to the Council, undertook the work which devolved on them in a very serious spirit, and in August, 1902, caused a circular letter to be sent to every person occupying an underground bakehouse informing him of his obligations under the Act, and requesting him to forward a plan of his bakehouse. Nearly every one complied with this request. About the same time your Medical Officer of Health made a minute inspection of each bakehouse, and in December, 1902, presented a very detailed report to the Committee of the conditions which had been noted. These reports were printed, and were duly considered, with the result that they agreed to demand certain requirements, having due regard to the peculiar and existing conditions of each bakehouse. These requirements were printed in the report of the Medical Officer of Health for 1902. With these requirements before them the Committee visited every underground bakehouse, and classified them in the following manner: — 1. Bakehouses which could be easily adapted to the requirements of the Act without structural alterations. 176 1903] 2. Bakehouses which could be made to comply with the Act, but only after structural alterations. 3. Bakehouses which in their opinion could not be made to comply with the requirements, unless serious structural alterations were made, and about which they were not prepared to advise the occupiers. In the first category there were 30 bakehouses, in the second 69, and in the third 18. Immediately after the Public Health Committee had visited a bakehouse the occupier was informed in writing of their decision, and was at the same time requested to send them as soon as convenient a plan and specification of the alterations which they proposed to execute to meet their requirements. These communications led to very many consultations between your Medical Officer of Health and the occupiers or owners, or their architects and builders. The specifications soon began to be sent in ; and when a batch had been received the Committee fixed an appointment at each bakehouse with its owner or occupier, at the same time requesting him to have his architect or builder present, so that the specification might be discussed with him. At these interviews such alterations and additions were made by the Committee as seemed to them to be necessary. The work was long and laborious, but the Committee did not flinch from its duty, although it became necessary for them to visit several of the bakehouses several times before the specifications were deemed satisfactory. Even then their work was not finished because as soon as the alteration at each bakehouse had been completed they again visited it, and with the amended specification in their hands saw for themselves that the proposed works had been duly executed. At the end of the year 94 bakehouses had been certified by the Council, and at the time of writing this report every underground bakehouse, except four, which are closed, had been put into a sanitary state, and consequently will be certified in due course. The chief requirements of the Public Health Committee were as follows :— 1. A height of not less than eight feet throughout. 2. A capacity of not less than 1,000 cubic feet. 3. Permanent inlet and outlet ventilators, other than windows. 4. Smooth walls, impervious to damp, made by the use of parian or ordinary cement (troweled). 5. Smooth floors, impervious to damp, consisting of 6 inches of concrete floated with cement; or York flags with well grouted joints. 6. Windows to provide efficient (day) light, and so constructed as to prevent the entrance of dust. 7. Closed-in ceilings, smocth, covered with parian cement. 177 [1903 8. Troughs and tables to be provided with castors or wheels. g. Water supply direct from the rising main. 10. Provision for the workmen's ablution in a suitable position outside the bakehouse. 11. Provision for the proper storage of coals. 12. Suitable staircase not directly entering the bakehouse. 13. The removal of all gullies and connections with the drains. In only one instance was any of these requirements not insisted on, namely at 415, Caledonian Road, where the Council decided, contrary to the recommendations of the Public Health Committee, that a certificate should be granted, although the bakehouse was not eight feet in height, chiefly on the ground that its entire capacity was 2,175 cubic feet. Islington now possesses good underground bakehouses, which if they are only kept in a good and cleanly state, should prove a great boon to the workers employed in them. It may be stated that your Medical Officer of Health and Chief Inspector made over 500 (actually 516) visits to these underground bakehouses during the year. Other Bakehouses.—Those which are situate above ground are 108 in number, and were duly inspected by the Inspector (Mr. West), who made 213 visits to them. He found them generally kept in a clean and orderly state. List of Bakehouses. UPPER HOLLOWAY DISTRICT. Bakehouses above (/round. 1. 16, Brecknock Road. 2. 29, Higbgate Hill. 3. 102, „ ,, 4. 44, Cheverton Road. 5. 103, Elthorne Road. 6. 57. ,, ,, 7. 582, Holloway Road. 8. Crisp & Co., Seven Sisters Road. 9. 90, Grove Road. 10. 62, Cottenham Road. 11. 127, Marlborough Road. 12. 166, Fairbridge Road. 13. 420, Hornsey Road. 14. 163, Seven Sisters Road. 15. 104, Andover Road. 16. 25, Lennox Road. 17. 47, Palmerston Road. 18. 114, Fonthill Road. 19. 144, Tollington Park. 20. 131, Stroud Green Road. 21. 626, Holloway Road. 22. 81, Junction Road. 23. 49, Higbgate Hill. 24. 19, Archway Road. 25. 58. Hazellville Road. 26. 75, Elthorne Road. 27. 634, Holloway Road. 28. 12, Hercules Road. 29. 60, Grove Road. 30. 29, Cottenham Road. 31. 110, Marlborough Road. 32. 103, Fairbridge Road. 33. 484, Hornsey Road. 34. 346, 35. 67, Durham Road. 36. 88, Andover Road. 37. 53, Poole's Park. 38. 49, Campbell Road. 39. 81, Fonthill Road. 40. 125, Hauley Road. 41. 51, Stroud Green Road. 42. 402, Hornsey Road (not used). 178 1903] Certified Underground Bakehouses. 43. 54, Archway Road. 44. 33, Bedford Terrace. 45. 10, Campdale Road. 46. 23, Girdlestone Road. 47. 87, Hazellville Road. 48. 676, Holloway Road. 49. 575, ,, ,, 50. 289, Junction Road. 51.104, „ ,, 52. 57, Marlborough Road. 53. 1, Stapleton Hall Road. 54. 84, Yerbury Road. 55. 47, Landseer Road. 56. 84, Ashbrook Road. 5 I. 26, Blenheim Road. 58. 144, Elthorne Road. 59. 487, Hornsey Road. 60. 27, Hornsey Rise. 61. 264, Hornsey Road. 62. 599, Holloway Road. 63. 167, Junction Road. 64. 7, ,, ,, 65. 32. Milton Grove. 66. 212, Tufnell Park Road. 67. 59, Junction Road. 68. 31, Salisbury Road. Underground Bakehouses. 69. 3, Cardwell Terrace. 70. 157, Thorpedale Road. Underground Bakehouses—not used. 71. 6, Higbgate Hill. 72. 5, Andover Road. 73. 38, Milton Grove. LOWER HOLLOWAY DISTRICT. Bakehouses above ground. 74. 69, Holloway Road. 75. 251, 76. 463, Liverpool Road. 77. 72, Rhodes Street. 78. 421a, Caledonian Road. 79. Factory, National Bakery, Brewery Road. 80. 254, York Road. 81. 85, Holloway Road. 82. 261, Holloway Road. 83. 106, St. James' Road. 84. 25, Cornelia Street. 85. V.V. Bread Co., Ltd., Brewery Road, Factory. 86. Factory, Whiteside's Bakery, Fakenham Street. 87. 1, Hope Street (not used). Certified Underground Bakehouses. 88. 5, Crossley Terrace. 89. 118, Roman Road: 90. 1, Frederick Street. 91. 78, Goodinge Road. 92. 415, Caledonian Road. 93. 132, St. James' Road. 94. 107, Roman Road. 95. 37, Cliarlesworth Street. 96. 480, Caledonian Road. 97. 376, York Road. 179 [1903 Underground Bakehouses. 98. Factory, 32, St. James' Road. 99. 70, George's Road. 100. 46. Roman Road. 101. 16, Westbourne Road. 102. 371, Caledonian Road. Underground Bakehouses—not used. 103. 16, Sberringham Road. 104. 25, Wellington Road. 105. 92 Wellington Road. 106. 214, York Road. HIGHBURY DISTRICT. Bakehouses above ground. 107. 112a, Drayton Park (Factory). 108. 232, Holloway Road. 109. 56, Hornsey Road. 110. 100 111. 370, Holloway Road (Factory). 112. 190, Seven Sisters Road. 113. 258, 114. 202, Blackstock Road. 115. 3, Highbury Park. 116. 123, Newington Green Road. 117. 16, St. Jude Street (not used). 118. 132, Holloway Road. 119. 17, Annette Road (Factory). 120. 86, Hornsey Road. 121. 154, 122. 48, Seven Sisters Road. 123. 210, 124. 10, Blackstock Road. 125. 225, 126. 226, St. Paul's Road. 127. 53, Boleyn Road. Certified Underground Bakehouses. 128. 64, Drayton Park. 129. 246, Hornsey Road. 130. 128, Blackstock Road. 131. 156, 132. 42, Newington Green Road. 133. 84, Mildmay Park. 134. 52, Balls Pond Road. 135. 132, Holloway Road. 136. 66, Blackstock Road. 137. 146, 138. 98, Gillespie Road. 139. 77, Newington Green Road. 140. 57, King Henry's Walk. 141. 1, Mildmay Park. Underground Bakehouses. 142. Salvation Army Bakery, Hawthorne Street (Factory). 143. 13, Highbury Place. Underground Bakehouses— not used. 144. 182, Drayton Park. 145. 25, Loivman Road. 146. 98, Balls Pond Road. 147. 2, Queen Square. 148, 77, Boleyn Road. 180 1903] BARNSBURY DISTRICT. Bakehouses above ground. 149. 19, Brooksby Street. 150. 112, Copenhagen Street. 151. 59, Caledonian Road. 152. 199 ,, ,, 153. 32, Biugfield Street (Factory). 154. 185, Copenhagen Street. 155. 44. Outram Street. 156. 129, Barnsbury Road. 157. 36, Caledonian Road. 158. 170, ,, ,, 159. 275, ,, ,, 160. 12, Bemerton Street. 161. 213, Copenhagen Street. 162. 40, Cloudesley Road. Certified Underground Bakehouses. 163. 44, Bingfield Street. 164. 21, Barnsbury Road. 165. 60, Bingfield Street. 166. 370, Caledonian Road. 167. 299, ,, ,, 168. 27, Dennis Street. 169. 26, Half Moon Crescent. 170. 1 & 3, Richmond Road. 171. 6, Wharfdale Road. 172. 12, Randall's Road. 173. 72, Bemerton Street. 174. 68, Barnsbury Road. 175. 100, Bemerton Street. 176. 76, Caledonian Road. 177. 159, ,, ,, 178. 179, Hemingford Road. 179. 44, North Street. 180. 52, Stanmore Street. 181. 62, Winchester Street. Underground Bakelwmes. 182. 57, Copenhagen Street. 183. 21, Caledonian Road. 184. 29, Offord Road. 185. 29, Hemingford Road. 186. 96, Caledonian Road. 187. 120, York Road. Underground Bakehouses—not used. 188. 181, Copenhagen Street. 189. 269, Liverpool Road. 190. 123, Offord Road. 191. 62, Barnsbury Street. 192. 205, Copenhagen Street. 193. 279, Liverpool Road. 194. 86, Thornhill Road. 195. 334, Caledonian Road. SOUTH-EAST DISTRICT. Bakehouses above ground. 196. 76, Baxter Road. 197. 322, Essex Road (not used). 198. 361, New North Road. 199. 38, Coleman Street. 200. 50, Popham Street. 201. 40, Cross Street. 202. 8, Islington Green. 203. 69, St. Peter Street. 204. 8, Danbury Street. 205. 5, Charlton Place (Factory). 206. 129, Upper Street. 207. 53, Queensbury Street (not used). 208. 229, Balls Pond Road. 209. 226, Essex Road. 210. 313, New North Road. 211. 20, Popham Road. 212. 172, Essex Road. 213. 51, Windsor Street. 214. 126, Packington Street. 215. 84, St. Peter Street. 216. 52, City Garden Row. 217. 107, Upper Street (not used). 218. 230, „ ,, 219. 298, New North Road (not used). 181 [1903 Certified Underground Bakehouses. 220. 24, Alfred Street. 221. 14, Charlton Crescent. 222. 398, Essex Road. 223. 68, „ ,, 224. 6, High Street. 225. 126, Liverpool Road. 226. 33, Park Street. 227. 32, Shepperton Road. 228. 51, Southgate Road. 229. 1, Theberton Street West. 230. 55, Clephaue Road. 231. 121, Packington Street. 232. 257, Balls Pond Road. 233. 353, Essex Road. 234. 114, „ ,, 235. 102, „ ,, 236. 262, Liverpool Road. 237. 263, New North Road. 238. 16, Rheidol Terrace. 239. 1, Shepperton Road. 240. Oxford House, Sherborne Street. 241. 102, Upper Street. 242. 57, Essex Road. Underground Bakehouses. 243. 192, New North Road. 244. 1, Cross Street. 245. 38, High Street. 246. 44, ,, ,, 247. 78, High Street. 248. 50, Arlington Street. 249. 67, Essex Road. 250. 14, Upper Street. Underground Bakehouses—not used. 251. 49, Dorset Street. 252. 26, Orchard Street. 253. 28, Baxter Road. 254. 285, Essex Road. 255. 30, Canonbury Street 256. 202, Essex Road. 257. 32, Parkfield Street. 258. 3, St. Paul's Street. 259. 76, 260. 24, Church Streer. 261. 289, City Road. 262. 2, High Street. 263. 29. Camden Street. 263. 1, Essex Road. Homework.—Employers of homeworkers, under the provisions of the Act, forwarded on the lists due to be returned on or before February ist, the names and addresses of 770 outworkers, and on those due on August ist 787. Of these 1,557 homeworkers no less than 841 lived in other districts, and their names and addresses were, in compliance with the provisions of the Act, forwarded to the proper authorities. On the other hand 919 names and addresses were received from other authorities, principally the City, Finsbury and Hackney. Consequently, when the necessary additions and substractions had been made it was found that 1,635 °f these addresses were in Islington. It is found, however, that the August lists for the most part contained all the names that were sent in February, so that the number of actual homeworkers were found to number not much more than 1,100. During the year Miss Gray called on 646 homeworkers, whom she had not previously visited. She has 182 1903] reported that in the majority of cases the condition of the homes, as regards cleanliness, was satisfactory. Indeed she has reported verbally that many of them are so clean, well furnished and comfortable, that it is almost waste of time to revisit them. No overcrowding was discovered, nor have the Inspectors reported any cases in which there was a deficiency of ventilation. In cases where infectious diseases occurred prompt measures were taken to disinfect the premises and the goods. Places where Food is prepared for Sale.—Under this heading are included kitchens of hotels or restaurants, eating houses, tripe and fried fish shops, and all other places where food is prepared for sale. During 1902 special attention was given to the condition of restaurant kitchens by Inspector West, who examined them with a view to ascertaining their structural defects. During 1903 Miss Gray commenced an inspection, which she had not quite finished at the end of the year, but which she is making with considerable minuteness, with the object of ascertaining the conditions under which the food is prepared, and the state of cleanliness of the kitchens, utensils and servants. In her report for the year she draws a striking contrast between the kitchens of working men's dining rooms and those of the more pretentious restaurants. It reads as follows : " Here, as in other districts, the kitchens of working men's dining rooms, which are usually on the ground floor, compare favourably, on the whole, with those of more pretentious restaurants, where they are in the basement. One is impressed by the fact that good management is the most essential point, as with equal advantages, in one kitchen there is nothing but dust and disorder, in another everything is clean and well kept." Her account too as to the removal of refuse is well worthy of consideration, for there is no doubt that a more frequent removal of refuse would be most desirable. The subject has been under the consideration of the Public Health Committee, who are in communication with the Works Committee on the subject. Miss Gray's further remarks respecting the lighting and ventilation of underground kitchens are entirely endorsed by your Medical Officer of Health, who cannot see any reason why these places should not be placed on the same footing as underground bakehouses. Workshops notified to H M. Factory Inspector.—135 workshops were notified to the Factory Inspector of the district, in which 378 persons were employed, of whom 20 were male " young persons," by which term is meant that they have ceased to be children, but were under the age of eighteen years. 183 [1903 The following is the list of these premises :— Workshops Notified to H.M. Inspector in 1903. Trade. Number of Workshops. Protected Persons Employed. Females. Male Young Persons. Total. Dressmaking 34 91 .. 91 Blouse and Skirt making 18 54 .. 54 Millinery 14 48 .. 48 Mantle making 8 24 .. 24 Tailoring 11 35 .. 3(i Laundries 6 31 .. 31 Fur Sewing 5 14 .. 14 Tie and Belt making 5 12 .. 12 Artificial Flower making 2 4 .. 4 Embroidering 4 8 .. 8 Dressing Gown, etc., making 2 7 .. 7 Leather Goods making 2 3 .. 4 French Polishing 2 3 .. 3 Gum Sorting 1 7 .. 7 Hassock making 1 1 .. 1 Pattern Card making 1 6 .. 6 Surp ice making 1 6 .. 6 Photograph Sorting 1 3 .. 3 Shoe making 1 4 5 Baking 1 .. 1 1 Clock making 1 .. 1 1 Cycle making .. 3 3 Dairy Can making 1 .. 2 2 Pianoforte making 1 .. 1 1 Picture Frame making 1 .. 1 1 Coach Building 2 .. 2 2 Metal Working 2 .. 2 2 Lamp making 1 .. 1 1 Totals 135 358 20 378 184 1903] Laundries.—At the end of 1902 there were 193 workshop laundries on the register, to which 8 were added during 1903, and from which 10 were removed, so that at the end of the year there remained igi. These received 332 inspections. They are now in a very much improved condition to that in which they were a few years ago. Indeed, it is hardly too much to say that the conditions under which the work is now carried out is very different to that which existed when inspections were commenced in 1895. Nevertheless these places can never be rendered absolutely healthy, because of the heat, steam, and the nature of the work itself, and consequently the workers will always be liable to contract colds which may lead to various chest diseases such as bronchitis and pneumonia. Indeed, the linen brought to be cleaned may be the vehicles for the conveyance of various diseases, particularly of enteric fever and phthisis. It may be stated that a few years ago it was proved at Clapham Infirmary that 1 in 11 laundresses (out of 446 who suffered from various other diseases) were affected with phthisis, and at Isleworth Infirmary 1 in 10 (out of 137) similarly suffered. The work imposed on the Workshop Inspectors.—The work which your two inspectors have now to undertake under the Factory and Workshops Act, has grown so enormously that they cannot much longer give the premises which it is their duty to inspect, that adequate supervision which is so necessary, if inspection is to be of any material service. Altogether they at present number 3,412 containing nearly 5,000 rooms, from which it will be seen that work as they may, they cannot visit many of these places more than once, especially if they pay due attention to those workshops which require, and must have, continued supervision. It will, therefore, be necessary that the Council should consider how much further they will increase their staff for the purpose of executing their duties under the Act. MISS GRAY'S REPORT. The Town Hall, Islington, 14th January, 1904. To A. E. Harris, Esq., Medical Officer of Health. Sir, I have the honour of presenting for your consideration a report of my work for the year 1903. In the course of the year I inspected 1,862 premises, which contained 2,535 workrooms, and I made 1,542 calls and re-inspections. The premises inspected were : — Registered workshops and laundries 1,095 The homes of female out-workers 511 Restaurant kitchens 149 Miscellaneous premises 107 Table CXVI. Giving a Summary of Miss Gray's Factory and Workshop Work during the Year 1903. Register Inspections. Forms and Notices. Sanitary Defects Discovered. Improvements Effected. 1903 Number of Workshops. Number of Laundries. Additions To. Removals From. Total. Number of Workrooms. Registered Workshops, &c. Homeworkers' Premises. Restaurant Kitchens. Miscellaneous. Total. Calls and Re-inspections. Workrooms. Workshops Reported to H.M. Inspector. Homeworkers notified to Local Authorities. Workroom Cards. Intimation Notices Served. ....... Statutory Notices Served. Workrooms Overcrowded. Workrooms insufficiently Ventilated. Workrooms in a Dirty Condition. Floors Defective or Undrained. Dustbins Wanting or Defective. Cisterns Dirty or Defective. Drains Defective. Drains Unventilated or Untrapped, &c. Sanitary Conveniences, Defective or Dirty. Insufficient Sanitary Accommodation. Miscellaneous. Total. Overcrowding Abated. Additional Means of Ventilation Provided. Rooms Whitewashed. Floors Repaired or Drained. Dustbins, Cisterns, Roofs, &c., Repaired. Sanitary Conveniences Repaired. Miscellaneous. Total. 1st Quarter 876 193 59 39 1,089 1,828 295 226 0 27 548 386 713 53 297 77 6 .. 4 .. 22 4 1 1 2 2 9 2 7 54 4 .. 18 4 3 3 2 34 2nd Quarter 899 190 53 65 1,077 1,826 387 77 0 25 489 413 778 31 18 100 22 .. .. 1 43 10 10 4 3 4 15 25 115 .. 1 43 6 11 10 7 78 3rd Quarter 888 189 30 36 1,071 1,827 196 133 17 30 376 419 488 16 316 30 27 .. 6 .. 30 3 9 6 1 6 17 1 24 103 6 .. 38 2 28 15 10 99 4th Quarter 883 188 44 32 1,083 1,850 217 75 132 25 449 324 556 27 5 87 10 .. 3 5 32 1 21 7 2 4 12 1 20 108 3 .. 31 1 10 3 1 49 Total for Year 876 193 186 172 1,083 1,850 1,095 511 149 107 1,862 1,542 2 535 127 636 294 65 .. 13 6 127 18 41 18 8 16 53 4 76 380 13 1 130 13 52 31 20 260 185 [1903 Registered Workshops.—At the end of the year there were on the " Register of Workshops, Workplaces and Laundries, where females are employed," a total of 1,083 registered premises, containing 1,850 workrooms. 186 workshops and laundries were added to the Register during the year, while 172 were removed from it. In four large workshops, mechanical power has been introduced to drive the machines, and the premises have thus become non-textile factories, and the work of four hand laundries has been taken over by steam laundries. The removal of the other workshops from the Register was due to the businesses being given up or transferred to other premises. The addresses of 127 workshops, which had not been previously visited by H.M. Inspector of Factories for the district, or in which no abstract of the Factory and Workshop Act was affixed, have been forwarded to the Home Office. The following table shows the trades carried on at the different registered workshops:— Nature of Business. Number of Workshops. Number of Workrooms. Dressmaking 293 369 Laundries 193 492 Millinery 89 183 Mantle making 58 95 Tiemaking 58 85 Blouse and skirt making 59 92 Fur sewing 44 60 Tailoring 45 58 Underclothing making 26 37 Artificial flower making 18 45 Jet and bead work 18 29 Leather goods making 16 30 Fancy goods making 8 14 Cardboard box making 8 25 Boot upper and shoe making 9 10 Apron and pinafore making 6 7 Stationery and valentine making 6 9 Shirt making 7 10 Dressing-gown making 6 6 Confectionery making 6 21 Trimming making 4 6 Rag and waste paper sorting 5 14 Hair work and wig making 3 8 Firewood cutting 4 6 Pickle making 4 4 Baby linen making 3 3 Photograph frame making 3 4 Feather curling 4 6 Embroidering 7 12 Collar making 3 5 Seed and drug packing 4 4 Curtain making 3 4 Lamp and candle shade making 2 4 Doll and toy making 3 6 Blind making 2 4 Umbrella making 2 2 186 1903] Nature of Business. Number of Workshops. Number of Workrooms. Paint-brush making 2 3 Brace making 2 5 French polishing 2 2 Work-box and cabinet making 3 3 Jewel and mandoline case making 2 3 Gold beaters' skin preparing 2 6 Tin box making 2 2 Waterproof making 2 3 Bassinette hood making 2 3 Surgical appliances making 2 2 Boys' blouse making 2 3 Clock case making 1 1 Belt making 1 1 Gum sorting 1 1 Perfumery making 1 1 Pattern card making 1 1 Chiffon tucking 1 1 Photographic enlargement making 1 1 Glass painting 1 1 Surplice making 1 1 Balloon making 1 1 Mattress making 1 2 Cork cutting 1 2 Funeral furnishing making 1 1 Marking ink making 1 2 Boot polish making 1 1 Musical string making 1 3 Buttonhole making 1 2 Gaiter making 1 2 Artificial fly making 1 1 Naval cap making 1 3 Bath glove making 1 1 Slate polishing 1 2 Japanning 1 1 Marquetry 1 1 Camera bellows making 1 2 Brush making 1 1 Wax figure making 1 2 Christmas stocking making 1 1 Aerated water makers' sundries making 1 2 Bottle washing 1 2 Hassock making 1 2 Total 1,083 1,850 Homes of Female Outworkers.—As required by the Factory and Workshops Act, lists of the names and addresses of persons doing manufacturing work in their own homes, were sent in by employers in the Borough, in February and August. It was found necessary to send a reminder to some manufacturers of their obligations in this matter, on both occasions. As a result of these 187 [1903 notifications, and those received from the Medical Officers of Health of other districts (principally from the City of London, Finsbury and Hackney), I have, during the year, called on 646 female homeworkers, whom I had not previously visited. I found that 135 of these had given up work at the time of my visit, or had removed, or were unknown at the addresses given. I inspected the homes of the remaining 511. The conditions of these homes varied greatly, but the majority were satisfactory as regards cleanliness. I found the work being done in kitchens, sitting rooms, bed rooms, living rooms, and, in one or two cases, in separate work rooms. The workers were principally:—women with home duties to perform, elderly women, or girls, who were delicate, or for some other reason preferred working at home to going out to work. The pay is as a rule small, the work irregular, and the worker has to provide machines, cotton, etc, and has to carry the goods to and from the warehouse. Fortunately in most cases the work does not seem to be the sole means of livelihood. The names and addresses of 636 homeworkets employed by Islington employers, but living outside the Borough, have been forwarded, during the year, through you to the Medical Officer of Health of forty different districts in which they live. Restaurant Kitchens.—In accordance with your instructions I have inspected the kitchens of 149 restaurants, dining rooms and tea shops. Some of these were scrupulously clean, others fairly so, while a minority were dirty and insanitary Here, as in other districts, the kitchens of working men's dining rooms—and which are usually on the ground floors—compare favourably, on the whole, with those of more pretentious restaurants, where they are in the basement. One is impressed by the fact that good management is the most essential point, as, with equal advantages, in one kitchen there is nothing but dirt and disorder, while in another everything is clean and well kept The most common defect which I found in the kitchens was the amount of vegetable and other refuse which was allowed to accumulate on the premises. In some places most of the vrgetable refuse is burned but in others it is only removed once a week and the dustbins are filled to overflowing. On removal this refuse is, as often as not, carried through the kitchens in open baskets by the dustmen. More frequent removal and the use of small dustbins which can be carried to the dust carts would be a distinct reform. Insanitary conditions also arise from the poor lighting and ventilation of most of the basement kitchens—and some of the stringent regulations which now apply to underground bakehouses might with advantage be made to apply to such kitchens. Miscellaneous Inspections.—These 107 inspections include inspections of the sanitary arrangements in factories, steam laundries, etc., where women are employed, and of the three public conveniences for women in the Borough -on which I have reported to you from time to time. I refer to the results of my inspections under the following headings : — Overcrowding.—The bad weather of the past year has made more marked the depression of trade in the Borough, which has been noticeable since the beginning of the South African war. In most of the workshops the number of persons employed has been smaller than usual I found, however, 13 overcrowded workrooms In these the overcrowding was abated upon intimation notices being served. Since 1895, when the amount of cubic feet required for each person was definitely stated in the Factory Act, a great improvement has taken place as regards overcrowding. Now, most employers, before opening a workshop or additional workrooms, have them measured, so that they may know how many persons they may legally employ. The cards which this Public Health Department supplies, stating the cubic capacity of rooms and the number of persons who may be employed in each, are most useful. During the year I have distributed 294 of these cards. Cleanliness.—The walls and ceilings of 130 workrooms, which I found in a dirty condition, have been cleansed and whitewashed during the year N 2 188 1903] Ventilation.—In one workroom, which was structurally insufficiently ventilated, additional means of ventilation has been provided In five restaurant kitchens, visited by me in December, the question of ventilation is being dealt with along with other matters, under the supervision of Inspector West. Sanitary Defects.—In addition to the defects mentioned above, I have discovered the existence of 232 nuisances on the premises which I inspected. These were:—41 defective dustbins, 18 defective or uncovered cisterns, 18 defective floors, 8 defective and 16 unventilated drains, 53 defective sanitary conveniences, 4 cases of insufficient sanitary accommodation and 76 miscellaneous defects I have personally supervise the abatement of 116 of these nuisances the remainder were reported to the male inspectors. I have served 65 intimation notices. I am, Sir, Your obedient Servant, JESSY M S. GRAY, Sanitary Inspector. INSPECTOR WEST'S REPORT. Town Hall, Upper Street, Islington, N , 18th January, 1904 To A. E. Harris, Esq , Medical Officer of Health. Sir, I have much pleasure in submitting my report to you for the year ending the 2nd January, 1904 During that time I have made 4,442 visits to places of business, consisting of factories, workshops and workrooms in the Borough, having made 2,117 inspections and 2,325 re inspections. The visits to the trades carried on in them were as follows:—261 tailors, 510 shoemakers, 232 pianoforte makers, 81 cycle makers, 308 bakehouses, 790 restaurants, etc., and 2,200 miscellaneous places of business. These are as follows :— Trade. No. Trade. No. Artificial florists 1 Cork cutters 1 Automatic machine manufacturer 1 Coopers 1 Art metal workers 1 Camera makers 1 Bakers 266 Cardboard box makers 1 Bamboo workers 3 Card gilders 1 Boot and shoe manufacturers 100 Compass makers 1 Builders 6 Cab yard 1 Brush manufacturers 2 Cribbage board makers 1 Blind makers 2 Clock makers 2 Bookbinders 1 Dairy outfitters 2 Beer bottlers 2 Die sinkers 2 Bird cage makers 1 Dyers and cleaners 2 Basket makers 1 Dining table makers 2 Confectioners 10 Enamellers 1 Coach builders 29i Engineers 1 Carpenters 13 Egg sorters 1 Cabinet makers 30 Farriers28 Cycle makers 22 Fancy working . 1 Table CXVII. Summary of Inspector West's Work-shop Work during the year 1903. 1903 Workshops on Register. Workrooms therein. Newly discovered workshops. Workrooms therein measured. Inspections. Re-inspections and Calls. Workshops. Notices. Nuisances. Improvements. Miscellaneous. Total of Improvements. Tailors. Shoemakers. Pianoforte Makers. Cycle Makers. Bakehouses Restaurants, &c. Miscellaneous. Total. Tailors. Shoemakers. Pianoforte Makers. Cycle Makers. Bakehouses. Restaurants, &c. Miscellaneous. Total. Overcrowded. Insufficiently Ventilated. Dirty condition. Reported to H.M Inspector. Removed from Register. Cards distributed. Intimations. Statutory Notices. Homeworkers reported to Local Authorities. Drains defective. W.C.'s defective. Cisterns dirty or uncovered. Dust bins defective or wanting. Miscellaneous. Water Closet. General Water. Ventilation and Cleansing. Constructed or provided. Pan and trap furnished. Water supply provided. Dust bins provided Cisterns provided. Cisterns repaired or cleansed. Water supply provided. Additional ventilation. Workrooms cleansed or limewhited. Yards, &c., repaired. Overcrowding abated. 1st Quarter 618 909 35 39 81 108 20 18 30 85 189 531 31 82 26 13 33 109 347 641 .. 2 98 3 .. 29 88 .. 140 4 27 3 14 52 7 9 11 16 .. 1 2 4 82 17 .. 48 197 2nd Quarter 1,136 1,520 119 212 24 58 27 14 61 69 285 538 10 55 33 14 68 57 361 598 •• 3 86 3 .. .. 95 •• .. 1 22 .. 7 51 13 11 12 9 1 4 108 12 .. 31 201 3rd Quarter 1,174 1,603 38 83 78 51 21 11 75 101 188 525 3 25 14 .. 22 73 294 431 •• 1 60 3 •• •• 68 •• 58 10 26 2 13 68 5 10 12 10 .. 1 .. .. 49 9 40 136 4th Quarter 1,196 1,656 22 53 26 80 32 11 17 120 207 523 8 51 59 •• 32 176 329 655 .. 1 52 4 .. 16 91 3 .. 11 33 8 17 72 10 12 12 14 .. 2 •• 2 72 15 .. 83 222 Total for Year 1.196 1,656 214 387 209 297 100 54 213 375 869 2.117 52 213 132 27 155 415 1,331 2,325 .. 7 296 13 .. 45 342 3 198 26 108 13 51 243 35 42 47 49 .. 4 3 10 311 53 •• 202 756 189 [1903 Trade. No. Trade No. Fish curing 1 jProvision dealers 1 File cutting 1 Patent medicine manufacturers 1 Gas stove manufacturers 1 Platers 1 Gutscraping 2 Rag sorters 2 Gasfitters 1 Scale makers 2 Gold beating 1 Saddlers 3 Gold beaters' skin makers 1 Slate polishers 1 Harness makers 2 Stone masons 2 Ironmongers 4 Sundial makers 1 Instrument case maker 1 Smith 2 Invalid chair maker 1 Stick maker 1 Instrument manufacturers 2 Shop fitters 3 Ironfounders 1 Sign writers 1 Leather manufacturers 2 Soap makers 1 Lath renders 2 Skin dressers 1 Laundry machine manufacturers 4 Shirt makers 1 Lamp cleaners 1 Tailors 37 Leather case makers 1 Typefounders 1 Lamp makers 3 Ticket writers 2 Ladder makers 1 Table makers 1 Monumental masons 1 Trunk makers 4 Marquetry inlaying 3 Tea sifters 1 Mail cart makers 1 Tea merchants 1 Mattress makers 2 Tin workers 1 Mount making 1 Upholsterers 4 Motor car manufacturers 2 Undertakers 2 Map makers 1 Ventilator making 1 Marble mason 1 Wheelwrights 17 Nosebag maker 1 Woodchoppers 4 Naturalist 1 Writing desk makers 1 Organ builder 3 Wreath case makers 1 Optician 1 Waterproof makers 1 Pianoforte works 56 Wood letter makers 1 Picture frame makers 4 Watchmakers 4 Perambulator makers 3 Wireworkers 1 Pianoforte siring makers 1 Workbox making 1 Patent food makers 1 Zinc workers 5 Pie makers 1 Pipe mounters 1 Total 509 Plumbers 1 Register.—During the year 214 workshops, containing 387 workrooms, have been measured and added to the Register, thus making a total of 1196 workshops and 1656 workrooms. Sanitarry improvements.—During the same period I have served 345 notices for the abatement of various nuisances. 311 workshops have been cleansed and limewhited. 35 w.c.s shave been provided at various factories and workshops, whilst 410 other improvements were carried out under my supervision. 190 1903] I have reported, through you, to H. M. Inspector of Factories as required by Section 27 of the Public Health Act, 1891, the addresses of thirteen workshops in the Borough where young people under the age of 18 years were employed Outworkers.—In accordance wi h Section 107 of the Factory and Workshops Act, 1901, I have, during the year, sent through you to the Medical Officer of Health of the Metropolitan Boroughs the names and addresses of 198 outworkers who reside in the various Boroughs of London, and who work for tradespeople in Islington Restaurants.—I have also, by your direction, commenced inspecting and testing the drains of restaurants and dining rooms ; but I am afraid this will take a very long time to complete, considering their number and the difficulty of making examinations whilst meals are being prepared for customers. Preparation of food commences soon after 11 a.m. and does not finish until after 2 p.m., this is followed soon after by the tea hours, viz , 4 to 6 p.m. I am. Sir, Your obedient Servant, GEORGE WEST. Sanitary Inspector of Workshops. HOUSES LET IN LODGINGS. At the end of the year there were 655 houses, or 1.69 per cent. of all houses in the Borough, on the register of houses let in lodgings, or occupied by members of more than one family, being an addition of 122 as compared with the number on the register at the end of the preceding year. Of these registered houses there were made 1,566 separate inspections, in addition to 6,841 re inspections and visits, so that 8,407 calls were made to them. The number now on the register is quite as many as the inspectors can systematically visit, although many more could be inspected if each inspector gave his whole time to the duty, which is not the case, for one of them divides his work between taking samples for analysis under the sale of Food and Drugs Acts and the inspection of the registered houses in the northern part of the Borough. It is much to be desired, indeed it is essential, if the work is to be done efficiently, that an inspector giving the whole of his time to the work should be appointed to assist Inspector Jordan, whose duty it is to look after the registered houses in the southern districts. In my report for last year this subject was mentioned, and the Medical Officer of Health expressed himself very clearly on the subject when he stated that " the time has now arrived when this duty (Food Adulteration) should be undertaken by one man, and when the inspection of the houses in the northern districts of the Borough should occupy the whole time of another, particularly as their number is being rapidly increased. At the present time the Public Health Committee have a report on this matter under their consideration." Well, the result of that consideration was that the Committee recommended the Council to appoint an additional inspector who would give the whole of his time to the administration of the Sale of Food and Drugs Acts, and that the sanitary districts, 191 [1908 numbering fourteen, should be increased to fifteen, that Inspector Jordan, then engaged in the southern part of the borough in inspecting houses let in lodgings, should be appointed to the new district, and that each inspector should inspect the registered houses in his district. This resolution of the Committee was adopted contrary to the advice of the Medical Officer of Health, who was strongly of opinion that the supervision of registered houses should be undertaken by special inspectors, for reasons set out in his report, which is given in an appendix of this report. The Chairman (Alderman Cufflin) also did not approve of the Committee's action, so that when the report came before the Council, it was withdrawn for further consideration. Unfortunately before that time arrived the term for which the Council had been elected came to an end, and a new Council, whose personnel is greatly different from its predecessor, has been elected. The Public Health Committee are now considering the whole position of the sanitary staff, and it is hoped that before very long the additional assistance will be obtained. It is much needed, for many of the houses on the register are occupied by the very worst class of tenants in the borough, and belong to the very worst class of owners, or are managed by the most indifferent agents. There are some houses and streets from which the inspectors are hardly ever absent, because they find it necessary to call frequently so that the houses may be kept in even habitable repair. The fault is not always that of the owner, because experience has shown that tenants are often wilfully destructive; indeed, so destructive as to tear down baluster rails and even doors, and to use them, it is supposed, for firewood. On the other hand, it must not be forgotten that much of this damage, if not all, might be prevented if owners appointed a caretaker, who might be a lodger, to each house, and who for some consideration in his rent, would look after the premises. Unfortunately such a proceeding is very rare, as the owners think they do quite enough if they send their agent once a week to collect the rent. On such visits, however, he is much more intent on money than on sanitary matters, and these are consequently neglected, particularly if the tenants should be irregular in their payments. Improvements.—The inspections resulted in 2,254 nuisances being abated in 1,049 houses, these included:— Drains constructed 8 „ repaired 193 Traps fixed 44 W.C.'s—extra provided 20 „ amended 74 „ supplied with water 166 192 1903] Dust bins provided 62 „ repaired or covered 22 Surface drains and yard pavements repaired 108 Water supply—cisterns provided 2 „ „ repaired and cleansed 219 ,, provided 81 Houses—repaired 82 „ cleansed and limewashed 342 ,, ventilated 21 Overcrowding abated 80 Invalidity of the By laws,—At the usual period of the year, that is to say, in the months of February and March, the inspectors commenced to serve notices on landlords of houses on the register, reminding them that the annual cleansing was expected to be done according to By-law 17 in the first week of the month of April. The by-law provides as follows:— 17. The landlord of a lodging-house shall, in the first week of the month of April in every year, cause every part of the premises to be cleansed. He shall, at the same time, except in such cases as are hereinafter specified, cause every area, the interior surface of every ceiling and wall of every water-closet belonging to the premises, and the interior surface of every ceiling and wall of every room, staircase, and passage in the house to be thoroughly lime-washed. Provided that the foregoing requirement with respect to the limewashing of the internal surface of the walls of rooms, staircases, and passages shall not apply in any case where the internal surface of any such wall is painted, or where the material of or with which such surface is constructed or covered is such as to render the lime-whiting thereof unsuitable or inexpedient and where such surface is thoroughly cleansed and the paint or other covering is renewed, if the renewal thereof be necessary for the purpose of keeping the premises in a cleanly and wholesome condition. Among others so reminded were the landlords (Messrs. Nokes and Nokes) of 9, St. Clement's Street. On failing to comply with the notice they were written to, but as they still failed to comply with the by-law they were summoned before Mr. d'Eynecourt, at Clerkenwell Police Court, " that they did 198 [1903 not in the first week of April, 1903, cause every part of the premises to be cleaned, contrary to the by-laws," when they pleaded that the by-law was unreasonable and ultra vires, and therefore invalid, having regard to the number of registered houses in the borough, and in the adjoining boroughs, in requiring them to be cleansed within so limited a time, as it was practically impossible that all such houses could be cleansed in the space of one week. Evidence was given for and against this contention by the Defendants and the Borough Council, and in the end the Magistrate was of opinion that although there might be some difficulty in complying with the by-law, yet, as there was no impossibility in so doing, the by-law was not so unreasonable as to be invalid; and fined the landlords ten shillings and two guineas costs. About the same time the Stepney Borough Council prosecuted a landlord under their by-law relating to cleansing, which provides—" That the ' landlord ' shall in the first week of the month of April in every year, and at such other times as the condition thereof may render it necessary, cause every part of the premises to be cleansed. He shall at the same time, subject to the proviso of the by-law, cause every area, the interior surface of every watercloset, and the interior surface of every ceiling and wall of every room, staircase, and passage in the house to be thoroughly limewashed. The above (and other) by-laws apply equally whether the lodging-house is or is not registered." The magistrate was of opinion that so much of the first clause of the by-law 14 as requires the annnal cleansing by the landlord, was invalid, on the following grounds:—(a) Being ultra vires; (b) being repugnant to the laws of England; (c) being repugnant to the provisions of the Public Health (London) Act, 1891; (d) being unreasonable. He therefore dismissed the summons. He considered (a) that Section 94 (d and e) did not empower the Borough Council to cast an obligation upon a " landlord " which did not already exist at Common Law, or by Statute, but merely entitled them to regulate the duties of persons already responsible, by requiring, e.g., periodical performances ; (b) that the by-law is repugnant to the laws of England because, in the absence of express covenants, there is no obligation upon a reversioner even to repair, much less to cleanse, any premises which have been let to a tenant for any term, at any rate, unless the state of the premises, in consequence of dirt or non-repair, is a nuisance of which he has notice, and it was in his power to abate the nuisance by putting an end to the tenancy : none of these conditions are appended to the by-law; (c) that under the Public Health 194 1903] (London) Act, 1891, the following state of things must exist before any obligation additional to the Common Law, can be cast upon the owner (the equivalent to the ' landlord ' under the by-laws) —(I.) A nuisance injurious to health, and (II.) inability to find the person by whose act, default, or sufferance the nuisance exists, or structural defect the cause of the nuisance; (d) that even if the by-law be otherwise good, in making the landlord responsible it is unreasonable, because it does not cast a primary, or at least a concurrent liability upon the lodger to cleanse his rooms, and also relieves the " keeper," who has more immediate control of the premises than the landlord, from all liability in the matter, either concurrent or prior, so far as the rooms and exclusive staircases, etc., are concerned. In the Islington case Messrs. Nokes and Nokes .appealed against the decision of the Magistrate, while in the Stepney case the Borough Council of Stepney appealed against the decision. After considerable delay the appeals were heard conjointly by the High Court of Justice, where they were fully argued, with the result that the by-laws were declared unreasonable, not on the point raised by Messrs. Nokes and Nokes, that the time specified was too limited, but on the ground that the by-law did not provide for the service of a notice, and that in consequence a person who, under certain circumstances, was merely entitled to the rack-rent of the premises might become liable to penalties under the by-laws. There was no objection to a by-law which, under certain circumstances, placed responsibility on the landlord, but the objection to the particular by-law was that a landlord, who might be quite unaware that the requirements of the by-laws had not been complied with, would be subjected to penalties without a notice having been served on him. It is a singular fact that although it was not necessary in this particular case to serve a notice on Messrs. Nokes and Nokes, they had in fact been served with one, yet because the by-law did not provide for the service of a notice under the circumstances mentioned, it was declared to be bad. On the other hand the court held on the point raised by the appellants as to the limited period of time in which to effect the cleansing, that the by-laws were not bad. Thus Messrs. Nokes and Nokes succeeded on a point not raised in their pleadings, but by the Court itself. The judgment of the Court is so important and so far reaching in its results, for it effects nearly all the by-laws in the country, that it is now given in extenso. 195 [1903 In the High Court of Justice. King's Bench Division. (Divisional Court.) Royal Courts of Justice, Wednesday, 5th February, 1904. Before The Lord Chief Justice of England, Mr. Justice Wills and Mr. Justice Kennedy. STILES versus GALINSKI. NOKES versus MAYOR, Etc., of ISLINGTON. (Transcript of the shorthand notes of Messrs. Harry Counsel &• Co., The Gateway, New Court, Carey Street, W.C. The Lord Chief Justice: Nobody can have listened to this argument without being struck with the extreme importance of the point that has been raised, and I am very glad (although we have had two cases) that we have had the advantage of having it thoroughly argued by two Counsel upon each side. In consequence of some observations that have been made, holding, as I do hold, that the bye-laws in both of these cases must be held to be unreasonable, I want expressly to point out that we are not interfering with the discretion of the local authorities to the extent to which it has been suggested by those who supported the bye-laws. In the first place, I recognise that on practical questions, where a power is given to a public authority tc make bye-laws within the ambitus of the power that is given to them, as, for instance, in this case, for cleansing and 'limewhiting at stated times the premises, that their discretion ought not to be lightly interfered with, especially where bye-laws have been sanctioned by a public department and particular duties and times and periods have been enforced. It is only where we clearly see that some legal principle is interfered with that we ought to hold that byelaws are unreasonable, and, therefore, I am not quite sure that we are all agreed as to all the grounds upon which we think these bye-laws are unreasonable. I also agree, as the Lord Chief Justice (Lord Russell) pointed out in Crews v. Johnson, that these bye-laws are not to be set aside or upheld except upon very strong grounds; it is not to be assumed against them that they would be construed unreasonably. On the other hand, of course, if, as we pointed out in Nokes' case, they necessarily involved that which is unreasonable, it is our duty to do so. There can be no difficulty in properly framing bye-laws which really can get rid of all these objections which have been taken to-day, and I think, although possibly it may be a difficult task to perform, the matter has not been quite sufficiently considered by the framers. They may have followed, as was suggested by Mr. Courthope-Munro, some model bye-laws, and those bye-laws may not sufficiently have considered the points which have been developed in this case, and the benefit of this kind of argument is that it does point to objections that may be raised, and enables local authorities to meet them in the future. 196 1908] Now, taking the case that was first argued, the Stepney case, the abjection that I take to this bye-law and the ground upon which I think the bye-law is unreasonable (byelaw 14) is that it includes or may include a class of people who are not legally responsible and not morally responsible, without properly safeguarding them before they can be made liable for a criminal offence. The words are : " The landlord of a lodging-house " shall in the first week of the month of April in every year, cause every part of the " premises to be cleansed," and bye-law 19 says, " Any person who shall offend against " any of the foregoing bye-laws shall be liable for every such offence to a penalty of £5." Now, the word "cause" is, of course, the word that gives rise to the difficulty. If " cause " could be constructed to mean " take reasonable steps," that is to say, make a contract with his tenants, or something of that kind, the same difficulty would not have arisen, but I think very properly in the interest of sanitation and in the interest of the good working of this kind of Act, " cause " does not mean merely " take steps," but " shall see that the thing is done." Therefore, we have the bye-law providing that the person upon whom the duty is cast was to see the thing done. Now I turn back to "landlord," and I find that landlord in these bye-laws includes in relation to a house or part of a house which is let in lodgings or occupied by members of more than one family, the person (whatever may be the nature or extent of his interest in the premises, and whether he resides on the premises or not) who receives or is entitled to receive the rack rent of a lodging house. Now, I do not read the definition of " keeper " from these bye-laws for the moment, because I quite agree that there would be less objection to the bye-law if it were confined to a person who really had what I may call the personal management of the house. I think this view is again confirmed by analogy by the same kind of argument as I pointed out with reference to Nokes' case, where the question was the supply of watercloset accommodation. The Act, by section 4, sub-section 3, makes provision that where the nuisance arises from any want or defect of a structural character, or where the premises are unoccupied, then notice shall be served upon the owner, and where the person causing the nuisance cannot be found, and it is clear that the nuisance does not arise from or sufferance of the occupier, or owner, of the premises, the Sanitary Authority may themselves abate the nuisance and may themselves do the work. Only by way of analogy, I point out that the Act seems at places to draw a distinction between the occupier, who would be responsible, or who ought to look after these things, and the owner. It seems to me that the objection to the bye-law, not any objection to the Local Authority making a proper bye-law which deals with the matter, is that a person who may have taken an agreement from a responsible agent, who is going to let the house in lodgings, would be held to be liable on the ground that he was entitled to receive the rack rent, and he had not caused it to be done. I think it right to say that I attach no importance to the objections taken by two of the counsel—I am not quite sure which they were—to the suggestion that he would not have a right of entry. I think it perfectly obvious that, under an ordinary agreement rights of entry would be reserved, or ought to be reserved, in order to justify a landlord and enable a landlord to see that the law is obeyed. I wish further to say this. I see no objection to a bye-law which puts the responsibility on the landlord, even though he may be the man who is merely entitled to the rent. What I think is that any such bye-law ought to be made with reference to such a man's position, and ought, in fact, provide that, in the case in which there is some person who is liable, or may be liable, to a landlord to fulfil the obligation of the statute, the landlord himself should not be subjected to a criminal charge without notice being given to him. 197 [1903 Therefore, I come to the conclusion that the bye-law in both these cases is bad, because it does not provide for the person who is going to be made subject to the charge, receiving notice in cases in which, under many circumstances, he may not, so to speak, have what I may call the ordinary means of knowing whether or not the law has been fulfilled. Now, with regard to the second case, Mr. Courthope-Munroe raised the point which, if he could have made good, would have differentiated his case from the decision which I am now giving. He said that under the bye-law the Parish of St. Mary, Islington, the definition of "landlord" is narrower and corresponds with the definition of a "keeper" in the Stepney case, and to a certain extent I agree with him, but I still think, even if you take the definition of " landlord" in the St. Mary, Islington, case, it is not sufficiently precise to exclude the case to which I have already referred. It seems to me that it does still render it possible that the bye-law might be constructed, without being unreasonable, to include the person who gets the profit, that is to say, receives the ultimate money, though he may not be in fact, in touch with the lodging house in the same way as the ordinary keeper is, I certainly think it is not possible to hold, as Mr. Courthope-Munroe contended, that there is no liability until the house is registered, because I think that certainly bye-law 2 brings the bye-law in force as soon as he has been required to give the particulars, and the subsequent particulars about that continuance of the liability do not in any way confer an exemption or removal of the liability. I think that these bye-laws no doubt designed with the very best intentions, and which ought to be supported, unless they are shown to give rise to a serious objection, require re-modelling from the point of view, not of preventing the landlord from being responsible if he does not see that the work is done, but of giving him reasonable and proper notice before he can be charged with the breach, as he was in this case, simply because the house had not been cleansed, or had not been cleansed by the given day. I now come to that part of the case which has given us more difficulty—or at any rate given me more difficulty—and upon which I am not quite sure that we are all agreed. Speaking for myself, and myself only, I should not have been disposed to interfere with this finding on the ground that the period taken was die end ol the first week in April. The statute says that they are to make bye-laws for cleansing and limewashing at stated times the premises. Undoubtedly, I think, that does mean fixed dates when about it should be done, or by which day it should be done. I trust that if the bye-laws come to be reconsidered, the objections, which seems to me to be very strong objections, to the taking of this particular period, which llrother Wills has pointed out in the course of the argument, will be considered. I can well imagine that a week at the end of April, or a fortnight at the end of April, or a fortnight at the beginning of May, or anything of that kind, would remove all these objections; but why I should not have been disposed to interfere on that ground is that that does seem to me exactly one of the things in which the knowledge and experience of the Local Authority, who have to fix a started time, ought to prevail, unless some what I may call grave objection, so serious as to amount to an objection in law, or some strong unreasonableness in fact prevail. While I have been very much impressed by the suggestion that the end of the first week in April will very often be a difficult time for it to be done, there may be other considerations in connection with the class of lodging house or the class of people who inhabit these lodging houses, of which 1 do not know, which may be counterbalanced by those considerations. Had it rested with me, I should not have been disposed to hold, and I do not hold, that the bye-law is bad because of that particular week being taken, but, for the reasons which I have stated, which are, in my opinion, more substantial with regard to the question of 198 1903] no notice being given to an absent landlord, who may be under no legal or moral responsibility to see the Act carried out as between himself and the real person in occupation or tenancy of the premises, I think this bye-law must be held to be unreasonable, and that being so, the first acquittal must be supported ; that is to say, the first appeal must be dismissed, and the second appeal must be allowed. Mr. Justice Wills: I am of the same opinion, and I desire to adopt as part of my judgment everything which my Lord has said, except with regard to the matter about the first week in the month of April; but there are a few observations which I should like to add. It seems to me that an initial mistake has been made in these bye-laws by trying to make the same hard and fast rule apply to two perfectly different classes or tenements. The lodging house proper, which is something in the character of a common lodging house, may be perfectly well dealt with by a series of regulations which are really quite inapplicable to the very large class of houses which are brought under the common operation of these bye-laws under the words " houses occupied by members of more than one family." Take the West End of London, where we are told the same sort of bye-laws apply. It is not too much to say that there are very large areas in some of the best parts of London where I should think it is no exaggeration to say that two-thirds or three-fourths of the houses are so occupied that they would come under this definition. You cannot pass through a great number of streets with which I am very familiar without finding half a dozen doctors' names up on the same door; everybody knows it is the commonest thing in the world for a medical man who has an extremely good house, very highly rented, to let off one or two rooms as consulting rooms to somebody else. Well, that immediately brings this house within the definition of a lodging house and makes all these bye-laws applicable to it, and when you come to such a case, the application of the bye-law seems to me to be unreasonable to the last extent. The definition of "landlord" embraces the person who receives the rack rent of the house. Just take the very large area, for instance, which is owned by the Duke of Portland. Probably there are from 500 to 1,000 houses of which he receives the rack rent, and for every one of which he would be liable as a lodging house within the meaning of these bye-laws, and to hold that he was liable because everyone of these houses is not thoroughly cleansed during the first week in April, or is not limewashed from top to bottom during the first week in April, would impose upon the landlord in such a case as that an absolutely intolerable burden, and one against which all good common sense and all instincts of fair-play rebel. I only give the instance because it is quite within the extreme instances which may be given. If they are fairly within the scope of the list, as undoubtedly that one would be, it is only by pointing out the circumstances of the bye-laws, as applied in such cases, that one sees whether or not, taken as a whole, and as applicable all round, they are reasonable. If they were confined to the class of houses like the same sort of houses, and occupied in the same sort of way, as lodging houses, of course there would be very much more to be said in their favour, but even there I agree with my Lord that unless the person who is struck at is a person who, from his position and from his relation to the property, ought to know exactly what his tenants are doing, and in what state they are keeping the house, and so on—unless he is some person of that sort, it would be quite unfair to render him liable, without his having had notice of what is tafting place. 199 [1908 Now, Mr. Courthope-Munroe defends, and it is part of his argument that I do not like at all, and that I feel bound to protest against on the great public principles a good deal of this by saying, " Oh, these bye-laws might be harsh and improper and unjust if they were applied all round" (and they might in some cases be so), "but the Borough Council, or whatever the Local Authority is, must be trusted only to put the law in motion in such cases in which it would be reasonable to do so." Now, to begin with, the Borough Council are not the only persons who are entitled to put the law in motion ; every subject of the Crown is. And to go on with it, 1 do not like legislation which is felt to be so unfair, applying it all round, that it requires to be justified by saying that in particular cases it would not be enforced. I think that it is as bad a ground upon which to defend legislation as you could very well have. Now I pass from that part of the case just to say one word about this first week in April. Of course, I feel fully the force of a great deal my Lord has said. One constantly knows the principles to be applied, but it is the application of principles which raises the difficulty. What I feel in this particular case is that it is hardly right to say that this can be a proper period because it is fixed by the local authoiity, to whom great discretion is necessarily committed, if it does lead in particular instances, which are not chimerical at all, to an almost preposterous state of the law. In one of the cases—I think it is the Islington case, but I only mention it because it shows that sometimes illustrations are not away from the point—we have had mentioned that the work which was required to be done would take a couple of men from ten days to a fortnight, working all day, to get through it. It is a fact which the Borough Council ought to have known, that Easter does very commonly fall very early in April, so as to embrace part of the first week in April within its operation. I am told that in this very present year there are really four days out of the seven which are allowed which are practically excluded, and one knows perfectly well that it is all very well to talk about four days—there are one or two more days when the British workman will not work if he can help it, and the result, as it seems to me, is, that the person may be called upon to do in two or three days, and if they do not do it he will be liable to a penalty, that which would be sufficiently extensive to require several men something between a week and a fortnight. I do not think that a bye-law which can have that operation has received the consideration of its applicability to practical purposes that it ought to have received. There seems to me to be no sort of difficulty in meeting all the objections that have been raised to these bye-laws, and in making them, if they are re-cast, really reasonable. For the reason I have mentioned, there seems to me that in the Stepney case it is clear that the bye-law cannot be sustained. In regard to the other case, it is not so bad a case, because the Council there have attempted to meet some of the difficulties, in the first place, by putting a much more moderate meaning on the word "landlord," and in the second place by attempting to provide for the exemption from the operation of the bye-laws of certain cases in which it seems reasonable enough that they should be exempt, but it has not gone far enough for the reasons which my Lord has pointed out. Even that modified definition of "landlord" is open to objection, and I quite agree with the criticisms which he has passed upon that and upon other parts of these byelaws. What I have said about the first week in April, of course, applies to both of them. I do say it is impossible to frame a set of bye-laws which should deal with both classes of tenements together, and I should be very far from saying that I should hold bye-laws wrong or unreasonable because they did not attempt to differentiate between them, but I should certainly like to throw out for the consideration of those who have to 200 1903] deal with this matter, and even for the consideration of the Local Government Board, of whom we have heard so much, but whose approval cannot make that reasonable which is not reasonable in itself, whether, if model bye-laws are to be framed, it would not be wiser and would not make them much more satisfactory if the two perfectly different classes of tenements were not attempted to be dealt with or comprised in the same legislation. Mr. Justice Kennedy: I have come to the same conclusion, and I have come to that conclusion with a great deal of reluctance from one point of view, and that is this: that it is the health of the helpless that is very largely protected by these bye-laws, and I cannot help thinking that a good many of the points that have been taken have been points which do not occur in practice—which raise no difficulty in practice—and in which no difficulty would arise if there was loyalty to the intentions of the Legislature on the part of those who raise these difficulties. I confess myself that I am unable to see, at the same time that the bye-law in either case could be supported, for the reasons given by my Lord, and I think it is unfortunate that that should have happened, because one knows perfectly well (it is not disputed here, and cannot be disputed anywhere) that persons who do not want to face liabilities which they incur by keeping property in an insanitary state, can raise a great many difficulties if they will only employ intermediate agents, who they say are the only persons in touch with the tenants. So it is very difficult, I believe, and I can quite understand, to frame bye-laws which shall, on the one hand, really make the man who has got the profits, as the law intended, (for I am only stating what I understand to be the law under the statutes) who is really receiving the high rent for these properties, responsible, and at the same time, of course, prevent a possible injustice, which is equally to be deprecated, of a person who is loyally doing his best, but has not the opportunity, from being attacked by summonses and found liable to penalties which really he could not help. It is very difficult, no doubt, to recognise the two, but I can only say for myself entirely that it does make one inclined, as far as one can consistently do so, with justice, to take a liberal and generous view of the efforts of public bodies who carry out this great sanitary legislation, and not allow either private greed or private carelessness to maintain an insanitary property. I cannot help thinking, speaking for myself, if I may, beyond doubt, that with regard to the word "landlord" in the bye-law in the Stepney case, the word to be one which does make it possible for a person who is merely a rent receiver, who has let to a perfectly respectable tenant, who again sub-lets in lodgings, to make that ultimate landlord responsible without notice for an unhealthy condition of the property. You see an instance of the importance of doing something, because in this case, according to paragraph 3, when the appellant visited the house he found the rooms and staircases dirty, and he again visited on the 14th April, and he found the same state of dirt in this place. All I can hope is, that the Local authority will bear in mind what my Lord has said, and what Brother Wills has said, and frame a bye-law which is in such terms as will avoid that which makes the present one unjust, namely, making a person responsible who may be simply landlord in the sense of the ultimate receiver of the rent, and apparently a perfectly respectable tenant, who is anxious to see that the lodgings when he lets them are kept in a good state, and takes care that his lodgers do their duty and keep them clean, without fair notice to him of any failure on the part of those who are actually managing the premises to do their duty. 201 [1908 I do not agree, speaking personally as regards myself, and naturally with great respect to my Brother Wills, about the period to be tied up, that you must not tie up in a definite period. I cannot help thinking that local bodies who know the local needs and who express the desire of the community by representation, and who must know their business, ought not to be lightly interfered with upon matters purely of management and routine such as this is. The first week in April has been found by one or two learned magistrates in one district of London not to be unreasonable, and I should npt have been inclined myself to interfere with any period they chose to fix if they are the appointed representatives of the ratepayers. With regard to the other case, I think it is impossible to accept as satisfactory, in the sense of reasonableness, the definition there of " landlord." I will not say more, having said that. I will not express my personal feeling any further thin to say, at any rate, that I can understand the local authorities thinking it arguable that " landlord" there did mean the person who was really in touch with the tenant. I say nothing more. They must make it more clear, and I hope they will adopt the recommendations of my Lord and my Brother Wills, if they do reconsider these bye-laws, as to how far they could not confine the lodgings to be dealt with in this fashion to lodgings in which there is no doubt that it is practically impossible to get at the necessary sanitary results by action against the lodgers or occupants of one or two rooms. Mr. Courthope-Munroe: My Lords, in the Islington case the only point I came to meet was the question of the first week in April. The Lord Chief Justice : I think the other point arose. Mr. Clarke Williams : It was raised below, but not mentioned in the case. The Lord Chief Justice : I think the costs of each case must follow the result. Mr. Courthope-Munroe : If your Lordship pleases. Mr. Bethune : The appeal will be dismissed with costs. The Lord Chief Justice : Yes. Mr. Clarke Williams : And the other appeal allowed. The Lord Chief Justice : Yes. The result of this judgment has been that your Public Health Committee at once set about amending the particular by-law, and as other by-laws relating to houses let in lodgings were, in the opinion of your Solicitor and Medical Officer of Health, open to grave objection, they have seized the opportunity to draft new by-laws, which will shortly be submitted to the Council. 202 1903] HOUSES LET IN LODGINGS. Table CXVIII. Summary of Sanitary Work carried out by Inspectors Jordan and Ward in Houses Let in Lodgings during the year 1903. Inspector Jordan. Inspector Ward. Totals. 1st Quarter. 2nd Quarter. 3rd Quarter 4th Quarter. Year. 1st Quarter. 2nd Quarter. 3rd Quarter 4th Quarter. Year. Lodging Houses on the Register 429 477 477 477 477 157 167 178 178 178 655 Number of Houses inspected 318 340 361 371 1,390 42 63 54 17 176 1,566 Re-inspections, Calls made, etc 1,287 1,250 1,119 1,263 4,919 499 695 252 476 1,922 6,841 Total inspections, etc 1,605 1,590 1,480 1,634 6,309 541 758 306 493 2,098 8,407 Improvements. Drains— Constructed 6 .. 1 1 8 .. .. .. .. .. 8 Improved or repaired 50 38 36 64 188 .. 1 4 .. 5 193 Traps fixed 15 1 10 12 38 .. 6 .. .. 6 44 Cesspools— Abolished .. .. .. .. .. .. .. .. .. .. .. Cleansed or disinfected .. .. .. .. .. .. .. .. .. .. .. Water Closets — Pan, trap and water supply furnished 1 1 12 9 23 .. .. 2 .. 4 27 Pan and trap only furnished 11 6 8 22 47 .. .. .. .. .. 47 Water supply furnished 40 16 28 57 141 .. 18 7 .. 25 166 Extra closets provided .. 1 6 5 12 .. .. 8 .. 8 20 Dust Bins — .. .. .. .. .. .. .. .. .. .. .. Provided 8 .. 12 28 56 .. 1 2 .. 6 62 Repaired 3 1 5 4 13 .. 9 .. .. 9 22 Surface Drains and Pavement of Yards— Constructed .. .. 1 1 2 .. .. .. .. .. 2 Relaid 16 21 21 43 101 .. 7 .. .. 7 108 Domestic Water Supply— New cisterns provided 1 1 .. .. 2 .. .. .. .. .. 2 Cisterns repaired and cleansed 21 61 35 55 172 .. 27 20 .. 47 219 Water supply provided 20 .. 30 22 78 .. 3 .. .. 3 81 Other Improvements— Houses generally repaired 3 .. 2 18 25 .. 29 28 .. 57 82 „ etc., cleansed or limewashed 9 124 95 61 289 .. 32 21 .. 53 342 „ ventilated .. .. .. .. .. .. 15 6 .. 21 21 Overcrowding abated 10 31 18 9 68 .. 9 3 .. 12 80 Illegal use of underground rooms for sleeping discontinued 1 1 .. .. 2 .. 1 .. .. 1 3 Other Amendments and Nuisances abated 122 81 131 239 573 .. 76 50 .. 148 721 Rooms Disinfected .. .. .. .. .. .. .. 4 .. 4 4 Total Improvements 337 400 451 650 1,838 .. 234 161 21 416 2,254 Total Premises Improved 170 234 249 306 959 .. 45 33 12 90 1,049 203 [1903 DISTRICT INSPECTION. For the purpose of the ordinary inspection of the borough, it is divided into fourteen sanitary districts, to each of which an inspector is assigned. It is his duty to inquire into all complaints relating to nuisances occurring in the houses, other than those placed on the register of houses let in lodgings, to detect smoke nuisances, to prevent nuisances through the accumulation of manure, to superintend places where ice-creams are made, to visit dairies and milkshops, to superintentend drainage work, the result of notices that have been served (including the drainage work required by the workshop inspectors), to make preliminary inquiries respecting houses for which application has been made under the Customs and Inland Revenue Acts, to inspect new houses with respect to their water supply, with a view to the grant of certificates by the Council, and finally to make inquiries respecting infectious diseases, which not only includes the diseases compulsorily notifiable under the Public Health (London) Act, but also those diseases respecting which information is received from the teachers of the public elementary schools. This last class of work is at times exceedingly heavy, and must be attended to before everything else, as it is incumbent on them to obtain information to satisfy the requirements of sec.55 (4) of the Act last mentioned, which are as follows: " Where a Medical Officer of Health receives a certificate under this section relating to a patient within the Metropolitan Asylum District, he shall, within 12 hours after such receipt, send a copy thereof to the Metropolitan Asylum Managers, and to the head teacher of the school attended by the patient (if a child), or by any child who is an inmate of the same house as the patient." Very few persons have a true idea of the amount of work which this entails on the membersof the staff. In the first place the patient's home is visited, and if it Be a tenement house the other homes in it are also visited; and as it frequently happens that the parents are out and the rooms shut up, it becomes necessary to revisit them, sometimes twice and thrice, to obtain the required information. Then comes the arrangement for the removal of the patient to hospital, for the disinfection of the premises, and the removal of clothing for disinfection at the Council's Disinfection Station ; all of which must be done at once, Consequently when disease is rife, the work of the district inspectors is very heavy, especially as at such times sanitary work is much increased owing to the thorough examination that is made of each premises in which the outbreak has occurred. Inspections and Visits.—In 1903, 5,156 houses were inspected as the result of complaints or of infectious diseases having broken out in them, in addition to which 1,999 houses were inspected in the course of a house-to-house 0 2 204 1903] inspection ; so that altogether 7,155 premises were examined. These examinations entailed no less than 58,163 further visits for the purpose of inspecting the work which was being carried out under the notices which had been served. In addition to these visits, 6,822 visits were made for other purposes. Ice Cream Shops 29 Dairies and Milkshops 573 Stables and Yards 4,663 Manure Depots 229 Workshops re drains 300 Certificates under Customs and Inland Revenue Acts 181 Water Certificates 28 Sale of Food and Drugs Acts 493 Smoke prevention 175 Miscellaneous 150 Notices Served.—Altogether 1,632 notices were served, of which 1,516 were preliminary notices served by the inspectors themselves, and 116 notices ordered by the Committee to be issued under the provisions of the Public Health Act. 104 of the first-mentioned notices referred to overcrowded dwellings, in addition to 80 not included under this heading served by the Inspectors of houses let in lodgings ; 47 to premises where milk was sold, and 17 to premises where ice-creams were made. Improvements effected.—As a result of these inspections and the notices which were served, the following sanitary defects were abated:— Houses. Dirty 651 Damp 349 Out of Repair 331 Water Closets. Foul 740 Without water supply 190 With deficient water supply 258 Improperly constructed 872 Defective 473 Stopped 92 Improperly situated 50 Insufficient external ventilation 97 Insufficient in number 75 205 [1908 Soil Pipes. Defective 176 Unventilated 240 Improperly ventilated 181 Yards. Improperly paved 617 Dirty 102 Undrained 43 Drains. Foul 80 Defective 1,303 Choked or stopped 227 Unventilated 588 Cesspools. Abolished 43 Overcrowding. Abated 117 Underground Rooms. Abolished for sleeping 25 ,, as a dwelling 40 Other Nuisances 5,553 Total Nuisances 13,513 Cesspools.—It will be noticed that the list of nuisances abolished includes 43 cesspools. Of course at this date no arrangements of this character are used for drainage purposes, but every now and again when inspections are made their existence is discovered—generally they are empty although sometimes they contain offensive matter, which no doubt had been left in them when the houses were drained, so as to avoid expense. Overcrowding.—In 117 instances overcrowding was abated by the District Inspectors, in addition to 80 cases that were discovered and abated in the registered houses let in lodgings, which were discovered and abated by the Inspectors in charge of these houses. 206 1903] The overcrowding is invariably found among the poorest class, who, with small wages and large families, are unable to procure rooms which are within their means, or else thev are found in cases where the father is addicted to drink and squanders his money. Nuisances of this character are difficult to deal with, because if the nuisance were to be abated immediately it would mean that the people would be turned into the streets, for it is very difficult for the tenants to find lodgings at a rent to suit their limited means, and it, therefore, takes them a long while before they can procure them. Indeed, in cases such as these it generally occurs that they only leave one tenement to overcrowd another; and as landlords and their agents, in Islington at all events, are far more careful now than formerly to avoid overcrowding their difficulties in finding a home are greatly increased. The consequence of this is, that the very greatest latitude and leniency must be given to these people, so that the great scandal of turning them into the streets may be avoided. Unlighted and Unventilated Staircases.—Occasionally staircases that have no light, either by direct or indirect means, or ventilation, are discovered, and owing to the fact that Magistrates have refused in a few instances to grant abatement orders to abolish this state of affairs, some of the worst class of landlords are unwilling to do anything to remedy the evils. And yet it is of great consequence both from the point of view of cleanliness and pollution of the air. The want of light leads to uncleanliness, because in these cases the tenants will not keep them clean, being unwilling to burn candles to enable them to see to wash them properly, no doubt thinking that when you cannot see dirt there is no use in getting rid of it. They forget, however, that dirty staircases, like dirty rooms, cause a fustiness which pervades the house, and renders them unhealthy, which is increased by the want of ventilation. The staircase is the natural channel through which fresh air passes, sweeping upstairs and pervading every part of the house. Houses of this character are unhealthy. The want of light largely increases this fustiness, for light not only purifies but also causes movement of air. It is a singular fact that in the Public Health Act the word "light" does not occur, and yet it is as essential as pure air to our well being, for without it we cannot obtain the latter. Such an oversight as this, and it is a great oversight, should be remedied in any amendment of the public health statutes of the country. Magistrates will not, as a rule, order the abatment of nuisances unless such nuisances are specifically mentioned in the Public Health Act itself, and hesitate to make an order under section 2 (Ia) of the Public Health (London) Act, 1891, which describes premises as being in such a state as to be " a nuisance, or injurious or dangerous to health." The clause is too general, and covers too much, 207 [1903 besides the want of something non-existent can hardly be described as a nuisance. Nevertheless a great many staircases have been lighted and ventilated, despite the fact that the Act provides no efficient or sufficient remedy, at the request of the inspectors, who have instructions always to require them—instructions which, the Medical Officer of Health ventures to think, will meet with the approval of every person who takes an intelligent interest in public health work. Customs and Inland Revenue Acts.—Under these Acts exemptions of house duty are given to the house owners of a certain class of property provided they can obtain a certificate from the Medical Officer of Health stating that it affords suitable accommodation and provides proper sanitary conveniences for the persons dwelling in them. During the year applications respecting fourteen houses containing 113 dwellings were received. These premises were first visited by your inspectors to obtain information with respect to these matters, after which they were visited by your Medical Officer of Health, with the result that in only 4 instances did he grant his certificate. The chief reasons for his refusal were either that the w.c.'s were placed in unsuitable positions, that there was no provision made for washing or drying clothes, that no suitable cupboards for food storage were provided, that there were no proper coal receptacles, or that water was not supplied from the rising main direct. Some property owners seemed to think that these refusals were a great hardship to them, but then they entirely forget, or choose to forget, that the great object of this remission of taxation was to enable them to provide those necessary adjuncts which are so essential both from the point of comfort and of health. Naturally then where they do not provide them the certificates were refused. Houses Closed.—Only one house was closed, and this was a signal man's cottage on the banks of the Regent's Canal. Notices had been served on the owners to provide means of draining it otherwise than into the canal, but as they found this to be impossible they elected to close it. The premises were also damp. It is very seldom that houses are found in such an insanitary state in this Borough that Magistrates can be induced to grant closing orders. Underground Rooms.—Underground occupied rooms are fortunately not so numerous now in Islington as in other Boroughs, for fortunately some years ago very stringent action was taken against them, and hundreds 1903] 208 were closed which did not comply with the requirements of the Public Health Act. Nevertheless it became necessary to cause the owners of houses to prevent 25 rooms from being used for sleeping purposes, and to close 40 rooms as dwellings, which had been illegally used. Nuisances from Sewers.—Complaints of nuisances from the street ventilators of sewers were very few; a fact which is explained by the continued heavy rainfalls that were experienced in the summer months. Whenever complaints are received they are at once referred to your Borough Engineer, who then causes the sewers to be well flushed. The heavy rainfalls have had, however, the effect of causing the County Council relief sewer to be so surcharged at times that the water has backed into the Borough sewers, whence it has overflowed through the drains into a great many houses in the northern part of the Borough, with the result that a very great nuisance was caused by the inflow of sewage matter into houses in Fairbridge Road. The aggravation of this matter is that the London County Council has long known that this particular relief sewer was not able to carry off the large quantity of water that was discharged, and neglected to take timely precautions. Stable Manure.—The removal of stable manure was in the earlier months of 1903 effected satisfactorily, but as the year advanced, and particularly during the summer months, the work was not performed in such a manner as to meet with approval. Indeed, the opposite was the case; for the contractors who depend almost entirely on the farmers for its disposal were unable to receive it owing to the flooded condition of the land, due to the continuous rains that prevailed. The result was that accumulations, which, hitherto, have not been usual, occurred. It is difficult to blame any person in particular, because the horsekeeper is in the hands of the contractor, the contractor is in the hands of the farmers, and the farmers are in the hands of the weather. Everywhere in the home counties the farms were under water, so that by no possibility could manure be moved on to the land, and, therefore, it accumulated in the borough. A large contractor collected a large quantity which he deposited on the Great Eastern Railway manure siding near Ashburton Grove, but as it became a nuisance he was served with a notice and had to remove it. Fortunately, however, for him the cessation of rain just at that time enabled many of the farmers to receive the manure. 209 [1903 During the year 230 visits were paid to the manure depots and mews that were known to produce it in large quantities, besides many visits to smaller stables. Regents Canal.—No complaints reached the Public Health Department respecting a nuisance caused from the Canal as it flows through Islington. This has not been the case hitherto, for generally there have been some complaints received. No doubt the freedom from nuisance has been due to the cool summer that was experienced, and not to any particular care on the part of the Canal Company, who usually have been charged with a too sparing renewal of water in the water way. The canal has been subjected to close examination and on several occasions the Medical Officer of Health visited it with a view of satisfying himself as to its condition. It is much to be desired that the canal authorities should prevent boys bathing in it as it passes through the borough in the neighbourhood of the bridge at Caledonian Road. Offensive Trades. These establishments are only 7 in number and comprise 3 tripe dressers, 2 gut scrapers, 1 tallow melter, and 1 knacker's yard, and were visited on 220 occasions during the year by Inspector Wilkinson, whose duty it is to supervise them; they were also visited on various occasions by the Chief Inspector, both of whom report that they have been kept in a favourable state. The knacker's yard, however, still emits effluvium, but the London County Council have decided that extensive structural alterations must be carried out in the near future if the licence is to be retained. Smoke Nuisances.—The most fertile source of the pollution of the atmosphere of towns, especially of manufacturing towns, is the smoke given off from the chimneys of the various factories and workshops. This kind of nuisance is very difficult to deal with, because of the sympathy so often, and so undeservedly, extended to manufacturers by Sanitary Authorities on the plea that to prevent it is to drive trade from the district, because factories, they say, cannot be conducted without the creation of smoke nuisances. Such talk as this is nonsense, because furnaces can be, and as a matter of fact thousands are, stoked in such a manner that no black smoke, or indeed medium smoke, or even faint smoke is ever emitted from the chimneys, unless it be at the time of lighting up. It is not unreasonable to presume that what some firms can do 1903] 210 every firm can do, provided that reasonable care is taken in the stoking of the furnaces, that these furnaces are properly constructed, that "smoke consumers" be provided, and that suitable coal be used. Efficient stoking, which includes the proper regulation of air to the furnaces, is, however, the great essential, and if that be not carried out then "smoke consumers" are likely to fail. The firms who do not endeavour to prevent smoke are neglectful of their best interests, for the escape of black smoke means the waste of fuel, which in turn means unnecessary loss of money. This fact seems to escape their attention for they forget that black smoke consists largely of particles of unconsumed carbon. Perfect combustion should, therefore, be aimed at, for, thereby, the greatest amount of heat together with economy of coals will be attained. The latter object is no small one in the light of the fact that the coal supply of this country has its limitations, and, indeed, it is alleged, that assuming that the output continues to increase at the same rate as heretofore it will be exhausted in a little over a century. The burning of coal lessens the vitalizing power of the atmosphere through the large quantities of carbonic acid gas that are set free, one ton of coal being estimated to create three tons of that compound. It also produces carbon monoxide, aqueous vapour, certain compounds of sulphur, as well as soot and organic matter. It is the production of these impurities which makes it so necessary that there should be a close watch kept on those places which do not adopt proper methods to ensure efficient combustion and thereby the prevention of smoke nuisances. The health of households is also directly affected by a smoky atmosphere, so that their members become pale and anaemic and lose their vigour; it also prevents the opening of windows to ventilate the rooms and passages of houses and to expel the polluted and used up air which they contain. So long ago as the time of Charles I. the well known diarist Evelyn in his pamphlet The Fumifugium wrote of the smoke produced by coal, "It is this which scatters and strews about those black and smutty atoms upon all things where it comes, insinuating itself into our very secret cabinets and most precious repositories. Finally it is this which diffuses and spreads a yellowness upon our choicest pictures and hangings; which is like Avernus to fowls, and kills our bees and flowers abroad, suffering nothing in our gardens to bud, display themselves or ripen; so that our anemones and many other choicest flowers will by no industry be made to blow in London or the precincts of it, unless they be raised on a hotbed, and governed by extraordinary artifice to accelerate 211 [1903 their springing, imparting a bitter and ungrateful taste to those few wretched fruits, which never arriving at their destined maturity, seem like the apples of Sodom, to fall even to dust when they are but touched."* The evil was not then stopped, although Evelyn prepared a Bill dealing with it, but on the contrary has continued practically ever since, without almost let or hindrance. In 1819 a Select Committee reported that they "Confidently hope the nuisance so universally and justly complained of may at least be considerably diminished, if not altogether removed;" and in the following year, 1820, another Select Committee further reported that "a full opportunity has been afforded of ascertaining how far the reduction of smoke can be practically effected, and that the evidence taken bears out the practicability of smoke prevention." We have only to visit Manchester, Leeds, Glasgow, Sheffield and the East of London, particularly outside the County boundary, to learn how this nuisance is still tolerated. The public have, however, been gradually making up their mind that this nuisance shall be greatly abated, and there has, concurrently with this determination, been a greater activity exhibited by Sanitary Authorities. In Islington the smoke nuisance from the chimneys of factories has not been great, but, nevertheless, it has been necessary to make 175 observations during the year, while the London County Council in addition reported 37 infractions of the smoke section of the Public Health (London) Act, 1891. In consequence of these infringements of the law 28 notices were served on the offenders to abate the nuisance, which were complied with. It is not satisfactory, however, to find that among them was the Board of Guardians, from whose chimneys at the Workhouse, St. John's Road, and at the Infirmary, Highgate Hill, black smoke was emitted. There was no offence noted at the Borough Council's Electricity Works, Eden Grove, at whose premises in previous years nuisances had been very frequent. Here, however, the use of better coal and smoke consumers, together with greater care in stoking, has had the desired effect, so that the Medical Officer of Health can no longer complain, as he has had to do in the past, that he could not deal with other offenders so long as these works continued to be a nuisance. * In his Diary under date Sept. 5, 1666, Evelyn writes concerning the Great Fire, "The coale and wood wharfes and magazines of oyle, rosin, &c. did infinite mischeife, so as the invective which a little before I had dedicated to his Majesty and published, giving warning what might probably be the issue of suffering those shops to be in the Citty, was looked on as a prophecy." This further shows his dislike of coal. 1903] 212 In August the City of Westminster wrote to the various Metropolitan Boroughs calling their attention to the fact that from experience it has been found that the majority of prosecutions for smoke nuisances are instituted under sec. 24 (b) of the Public Health (London) Act, 1891, which deals exclusively with "black" smoke, and expressing the opinion that the word "black" should be repealed, so that a nuisance from smoke of any colour could be dealt with, which would obviate the necessity of having to prove before a Court that it was "black," a colour which is of many hues, and thereby facilitate the work of the Authorities in dealing with nuisances of this class. This communication was referred to the Public Health Committee by the Council for report, and they, after carefully considering the subject, resolved that the Council be recommended to support the City of Westminster in their action by making similar representations to the Local Government Board and the London County Council. This recommendation came before the Borough Council on October 16th, when it was unanimously adopted. This is a step in the right direction, for there can be no doubt that smoke, whatever may be its colour, is injurious to health and deleterious to property, because it contains the same obnoxious gases, although it may be deficient in carbon and soot. It is sincerely to be hoped that the Local Government Board and the London County Council will view the matter in a similar light to that in which the Councils of the City of Westminster, of Islington, and of the other Metropolitan Borough Councils who approve of the alteration, see it, for such an alteration is urgently required. The following is a list of the premises where smoke nuisances were observed:— St. Pelagia's Laundry, 25, Bickerton Road. 299, Caledonian Road. Great Northern Railway, Drayton Park. Pearson & Sons, Drayton Park (2 offences). Smethurst's Laundry. May's, Fakenham Street. Great Northern Hospital. Workhouse New Infirmary. Slater's, North Road (4 offences). 21, Rock Street. 16, Sherbourne Street. 213 [1903 134, Holloway Road (2 offences). Chatterton's Lead Works, Caledonian Road. 131, Seven Sisters Road. 20 York Road. School Board, Highbury Grove. 34, York Road. 16, Westbourne Road. Conolly, Wharf Road (2 offences). SYNOPSIS OF THE DISTRICT INSPECTORS SANITARY WORK FROM 1891 to 1903. Houses inspected and visited 719.307 Drains constructed 15.055 „ Improved and repaired 12,406 „ Traps fixed 69,445 Water closets, pan, trap, etc., furnished 18,780 „ Pan and trap only, furnished 11,859 „ Water only, furnished 5,258 Soil Pipe, Defective, renewed or remedied 2,979 „ Insufficiently ventilated, fully ventilated 2,455 „ Unventilated, ventilation supplied 4,892 Dust Bins, Constructed 9,577 Repaired 3,256 Surface drainage, Constructed 9,567 „ Relaid 17,490 Water supply, New cisterns provided 3,950 „ Cisterns repaired and cleansed 7,894 „ New supply 4,194 Houses generally Repaired 4,763 „ Cleansed 9,495 „ Ventilated 11,966 Other Improvements 82,853 Total Improvements 308,134 1903] 214 Showing summary of Sanitary Work from Inspectors' reports for the Year 1903. DISTRICTS. Totals. 1 2 3 4 5 6 7 8 9 1 11 12 13 14 House to House Inspections 151 33 51 163 9 310 306 71 136 170 344 68 8 171 1999 Number of Houses inspected 163 285 495 241 337 577 251 323 404 52 423 378 292 457 5156 Re-inspections, Calls made, etc. 4320 3582 4030 3737 3569 3771 4768 4264 3502 5071 4237 4821 3126 5364 58163 Total Visits 4634 3900 4584 4147 3915 4658 5326 4658 4042 5765 5004 5267 3426 5992 65318 Visits to Ice Cream Factories 2 2 .. 1 .. .. .. .. 6 10 .. 8 .. .. 29 Dairies and Milkshops 47 56 11 23 9,4 65 28 37 27 18 84 87 57 9 573 „ Stables and Yards 4 99 287 234 282 385 117 191 58 114 44 407 2347 164 4663 ,, Manure Depots 1 .. 204 5 .. 1 .. 2 11 3 1 1 .. 229 ,, Workshops, with respect to drains .. 6 .. .. .. 9 3 4 64 14 .. 196 3 1 300 ,, Under Customs and Inland Revenue Acts .. .. 13 ... .. .. .. .. .. .. .. .. 168 .. 181 ,, re Water Certificates .. .. 20 .. .. .. .. .. .. 4 .. 1 .. 3 28 ,, Under Sale of Food and Drugs Acts 45 89 45 33 35 35 37 34 37 41 35 44 .. 33 493 „ Registered Lodging Houses .. .. .. 1 .. .. .. .. .. .. .. .. .. .. 1 Smoke observations 1 5 8 52 50 .. 1 2 .. 6 16 14 20 .. 175 Miscellaneous inspections .. 2 .. 3 8 8 .. .. 6 15 .. 56 51 1 150 All Inspections, visits, etc 4734 4109 5172 4499 4314 5161 5512 4856 4242 5998 5186 6081 6073 6203 72140 Notices Served. .. Intimation — Personally 98 105 49 58 64 145 91 79 73 110 182 166 71 152 1443 By Post 1 7 24 11 .. .. 14 .. 2 .. .. 11 .. 3 73 Statutory— Personally 2 3 2 1 .. 1 2 .. .. 3 3 4 2 8 31 By Post 1 4 19 3 4 7 3 3 2 7 13 8 5 6 85 Improvements Drains— Constructed 117 67 132 43 40 447 146 129 102 123 29 133 61 142 1711 Improved of repaired 24 40 7 16 37 18 75 7 36 36 58 70 59 47 530 Traps fixed 489 312 590 176 262 720 666 719 402 390 135 437 202 440 5940 Cesspools— Abolished .. .. 4 .. .. 29 .. .. 5 .. .. .. 4 1 43 Cleansed or disinfected .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Water Closets— Pan, trap and water supply nished 210 40 203 7 18 150 12 50 67 35 18 24 67 46 947 Pan and trap only furnished 23 92 37 56 67 136 235 176 76 118 38 217 4 156 1431 Water supply furnished 9 15 89 14 11 111 5 7 27 25 55 19 11 30 428 Dust Bins— 94 24 14 45 33 120 71 29 55 46 59 50 29 106 705 Repaired 1 .. 132 .. 4 40 14 .. 9 25 9 5 .. 1 210 Surface Drains and Pavements of Yards— Constructed 1 26 6 31 10 23 153 117 14 75 15 194 32 27 721 Relaid 98 51 207 49 60 175 84 31 110 74 60 47 74 262 1382 Domestic Water Supply — New Cisterns provided 3 1 .. 9 1 40 3 .. 1 .. 3 6 30 5 120 Cisterns repaired and cleansed 39 11 63 28 14 120 16 12 6 42 19 104 38 56 568 Water Supply provided 91 12 51 27 12 48 5 22 23 20 7 46 22 25 411 Other Improvements — Houses generally repaired .. 19 20 50 11 115 29 6 9 15 163 125 24 65 651 ,, etc., cleansed or lime- washed 34 20 155 72 15 216 40 10 24 19 151 132 48 71 1007 ,, ventilated .. 2 12 28 .. 17 40 49 4 90 11 77 86 98 514 Overcrowding abated .. 4 4 6 .. 32 .. 1 2 4 22 26 13 3 117 Illegal use of underground Rooms for sleeping discontinued .. .. 1 .. .. 4 .. .. 2 1 3 12 1 1 25 Other Improvements, or Nuisances abated 206 531 135 353 260 770 223 494 381 666 476 1612 1563 820 8490 Rooms Disinfected 93 117 24 119 206 92 73 111 117 94 127 135 88 118 1514 Total Improvements 1462 1384 1911 1122 1061 3423 1890 1970 1472 1898 1458 3471 2456 2520 27498 Total Premises Improved 329 246 168 324 305 1019 404 297 253 421 539 417 1555 479 6756 215 [1903 Table CXX. Giving a Summary of the Nuisances discovered by the District Sanitary Inspectors during the Four Quarters and for the Year 1903, for the abatement of which notices were served. NUISANCES. QUARTERS. 1st Quarter 2nd Quarter 3rd Quarter. 4th Quarter. The Year. 1. The house or part of the house in a dirty condition 155 242 137 117 651 2. „ in a damp condition 52 108 92 97 349 3. in a dilapidated condition 88 110 78 55 331 4. The inlet of surface drain improperly trapped 97 130 109 74 410 5. The water-closet so foul as to be a nuisance 196 186 185 173 740 6. „ „ without a water supply 53 61 42 34 190 7. ,, „ with a deficient supply of water 74 57 62 65 258 8. ,, „ improperly constructed so as to be a nuisance 258 209 216 189 872 9. ,, ,, so defective as to be a nuisance 154 118 99 102 473 10. ,, stopped 26 24 17 25 92 11. ,, „ placed in an improper position 9 27 9 5 50 12. Insufficient external ventilation to water-closets 19 35 26 17 97 13. Insufficient water-closet accommodation 18 23 13 21 75 14. The soil pipe defective 76 28 37 35 176 15. unventilated 93 68 64 45 270 16. „ improperly ventilated 51 33 55 42 181 17. The yard in a condition injurious to health by reason of the want of proper paving 135 194 135 153 617 18. The yard dirty 39 30 13 20 102 19. ,, undrained 8 19 6 10 43 20. A gully trap improperly placed within the house 106 113 68 72 359 21. The waste pipe of sink directly connected with the drain 74 77 60 40 251 22. „ ,, improperly trapped 27 29 26 17 99 23. „ ,, untrapped 92 98 78 94 362 24. ,, of lavatory directly connected with the drain 3 8 2 1 14 25. „ ,, improperly trapped 1 5 .. .. 6 26. „ ., untrapped 35 18 15 17 85 27. „ of bath directly connected with the drain 11 5 10 3 29 28. ,, „ improperly trapped 3 3 1 3 10 29. „ ,, untrapped 50 17 24 23 114 30. The water cistern so foul as to be a nuisance 48 98 70 86 302 31. „ „ being without a close fitting cover 68 131 108 123 430 32. „ ,, being placed in an improper position 66 65 83 63 277 33. ,, ,, defective 10 10 8 14 42 1903] 216 TABLE CXX.—continued. NUISANCES. QUARTERS. 1st Quarter. 2nd Quarter. 3rd Quarter. 4th Quarter. The Year. 34. An accumulation or deposit of refuse injurious to health, by reason of the want of a proper dustbin or ashpit 43 22 33 30 128 35. The dustbin or ashpit defective 135 168 127 128 558 36. ,, „ placed in an improper position 2 6 6 4 18 37. The drain foul 24 28 14 14 80 38. ,, defective 372 363 295 273 1.303 39. „ choked or stopped 61 64 60 42 227 40. ,, unventilated 154 195 133 106 588 41. The rain-water pipe in direct communication with the drain 145 138 98 67 448 42 „ ,, in direct communication with the soil-pipe 6 6 3 4 19 43. „ defective 56 59 48 50 213 44. The water supply used for domestic purposes connected with the cistern which is used for flushing the W.C. 2 2 3 8 15 45. The house without a proper water supply 37 25 28 23 113 46. The roof defective 57 118 103 125 403 47. The guttering defective 35 77 51 55 218 48. The area improperly paved 15 22 20 22 79 49. ,, dirty 3 5 6 9 23 50. ,, undrained 6 4 2 12 51. The paving of the washhouse defective 39 52 44 40 175 52. The back addition walls defective 2 3 1 1 7 53. The want of a proper manure receptacle 5 3 1 6 15 54. The bakehouse wall6 dirty 1 .. .. .. 1 55. An animal kept in such a manner as to be a nuisance 15 10 12 12 49 56. The house or part of a house so overcrowded as to be injurious or dangerous to the health of the inmates 22 39 19 24 104 57. An underground room occupied as a dwelling contrary to the provisions of the Act 12 8 13 7 40 58. A tent, van, shed or similar structure used for human habitation which is in such a state as to be injurious or dangerous to the health of the inmates .. .. .. .. .. 59. The space below floor in the basement or ground floor being unventilated 26 46 25 23 120 60. The space below floor in the basement or ground floor being improperly or insufficiently ventilated 39 47 44 70 200 All Nuisances 3,503 3,891 3,139 2,980 13,513 217 [1903 Table CXXI. Giving a Summary of the Sanitary Work performed by the District Inspectors in 1903. Inspections. QUARTERS. The Year. First. Second. Third. Fourth. House to House Inspections 659 562 405 373 1,999 Number of Houses Inspected 1,470 1,410 1,167 1,109 5,156 Re-inspections, Calls made, &c. 16,062 15,534 12,515 14,052 58,163 Total Visits 18,191 17,506 14,087 15,534 65,318 Visits to Ice Cream Factories .. .. 20 9 29 Do. Dairies and Milkshops 2 14 88 469 573 Do. Stables and Yards 748 1,263 1,024 1,628 4,663 Do. Manure Depots .. .. 50 180 230 Do. Workshops, with respect to Drains 32 48 103 116 299 Do. Under Customs and Inland Revenue Acts .. .. 181 .. 181 Do. re Water Certificates .. .. 22 6 28 Do. Under Sale of Food and Drugs Acts 205 73 60 155 493 Do. Registered Lodging Houses .. .. 1 •• 1 Do. Miscellaneous 14 136 .. .. 150 Smoke Observations .. .. 81 94 175 All Inspections, Visits, &c. 19,192 19,040 15,717 18,191 72,140 1903] 218 Removal and Disposal of Dust.—The removal of ashes, refuse and dust from occupied houses was again accomplished in a satisfactory manner. The number of complaints which were received, considering the great number of separate assessments and houses, was insignificant, being altogether only 152, or in the proportion of 0.331 per cent. of the assessments. To understand the work, and to enable the Council to rightly appreciate the change that has been effected since 1896 the following particulars are given: — Year. Applications to remove dust. Year. Applications to remove dust 1891 10,138 1898 303 1892 9,964 I899 262 1893 4,986 1900 234 1894 4,506 1901 157 1895 4,596 1902 198 1896 4,245 1903 152 1897 312 The weekly removal of house refuse effected a very great sanitary revolution, and although it met with considerable opposition from some householders and vestrymen, it may now be fearlessly asserted that there is not one of these opponents who would revert to the old state of affairs. One great objection was undoubtedly the fear that the nuisance caused by the disturbance of the refuse, which was often the accumulation of three months or more, would be a weekly instead of a quarterly one, forgetting that the great object that was in view was to avoid such an annoyance by removing the refuse in a comparatively fresh state. The introduction of the weekly removal has been the cause of the abolition of thousands of the old fashioned fixed ashpits which are now fast disappearing, being replaced by moveable iron or zinc receptacles. The opinion of sanitarians, who have considered the question of household refuse in its relation to health, is that a daily removal is essential to the highest state of health. This is the view held by the London County Council, who, however, have not pressed it on the metropolitan boroughs. They, however, think that "it is most important that house refuse, which generally contains decaying vegetable matter and rapidly becomes offensive, should be removed at frequent intervals; and it appears to the Council that the time has now arrived when an effort should be made to secure the collection of house refuse in London more than once a week." (Letter to Metropolitan Borough received 1st June, 1901). In consequence of this opinion of the Council it is not surprising to find that there is a proposal at present under their consideration to substitute the word "twice" for "once" in the existing bylaw relating to the removal of house refuse. The Medical Officer of Health entirely approves of the suggestion, against which the only argument that has been advanced is that of cost, which, it has been stated, would be doubled in Islington. This statement must surely be erroneous, for although the journeys to and from the 219 [1903 depots must be largely increased, the amount of refuse to remove will remain the same. Be this as it may the fact remains that it is most desirable that there should be at least a removal of refuse at least twice a week, and as the Medical Officer of Health desires that there should be no misunderstanding of his view of the matter he has prepared the following memorandum:— MEMORANDUM BY THE MEDICAL OFFICER OF HEALTH ON THE IMPORTANCE OF DUST REMOVAL. 1. The great essential condition for the reduction of the vast quantity of preventable disease is cleanliness. This doctrine has been the cardinal one of all Medical Officers of Health for many years, and the practice of it has led to the saving of innumerable human lives. 2. It follows, therefore, that the more thoroughly it is practised, the less will be the loss of life. The first great step in removing filth diseases, of which Enteric Fever is the great type, was the abolition of Middensteads and similar means for the disposal of filth and house refuse, and the last, the introduction of water carriage for the removal of excreta. 3. When Middensteads were abolished, the house refuse still remained for removal, and, until a comparatively recent time, was only carted away at uncertain dates, depending greatly on the idea of cleanliness possessed by the individual householder. 4. The dust of each household contains more or less decomposing moist organic matter, the refuse of the different comestibles of the house, the peelings of potatoes and the waste of various other vegetables, according to the season of the year, also tea leaves; the guts of fish or the entrails of fowls; and, therefore, the necessity for frequent removal has to be estimated not by what the mere fire ash and other dry refuse would require, but by the extreme offensiveness of these unusual adjuncts. 5. Householders of the wealthier classes can with ease keep their dust comparatively free from organic matter likely to cause effluvia by destroying the waste matters in their kitchens, but not nearly to the same extent as formerly, for owing to the great difficulty of getting servants, the use of gas stoves for cooking has very largely superseded closed ranges. But in any case they do not practise that care their education should have caused them to take. 6. The domestic power of burning refuse among the lower classes is limited by the poverty which must spare fuel, and there are many poor persons to whom such fires as would consume their scant potato peelings are luxuries entirely unknown. p 2 1903] 220 7. Scavenging arrangements in relation to house refuse should, therefore, be framed with reference to the fact that such refuse soon becomes highly offensive, and that any two day's detention of it creates a nuisance. 8. The presence of a nuisance of this character pollutes the air near the dwelling, and it must also be remembered that many of these dustbins are kept in the houses, especially in flats and tenement houses, and not in the yards, with the result that such diseases as diarrhoea, diphtheria, sore throats, nausea, giddiness, faintness, a general sense of depression, and headache follow. 9. The effluvium attracts flies to the house, and they, after feeding on putrescible matters, frequently contaminate milk and food, if they do not actually act as the direct carriers of disease. 10. The removal of week old dust from houses has caused frequent complaints to be made by the School Board Authority as to a nuisance caused at the Great Eastern Railway Siding at Upper Holloway, while it also occasionally causes a nuisance at the depot at Ashburton Grove. These nuisances are of course much less in winter than in the summer, when they are at times considerable. 11. The removal of this refuse has been the subject of complaint to the Great Eastern Railway Company by the Tottenham Sanitary Authority, who have threatened to stop the passage of offensive matter through their district unless the waggons are properly covered in, so that the effluvium shall not create a nuisance. 12. This stoppage would mean a very serious extra charge for carriage alone, owing to the necessity it would involve of providing covered railway trucks. 13. The Conference of London Local Authorities held in 1901 on streets and street traffic passed the following resolution: "That in the opinion of the Conference house refuse should be removed daily where practicable." 14. The desire of the London County Council, knowing and understanding the direct bearing it has on the health of the Metropolis, is to procure daily removal of dust, but they have for the present waived this with a view of securing its removal twice a week, a proposal which is most desirable and should not be impossible to accomplish. Dust Receptacles.—During the year, 705 new sanitary dustbins were provided, and 240 dust receptacles were repaired, while 558 were ordered to be removed because they had been placed in improper positions, 221 [1903 Table CXXII. Summary of Applications for the Removal of Dust during the Year 1903. Ward. 1st Quarter. • 2nd Quarter. 3rd Quarter. 4th Quarter. Year. Number of Assessments Christmas, 1903. Number of Applications to every 100 Assessments. 1 5 7 7 2 21 4,570 0.459 2 3 3 4 2 12 4,702 0.255 3 4 2 5 2 13 4,400 0.295 4 3 3 6 2 14 5,062 0.277 5 2 5 8 — 15 5,650 0.265 6 4 10 8 1 23 4,037 0.570 7 1 6 1 3 11 4,054 0.271 8 3 — 1 2 6 2,694 0.223 9 1 6 4 7 18 2,646 0.680 10 1 2 3 2 8 3,509 0.228 11 3 3 3 2 11 4,573 0.240 Totals 30 47 50 25 152 45,897 0.331 1903] 222 COMMON LODGING HOUSES. These Common Lodging Houses are under the control of the London County Council, whose Inspectors' visit them regularly. They are generally to be found in a clean orderly condition. They now number 45 houses which are licensed to fifteen persons. 31 are licensed for men, 4 for women and 1 for married couples. Table CXXIII. Showing the Addresses of the Common Lodging-Houses in the Borough. (Under the Control of the London County Council). Situation of Premises. Authorized No. of Lodgers. Sex of Lodgers. M = Men. W = Woman. MC = Married Couples. Date when Licensed. Name of Licensee. 1, Gordon Place, Highgate Hill 5 M. 6th September, 1879 George Willis. 2, Gordon Place 5 M. „ „ 3, Gordon Place 5 M. „ „ 4, Gordon Place 10 M. „ „ 5, Gordon Place 10 M. „ „ 6, Gordon Place 9 M. 30th October, 1880 „ 7, Gordon Place 9 M. „ „ 12, Gordon Place Deputy „ „ 13, Gordon Place 9 M. „ „ 180, Caledonian Road 5l M. 16th April, 1881 Samuel Wm. Jefcoate. 8, Flower's Mews 72 M. 3rd June, 1882 „ 36, Ball's Pond Road 25 M. 17th February. 1888 John Watts. 92, York Road 29 M. 25th September, 1893 Albert Bingham. 128, York Road 22 M. „ „ 87, Essex Road 52 M. 20th October, 1894 Jas. Shuttleworth, Jun. 89, Essex Road 35 M. „ „ 23, Queensland Road 28 W. „ Margaret Jones 25, Queensland Road „ ,, 127, Englefield Road 64 M 30th October, 1894 Wm Jno. Cragg 102, 104 & 106, George's Road 51 W 4th February, 1897 Robert Crosher Maples. 160, St. James' Road 76 M. 10th March, 1897 Wm. John McGrath. 162, St. James' Road M „ „ 235a, Upper Street 37 M 30th September, 1897 John Watts. 29, Hornsey Road 88 M. 23rd December, 1897 Sidney Allen. 47a, Campbell Road 71 M. 14th November, 1898 Wm. Jno. Cragg 24, North Road 17 W. 17th November, 1899 Louisa Pryce 18, 20 & 22, Barnsbury Street 91 M. 13th March, 1900 Robert Crosher Maples. 35, Campbell Road 27 W. 18th July, 1900 Wm. Jno. Cragg. 37, Campbell Road 61 M „ ,, 39, Campbell Road „ ,, 68, George's Road 38 W. 15th October, 1900 .. Robert Crosher Maples. 8, Queensland Road 16 M.C. „ Margaret Jones. 10, Queensland Road „ „ 6, Queensland Road 34 M. „ „ 4, Queensland Road „ „ 1, Eden Grove 129 M. 26th November, 1900 Lewis Henry Levy. 3, Eden Grove „ 10, Milton Place „ 10 & 12 Campbell Road 52 M. 2nd August, 1901 Hugh Hersey. 29, Halton Road 59 M. 14th October, 1903.. Chas. Jas. Vincent Somerville. 8a, Hornsey Street 48 M. „ Colin F. Campbell 223 [1903 THE STATE OF PAUPERISM. The weekly average number of persons relieved shows a large increase on the average of the preceding seven years, for no less than 8,004 persons were relieved per week as against an average of 6,909, or an increase of 1,095. The returns since 1896 have been as follows:— 1896 6,436 per week relieved. 1897 6,486 1898 6,635 1899 6,854 1900 6,956 1901 7,327 1902 7,668 Average 6,909 1903 8,004 Increase 1,095 It will be noticed from these figures that there has been a progressive increase in each year, so that compared with 1896 the increase now recorded is 1,564, truly a very substantial one. Outdoor Paupers.—The weekly average of outdoor paupers who were relieved a mounted to 4,125, of whom 2,739 were adults and 1,386 children under sixteen years of age, as respectively compared with averages during the preceding nine years of 2,331 and 1,307. Indoor Paupers.—Including adults and children these numbered on a weekly average 3,879, being an increase on the mean of the years 1896-1902. Vagrants Relieved.—These averaged 17 per week, which is exactly the average of the preceding nine years, although 7 per week above that of the preceding year. Still in a large borough like Islington it cannot be said to be excessive. Children Boarded Out.—The average number cf children boarded out was 127, which is 9 above the mean number of the nine years immediately preceding. 1903] 224 Table CXXIV. Showing the State of Pauperism in the Borough during the years 1896-1903 Years. 1 Average number Relieved during each week. Deathrates. 9 Indoor Paupers, Adults and Children. 2 Outdoor Paupers. Totals Outdoor. 5 Totals. All paupers relieved, cols. 2 & 5. 6 Vagrants Relieved. 7 Children Boarded out. 8 Adults. 3 Children under 16. 4 1896 2,912 2,215 1,309 3,524 6,436 24 117 17.09 1897 2,951 2,250 1,285 3,535 6,486 25 108 15.80 1898 3,168 2,224 1,243 3,467 6,635 27 116 16.53 1899 3,351 2,237 1,266 3,503 6,854 16 131 18.04 1900 3,397 2,288 1,271 3,559 6,956 7 100 16.23 1901 3,522 2,444 1,361 3,805 7.327 12 130 15.98 1902 3,594 2,662 1,412 4,074 7,668 10 125 16.39 Average 3,271 2,331 1,307 3,638 6,909 17 118 16.58 1903 3,879 2,739 1,386 4125 8.004 17 127 14.26 Table CXXV. Showing the State of Pauperism in the Borough during the year 1903. Quarters. 1 Average number Relieved during each week. Death rates. 9 Indoor Paupers, Adults and Children. 2 Outdoor Paupers. Totals. 5 Totals corresponding periods 1902. 6 Vagrants Relieved. 7 Children Boarded out. 8 Adults. 3 Children under 16. 4 1st Qr. 3,945 2,783 1,463 8,191 7,818 17 129 16.31 2nd „ 3,771 2,653 1,312 7,736 7,429 16 125 14.46 3rd „ 3,741 2,699 1,352 7,792 7,427 16 126 12.16 4th ,, 4,061 2,820 1,416 8,297 7,998 21 127 14.14 The Year 3,879 2,739 1,386 8,004 7,668 17 127 14.26 PART V. FOOD. INSPECTION OF FOOD and PLACES WHERE FOOD IS PREPARED. THE ADULTERATION OF FOOD and THE ADMINISTRATION OF THE ADULTERATION ACTS. WATER SUPPLY. 1903] 226 INSPECTION OF FOOD. Inspections of food were made systematically and at short intervals by your inspectors during the year, the chief work falling on the Inspector of Meat (Mr. H. Wilkinson), whose duty it is not only to examine all foods, but also all places, bakehouses excepted, where food is prepared, the district inspectors only making inspections on Saturday evenings in their several districts, on which occasions they pay special attention to fruit, vegetables, fish, meat, etc., sold by costers and other persons in the streets. Your Inspector of Meat performed a very great deal of useful work quietly and without friction, and generally carried out his duties in a satisfactory manner. One butcher, who, not residing in the borough, formerly killed a great many cattle, especially cows, at a slaughter-house in Roman Road, removed his slaughtering elsewhere, as the supervision was too strict: or in other words animals or parts of animals that were diseased were not allowed to be sold, but were destroyed. In no case did this butcher appeal against your inspector's decision, a fact which shows that his decisions had not been wrong. Out of the 40,895 animals slaughtered 267, or 0.6 per cent., were found to be diseased, of which number, 59 or 22.1 per cent., were suffering from tuberculosis. To the shops and stall boards of persons exposing food for sale 4,889 visits were made, which resulted in the seizure of varying quantities of unsound Fish, Rabbits, Meat, Livers, Tomatoes, and Fruit, in addition to which considerable quantities of meat and the diseased organs of animals were seized in slaughter houses. slaughter houses. The following are the particulars:— 1st Quarter. Cwts. Qrs. lbs. Tons Cwts, Qrs lbs. Diseased Meat and organs, etc., from Slaughter Houses 11 2 6 Ditto from shops and stalls 4 I 10 Unsound Fruit 0 2 22 — 16 2 10 2nd Quarter. Diseased Meat, organs, etc, from Slaughter Houses 15 0 15 Unsound Meat (from shops and stalls) 18 3 11 Unsound Fruit 0 0 24 1 14 0 22 3rd Quarter. Diseased Meat, organs, etc., from Slaughter Houses 1 0 22 Unsound Meat (from shops and stalls) 1 1 19 Unsound Fruit 0 0 13 Unsound Fish (Herrings and Skate) 1 2 16 Rabbits 0 0 6 — 4 1 20 227 [1903 4th Quarter. Diseased Meat, organs, etc., from Slaughter Houses 8 1 5 Ditto ditto (from shops and stalls) 1 3 10 Unsound Fish 0 0 25 Unsound Rabbits 0 0 5 Unsound Tomatoes 0 0 19 — 10 2 8 Total weight 3 5 3 4 It is satisfactory to find that whereas in former years before an inspector of meat was appointed, very many persons used to come to the Medical Officer complaining of the unsound food that had been sold them, such an event is now a rare occurrence, a fact which proves that the mere presence of a skilled inspector is sufficient to prevent dealers foisting unsound articles on their customers. Cowsheds. There are now only 12 cowhouses in the borough, one at 31, Ashbrook Road having been removed from the register during the year, because the owner had allowed the licence to lapse. They were inspected on 152 occasions, and were generally found in a fairly clean state. None of them can be said to be model cowhouses, but it can be asserted without fear of contradiction that they are in a far better condition than the majority of cowhouses throughout the rural districts of England, where generally the administration of the Dairies, Cowsheds, and Milk Shops Order, under which they are controlled, is not enforced, and consequently the milk does not come to the consumers in that pure and unpolluted state which they have every right to expect and demand. A decided improvement in the manner in which the cowkeepers looked after their cows has been noticed, for whereas formerly it was with great difficulty that they were induced to keep them clean, they are now making efforts to meet the requirements of your inspectors. Old habits and customs die hard, and therefore it has not been a surprise to find that some difficulty has been met with in inducing them to more stringently carry out the requirements of the Dairies, Cowsheds, and Milkshops Order. One cowkeeper especially has had to be warned on several occasions that if he did not maintain his cows in a more cleanly state he would undoubtedly be summoned. 1903] 228 LIST OF LICENSED COWHOUSES IN THE BOROUGH OF ISLINGTON. Registered No. Name of Licensee. Situation of Premises. 432 Matthias, Thomas 66, Andover Road. 5,549 Davies, Thomas 120, Cottenham Road. 2,220 Bryant, Jane 108, Elmore Street. 891 Jones, Elizabeth .. 3, Frome Street. 6,592 Townsend, Alice 1, Gifford Street. 3,52J Edwards, Eleazar 1, Hale Street 1,554 Jones, Samuel 24, Hercules Place, Holloway. 10,260 Wright, Henry 11, Matilda Street. 1,062 Jenkins, David 1, Northampton Street. 8,846 Jones, Edward 88, Roman Road. 1,741 Arnold, George 233, Seven Sisters Road. 12,574 Hollingworth, Chas. Frank Wilson's Yard, Upper Street. Total 12 Cowsheds. SLAUGHTER-HOUSES. There were at the beginning of the year 42 licensed slaughter-houses in the borough, but this number was reduced to 40 at the licensing sessions of the London County Council held in October. In one case the licence was refused, and in the other the premises had been pulled down. The slaughter-houses were as usual very frequently visited by your Inspector of Meat, who made no less than 2,414 visits to them. All of them were also visited by the Medical Officer of Health, who is able to report that he invariably found them in a good cleanly condition. During the year as many as 40,895 animals were slaughtered in them, as against 44,785 in 1902. The animals killed were as follows:— Quarters. Oxen. Cows. Calves Sheep and Lambs. Pigs. Totals. 1st 668 102 8 8,789 31 9,598 2nd 567 71 91 11,119 — 11,848 3rd 531 — 39 10,843 — 11,413 4th 679 — 3 7,339 15 8,036 Year 2,445 173 141 38,090 46 40,895 Such a large return as this is clear evidence that the post of your Inspector of meat is no sinecure, especially when it is remembered that there is no fixed hours during which slaughtering is done, and also that the various slaughterhouses are widely scattered throughout the borough. In his report he gives full details of the various diseases that he discovered in the carcases of the slaughtered animals. 229 [1903 LICENSED SLAUGHTER-HOUSES. Registered No. Name of Licensee. Situation of Premises. Remarks. 501b Gayes, W. D. 4, Athelstane Mews 400 Cockerill, A. E 34, Balls Pond Road To kill not more than three beasts a week and small cattle. 451 Clarke, Jno. 259, Balls Pond Road 475 Sharman, W. C. 53, Barnsbury Street To kill small cattle only and for purposes of own shop. 461 Hack, T. 40, Bingfield Street Small cattle. 401 Pearce, Hy. 18, Brecknock Road Small cattle. 416 Marshall, Wm. 41, Caledonian Road 413 Cheatle, Wm. 174, Caledonian Road 477 Jaeger, W. 309, Caledonian Road 434 Luxton, J. Carter's Yard, 170, Essex Rd 423 Selman, W. G. (Between)185-7, Church Road 453 Toop, W. (Rear of) 1, Clayton Street 480 Clark, C. 12, Cloudesley Road 474 Mobbs, Jas. Hy. 219, Copenhagen Street Small cattle. 486 Sparry, T. 62, Essex Road Cattle admitted only between 11 p.m. and 7 a.m., and not more than five large animals to be killed per week. 449 Salter, Lewis 410, Essex Road 425 Hammond, F. 6, George's Road 402 Wadsworth, A.B 32, High Street 499 Webber, W. 81, Highgate Hill 484 Stone, S. 234, Holloway Road 443 Wilde, F. 498, Holloway Road 432 Watson, Harriet 576, Holloway Road 412 Tuck, W. 152, Hornsey Road 418 Worboys, R. 410, Hornsey Road 501c Haggar, Geo. 12, Hazelville Road, Hornsey Rise 485 Webber, Jno. 9, Junction Road, Upper Holloway 488 Buckingham, J 393, Liverpool Road 120 Crisp, Tom 81, Newington Green Road Small cattle only belonging to licensee. 470 Wright, C. 275, New North Road Small cattle. 431 Watson, R. (Jr.) 317, New North Road 421 Folkard, H. L 52, Packington Street Small cattle. 458 Newbury, G. J. 102, Roman Road 472 Eteen, R. E. 49, St. Peter Street Small cattle. 498 Stone, A. 194, Seven Sisters Road 4519 Farmer, C. 280, Seven Sisters Road 467 Fothergill, H. 79, Stroud Green Road Cattle received upon the premises only between 7 p.m. and 8 am., and killing limited to requirements of own shop. 407 Richardson, J. 149, Upper Street Small cattle. 482 Wright, W. (E. side of) Wycombe Mews 419 Lidstone (Ltd.) Pemberton.G. J. 398, York Road 53, Southgate Road Small cattle only. Total 40 Slaughter-Houses. 1903] 230 INSPECTOR WILKINSON'S REPORT. Public Health Department, Town Hall, Upper Street, N. March 10th, 1904. To A. E. Harris, Esq., Medical Officer of Health. Dear Sir, I have much pleasure in submitting my second annual report, being a report for the year 1903 on the inspection of slaughterhouses, cowhouses, offensive trade establishments, butchers' shops, fish shops, etc., etc. There were at the commencement of the year 42 slaughter-houses within the Borough, one of which was demolished on expiration of the lease at the rear of 21, Seven Sisters' Road, and at the Annual Licensing Meeting of the London County Council in October last an objection was made to the renewal of licence at 64, Benwell Road, by the London County Council's inspector, on the ground that no slaughtering had been carried on for a period of nine months last passed; in the absence of the applicant or any representative, the objection was sustained and the renewal refused. The number of licensed slaughter-houses being now reduced to 40. The total number of visits to these establishments during the year was 2,414, and generally speaking they have been well kept and conducted. In half a dozen instances cautions have been given for allowing blood to enter the drain contrary to the by-laws; in one instance a choked drain was found inside a slaughter-house, but on service of an intimation notice the defect was remedied within two days. I have also during the year reported that a horse was being stabled in a sheep pen within a slaughter-house, contrary to the provisions of the by-laws, and in the event of a friendly warning not being effectual the Public Health Committee ordered a prosecution, and two summonses were taken out against the licensee at the North London Police Court, but owing to the fact that the defendant lived in Cambridgeshire and denied all knowledge of the offences, or that the horse was his property, Mr. Fordham dismissed the cases without costs and granted summonses against the manager, who was the actual offender. On the cases being subsequently brought before Mr. Mead at the same Court, he refused to convict on the ground that the present defendant was not the licensee, and again the summonses were dismissed without costs. The number of animals slaughtered at the whole of these slaughterhouses during the year was as follows:— Oxen. Cows. Calves. Sheep and Lambs. Pigs. Total. 2,445 173 141 38,090 46 40,895 These figures are obtained through the courtesy and kindness of the individual occupiers from time to time, in nearly every case supplied weekly. 231 [1908 The total number of animals was 3,890 below that of the previous year, and the quality generally has again been very satisfactory. The number requiring special attention on account of disease or some abnormal condition being 267, as compared with 307 for the previous year. It will thus be seen that the gradual decrease in the percentage of diseased carcases which has been noted from year to year since the records have been kept, has again been satisfactorily maintained. Of the 267 diseased animals, 59 were due to tuberculosis, 48 of which were cows and 11 oxen, and in nearly every instance the affection was mild in degree and localised in extent; only in one case was it necessary to confiscate the entire carcase, and this being a very well nourished cow of the value of about ,£16, was a serious loss to the owner. In another instance the two fore-quarters of an ox were condemned, representing about half the total value, which was about £28. The remaining cases were less serious, and necessitated only the rejection of inferior portions of the carcase (in some instances) and the particular organs affected, whilst in the majority of cases the disease was confined to some individual organ and the lining membrane of the carcase adjacent thereto, such membranes in every instance being carefully stripped, and with the affected organs destroyed. Appended herewith is a table showing in detail the various diseases and abnormal affections from which the animals had suffered, where it will be seen that for the most part the remaining cases were of a parasitic nature, requiring only the rejection of the individual organ or organs affected, whilst in a few instances the disease had become so acute as to produce septic changes necessitating the rejection of adjacent portions of the carcase as well as the organs concerned. With one exception the whole of the carcases and organs condemned as unfit for human food in slaughter-houses was destroyed with the owners' consent without resorting to the legal form of seizure, the one exception being the case where the owner's attention was called to four livers and lungs of sheep parasitically affected, which were in the course of preparation for sale amongst other organs of sound condition, and he with indignity disagreed with my assertion that the organs in question were unfit for that purpose. Consequently I was reluctantly compelled to carry them before a magistrate, who gave an order for their destruction. On the case subsequently being brought before the Stipendiary at the Clerkenwell Police Court, it was defended by the London Butchers' Trade Society, represented by counsel instructed by Mr. Ricketts. The diseased condition of the organs was admitted, but several witnesses were called who stated that it was the custom to throw all organs together, and when the slaughtering was done to reject in the inspector's absence all such as were considered unfit for human food and leave them behind. Although this statement strictly accurate, the magistrate gave the defendant the benefit of the doubt and dismissed the summons without costs. This is very unsatisfactory, as the butcher knows, or has the opportunity of ascertaining, the condition of each organ immediately it is taken from the carcase, and ought to be held responsible for any further treatment, or placing diseased organs with those of perfect condition. 1903] 232 Table of Diseases or Abnormal Affections detected in Carcases or Individual Organs found in Slaughterhouses. No. Description Animal. Extent of Disease or Affection. Nature of Disease. How disposed of. 1 Cow Carcase and all internal organs Tuberculosis (generalised) Carcase and all organs destroyed 1 do. All internal organs (less hearty do. Affected organs destroyed 1 do. Thin flank, sternum and all internal organs (less heart) do. Affected parts and organs destroyed 4 Cows Lungs, liver and bronchial lymphatic glands do. Affected organs destroyed 16 do. Lungs and do. do. do. do. 1 Cow .. Lungs, liver and diaphragm do. do. do. 1 do. do., tripe and spleen do. do. do. 14 Cows Lungs do. do. do. 7 do. Mediastinal and other bronchial glands do. do. do. do. Livers do. do. do. 1 Ox Dorsal, subdorsal and sternocostal glands, lungs, heart and diaphragm do. Two fore-quarters & aflected organs destroyed 1 do. All internal organs (less heart and liver) do. Affected organs destroyed 1 do. Lungs, tripe & great omentum do. do. do. Oxen Lungs and bronchial glands do. do. do. 1 Ox Great omentum, and slight traces on costal pleura do. (slight) do. do. 1 do. Spleen and portions of peritoneum adjacent do. do. do. do. 1 do. Pharyngeal lymphatic glands do. do. do. do. 4 Sheep Carcase and all internal organs Found dead, or slaughtered in a moribund condition Carcases and all organs destroyed 2 Calves do. do. Unwholesome do. do. 1 Cow Head and tongue Actinomycosis Affected organs do. 1 do. Portion of flank Bruised Affected portions do. 1 Ox do do. do. do. 10 Cows Livers Abscess or Multiple abscesses Affected organs do. 12 Oxen do. do. do. do. do. 1 Ox Liver and spleen Congested (result of bruising) do. do. 4 Cows Livers Parasitic "Distoma Hepaticum " do. do. 7 Oxen do. do. do. do. do: 1 Ox do. Cirrhosis do. do. 1 Cow Lungs Parasitic "Echinococcus Veterinorum " do. do. 1 Ox do. do. do. do. do. 133 Sheep Liver or lungs, or both do. do. do. do. 14 do. Livers do. " Distoma Hepaticum " do. do. 1 do. Lungs, heart, head, etc. Septic inflammation of lungs do. do. 1 do. Liver, lungs and diaphragm Abscess do. do. 2 do. do. do. heart do. do. do. 4 do. Lungs do. do. do. 7 do. Various organs Various affections do. do. 233 [1903 The butchers', fishmongers' and greengrocers' shops and stalls, and other establishments where foodstuffs are sold or prepared for sale, have been regularly and frequently visited during the year, to which 4,889 visits have been paid. The quality and condition of the foodstuffs generally which came under observation were fairly satisfactory, but in many instances warnings have been given to traders, including butchers, fishmongers, fruiterers, etc., for having in their possession under somewhat suspicious circumstances foodstuffs which were more or less unsound on account of decomposition, and in each case the parties concerned have willingly destroyed them and promised to exercise greater care in the future. In one instance (more glaring) a fishmonger exposed unsound fish for sale, which was seized, and condemned by a magistrate, the particulars being reported to the Public Health Committee, who ordered an official warning to be addressed to the vendor. The following cases were disposed of in the Police Courts: — A firm of offal salesmen were summoned for having in the course of preparation for sale certain sheeps' heads which were in a state of decomposition, rendering them unfit for human food. The defence acknowledged their unsound condition, and admitted that they were found on the table where such organs are usually prepared for food, but denied that these were intended for any such purpose; and as the men were not actually engaged in their preparation at the time of the Inspector's visit the magistrate gave the defendants the benefit of the doubt and dismissed the summons, but without costs. A butcher was fine 40s. and costs for exposing four pieces of meat for sale which were unsound by decomposition. Another well-known firm of butchers or meat salesmen were found in possession of a large quantity of beef and mutton in an unsound condition in a cellar under the shop, the floor of the room being at the time of seizure two or three inches deep with sewage matter. On the case being brought before the North London magistrate, the defence admitted the putrid condition of the meat, but denied that any part of it was intended for sale, and the magistrate dismissed the case without costs, on the ground that no evidence had been brought to prove that it was so intended, although the onus of proof under the section rests with the party charged. A fruiterer at the North London Court was fined 20s. and 23s. costs for exposing for sale certain unsound fruit. Three separate charges for exposing for sale, depositing for the purpose of sale, and depositing for the purpose of preparation for sale respectively, were brought against a butcher at the same Court, and fines of £3 and ,£1 1s. costs on each summons were imposed, or one month's imprisonment. An itinerant ice-cream vendor was fined 2s. 6d., including costs, at Clerkenwell Court for failing to exhibit name and address on barrow. The following summary shows the amount of diseased carcases, organs and unsound meat which was destroyed during the year: — Tons. Cwts. Qrs. Lbs. Diseased carcases, organs, etc., from slaughter-houses 1 16 0 20 Unsound meat, rabbits, etc., from shops and stalls 1 6 2 5 Unsound fish, from thops and stalls 0 1 3 13 Unsound fruit from shops and stalls 0 1 0 22 Tons 3 5 3 4 Q 234 1903] The cowsheds within the Borough at the commencement of the year numbered 13, but one at Ashbrook Road, Upper Holloway, was disused during the whole of the year, and no application was made for the renewal of the licence. To these, 152 visits have been paid, ard, generally speaking, they are fairly well conducted, but complaints have to be made at one or two places regarding the dirty condition of the cows, and in one instance repeated complaints and warnings have been given, but with little effect, several of the cows being often found with thick layers of excreta dried on the butts, flanks, etc., under which circumstances it would be impossible to prevent fouling of the milk during milking operations, and as the structure and sanitary arrangements of this particular cowshed are the best and most modern within the Borough, such a condition of things can only result from rank carelessness or wilful neglect. The offensive trade establishments, comprising 3 tripe dressers, 2 gut scrapers, and 1 tallow melter, have received 172 visits during the year, and have been very satisfactorily conducted. The knacker's yard has been visited on 48 occasions, and no complaint of a serious nature has arisen during the year. I remain, Sir, Yours obediently, H. WILKINSON, Meat Inspector, &c. PLACES WHERE ICE CREAMS ARE MADE. There are in the borough 183 premises where ice creams are either made or sold. These were visited on many occasions with the result that it became necessary to serve 17 notices on the occupiers to put their premises into a sanitary state. The difficulty ot inducing the foreigners, all Italians, who make these edibles, to store their ingredients in proper places has been gradually got over, thanks mainly to the London County Council Act of 1902, which has been a great help in dealing with these people. They, however, require a tight hand to be kept on them, and arrangements have been made so that their premises shall be visited more frequently than heretofore. The Medical Officer of Health was on three occasions invited to inspect premises with a view of advising the intending tenants as to their fitness for the manufacture of ice creams. In each instance an opinion adverse to their occupation was given, so that ultimately they went to other parts of the metropolis. These were voluntary actions on the part of these people, for unfortunately there is no power under the London County Council General Powers Act, 1902, to compel them to obtain a certificate of the fitness or suitability of their ice cream factories before they start work. One itinerant ice cream vendor was fined 2s. 6d., including costs, for failing to exhibit his name and address on his barrow. 235 [1903 BAKEHOUSES. These places are dealt with in Part IV. of this report which treats of the work done under the Factory and Workshops Act, because such work must be reported on as a whole (vide p. 175). KITCHENS OF RESTAURANTS AND EATING HOUSES. These are also dealt with in Part IV. of this report under the heading of " The Administration of Factory and Workshop Act, 1901." MILKSHOPS AND DAIRIES. There were at the end of the year 674 milkshops, dairies, and premises where milk was sold on the register, as compared with 661 at the end of the preceding year. They were from time to time carefully inspected, with the result that it became necessary in 47 instances to serve notices, and in two instances to prosecute the proprietors for keeping the milk vessels in a dirty condition. In each of these cases the defendants were cautioned by the magistrates and fined a small penalty. ADULTERATION OF FOOD AND DRUGS. There were 1,016 samples of food and drugs submitted to the Public Analyst (Mr. F. L. Teed, D.Sc.) as compared with 932 in the previous year, and with an annual decennial average of 769. The increase in the number of samples was due to the desire of the Public Health Committee that in future not less than 1,200 samples should be procured annually. This resolution came into effect in the fourth quarter, when 301 samples were examined, as compared with 284 in the first quarter, 203 in the second quarter, and 228 in the third quarter. The number now fixed on is none too many, for it is to be recollected that nearly fifty per cent. of the samples are milks, and twenty per cent. butter and margarine. These may seem large percentages of the whole number of samples examined, but it must not be forgotten that they are the chief foods of the people that are liable to adulteration, and are, in fact, the articles that are most frequently and most largely adulterated. Q 2 236 1903] Proportion of adulteration.—Of the 1,016 samples of food that were analysed 118 were adulterated, or 11.6 per cent. This is a smaller percentage than obtained on the average of the preceding ten years, when it amounted to 12.3. It is very difficult to make a comparison between one year and another with respect to adulteration, because unless the articles that are analysed are similar to those examined in the preceding years, the results are apt to be misleading. Thus, for instance, if a large number of Demarara sugars had been procured the percentage of adulteration would appear to be large because it has been found that the fraud of substituting "yellow crystals" for that article is still very largely practised, especially by very small dealers. Thus in 1902 it was found that 64.7 per cent., and 1903 45.9 per cent., of the samples of that sugar were not genuine. The Inspectors' Work.—The samples are taken both by your district inspectors and by an inspector (Mr. Ward), who devotes at least half his time to this duty. The district inspectors' work has been chiefly confined to procuring samples of milk at the Railway Stations where it is a rare thing to find an adulterated sample, and on Sundays from itinerant vendors. They were compelled, however, to take other samples during the fourth quarter, as it was impossible for Mr. Ward with his other duty of inspecting houses let in lodgings, to procure the increased number that it had been decided to have analysed in that quarter. The result of the work of the inspectors is set out herewith :— Inspector Ward. District Inspectors. Quarter. Samples. Adulterated. Percentage Adulterated. Quarter. Samples. Adulterated. Percentage Adulterated. 1 99 25 25.3 1 185 18 97 2 133 15 11.3 2 70 1 1.4 3 162 15 9.3 3 66 9 13.6 4 155 23 14.8 4 146 12 8.2 Totals 549 78 14.2 Totals 467 40 8.6 All Inspectors. Quarter Samples. Adulterated. Percentage Adulterated. First 284 43 15.1 Second 203 16 7.9 Third 228 24 10.5 Fourth 301 35 11.6 Total 1,016 118 11.12 237 [1908 It is not possible to compare the first two returns, for as pointed out the district inspectors mainly obtained milks on Sundays, when the rate of adulteration is about 11.9 per cent., and at Railway Stations, at which the adulteration rate is 1.7 per cent., whereas the other inspector obtained samples of many articles of food and drugs; and, therefore, was more likely to show a larger percentage of adulteration among his samples. Nevertheless there can be no doubt that if the Adulteration Acts are to be administered in a thorough manner the duty of procuring samples must be placed on an inspector specially detailed for the work. This has been again and again made manifest, especially when it became necessary to detect traders who carried on their frauds in a very cautious manner, who, in fact, would on no account sell adulterated articles to a stranger, but who would have no compunction in palming off on regular customers sophisticated foods. These are the class of fraudulent dealers whom it is most desirable to detect and crush, but whom the ordinary inspectors cannot detect, because, with the multiplicity of their other duties, they cannot afford the time to watch them. There are many other reasons why it is better to have this work done by a special inspector, but there is one in particular, namely, that having only one duty he will be able to give all his thoughts and energies to that special work, and to carefully note in the trade and other journals the new directions in which the adulterer of food is working, and so be prepared to meet him at the earliest moment, and spoil his evil intent. Now that additional samples of food are analysed in Islington it is clear that there will be ample work to engage the whole time of one inspector, and therefore such an appointment is strongly recommended by your medical officer of health.* The samples obtained for analysis may be classified under the headings of Dairy Produce, Groceries, Spirituous Drinks, and Drugs. Dairy Produce. The following samples were analysed:— Samples. Adulterated. Percentage Adulterated. Percentage Adulterated in 1902. Milk 508 50 9.8 9.9 Butter 180 13 7.2 15.7 Margarine 29 9 31.0 56.5 Cheese 17 0 ... ... Lard 11 0 ... ... 745 72 9.7 12.5 * Since the above remarks were printed the Borough Council at its meeting of May 20th, 1904, decided that Inspector Ward should devote his whole time to this duty. 238 1903] Milk.—Of the 508 samples analysed 50 or 9.8 per cent. were adulterated, or almost the identical percentage of the preceding year. 120 of these samples of milk were obtained at Railway Stations, 218 were purchased from retail vendors on Week Days, and 167 on Sundays. The proportion of adulteration among the Railway Station milks was 17 per cent., among Week Day milks 12.8 per cent., and among Sunday milks 11.9 per cent. These figures are sufficient evidence, as has frequently been pointed out in these reports, that the adulteration of milk does not occur to any large extent in the country, but that it is the milk dealers in London who act fraudulently. Quality of the Milks.—The. fact is also borne out by the difference in the quality of the milk as it arrives at the railways, and as it is sold in the streets. No. of Samples Analysed. Percentage of Fat. Percentage of Solids, not Fat. Percentage of Total Solids. Railway Milks 120 3.90 8.66 12.56 Week Day Milks 218 3.74 8.47 12.21 Sunday Milks 167 3.86 8.42 12.28 Official Standard ... 3.OO 8.50 11.50 These figures show us that the fat of the milk sold to the public is less than when it arrives from the country, and also that the milk has been "doctored" with water. We may, however, be thankful that the fat has not been abstracted to the extent that the official standard permits. A recent writer (Mr. Ernest Mathews), who is well known in the dairy world, declares in reference to the official standard, in Lis book, "Economies in Dairy Farming," that " the public are wronged if milk of this quality is supplied." He, if anyone, ought to know. At all events if the milk sold in Islington had been deprived of its fat to the extent that it lends itself to, the public would have been defrauded of nearly one-fourth (23.1 per cent.) of the quantity of the fat of the milk which arrived from the farms. Happily nothing like this has happened, from which it may be assumed that milk dealers have still a conscience left them. In the light of the figures given for many years by your medical officer of health there can be no doubt that the official standard set up by the Board of Agriculture should be revised. Railway Milks. Fat. Solids, not Fat. Total Solids. 1898 120 4.04 8.84 12.88 1899 120 4.23 8.82 13.05 I900 121 3.93 8.75 12.68 1901 141 3.69 8.77 12.46 I902 90 3.85 8.82 12.67 1903 120 3.90 8.66 12.56 Total and Averages 712 3.93 8.78 12.71 Official Standard 3.00 8.50 11.5 Further particulars respecting the milk samples are given in tables CXXVII. and CXXVIII. 239 [1903 Butter.—The adulteration of butter, as judged by the analyses, does not seem to have been practised to the same extent as in the previous year, for whereas then the percentage of adulteration was 157 per cent., in 1903 it was only 7.2 per cent. 180 samples were purchased, of which 13 were returned as adulterated with foreign fats, which may be considered tantamount to saying that margarine was substituted for the article demanded. No sample of butter was returned as containing more than 16 per cent. of water, which is the maximum amount laid down in the Sale of Butter Regulations of the Board of Agriculture. Margarine.—29 samples were purchased, of which 9, or 31.0 per cent., were sold contrary to the provisions of the Margarine Act. GROCERIES. 169 samples were purchased, of which 29 were adulterated. They were as follows:— No. of Samples. No. Adulterated. Percsntage Adulterated. Percentage Adulterated in 1902. Coffee 39 6 15.4 40.0 Cocoa 14 1 7.1 ... Tea 4 ... ... ... Sugar, Demarara 37 17 45.9 64.7 Pepper (Black) 10 ... ... ... „ (White) 8 1 12.5 ... Mustard 20 ... ... ... Arrowroot 3 ... ... ... Vinegar (Malt) 9 1 11.1 Ginger (Ground) 6 ... ... ... Baking Powder 2 ... ... ... Jam (Black Currant) 2 ... ... ... Sweets 1 . . . ... ... Yeast 6 2 33.3 ... Dripping 8 1 12.5 ... 169 29 17.2 27.8 Spirituous Drinks. 26 samples of spirits were examined, of which 6 were returned as reduced by added water below the strength allowed by Act of Parliament. 240 1903]  Number of samples. Number adulterated. Percentage adulterated. Percentage adulterated in 1902. Whiskey (Scotch) 8 2 25 0 — Brandy 5 — — — Rum 5 2 400 — Gin 8 2 250 18.2 26 6 23 8 9.1 Drugs. 76 samples of various drugs were examined, of which 11, or 14.4 per cent., were returned as adulterated. Samples. Number adulterated Percentage adulterated. Percentage adulterated 1902. Lime Water 3 — — Linseed, Crushed 20 2 10.0 Paregoric 2 — — Sweet Spirits of Nitre 4 — — Liniment of Soap 1 — — Sal Volatile 2 — — Cod Liver Oil 2 — — Camphorated Oil 1 — — Olive Oil 8 — — Tincture of Rhubarb (Compound) 2 — — Cream of Tartar 4 2 50.0 100.0 Blaud's Pills 13 5 38.4 33.3 Tincture of Gentian 2 — — Tincture of Digitalis 2 — — Tincture of Perchloride of Iron 1 1 100.0 Tincture of Iodine 1 — — 100.0 Tincture of Nux Vomica 1 — — Spirits of Camphor 2 — — Solution of the Hydrochloride of Strychnine 2 — — Oil of Almonds 1 — — Oil of Juniper 1 — — Prescription 1 1 100.0 76 11 14.4 241 [1908 Liniment of Soap.—An important magisterial decision which was dealt with very fully in the report (p. 19) of the Medical Officer of Health for the second quarter of the year, decided that when soap liniment is demanded by a customer he must be supplied with that article made according to the formula of the British Pharmacopa:ia, or in other words, that it must be made with rectified spirit, and not with methylated spirit. It has, unfortunately, been the practice, which the evidence showed was much more extensive than had been suspected, for druggists, especially those doing business in the poorer neighbourhoods, to compound this medicine with methylated spirit. It was pleaded that there was a commercial standard as well as a pharmacopaeal standard for this article; but the Magistrate held that, "the only answer he could give upon the evidence is this, that the facts are that there is no commercial standard for liniment of soap different from the British Pharmacopaeia." He also quoted the words of the Lord Chief Justice, when the case was before the Court of Appeal on the point that the Magistrate had refused to hear evidence as to the existence of a commercial standard, who said: "It was liniment of soap improperly compounded, and that they (the appellants) attempted to sell under another name what they had no right to sell under that name, viz., they attempted to sell methylated spirits under the name of liniment of soap, when it was not liniment of soap according to the proper meaning of that word." The Magistrate fined the defendants five pounds, and awarded costs to the amount of sixty-five guineas. This case, which consumed a great deal of time and must have cost the defendants a great deal of money, for witnesses were brought to London from distant parts of the country, would never have arisen if the defendants had labelled their liniment—as they ought to have done—" soap liniment —methylated,"or "methylated liniment of soap," or in such a manner that the purchaser would be made aware that he was purchasing an article other than that laid down in the British Pharmacopaeia. It was impossible for your Public Health Committee to refrain from prosecuting in this case, for by so doing they would have opened the door to a wide infraction of the formulae prescribed by the British Pharmacopaeia for the compounding of many medicines, because it would have been a tacit admission that it was not authoritative or binding on chemists and druggists. Indeed during the trial at least one witness went so far as to assert that it was only compiled as a guide for medical men in writing their prescriptions. Blaud's Pills.—Another most important conviction was that of the proprietors of a large drug store, who were fined £50 and £10 10s. costs, in which the defendants who had sold Blaud's Pills deficient in Ferrous Carbonate to the extent of 78.5 per cent., endeavoured to excuse themselves on the ground that it was not a preparation 242 1903] in the British Pharmacopaeia, and that no one knew the formula of these pills, which had been invented by a Frenchman, Dr. Blaud. The judgment of the Magistrate was as follows:— Mr. Mead : I am of opinion, in the first place, that when the Inspector asked to be supplied with iron pills, he was entitled to be supplied with iron pills in nature, substance, and quality as laid down by the British Pharmacopaeia. The fact that the man said, " Blaud's Pills," does not take it out of that category. The ejaculation he used was in a synonymous and explanatory sense, and nothing was said which was intended to convey to the mind of the purchaser that he was taking something which was out of the description of the British Pharmacopaeia. Therefore, he was entitled to receive pills according to the Biitish Pharmacopaeia. Then it is contended that this case fails under Section 8. The mere fact that this was on the bottle : " These pills are not prepared according to the British Pharmacopaeia," and " Blaud's formula," does not cover the defendants, because these notices were hidden by the outer casing. Therefore, I am of opinion that this case does not come under the section. There is no evidence that any specific matter or ingredient has been mixed with the substance that was asked for, so that the label could be applied to such substance. The next question is that, though the protection of Section 8 does not follow, has there not been sufficient notice to the purchaser under Section 6? The bottle was wrapped in paper, and if the Inspector had been an ordinary purchaser and had gone home with his purchase before opening it, he would not have known that he had not got what he expected to be served with. If he was not entitled to have pills according to the British Pharmacopæia, he is entitled to have something which is called Blaud's pills. That this is so we have on the evidence. Both verbally and on the bottle he is entitled to have Blaud's pills. There is, consequently, prima facie evidence that Blaud's formula does exist, notwithstanding the contention that it was a mere name with no particular basis. The scientific witnesses say that such a thing does exist, and is recognised in the edition of the British Pharmacopaeia of 1885. It is shown that such a thing does exist, and it was recognised by the application of the label on the bottle sold in the vendor's name. It is shown that a certain formula requires certain drugs to be mixed so as to create 20 per cent. of ferrous carbonate, ingredients of manufacture by the chemical action of which the desired result is obtained. It is perfectly clear that the article supplied the Inspector in this case does not comply with such formula. Substantially there should be 20 per cent. of ferrous carbonate; but the evidence here shows that there was only 4.3; and at the most, allowing for deterioration, there could not have been more than 8.4. So that there was a tremendous deficiency. Mr. Bonsey has asked several questions with regard to the various formulas for the manufacture of Blaud's pills in different countries —Germany, France, Austria, and America; but in my opinion we have nothing to do with any foreign nation in this case except France; and we have something to do with France, because that is the country where it came from. There are variations of detail in making up, and, possibly, in ingredients, but all the formulas come out practically with 20 per cent. of ferrous carbonate, etc. There is another point. Mr. Bonsey says there is no formula at all. That is his defence. And if that is so, there is a misrepresentation at once, because of the label on the bottle, which says that the pills are prepared from Dr. Blaud's formula. The pills, in fact, are prepared from a something that does not exist. On that ground alone the prosecution is entitled to succeed. Then it is said that this is a proprietary medicine. It is difficult to say what a proprietary medicine is. But it is a very strong thing to say that, whether the man is alive or dead, it is a proprietary medicine. All other things failing, he has taken refuge in saying someone must come forward and say, " I have proprietary rights in this medicine." I cannot accept this defence; and the prosecution, under all circumstances, must succeed. I find that on both summonses the offence has been committed. 243 [1908 Table CXXVI. Showing the Number of Samples of Food and Drugs Analysed with the Result of the Analyses for the Year 1903 and the preceding Ten Years. Year. No. of Samples. Genuine. Adulterated Per cent. Adulterated. 1893 378 327 51 13.5 1894 390 342 48 12.3 1895 772 673 99 12.8 1896 755 661 94 12.4 1897 863 765 98 11.3 1898 875 784 91 10.4 1899 899 820 79 8.8 1900 885 774 HI 12.5 1901 942 800 142 15.0 1902 932 796 136 14.6 Average (10 yrs.) 769 674 95 12.3 1903 1016 898 118 11.6 Table CXXVII. Giving the particulars of the Milk taken during each quarter of 1903 on Sundays, on Week days, and at the Railway Stations. 1903. No. of Samples Taken. Genuine. Adulterated. Per cent. Adulterated. Quarters. Sundays. Week-days. Railway Stations. All Milks. Sundays. Week-days. Railway Stations. All Milks. Sundays. Week-days. Railway Stations. All Milks. Sundays. Week-days. Railway Stations. All Milks. 1st Quarter 52 69 30 151 46 56 29 131 6 13 1 20 11.5 18.8 3.3 13.2 2nd „ 40 47 30 117 39 40 30 109 1 7 0 8 2.5 14.9 0.0 6.8 3rd „ 39 43 30 112 30 41 30 101 9 2 0 11 23.08 46.5 0.0 9.8 4th ,, 36 59 30 125 32 53 29 114 4 6 1 11 11.1 10.2 3.3 8.8 The Year 167 218 120 505 147 190 118 455 20 28 2 50 11.9 12.8 1.7 9.9 244 1908] Table CXXVIII. Showing the Average Composition of 1,061 Milks procured or purchased in Islington during the periods mentioned. Periods of the year when Samples were obtained. Railway Milks. Sunday Milks. Week Day Milks. No. Analysed. Fat, per cent. Solids not fat, per cent. Total Solids, per cent. No. Analysed. Fat, per cent. Solids not fat, per cent. Total Solids, per cent. No. Analysed. Fat, per cent. Solids not fat, per cent. Total Solids, per cent. 1902. 1st Quarter 30 4.26 8.83 13.09 48 3.43 8.52 11.95 90 3.43 8.53 11.96 2nd „ ... ... ... ... 48 3.49 8.57 12.06 77 3.42 8.76 12.18 3rd 30 3.50 8.81 12.31 48 3.57 8.65 12.22 65 3.60 8.60 12.20 4th ,, 30 3.80 8.82 12.42 48 3.93 8.62 12.55 42 3.61 8.70 12.31 The Year 1902 90 3.85 8.82 12.61 192 3.60 8.59 12.19 274 3.51 8.64 12.15 1903. 1st Quarter 30 3.71 8.70 12.41 52 3.55 8.41 11.96 69 3.64 8.45 12.09 2nd 30 3.71 8.60 12.31 40 3.69 8.46 12.15 47 3.63 8.49 12.12 3rd ,, 30 4.01 8.53 12.54 39 3.82 8.32 12.14 43 3.84 8.45 12.29 4th ,, 30 4.18 8.81 12.99 36 4.37 8.50 12.87 59 3.86 8.50 12.36 The Year 1903 120 3.90 8.66 12.56 167 3.86 8.42 12.28 218 3.74 8.47 12.21 246 [1908 Table CXXIX. Showing the Samples of Foods and Drugs submitted to the Public Analyst, with the result nf his analyses. Samples taken. Description. Genuine. Adulterated. Percentage Adulterated. 180 Butter 107 13 7.2 508 Milk 458 50 9.8 17 Cheese 17 .. .. 8 Dripping 7 1 12.5 39 Coffee 33 6 15.4 14 Cocoa 13 1 7.1 4 Tea 4 .. .. 11 Lard 11 .. .. 10 Pepper (Black) 10 .. .. 8 Pepper (White) 7 1 12.5 20 Mustard 20 .. .. 3 Arrowroot 3 .. .. 9 Malt Vinegar 8 1 11.1 6 Ground Ginger 6 .. .. 2 Baking Powder 2 .. .. 37 Demerara Sugar 20 17 45.9 2 Black Currant Jam 2 .. .. 1 Sweets 1 .. .. 6 Yeast 4 2 33.3 8 Scotch Whiskey 6 2 25.0 5 Rum 3 2 40.0 5 Brandy 5 .. .. 8 Gin 6 2 25.0 3 Lime Water 3 .. .. 20 Crushed Linseed 18 2 10.0 2 Paregoric 2 .. .. 4 Spirits of Nitre 4 .. .. 1 Soap Liniment 1 .. .. 2 Sal Volatile 2 .. .. 2 Cod Liver Oil 2 .. .. 1 Camphorated Oil 1 .. .. 8 Olive Oil 8 .. .. 2 Comp: Tincture of Rhubarb 2 .. .. 4 Cream of Tartar 2 2 50.0 1 Prescription .. 1 100.0 13 Iron Pills (Blaud's) 8 5 38.4 2 Tincture of Gentian 2 .. .. 2 Tincture of Digitalis 2 .. .. 1 Tincture of Iodine 1 .. .. 2 Spirits of Camphor 2 .. .. 1 Tincture of Nux Vomica 1 .. .. 2 Solution of Strychnine Hydrochloride 2 .. .. 1 Tincture of Perchloride of Iron .. 1 100.0 1 Oil of Almonds 1 .. .. 1 Oil of Juniper 1 .. .. 987 All Articles 878 109 11.0 MARGARINE ACT. Samples taken. Description. Samples sold in accordance with the Act. Samples sold contrary to Act. Percentage sold in contravention of the Act. 29 Margarine 20 9 31.13 246 1903] Table CXXX. SUMMARY OF PROSECUTIONS.—During year 1903. Prosecutions. Successful. Dismissed. Withdrawn. "Public Health (London) Act, 1891" 55 35 8 *12 "Sale of Food and Drugs Acts, 1875-99" 77 72 4 1 "Margarine Act, 1887" 1 1 — — "Dairies, Cowsheds and Milkshops Order, 1885" 2 2 — — "London County Council General Powers Act" 5 3 1 1 Total 140 113 13 14 * This number includes nine summonses that were withdrawn owing to the completion of work. Further particulars of these prosecutions will be given by the Town Clerk in his Annual Report to the Council. 247 1908] WATER SUPPLY. The water supply of the borough is now entirely delivered on the constant system, and is excellent in quality. It is, however, frequently deteriorated by having to pass through storage cisterns prior to its use for purely domestic purposes, which is much to be deplored because its disadvantages far outnumber its advantages, which are entirely those of the company and not of the consumer. On the other hand the advantages of a constant supply are very important to the consumer as well as to the public. They include the following among others:— (1) It prevents the corrosion of pipes, which in turn causes turbidity, which an intermittent supply favours. (2) As the water is not shut off from the service mains it prevents their depletion, by the gravitation of water into the basement cisterns, or by leakage, which tend to create a vacuum into which may be drawn foul air or foul water. (3) In case of fire the water is ready for immediate use, and the delays caused by the search for a turncock are avoided. (4) It obviates the necessity for storage cisterns, and consequently gets rid of the danger caused by the pollution of water, due to dirt, dust, or even the drowning of animals, such as mice, birds, and insects, in them. (5) It enables consumers by means of a draw-off tap from the rising main to obtain water for drinking and other domestic purposes in a pure and cool condition. The New River Company, like other London companies, still require the provision of water storage cisterns in houses of any size, although their retention is not now insisted on in small cottage properties. This is much to be regretted, because it is only with the greatest difficulty that many landlords can be prevailed upon to supply water direct from the supply pipe when there already exists a supply from a cistern. Nevertheless there has been a steady and continued increase in the number of draw-off taps fitted to the rising mains, and it is only a question of time, and not a long time either, before their use will become the rule and not the exception; for as soon as the London public, who have been taught to look on a cistern as a necessity (and it was a necessity under the intermittent system), find out that it is no longer so, but that it is a means by which the water may be polluted, and therefore a danger to health, they will insist on being supplied with water direct from the mains. Ever since your Medical Officer of Health took up his duties in Islington it has 248 1903] been his constant endeavour to abolish cisterns, or at least to obtain a direct supply as an alternative. He has succeeded beyond his expectations, although on several occasions he experienced great difficulty with the New River Company in securing his requirements. The Public Health Committee have always supported him in his efforts, and, indeed, have for many years insisted that, unless every new house is supplied with water for domestic supply direct from the main, they will not recommend the Council to grant a certificate, as required by sec. 48 (2) of the Public Health London Act, 1891, without which a house cannot be occupied. The advantages of a direct supply from the main are, however, heavily discounted so long as the cistern is allowed to remain, for unfortunately it happens that the draw-off taps from the main are usually only fitted in the lowest part of the houses, either in the kitchens or sculleries, while the supplies for baths and lavatory basins upstairs are obtained through cisterns. This is usually the water which is used for drinking purposes in the bed rooms, and for washing the teeth and mouth, and, therefore, such a supply sti'l remains a grave danger to the public health. Now if we examine the reason that the Water Companies object to a direct supply we will find that they allege that "the extreme daily demand for water which occurs between the hours of 8 and n in the morning is met by a cistern supply, and this is gradually renewed as the demand slackens. The work of water conveyance devolving on the mains is in this way distributed throughout a great part of the 24 hours, and neither their capacity nor the pressure on them need be so great as in the case of a system of supply in which house storage would have no part, and in which they would have to deliver, perhaps, one-fourth of the whole daily supply within the period mentioned above."* There is no question but that the demand in the early part of the day is caused by the use of the water for flushing W.C.'s. Of course there are other calls on the supply, although this one is undoubtedly by far the greatest. But this demand on the companies should not prevent them allowing the general use of a direct supply for drinking and cooking and ordinary domestic purposes, for they could still retain the storage cisterns for the supply of water * Report for 1902 of the Water Examiner to the Local Government Board. 249 [1903 to the water-waste-preventers attached to W.C.'s. Such cisterns should, however, supply nothing else, and consequently should have no draw-off taps fitted to them. If they were reserved solely for this purpose then a long step would have been taken towards the universal supply of an uncontaminated water supply. In this connection it might be pointed out that the water for domestic purposes supplied by the water companies of nearly all, if not all, the great towns is drawn direct from the main, without the intervention of a cistern. In towns with which your Medical Officer of Health is well acquainted the supply is direct, and cisterns are never used except to supply water closets. Indeed the public would not tolerate a system by which it is always possible for the supply to be seriously contaminated. Purity of the Supply. —For the first time for many years complaints were received as to the character of the water supplied by the New River Company. There was, however, no cause for alarm, because, beyond the fact that the water was more or less discoloured owing to the floods which followed heavy rainfalls at various periods of the year, there was nothing seriously wrong with it, as the Company's filters, which as usual worked efficiently, had removed the impurities, although they were not able to remove all the discoloration. This discoloration was never very great, and at times could only be perceived when the water was examined through a deep glass, or in considerable quantity, as in a swimming bath. The Chairman of the Baths and Washhouses Committee (Councillor Ambrose Jones) drew the attention of the Medical Officer of Health to the matter, but he was in a position to assure him that apart from the discoloration there was nothing in the water that could affect the health of the bathers. New River Company.—In 1902, the latest period for which particulars relating to the Company are available, the principal facts which refer to the whole district supplied by them, and not to Islington alone, are as follows:— Houses supplied 176,981 Houses in constant system 170,822 Houses not in constant system 6,159 Percentage of houses on constant system 96.5 Population supplied 1,272,000 Average daily supply (gallons) 39,712,437 R 250 1903] Estimated daily supply for domestic purposes (gallons) 31,769,950 Estimated daily supply for all other purposes (gallons) 7,942,487 Total quantity of water supplied during the year (gallons) 14.495.039.379 Average daily supply per house (gallons) 226.23 „ „ per head (gallons) 31.20 „ „ per house for domestic purposes only (gallons) 180.98 Average daily supply per head for domestic purposes only (gallons) 24.96 Average number of persons supplied per house (gallons) 7.25 APPENDIX I. —o— VITAL AND SANITARY STATISTICS, 1 9 0 3. TOGETHER WITH Abstract for Ten Years, 1893-02. 252 1903] Table A. Showing the Deaths from All Causes in Islington during the Year 1903. Deaths of Non-Residents in Hospitals excluded. Deaths of Residents in Public Institutions are distributed. Deaths in Institutions within Borough. DISEASES. AGES. Under 5 Over 5 DISTRICTS. Males. Females. Totals. 0- 1- 5- 10- 15- '10- 25- 35- 45- 55- 65- 75- 85- Tuf. U.H. Toll. L.H. H. B. S E. Small Pox .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. (b) Unvaccinated .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. (c) No Statement .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 12 Measles 29 90 1 .. .. .. .. .. .. .. .. .. .. 119 1 9 4 3 22 22 41 19 63 57 120 Scarlet Fever 1 12 7 2 .. 1 1 .. .. .. .. .. .. 13 11 4 1 3 4 6 5 1 9 15 24 Typhus Fever .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 2 Epidemic Influenza 1 2 1 1 1 3 b 9 8 6 3 3 37 4 4 3 2 9 7 11 22 18 10 15 Whooping Cough 63 85 4 .. .. .. .. .. .. .. .. .. .. 148 4 12 20 24 24 19 24 29 73 79 152 4 Diphtheria 4 22 12 2 .. 1 1 .. .. 1 .. .. .. 26 17 4 3 4 14 2 10 6 21 22 43 Enteric Fever .. 1 2 1 2 3 6 4 2 1 .. .. .. 1 21 3 .. 2 2 7 6 2 13 9 22 Asiatic Cholera .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 5 Diarrhoea, Dysentery 44 15 .. .. .. .. .. 1 1 1 3 1 .. 59 7 6 4 9 12 6 9 20 40 26 66 1 Epidemic Enteritis 39 4 .. .. .. .. .. .. .. .. .. .. .. 43 .. 2 7 8 7 4 8 7 24 19 43 Other Allied Diseases .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Hydrophobia .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Glanders .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Tetanus 1 .. .. .. .. .. .. .. .. .. .. .. .. 1 .. .. .. .. .. .. .. 1 1 .. 1 Anthrax .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Cow Pox .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 6 Syphilis 10 1 .. 1 .. .. 1 3 2 .. .. .. .. 11 7 2 5 2 2 1 2 4 11 7 18 1 Gonorrhoea .. .. .. .. .. .. .. .. .. 1 .. .. .. .. i 1 .. .. .. .. .. .. 1 .. 1 Phagedæna .. .. .. .. .. .. .. .. .. .. .. 1 .. .. 1 .. .. .. .. .. 1 .. 1 .. 1 1 Erysipelas 4 .. .. .. .. .. 1 1 .. 1 1 1 .. 4 5 1 .. 2 1 1 2 2 5 4 9 3 Puerperal Fever .. .. .. .. 3 6 .. .. .. .. .. .. .. 9 1 3 .. 2 2 .. 1 .. 9 9 1 Pyaemia 2 • • 1 3 1 2 1 1 .. .. 2 9 .. 1 1 2 2 2 3 6 5 11 Infective Endocarditis .. .. .. .. 1 .. 2 1 .. .. .. .. .. .. 4 .. .. 1 1 .. 2 .. 2 2 4 3 Other Allied Diseases 5 1 *1 .. .. 1 .. .. 1 .. 2 1 .. 6 6 *3 2 .. 3 1 1 2 8 4 12 Malarial Fever .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Rheumatic Fever .. .. 1 1 1 1 2 2 3 2 2 1 .. .. 16 1 .. 2 1 5 1 6 10 6 16 Rheumatism of Heart .. .. .. .. .. 1 .. 1 1 3 .. .. .. .. 6 .. 1 .. .. 3 .. 2 1 5 6 Tuberculosis of Brain 20 36 8 2 2 2 .. 1 .. .. .. .. .. 56 15 6 3 3 17 13 14 15 41 30 71 1 Tuberculosis of Larynx .. .. 1 .. .. .. 3 2 .. 1 .. .. .. .. 7 1 .. 1 .. 2 1 2 6 I 7 128 Phthisis 16 13 8 5 26 40 110 106 95 50 21 2 .. 29 463 47 58 43 72 70 85 117 291 201 492 5 Abdominal Tuberculosis 20 15 1 .. .. 2 .. 1 1 .. .. .. .. 35 5 2 6 8 2 4 6 12 19 21 40 3 General Tuberculosis 4 7 3 1 1 .. .. 1 .. 1 1 .. .. 11 8 2 5 3 3 2 2 2 12 7 19 Other forms Tuberculosis .. 1 2 .. .. .. .. .. .. .. .. .. .. 1 2 .. .. .. 2 .. .. 1 2 1 3 Other Infective Diseases .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Thrush 1 .. .. .. .. .. .. .. .. .. .. .. .. 1 .. .. .. .. .. .. .. 1 1 .. 1 Actinomycosis .. .. .. .. .. .. 1 .. .. .. .. .. .. .. 1 .. .. .. .. .. 1 .. 1 .. 1 Hydatid Diseases .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Scurvy .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Other Diseases due to Altered Food .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Acute Alcoholism .. .. .. .. .. .. 1 .. .. 2 .. .. .. .. 3 .. .. .. .. .. 2 1 3 .. 3 Chronic Alcoholism .. .. .. .. .. .. 2 6 9 4 1 1 .. .. 23 4 2 2 4 5 2 4 10 13 23 Chrome Industrial Poisonings .. .. .. .. .. .. .. 1 .. .. .. .. .. .. 1 .. .. .. .. .. 1 .. 1 .. 1 Other Chronic Poisonings .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Osteo-arthritis .. .. .. .. .. .. .. .. 1 4 6 2 2 .. 15 .. 1 1 2 2 2 7 1 14 15 Gout .. .. .. .. .. .. .. .. 1 1 2 2 .. .. 6 .. .. .. 1 1 2 2 5 1 6 69 Cancer 1 3 2 1 2 5 5 43 75 95 83 34 1 4 346 33 35 31 30 71 66 84 155 195 350 Diabetes Mellitus .. .. .. 1 .. 1 2 2 2 8 7 3 .. .. 26 2 5 6 2 6 3 2 11 15 26 Purpura Hæmorrhagica .. .. .. .. .. .. .. 1 .. .. .. .. .. .. 1 .. .. .. .. .. .. 1 1 .. 1 Haemophilia .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Anæmia .. .. 1 .. .. .. 1 1 1 2 2 .. .. .. 8 2 1 1 .. 1 3 .. 4 4 8 Lymphadenoma .. .. .. .. 1 .. .. .. .. .. .. .. .. .. 1 .. .. .. .. .. 1 .. .. 1 1 1 Premature Birth 174 .. .. .. .. .. .. .. .. .. .. .. .. 174 .. 9 17 14 20 36 33 4b 97 77 174 Injury at Birth 1 .. .. .. .. .. .. .. .. .. .. .. .. 1 .. .. 1 .. .. .. .. .. 1 .. 1 Debility at Birth 38 .. .. .. .. .. .. .. .. .. .. .. .. 38 .. 1 1 2 8 6 7 13 27 11 38 Atelectasis 18 .. .. .. .. .. .. .. .. .. .. .. .. 18 .. 2 5 1 2 3 5 11 7 18 Congenital Defects 29 1 .. .. .. .. .. .. .. .. .. .. .. 30 .. 2 3 7 3 8 7 20 10 30 Want of Breast Milk 7 .. .. .. .. .. .. .. .. .. .. .. .. 7 .. 2 .. .. 3 .. 2 4 3 7 1 Atrophy, Debility, Marasmus 145 11 .. .. .. .. .. .. .. .. .. .. .. 156 .. 20 27 13 17 23 27 29 97 59 156 * Continued Fever. 253 [1903 Table A.—Continued. Deaths in Institutions within Boroueh. DISEASES. AGES. Under 5. Over 5. DISTRICTS. Males. Females. Totals. 0- 1- 5- 10 15- 20- 25- 35- 45- 55- 65- 75- 85- Tuf. U.H. Toll. L.H. H. B. S.E. Dentition 18 15 .. .. .. .. .. .. .. .. .. .. .. 33 .. 2 7 9 3 4 5 3 19 14 33 Rickets 1 8 .. .. .. .. .. .. .. .. .. .. .. 9 .. 1 1 .. 2 .. 3 2 4 5 9 Old Age, Senile Decay .. .. .. .. .. .. .. .. .. 1 39 93 *46 .. 179 22 27 19 25 31 26 29 79 100 179 Convulsions 47 7 .. .. .. .. 1 .. .. .. .. .. .. 64 1 4 6 4 6 12 7 16 31 24 55 Meningitis 18 12 6 .. .. .. 1 .. 1 3 .. .. .. 30 11 2 4 3 7 7 6 12 24 17 41 Encephalitis .. .. .. .. 2 .. .. .. 1 .. .. .. .. .. 3 1 .. 2 .. .. .. .. .. 3 3 Apoplexy .. .. .. .. .. .. .. 3 11 7 20 17 3 .. 61 6 9 3 6 13 12 12 27 34 61 Softaining of Brain .. .. .. .. .. .. .. 2 1 5 10 4 .. .. 22 3 1 3 3 5 2 5 10 12 22 Hemiplegia .. .. .. .. .. .. .. 3 .. 6 15 7 1 .. 32 1 5 1 3 7 4 11 13 19 32 General Paralysis of the Insane .. .. .. .. .. .. 7 10 8 1 .. 2 .. .. 28 4 3 3 3 2 6 7 24 4 28 Other forms of Insanity .. .. .. .. .. .. 1 2 3 3 6 3 1 .. 19 2 6 2 1 2 4 2 5 14 19 Chorea .. .. 1 .. .. .. .. .. 1 .. .. .. .. .. 2 .. 1 .. .. .. .. 1 1 1 2 Cerebral Tumour .. 1 1 .. .. .. 2 1 2 .. .. .. .. 1 6 1 3 1 .. .. 1 1 7 .. 7 Epilepsy .. .. .. .. .. .. 3 2 2 1 2 1 .. .. 11 2 1 .. 3 1 .. 4 7 4 11 Laryngismus Stridulus 1 .. .. .. .. .. .. .. .. .. .. .. .. 1 .. .. .. .. .. 1 .. .. 1 .. 1 Locomotor Ataxy .. .. .. .. .. .. 1 1 4 1 3 .. .. .. 10 .. 2 .. 2 3 .. 3 9 1 10 Paraplegia .. .. .. 1 .. .. 1 1 2 4 11 14 .. .. 34 4 4 2 3 4 6 11 13 21 34 Other forms, Brain Diseases 1 1 .. .. 1 1 5 2 3 3 2 3 .. 2 20 1 3 1 1 6 6 4 8 14 22 Otitis 4 3 1 1 1 2 2 1 .. .. .. .. .. 7 8 1 2 .. 3 4 5 .. 7 8 l5 Diseases of Nose Epistaxis 1 .. .. .. .. .. .. .. .. .. .. .. .. 1 .. .. .. 1 .. .. .. .. 1 .. 1 Disease of Eye 1 .. .. .. .. .. .. .. .. .. .. .. .. 1 .. .. .. .. .. 1 .. .. .. 1 1 Percicarditis .. .. 1 1 .. .. 1 1 .. .. .. .. .. .. 4 1 .. .. .. 2 .. 1 3 1 4 1 Endocarditis .. .. 2 .. 1 2 1 3 .. .. .. .. .. .. 9 2 1 .. 1 2 2 1 3 6 9 Hypertrophy of Heart .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Angina Pectoris .. .. .. .. .. .. .. .. .. .. 4 1 .. .. 5 .. .. 2 1 .. 1 1 4 1 5 1 Aneurism .. .. .. .. 1 .. .. 1 3 1 1 .. .. .. 7 .. 1 .. .. 1 4 1 6 1 7 4 Senile Gangrene .. .. .. .. .. .. .. .. .. 1 1 5 2 .. 9 .. .. .. 2 4 3 .. 6 3 9 10 Embolism, Thrombosis .. .. .. .. .. .. 1 3 2 5 7 4 1 .. 23 1 2 2 6 3 3 6 11 12 23 Phlesbitis .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Varicose Veins .. .. .. .. .. .. .. .. 1 .. .. .. .. .. 1 .. .. .. .. .. 1 .. .. 1 1 137 Other Diseases, Heart and Vessels 11 4 3 12 13 13 20 41 88 116 115 76 21 15 518 50 57 44 67 8b yy 130 218 315 533 Laryngitis 4 5 .. .. .. .. .. .. .. 1 .. .. .. 9 1 1 1 .. 3 .. 4 1 6 4 10 Croup .. 1 .. .. .. .. .. .. .. .. .. .. .. 1 .. .. .. .. .. .. .. 1 1 .. 1 Other Diseases, Larynx and Travhea 2 .. .. .. .. .. .. .. .. .. .. .. .. 2 .. .. 1 .. .. 1 .. .. .. 2 2 20 Acute Bronchitis 86 33 1 .. .. .. 4 6 8 8 17 17 3† 119 64 16 20 15 24 30 32 46 100 83 183 69 Chronic Bronchitis 4 5 1 .. .. 1 5 13 26 56 79 60 20 9 261 19 12 28 30 43 54 84 126 144 270 1 Lobar Pneumonia 1 .. .. 1 1 .. 2 3 3 2 .. 1 .. 1 13 .. 2 1 1 1 6 3 9 5 14 Lobular Pneumonia 1 .. .. .. .. .. .. .. .. .. .. .. .. 1 .. .. .. .. .. 1 .. .. 1 .. 1 40 Pneumonia 107 86 7 2 2 8 21 21 23 20 24 13 5 193 146 25 40 36 45 37 77 79 195 144 339 3 Emphysema, Asthma .. 1 .. .. .. .. 1 .. 3 7 5 5 .. l 21 5 4 1 3 3 2 4 9 13 22 4 Pleurisy 1 2 .. .. .. 1 2 3 3 3 2 3 .. 3 17 1 2 1 1 6 2 7 15 5 20 5 Other Diseases, Respiratory System .. 2 1 .. 1 .. 2 2 .. 2 1 1 .. 2 10 2 .. 1 1 3 1 4 7 5 12 Diseases of Month and Annexa .. .. 3 .. .. .. .. .. .. .. .. .. .. .. 3 .. .. .. 1 1 .. 1 1 2 3 Diseases of Pharynx 2 .. .. .. .. .. .. .. .. .. .. .. .. 2 .. .. 1 1 .. .. .. .. 1 1 2 Diseases of Œsophagus .. .. .. .. .. .. .. .. .. 2 1 1 .. .. 4 .. 1 .. .. 1 2 .. 4 .. 4 Ulcer of Stomach and Duodenum 1 .. .. 1 1 3 6 6 4 2 .. .. 1 1 24 6 2 1 3 3 3 7 10 15 25 Other Diseases of Stomach 22 2 .. .. .. .. 3 .. 4 1 2 2 .. 1:4 12 10 5 3 2 9 4 3 20 lb 36 Enteritis 46 7 .. .. 1 .. .. 3 .. .. 3 3 .. 53 10 3 6 2 7 12 20 13 37 26 63 Appendicitis 1 4 3 4 7 5 3 2 1 2 .. .. 1 31 1 3 2 2 6 5 7 16 16 32 Obstruction of Intestine 11 1 .. .. 1 2 1 1 1 4 7 2 12 20 5 5 3 4 4 2 9 l6 l6 32 Other Diseases of Intestine 2 2 .. .. 1 .. 1 1 .. .. .. .. .. 4 3 2 .. .. 1 2 1 1 2 5 7 5 Cirrhosis of Liver .. .. .. .. .. .. 2 5 9 11 8 1 .. .. 36 2 3 4 6 6 5 10 22 14 36 Other Diseases of Liver 3 .. .. .. .. .. 2 2 1 3 4 2 1 3 15 2 1 1 1 3 4 6 14 4 18 Peritonitis 1 1 ft 4 2 1 3 2 12 2 1 1 5 9 14 Other Diseases, Digestive System .. 1 .. .. .. .. .. 1 .. .. .. 1 .. 1 2 .. 1 1 .. 1 .. .. .. 3 3 Diseases, Lymphatic System and Glands 1 .. .. .. 1 1 2 .. 1 2 3 .. .. 1 10 1 1 1 1 4 1 2 4 7 11 Acute Nephritis .. .. 2 .. .. .. 2 5 2 1 4 1 .. .. 17 5 1 1 3 5 .. 2 12 5 17 1 Bright's Disease .. 1 1 .. 2 1 10 11 23 29 15 10 .. 1 103 8 17 10 l6 19 17 17 5b 48 104 Calculus .. .. .. .. .. 1 .. .. 1 .. 1 .. .. .. 3 .. .. 1 .. 1 .. 1 .. 3 3 Diseases of Bladder and Prostate .. .. .. .. .. 1 .. .. .. 3 8 4 .. .. 16 1 1 1 2 2 4 5 15 1 l6 Other Diseases, Urinary System .. 1 .. .. .. .. 1 1 3 1 2 3 .. 1 11 3 .. 2 3 1 3 .. 5 7 12 Diseases of testis and Penis .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Diseases of Ovaries .. .. .. .. .. 2 2 .. 1 2 1 .. .. .. 8 2 1 1 1 2 .. 1 .. 8 8 Diseases of Uterus and dages .. .. .. .. .. .. 1 4 .. 1 1 .. .. .. 7 .. .. .. 1 3 1 2 .. 7 7 Diseases of Vagina and External Genitals .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Diseases of Breast .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Abortion, Miscarriage .. .. .. .. .. 1 .. 1 .. .. .. .. .. .. 2 .. .. .. .. 1 .. 1 .. 2 2 Puerperal Mania .. .. .. .. .. 1 .. .. .. .. .. .. .. .. 1 .. .. .. .. 1 .. .. .. 1 1 Puerperal Convulsions .. .. .. .. .. 2 .. 1 .. .. .. .. .. .. 3 .. 2 .. .. 1 .. .. .. 3 3 1 Placenta Prævia, Flooding 1 .. .. .. .. .. 2 1 .. .. .. .. .. 1 3 .. 1 .. 2 .. 1 .. .. 4 4 + One female at workhouse aged 104. * One female inhabitant aged 104. 254 1903] Table A.—Continued. Deaths in Institutions within Borough. DISEASES. AGES. Under 5. Over 5. DISTRICTS. Males. Females. Totals. 0- 1- 5- 10- 15- 20 25- 35- 45- 55- 65- 75- 85- Tuf. U.H. Toll. L.H. H. B. S.B. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Other Diseases, Pregnancy and Childbirth 3 .. .. .. .. 1 2 2 .. .. .. .. .. 3 5 2 .. I 1 2 .. 2 2 6 8 Arthritis, Ostitis, Periostitis 1 .. .. .. .. .. .. .. 1 .. 3 .. .. 1 4 .. .. 1 1 2 .. 1 2 3 5 Other Diseases, Osscous System .. .. 1 1 1 1 .. 2 2 1 1 1 .. .. 11 .. 2 .. .. 4 1 4 3 8 11 Ulcer, Bedsore .. .. .. .. .. .. .. .. .. 1 2 1 .. .. 4 1 2 .. .. .. 1 .. 2 2 4 Eczema 3 .. .. .. .. .. .. .. .. .. .. .. .. 3 .. 1 .. .. .. 1 1 .. 2 1 3 Pemphigus 3 .. .. .. .. .. .. .. .. .. .. .. .. 3 .. .. .. .. 1 2 .. .. 1 2 3 Other Diseases, Integumentary System 2 1 .. .. 1 .. .. 1 .. .. 1 .. .. 3 3 1 .. 2 .. 2 1 .. 4 2 6 Accidents and Negligence. In Mines and Quarries .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 2 In Vehicular Traffic .. 2 .. 1 1 1 1 4 2 1 .. .. .. 2 11 .. 3 1 .. 3 4 2 12 1 13 On Railways .. .. .. .. .. .. .. 3 2 1 .. .. .. .. 6 1 1 .. 1 .. 3 .. 6 .. 6 On Ships, Boats, etc. (not drowning) .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. In Building Operations .. .. .. .. .. .. 1 .. .. 1 .. .. .. .. 2 .. 1 .. .. .. 1 .. 2 .. 2 1 By Machinery .. .. .. .. .. .. .. 1 .. .. .. .. .. .. 1 .. .. 1 .. .. .. .. 1 .. 1 By Weapons and Implements. .. .. .. .. 1 .. .. .. .. .. .. .. .. .. 1 .. .. .. .. 1 .. .. 1 .. 1 4 Burns and Scalds 2 8 1 .. 2 .. 3 3 2 .. .. 2 .. 10 13 .. 5 1 3 4 4 6 8 15 23 1 Poisons, Poisonous Vapours .. .. .. .. 1 .. 1 .. .. 1 .. 1 .. .. 4 1 2 .. .. .. .. 1 3 1 4 1 Surgical Narcosis .. .. 1 .. .. .. .. .. .. 2 .. .. .. .. 3 .. 1 .. .. .. 1 1 2 1 3 Effects of Electric Shock .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Corrosions by Chemicals .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Drowning .. 1 2 .. .. .. .. .. .. .. .. .. .. 1 2 .. .. .. .. .. 2 1 2 1 3 Suffocation, Overlaid in Bed 30 .. .. .. .. .. .. .. .. .. .. .. .. 30 .. 1 1 6 1 3 8 10 17 13 30 Otherwise 5 1 .. .. .. 2 .. 1 .. 1 .. .. .. 6 4 .. .. .. 2 2 2 4 7 3 10 11 Falls not specified 2 2 2 .. .. 1 2 4 5 5 3 6 1 4 29 3 2 3 5 5 6 9 19 14 33 Weather Agencies .. .. .. .. .. .. .. .. .. 1 .. .. .. .. 1 1 .. .. .. .. .. .. .. 1 1 1 Otherwise, not stated 2 .. 1 .. .. .. 1 1 .. .. .. .. .. 2 3 .. .. .. 1 .. 2 2 5 .. 5 Homicide 7 .. .. .. .. .. .. .. .. .. .. .. .. 7 .. 1 2 .. .. 1 1 2 5 2 7 Suicide. 2 By Poison .. .. .. .. .. 1 3 3 9 3 .. .. .. .. 19 4 1 1 1 3 5 4 14 5 19 By Asphyxia .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. By Hanging and Strangulation .. .. .. .. .. .. 1 .. 3 2 .. .. 1 .. 7 .. 1 1 1 .. 2 2 6 1 7 By Drowning .. .. .. .. 1 .. .. 2 3 1 .. .. .. .. 7 1 1 .. .. .. 3 2 4 3 7 By Shooting .. .. .. .. .. .. 1 .. .. .. .. .. .. .. 1 .. .. .. .. .. 1 .. 1 .. 1 By Cut or Stab .. .. .. .. .. .. 3 3 1 1 .. .. .. .. 8 .. 2 .. .. .. 2 4 6 2 8 By Precipitation from Elevated Places .. .. .. .. .. .. .. 1 .. .. .. .. .. .. 1 1 .. .. .. .. .. .. .. 1 1 1 By Crushing .. .. .. .. .. .. .. 2 1 .. .. .. .. .. 3 .. .. 1 .. 1 .. 1 2 1 3 By other and unspecified .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 1 Execution .. .. .. .. .. .. 1 .. 1 .. .. .. .. .. 2 .. .. .. 1 .. .. 1 1 1 2 Sudden Death, cause not tained .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Ill-defined and unspecified causes .. .. .. .. .. .. .. .. 1 1 3 .. .. .. 5 .. .. 2 .. 2 1 .. 2 3 5 Males 678 272 55 18 34 52 62 194 291 282 257 186 42 950 1573 205 281 202 333 405 489 608 .. .. 2523 Females 458 266 43 23 47 68 37 196 200 251 120 237 70 724 1592 235 294 235 285 391 410 506 .. .. 2316 594 TOTAL DEATHS 1136 538 98 41 81 120 299 390 191 >33 77 123 12 1674 3165 440 535 137 618 796 899 1114 2523 2316 4839 255 [1903 Table B. Showing the Deaths from All Causes registered during the Quarters of the Year 1903 at three periods of life. CAUSES OF DEATH. 1st Quarter. Total. 2nd Quarter- Total. 3rd Quarter. Total. 4 th Quarter. Total. Total for Year. Under 1 1 to 5 Over 5 Under 1 1 to 5 Over 5 Under 1 1 to 5 Over 5 Uuder 1 1 to 5 Over 5 Small Pox— (a) Vaccinated .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. (b) Unvaccinated .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. (c) No Statement .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Measles 7 28 .. 35 14 49 1 b4 6 11 .. 17 2 2 .. 4 120 Scarlet Fever 1 4 4 9 .. .. 2 2 .. 5 3 8 .. 3 2 5 24 Typhus Fever .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Epidemic Influenza .. 1 29 30 .. .. 3 3 .. .. 1 1 1 1 4 6 40 Whooping Cough 43 44 l 88 8 32 2 42 7 7 l 15 5 2 .. 7 152 Diphtheria 1 8 11 20 2 7 2 11 .. 4 2 6 l 3 2 6 43 Enteric Fever .. .. 7 7 .. .. 2 2 .. .. 4 4 .. 1 8 9 22 Asiatic Cholera .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Diarrhœa Desentery 6 3 .. 9 3 2 3 8 25 6 3 34 10 4 1 15 66 Epidemic Enteritis .. 1 .. 1 2 .. .. 2 30 1 .. 31 7 2 .. 9 43 Other Allied Diseases .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Hydrophobia .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Glanders .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Tetanus .. .. .. .. .. .. .. .. 1 .. .. 1 .. .. .. .. 1 Anthrax .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Cow Pox .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Syphilis 2 1 1 4 4 .. 4 8 3 .. 1 4 1 .. 1 2 18 Gonorrhoea .. .. .. .. .. .. .. .. .. .. 1 1 .. .. .. .. 1 Phagedæna .. .. .. .. .. .. 1 1 .. .. .. .. .. .. .. .. 1 Erysipelas 2 .. .. 7 .. .. 1 1 .. .. 1 1 2 .. 3 5 9 Puerperal Fever .. .. 3 3 .. .. 4 4 .. .. .. .. .. .. 2 2 9 pyæmia 1 .. 4 5 .. .. 1 1 .. .. 1 1 1 .. 3 4 11 Infective Endocarditis .. .. 2 2 .. .. .. .. .. .. 1 1 .. .. 1 1 4 Other Allied Diseases 1 1 2 4 2 .. 4 6 2 .. .. 2 .. .. .. .. 12 Malarial Fever .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Rheumatic Fever .. .. 2 2 .. .. 6 6 .. .. 3 3 .. .. 5 5 16 Rheumatism of Heart .. .. 3 3 .. .. 2 2 .. .. 1 1 .. .. .. .. 6 Tuberculosis of Brain 5 10 4 19 7 12 3 22 5 5 2 12 3 9 6 18 71 Tuberculosis of Larynx .. .. 1 1 .. .. 3 3 .. .. 2 2 .. .. 1 1 7 Phthisis 5 6 97 108 3 3 122 128 2 3 112 117 6 1 132 139 492 Abdominal Tuberculosis 4 5 .. 9 3 8 .. 11 6 1 2 9 7 1 3 11 40 General Tuberculosis .. 2 1 5 2 2 .. 4 1 1 4 6 1 2 1 4 19 Other Forms Tuberculosis .. .. 1 l .. .. .. .. .. 1 .. 1 .. .. 1 1 3 Other Infective Diseases .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Thrush 1 .. .. l .. .. .. .. .. .. .. .. .. .. .. .. 1 Actinomycosis .. .. .. .. .. .. 1 1 .. .. .. .. .. .. .. .. 1 Hydatid Diseases .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Dcurvy Diseases .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Other Diseases due to Altered Food .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Acute Alcoholism .. .. 1 l .. .. 1 1 .. .. .. .. .. .. 1 1 3 Chronic Alcoholism .. .. 8 8 .. .. 1 1 .. .. 7 7 .. .. 7 7 23 Chronic Industrial Poisonings .. .. .. .. .. .. .. .. .. .. 1 1 .. .. .. .. 1 Other Chronic Poisonings .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. • • Osteo-arthritis .. .. 4 4 .. .. 8 8 .. .. 2 1 .. .. 1 1 15 Gout .. .. 1 1 .. .. 3 3 .. .. .. .. .. .. 2 2 6 Cancer .. .. 90 90 .. 1 81 82 .. 1 93 97 1 1 79 81 350 Diabetes Mellitus .. .. 3 3 .. .. 11 11 .. .. 7 7 .. .. 5 5 26 Purpura Hemorrhagica .. .. .. .. .. .. 1 1 .. .. .. .. .. .. .. .. 1 Haemophilia .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Anæmia .. .. 2 2 .. .. 1 1 .. .. 3 3 .. .. 2 2 8 Lymphadenoma .. .. .. .. .. .. .. .. .. .. 1 1 .. .. .. .. 1 Premature Birth 54 .. .. 54 52 .. .. 52 33 .. .. 33 35 .. .. 35 174 Injury at Birth .. .. .. .. 1 .. .. 1 .. .. .. .. .. .. .. .. 1 Debility at Birth 9 .. .. 9 7 .. .. 7 11 .. .. 11 11 .. .. 11 38 Atelectasis 5 .. .. 5 4 .. .. 4 6 .. .. 6 3 .. .. 3 18 Congenital Defects 5 1 .. 6 8 .. .. 8 11 .. .. 11 5 .. .. 5 30 Want of Breast Milk .. .. .. .. 1 .. .. 1 3 .. .. 3 3 .. .. 3 7 Atrophy, Debility, Marasmus 32 5 .. 37 28 1 .. 29 32 3 .. 35 53 2 .. 55 156 256 1903] Table B.—Continued. CAUSES OF DEATH. 1st Quarter. Total. 2nd Quarter Total. 3rd Quarter. Total. 4th Quarter- Total Total for Year Under 1 1 to 5 Over 5 Under 1 1 to 5 Over 5 Under 1 1 to 5 Over 5 Under 1 1 to 5 Over 5 Dentition 6 4 .. 10 5 3 .. 8 2 7 .. 9 b 1 .. 6 33 Rickets 1 3 .. 4 .. 2 .. 2 .. 1 .. 1 .. 2 .. 2 9 Old Age, Senile Decay .. .. 42 42 .. .. 49 49 .. .. 56 36 .. .. 52 52 179 Convulsions 18 1 .. 19 14 .. .. 14 3 2 1 6 12 4 .. 16 55 Meningitis 3 2 4 9 4 2 3 9 8 4 1 13 3 4 3 10 41 Encephalitis .. .. 1 1 .. .. 1 1 .. .. .. .. .. .. 1 1 3 Apoplexy .. .. 19 19 .. .. 16 16 .. .. 10 10 .. .. 16 16 61 Softening of Brain .. .. 3 3 .. .. 3 3 .. .. 7 7 .. .. 9 9 22 Hemiplegia .. .. 9 9 .. .. 11 11 .. .. 4 4 .. .. 8 8 32 General Paralysis of Insane .. .. 7 7 .. .. 7 7 .. .. 3 3 .. .. 11 11 28 Other forms of Insanity .. .. 7 7 .. .. 7 7 .. .. 3 3 .. .. 2 2 19 Chorea .. .. .. .. .. .. 1 1 .. .. .. .. .. .. 1 1 2 Cerebral Tumour .. 1 1 2 .. .. 2 2 .. .. 2 2 .. .. 1 1 7 Epilepsy .. .. .. .. .. .. 2 2 .. .. 5 5 .. .. 4 4 11 Laryngismus Stridulus .. .. .. .. .. .. .. .. 1 .. .. 1 .. .. .. .. 1 Locomotor Ataxy .. .. 2 2 .. .. 4 4 .. .. 1 1 .. .. 3 3 10 Paraplegia .. .. 14 14 .. .. 8 8 .. .. 8 8 .. .. 4 4 34 Other forms, Brain Diseases 1 .. 5 6 .. 1 4 5 .. .. 5 5 .. .. 6 6 22 Otitis 4 .. 2 6 .. 1 4 5 .. 1 1 2 .. 1 1 2 l5 Disease of Nose, Epistaxis 1 .. .. 1 .. .. .. .. .. .. .. .. .. .. .. .. 1 Disease of Eye 1 .. .. 1 .. .. .. .. .. .. .. .. .. .. .. .. 1 Pericarditis .. .. .. .. .. .. 2 2 .. .. 1 1 .. .. 1 1 4 Endocarditis .. .. 3 3 .. .. 5 5 .. .. 1 1 .. .. .. .. 9 Hypertrophy of Heart .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Angina Pectoris .. .. 1 1 .. .. 2 2 .. .. 1 1 .. .. 1 1 5 Aneurism .. .. 4 4 .. .. 1 1 .. .. 1 1 .. .. 1 1 7 Senile Gangrene .. .. 1 1 .. .. 3 3 .. .. 2 2 .. .. 3 3 9 Embolism, Thrombosis .. .. 6 6 .. .. 6 6 .. .. 6 6 .. .. 5 5 23 Phlebitis .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Varicose Veins .. .. 1 1 .. .. .. .. .. .. .. .. .. .. .. .. 1 Other Diseases, Heart and Vessels 1 2 128 131 4 .. 141 145 4 1 110 l15 2 1 139 142 533 Laryngitis .. 2 1 3 1 2 .. 3 .. .. .. .. 3 1 .. 4 10 Croup .. 1 .. 1 .. .. .. .. .. .. .. .. .. .. .. .. 1 Other Diseases. Larynx and Trachea 1 .. .. 1 1 .. .. 1 .. .. .. .. .. .. .. .. 2 Acute Bronchitis 26 19 29 74 11 6 11 28 7 2 12 21 42 6 12 60 183 Chronic Bronchitis .. 2 108 110 .. 1 49 50 .. .. 32 32 4 2 72 78 270 Lobar Pneumonia .. .. 4 4 .. .. 3 3 .. .. 4 4 1 .. 2 3 14 Lobular Pueumonia .. .. .. .. 1 .. .. 1 .. .. .. .. .. .. .. .. 1 Pneumonia 30 34 44 108 23 23 43 89 12 11 27 50 42 18 32 92 339 Emphysema, Asthma .. .. 1 1 .. .. 7 7 .. .. 4 4 .. 1 9 10 22 Pleurisy .. .. 4 4 .. 1 3 4 .. .. 2 2 1 1 8 10 20 Other Diseases, Respiratory System .. .. 5 5 .. .. 2 2 .. 1 1 2 .. 1 2 3 12 Diseases of Mouth and Anntxa .. .. 2 2 .. .. .. .. .. .. .. .. .. .. 1 1 3 Diseases of Pharynx 2 .. .. 2 .. .. .. .. .. .. .. .. .. .. .. .. 2 Diseases of Œsophagus .. .. .. .. .. .. 2 2 .. .. .. .. .. .. 2 2 4 Ulcer of Stomach and Duodenum .. .. 8 8 1 .. 8 9 .. .. 1 1 .. .. 7 7 25 Other Diseases of Stomach 6 .. 3 9 4 .. 1 5 4 .. 3 7 8 2 5 15 36 Enteritis 14 3 2 19 8 2 3 13 18 1 4 23 6 1 1 8 63 Appendicitis .. .. 5 5 .. 1 7 8 .. .. 9 9 .. .. 10 10 32 Obstruction of Intestine 5 .. 2 7 3 .. 9 12 2 1 5 8 1 .. 4 5 32 Other Diseases of Intestine .. .. .. .. .. 1 2 3 2 .. .. 2 .. 1 1 2 7 Cirrhosis of Liver .. .. 3 3 .. .. 10 10 .. .. 13 13 .. .. 10 10 36 Other Diseases of Liver .. .. 3 3 .. .. 4 4 1 .. 6 7 2 .. 2 4 18 Peritonitis. 1 .. 2 3 .. .. 4 4 .. 1 3 4 .. .. 3 3 14 Other Diseases, Digestive System .. .. .. .. .. .. .. .. .. .. .. .. .. 1 2 3 3 Diseases. Lymphatic System Glands 1 .. 4 5 .. .. 2 2 .. .. 1 1 .. .. 3 3 11 Acute Nephritis .. .. 4 4 .. .. 7 7 .. .. 6 6 .. .. .. .. 17 Bright's Disease .. .. 22 22 .. .. 28 28 .. .. 29 29 .. 1 24 25 104 Calculus .. .. .. .. .. .. 2 2 .. .. .. .. .. .. 1 1 3 Diseases of Bladder and Prostate .. .. 6 6 .. .. 2 2 .. .. 5 5 .. .. 3 3 16 Other Diseases, Urinary System .. 1 5 6 .. .. 4 4 .. .. 1 1 .. .. 1 1 12 Diseases of Testis and Penis .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Diseases of Ovaries .. .. 2 2 .. .. 1 1 .. .. 1 1 .. .. 4 4 8 Diseases'of Uterus and Appendages .. .. 3 3 .. .. 2 2 .. .. 2 2 .. .. .. .. 7 Dis. of Vagina and External Genitals .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Diseases of Breast .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Abortion, Miscarriage .. .. .. .. .. .. .. .. .. .. 2 2 .. .. .. .. 2 Puerperal Mania .. .. .. .. .. .. 1 1 .. .. .. .. .. .. .. .. 1 Puerperal Convulsions .. .. .. .. .. .. .. .. .. .. 1 1 .. .. 2 2 3 Placenta Prævia, Flooding .. .. 1 1 1 .. .. 1 .. .. 1 1 .. .. 1 1 4 Puerperal Thrombosis .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Other Dis., Pregnancy and Childbirth. .. .. 1 1 1 .. 2 3 2 .. 1 3 .. .. 1 1 8 Arthritis, Ostitis, Periostitis .. .. 4 4 .. .. .. .. .. .. .. .. 1 .. .. 1 5 Other Diseases. Osseous System .. .. 2 2 .. .. 3 3 .. .. 4 4 .. .. 2 2 11 Ulcer, Bedsore .. .. 1 1 .. .. .. .. .. .. 1 1 .. .. 2 2 4 257 [1908 Table B.—Continued. CAUSES OF DEATH. 1st Quarter Total. 2nd Quarter. Total. 3rd Quarter. Total. 4th Quarter. Total. Total for Year Under 1 1 1 to 5 Over 5 Under 1 1 to 5 Over 5 | Under 1 1 to 5 Over 5 Under 1 | 1 to 5 Over 5 | Eczema ... ... ... ... 1 ... ... 1 1 ... ... 1 1 ... ... 1 3 Pemphigus ... ... ... ... ... ... ... ... 3 ... ... 3 ... ... ... ... 3 Other Diseases, Integumentary System 1 1 ... 2 1 ... 1 2 ... ... ... ... ... ... 2 2 6 Accidents and Negligence. In mines and Quarries ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... In Vehicular Traffic ... ... 1 1 ... 1 1 2 ... 1 5 6 ... ... 4 4 13 On Railways ... ... ... ... ... ... 3 3 ... ... 1 1 ... ... 2 2 6 On Ships, Boats &c.(not drowning) ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... In Building Operations ... ... ... ... ... ... 1 1 ... ... ... ... ... ... 1 1 2 By Machinery ... ... ... ... ... ... ... ... ... ... 1 1 ... ... ... ... 1 By Weapons and Implements ... ... 1 1 ... ... ... ... ... ... ... ... ... ... ... ... 1 Burns and Scalds ... 2 7 9 ... ... 2 2 1 1 ... 2 1 5 4 10 23 Poisons, Poisonous Vapours ... ... 1 1 ... ... 1 1 ... ... 1 1 ... ... 1 1 4 Surgical Narcosis ... ... ... ... ... ... 1 1 ... ... 2 2 ... ... ... ... 3 Effects of Electric Shock ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Corrosions by Chemicals ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Drowning ... ... ... ... ... 1 ... 1 ... ... 2 2 ... ... ... ... 3 Suffocation, Overlaid in Bed 15 ... ... 15 5 ... ... 5 3 ... ... 3 7 ... ... 7 30 ,, Otherwise 3 ... ... 3 1 2 3 1 ... 1 2 1 ... 1 2 10 Falls not specified ... 1 8 9 2 1 10 13 ... ... 5 5 ... ... 6 6 33 Weather Agencies ... ... ... ... ... ... 1 1 ... ... ... ... ... ... ... ... 1 Otherwise, not stated 2 ... ... 9 ... ... 1 1 ... ... 1 1 ... ... 1 1 5 Homicide 2 ... ... 2 1 ... ... 1 3 ... ... 3 1 ... ... 1 7 Suicide. By Poison ... ... 4 4 ... ... 5 5 ... ... 5 5 ... ... 5 5 19 By Asphyxia ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... By Hanging and Strangulation ... ... ... ... ... ... 3 3 ... ... 2 2 ... ... 2 2 7 By Drowning ... ... 2 2 ... ... ... ... ... ... 4 4 ... ... 1 1 7 By Shooting ... ... ... ... ... ... ... ... ... ... 1 1 ... ... ... ... 1 By Cut or Stab ... ... 2 2 ... ... 3 3 ... ... 2 2 ... ... 1 1 8 By Precipitation from Elevated Places ... ... 1 1 ... ... ... ... ... ... ... ... ... ... ... ... 1 By Crushing ... ... 1 1 ... ... 1 1 ... ... ... ... ... ... 1 1 3 By Other and unspecified methods ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Execution ... ... 1 1 ... ... ... ... ... ... ... ... ... ... 1 1 2 Sudden Death, cause not ascertained ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Ill-defined and unspecified causes ... ... 1 1 ... ... 2 2 ... ... ... ... ... ... 2 2 5 Males 193 102 386 681 145 73 432 650 154 49 355 558 186 48 400 634 2523 Females 136 97 469 702 98 94 384 576 108 35 330 473 116 40 409 565 2316 TOTAL DEATHS 329 199 855 1383 243 167 816 1226 262 84 685 1031 302 88 809 1199 4839 258 1903 Table C. Showing the Population, Inhabited Houses, Marriages, Births and Deaths for the year 1903, and 10 years preceding. gross numbers. Year. Estimated Population. No. of Inhabited Houses. Marriages. Registered Births. Number of Deaths. Deaths of Residents ir. Public Institutions. Total all ages. Under one year. Under five 1 2 3 4 5 6 7 8 9 1903 339137 39,902 3,053 8,983 4,839 1,136 1,674 1,539 1893 326,958 38,595 2,653 9,749 6,391 1.595 2,498 1,128 1894 330,485 39,015 2,694 9,502 5,263 1,229 2,114 1,090 1895 334,058 39,440 2,680 9,879 5,760 1,416 2,219 1,245 1896 337,666 39,860 2,969 9,921 5,884 1,490 2,498 1,434 1897 337,197 40,079 3,000 9,842 5,395 1,338 2,017 1,295 1898 336,727 42,672 3,205 9,453 5,705 1,504 2,428 1,327 1899 336,259 42,973 3,254 9,658 6,293 1,548 2,315 1,586 1900 335,892 42,959 2,968 9.254 5,721 1,344 1,956 1,542 1901 335,325 38,645 2,994 9,264 5,36I 1,290 1,928 1,533 1902 337,268 39,766 3,108 9,214 5,635 1,219 1,906 1,646 Average of 10 years. 334,783 40,400 2,952 9,574 5,741 1,397 2,188 1,383 Notes.—i. Population of Census, 1901 = 334,991 = 159,290 Males. 175,701 Females. 2. Average number of persons in each house at Census, 1901 = 8'6. 3. Area of Parish in acres = 3,091 5. 4.Average number of Persons living on each acre at Census, 1901 = 108. 259 1908 Table D. Showing the Annual Birth and Death rates, Death rates of Children, and Deaths in Public Institutions per 1,000 Total Deaths, for the year 1903, and 10 years preceding. Year. Birth-rates per 1,000 of the population. Deathrates per 1,000 of the population. "Corrected Death-rates per 1,000 of the population. Deaths of Children under 1 year per 1,000 of Registered Births. Deaths of Children under 1 year per 1.000 of Total Deaths Deaths of Children under 5 years per 1,000 of Total Deaths. Deaths of Residents in Public Institutions per 1,000 ot Total Deaths. 1 2 3 4 5 6 7 8 1903 26 48 14.26 14.79 126 235 346 318 1893 29.8 19.5 209 I63 249 398 190 1894 28.7 15.9 17.0 129 233 401 207 1895 29.6 17.2 18.4 143 245 385 216 1896 28.8 17.1 18.6 !5° 253 424 244 1897 29.2 16.0 17.1 136 248 374 240 1898 28.1 16.9 18.1 159 264 425 233 1899 28.7 18.7 20.0 160 246 368 252 1900 27.5 17.0 l8.2 m5 235 342 269 1901 27.6 15.9 16.5 139 241 360 286 1902 26.8 16.4 17.0 132 216 338 292 Average of 10 years. 28.5 17.1 l8.2 146 243 381 243 •The Death Rates in column 4 are corrected for sex and age distribution for the purpose of contrasting them on an equal basis with those of England. 260 1903 LOCAL GOVERNMENT BOARD RETURN.—Table t. Table E. Metropolitan Borough of Islington. vital statistics of whole district during 1903 and previous years. Year. Population estimated to Middle of each Year. Births. Total Deaths Registered in the District. Total Deaths in Public Institutions in the District. DeathsofNonResidents registered in Public Institutions in the District. Deaths of Residents registered in Public Institutions beyond the District. Nett Deaths at all Ages belonging to the District Under 1 Year of Age. At all Ages. Number. Rate.* Number. Rate per 1,000 Births registered. Number. Death Rate.* Number. Death Rate.* 1 2 3 4 5 6 7 8 9 10 11 12 13 1893 326,958 9,749 29.8 1,595 163 6,317 19.3 1,128 458 532 6,391 19.5 1894 330,485 9,502 28.7 1 ,229 129 5,091 15.4 1,090 370 542 5.263 15..9 1895 334.058 9,879 29.6 1,416 14 5,733 17.2 1,245 497 524 5.760 17. 2 1896 337,666 9,921 28.8 1,490 150 5,749 16.7 1,43 523 658 5,884 17.1 1897 337.197 9,842 29.2 1,338 136 5,370 15 9 1,295 541 566 5.395 16.0 1898 336,727 9,453 28.1 1,504 !59 5,746 17,1 1,327 558 517 5.705 16.9 1899 336,259 9,658 28.7 1,548 160 6,395 19.0 1,586 695 593 6,293 18.7 1900 335,892 9,254 27.5 1,344 M5 5,767 17.2 1,542 599 553 5.721 17.0 1901 335,325 9,264 27.6 1,290 139 5,222 15 .6 1,394 491 630 5.361 15.9 1902 337,268 9,214 26.8 1,219 132 5,530 16.1 1,541 632 737 5.635 16.4 A v e r ages for yrs. 1 18931902/ 334,783 9.574 28.5 1,397 146 5,741 17.1 1,358 536 585 5.741 17.1 1903 339,137 8,983 26.5 1,136 126 4,772 14.1 1,472 560 627 4.839 14. 2 * Rates in Columns 4, 8 and 13 calculated per 1,000 of estimated population. Note—The deaths included in Column 7 of this table are the whole of those registered during the year as having actually occurred within the district or division. The deaths included in column 12 are the number in Column 7, corrected by the subtraction of the number in Column 10 and the addition of the number in Column 11. By the term "non-residents" is meant persons brought into the district on account of sickness or infirmity, and dying in public institutions there; and by the term "Residents" is meant persons who have been taken out of the district on account of sickness or infirmity, and have died in public institutions elsewhere. The "Public Institutions" to be taken into account for the purposes of these Tables are those into which persons are habitually received on account of sickness or infirmity, such as hospitals, workhouses, and lunatic asylums. Area of District in acres (exclusive of area covered by water) 3.085 Total population at all ages, 334,991 Number of inhabited houses, 38,645 Average number of persons per house, 8 6 At Census of 1901 LOCAL GOVERNMENT BOARD RETURN.—TABLE II. Metropolitan Borough of Islington.—TABLE F. VITAL STATISTICS OF SEPARATE LOCALITIES IN 1903 AND PREVIOUS YEARS. Names of Localities 1.—Upper Holloway. 2.-South-west. 3.—Highbury. 4.—South-East. 5.— 6. 7. Year. Population estimated to middle of each Year. Births registered. Deaths at all Ages. Deaths under 1 year. Population esttimated to middle of each Year. Births registered. Deaths at all Ages Deaths under 1 year. Population estimated to middle of each year. Births registered. Deaths at all Ages. Deaths under 1 year. Population estimated to middle of each year. Births registered. Deaths at all Ages. Deaths under 1 year. Population estimated to middle of each year. Births registered. Deaths at all Ages. Deaths under 1 year. Population estimated to middle of each year. Births registerod. Deaths at all Ages. Deaths under 1 year. Population estimated to middle of each year. Births registered. Deaths at all Ages. Deaths under I year. a. b. c. d. a. b. c. d. a. b. c. d. a. b. c. d. a. b. c. d. a. b. c. d. a. b. c. d. 1890 89,049 2,740 2,059 105,290 3,311 2,007 58,399 1,452 1,234 - 63,805 1,916 898 - 1891 90,622 2,751 2,170 — 105,644 3,456 2,065 - 59,452 1,639 937 — 64,273 1,956 1,148 - 1892 92,201 2,753 2,158 — 105,999 3,385 1,813 - 60,509 1,542 952 - 64,742 1.872 1,152 - 1893 93,801 2,768 1,702 409 106,359 3,386 2,303 647 61,581 1,601 1,008 219 65,217 1,994 1,378 320 1891 95,411 2,698 1,458 326 106,721 3,301 1,859 464 62,658 1,608 865 183 65,695 1,895 1,081 256 1895 97,041 2,779 1,564 400 107,088 3,475 2,023 527 63,750 1,621 939 211 66,179 2,004 1,234 278 1895 97,449 2,929 1,603 395 107,457 3,390 2,099 561 66,146 1,709 997 246 66,614 1,893 1,185 288 1897 97,879 2,904 1,481 347 107,332 3,289 1,855 502 66,283 1,657 886 217 65,703 1,992 1,173 272 1898 98,308 2,793 1,530 414 106,984 3,244 2,050 576 66,417 1,578 931 214 65,018 1,838 1,164 300 1899 98,736 2,792 1,698 407 106,397 3,269 2,184 590 66,520 1,651 1,093 238 64,606 1,946 1,318 313 Averages of Years 1890 to 1899 95,047 2,790 1,742 385 106,527 3,350 2,025 552 63,171 1,605 984 218 65,185 1,930 1,176 289 Upper Holloway. Lower Holloway Highbury. Barnsbury. South-East. 1900 99,071 2,699 1,635 375 41,618 1,170 738 181 62,092 1,551 932 186 55,445 1,782 1,004 265 77,666 2,052 1,412 337 1901 100,099 2,707 1,454 318 41,433 1,179 688 193 59,540 1,463 898 202 54,457 1,788 1,033 253 79,796 2,127 1,288 324 Tufnell. Upper Holloway. Tollington. Lower Holloway. Highbury. Barnsbury. South-East. 1902 32,58 745 491 93 34,442 1,131 605 117 34,385 849 527 122 41,486 1,122 714 175 64,519 1,488 945 169 54,368 1,757 1040 266 75,610 2,122 1,313 277 1903 32,38 740 440 83 34,822 1,108 535 138 34,765 850 437 105 41,537 1,126 618 159 65,112 1,460 796 178 54,278 1,648 899 210 75,785 2,051 1,114 263 Notes.-(a) The separate localities adopted for this Table should be areas of which the populations are obtainable from the census returns, such as wards, parishes or groups of parishes, or registration sub-districts. Block 1 may, if desired, be used for the whole district; and blocks 2, 3, &c., for the several localities. In small districts without recognised divisions of known population this Table need not be filled up. (b) Deaths of residents occurring in public institutions beyond the district are to be included in sub-column c of this Table, and those of non-residents registered in public institutions in the district excluded. (See note on Table I. as to meaning of terms "resident" and "non-resident.") (c) Deaths of residents occurring in public institution whether within or without the district are to be allotted to the respective localities, according to the addresses of the deceased. (d) Care should be taken that the gross totals of the several columns in this Table respectively equal the corresponding totals for the whole districts in Tables I. and IV. : thus, the totals of sub-columns a, b, and c should agree with the figures for the year in the columns 2, 3, and 12 respectively of Table I : the gross total of the sub-columns c should agree with the total of column 2 in Table IV., and the gross total of sub-columns d with the total of column 3 in Table IV. 261 [1903 LOCAL GOVERNMENT BOARD RETURN.—Table IV. Table G. Metropolitan Borough of Islington. causes of, and ages at, death during year, 1903. Deaths in or belonging to whole District at subjoined Ages. Deaths in or belonging to Localities (at all Ages). Total Deaths in Public Institutions in the District. Causes of Death. All ages. Under 1 yr. 1 and under 5. 5 and under 15. 15 and under 25. 26 and under 65. 65 and "p. wards Tufnell. Upper Holloway. Tollington. Lower Holloway. Highbury. Barnsbury. South-East Islington. 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 Small-pox .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Measles i20 29 90 1 .. .. .. 9 4 3 22 22 41 19 12 Scarlet Fever 24 1 12 9 1 1 .. 4 1 3 4 6 5 1 .. Whooping Cough 152 63 85 4 .. .. .. 12 20 24 24 19 24 29 15 Diphtheria and Mem branous Croup 43 4 22 14 1 2 .. 4 3 4 14 2 10 6 4 Croup Fever 1 .. 1 .. .. .. .. .. .. .. .. .. .. 1 .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Enteric 22 .. 1 3 5 13 .. 3 .. 2 2 7 6 2 .. Other continued 1 .. .. 1 .. .. .. 1 .. .. .. .. .. .. .. Epidemic Influenza 40 1 2 1 2 25 9 4 4 3 2 9 7 11 2 Cholera .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Plague .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Diarrhœa 109 83 19 .. .. 3 4 8 11 17 19 10 17 27 6 Enteritis 61 46 7 .. 1 3 6 3 6 2 7 12 20 13 .. Puerperal Fever 9 .. .. .. 3 6 .. 1 3 .. 2 2 .. 1 3 Erysipelas 9 4 .. .. .. 3 2 1 .. 2 1 1 2 2 1 Other Septic Diseases 26 7 1 .. 3 11 4 2 3 2 6 3 5 5 4 Phthisis 492 16 13 13 66 361 23 47 58 43 72 70 85 117 128 Other Tubercular Diseases 140 44 59 18 7 11 1 11 14 15 24 21 23 32 9 Cancer, Malignant Disease 350 1 3 3 7 218 118 33 35 31 30 71 66 84 69 Bronchitis 453 90 38 2 1 126 196 35 32 43 54 73 86 130 89 Pneumonia 354 109 86 10 11 05 43 2.5 42 37 46 39 83 82 41 Pleurisy 20 1 2 .. 1 11 5 1 2 1 1 6 2 7 4 Other Diseases of Respiratory Organs 44 4 8 1 1 18 12 8 5 2 7 6 7 9 8 Alcoholism Cirrhosis of Liver 62 .. .. .. .. 51 11 6 5 6 10 11 9 15 10 Venereal Diseases 19 10 1 1 .. 7 .. 3 5 2 2 1 2 4 7 Premature Birth 174 174 .. .. .. .. .. 9 17 14 20 36 33 45 1 Diseases and Accidents of Parturition 33 4 .. .. 7 20 2 4 4 2 5 10 2 6 1 Heart Diseases 591 11 4 19 30 289 238 54 61 48 77 98 113 140 153 Accidents 135 41 14 8 9 50 13 7 16 12 13 18 33 36 21 Suicides 46 .. .. .. 2 43 1 6 5 3 2 4 13 13 3 All other causes 1307 393 70 31 43 346 424 139 179 116 152 239 205 277 321 All causes 4839 1136 538 139 201 1713 1112 440 535 437 618 796 899 1114 912 262 t—i CO 0 co 1 i Table h. Showing the Births, Deaths, Infantile Mortality, the Deaths from the Principal Zymotic Diseases, and from Influenza Cancer, Phthisis, and Puerperal Fever occurring in the Year 1903, and during the Years 1893-1902. Year. Births. Birth-rates. Deaths. Death-rates. Deaths of Infants under 1 year of age. Deaths under 1 year to 1,000 Births. Deaths from the Principal Zymotic Diseases. Total Zymotic Death-rates. Influenza. Cancer. Phthisis. Puerperal Fever Totals. Small Pox. Measles. Scarlet Fever. Diphtheria. Whooping Cough. Typhus Fever. Enteric Fever. Simple and undefined Fevers. Diarrhceal Diseases. Deaths. Death-rates. Deaths. Death-rates. Deaths. Death-rates. Deaths. Deaths in 1,000 births. 1893 9,749 29.8 6,391 19.5 1,595 163 884 2 119 94 200 181 1 48 2 237 2.70 123 0.37 238 0.73 560 1.71 13 1.33 1894 9,502 28.7 5,263 15.9 1,229 129 808 3 199 69 218 188 .. 36 .. 95 2.44 51 0.15 239 0.72 539 1.63 8 0.84 1895 9,879 29.6 5,760 17.2 1,416 143 650 1 135 66 144 81 1 30 3 189 1.94 179 0.53 266 0.79 568 1.70 12 1.21 1896 9,921 28.8 5,884 17.1 1,490 150 1038 1 288 57 257 234 .. 46 2 153 3.07 33 0.09 291 0.85 530 1.54 11 1.11 1897 9,842 29.2 5,395 16.0 1,338 136 638 1 97 61 131 130 .. 44 .. 174 1.89 47 0.14 304 0.90 520 1.54 10 1.01 1898 9,453 28.1 5,705 16.9 1,504 159 933 .. 325 26 93 168 1 36 1 283 2.77 65 0.19 283 0.84 527 1.56 7 0.74 1899 9,658 28.7 6,293 18.7 1,548 160 781 •• 155 33 128 160 .. 47 •• 258 2.32 126 0.37 270 0.80 583 1.73 14 1.45 1900 9,254 27.5 5,721 17.0 1,344 145 660 1 159 24 106 142 .. 46 2 180 1.96 149 0.44 303 0.90 602 1.79 6 0 .65 1901 9,264 27.6 5,361 15.9 1,290 139 628 8 151 30 134 85 •• 47 1 172 1.87 46 0.14 289 0.86 545 1.62 15 1.62 1902 9.214 26.8 5,635 16.4 1,219 132 608 53 114 40 104 152 .. 45 1 99 177 83 0.24 326 0.95 515 1.50 12 1.30 Corrected average. 9,699 28.6 5,816 17.1 1,415 146 773 7 176 51 154 154 •• 44 1 186 228 9l 0.27 285 0.84 556 1.64 11 1.13 1903 8,983 26.5 4,839 14.2 1,136 126 471 .. 120 24 43 152 .. 22 1 109 1 39 40 0 .12 350 1.03 492 1.45 9 1.00 Departure from average. -716 — 2.1 -977 -2.9 -279 — 20 -302 -7 -56 -27 -111 — 2 .. —22 •• -77 — o'8g -51 -0.15 + 65 +0.19 -64 — 0.19 — 2 -0.13 263 1903 Table I. Showing the deaths since 1882 from the several diseases specified, under and above five years of age, and the total number of deaths, with death-rate per 1,000. Year. Population in the middle of the year. Ages Deaths from the principal diseases of a Zymotic nature.* Deaths from Tubercular Diseases. Deaths from Diseases of the Respiratory Organs. Deaths from Diarrhcea. Deaths trom Diseases of the Digestive Organs. Deaths from Violence. Total Deaths Jeath Rate per 1,000. Total Total Total Total Total Total †1882 287,191 under 5 years 580 739 236 . 753 530 1.146 137 149 53 248 65 126 5,264 18.3 above 5 159 517 516 12 195 61 †1883 290,711 under 5 „ 385 536 269 836 522 1,088 149 162 45 227 53 104 5,140 17.6 above 5 „ 151) 567 566 13 182 51 †1884 294,267 under 5 „ 502 683 313 835 465 978 247 266 43 274 71 129 5,229 17.7 above 5 ,, 181 522 513 19 231 58 †1855 297,867 under 5 „ 592 749 217 706 530 1.197 172 1 191 36 268 55 102 5,740 19.3 above 5 „ 157 489 667 19 232 47 †1886 301,512 under 5 „ 313 396 252 772 495 1,201 291 307 49 231 57 127 5,434 18.0 above 5 ,, 83 480 706 16 182 70 †1887 305,112 under 5 ,, 593 687 252 725 492 1.169 275 291 69 246 64 122 5,699 18.7 above 5 „ 94 473 677 16 177 58 †1888 308,936 under 5 „ 411 515 218 671 442 1,040 131 146 62 253 54 115 5,197 16.8 above 5 „ 104 453 598 15 191 61 †1889 312,713 under 5 „ 326 425 194 702 395 970 157 170 67 250 60 120 5,035 16.1 above 5 „ 99 508 575 13 183 60 †1890 316,543 under 5 ,, 416 496 260 785 569 1,406 154 169 82 250 73 166 6,152 19.4 above 5 ,, 80 525 837 15 168 93 †1891 319,991 under 5 „ 486 587 207 717 624 1.476 131 146 82 263 65 133 6,326 19.8 above 5 ,, 101 510 852 15 181 68 † 1892 323,451 under 5 ,, 378 481 198 677 509 1,301 143 156 88 270 71 139 6,075 18.8 above 5,, 103 479 792 13 182 68 1893 326,958 under 5 „ 466 634 224 758 452 1.313 223 237 136 379 84 206 6,391 19.5 above 5,, 168 534 861 14 243 122 1894 330,485 under 5 ,, 547 703 176 673 420 973 84 93 131 330 78 173 5,263 15.9 above 5,, 156 497 553 9 199 95 1895 334,058 under 5,, 341 450 240 763 461 1,131 172 188 168 389 76 191 5,760 17.2 above 5,, 109 523 670 16 221 115 1896 337,666 under 5,, 693 875 218 730 494 997 141 153 158 380 80 206 5,884 17.1 above 5,, 182 512 503 12 222 126 1897 337,197 under 5 „ 328 448 178 689 419 975 161 174 151 380 69 186 5,395 16.0 above 5 „ 120 511 556 13 229 117 1898 336,727 under 5 ,, 557 647 179 686 426 1.013 266 283 208 409 68 174 5,705 16.9 above 5,, 90' 507 587 17 201 106 1899 336,259 under 5 ,, 397 515 174 729 420 1,272 241 258 266 487 85 229 6,293 18.7 above 5 „ 118 555 852 17 221 144 1900 335,892 under "5 „ 375 480 135 710 411 1.132 164 l80 169 387 58 195 5,721 17.0 above 5,, 105 575 721 16 218 137 1901 335,325 under 5 „ 347 455 143 677 381 986 158 172 151 423 70 180 5,361 15.9 above 5 „ 108 534 605 14 242 110 1902 337,268 under 5 „ 367 508 154 672 435 1,242 94 99 144 366 85 240 5,635 16.4 above 5 „ 141 518 807 5 222 155 1903 339,137 under 5 ,, 308 362 132 632 341 874 102 109 136 298 62 190 4,839 14.2 above 5,, 54 500 533 7 - 162 128 *This includes Small-Pox, Measles, Scarlatina, Typhoid Fever, Diphtheria and Whooping Cough. †The deaths in these years do not include those of residents occurring in outlying institutions. 264 l—i CO o 05 LOCAL GOVERNMENT BOARD RETURN.—Table III. Table J. Cases of Infectious Disease coming to the knowledge of the Medical Officer of Health during the year 1903. Notifiable Disease. Cases Notified in Whole District. Total Cases Notified in each Locality. No. of Cases Removed to Hospital from each Locality. At all Ages. At Ages—Years. 1 2 3 4 5 6 7 1 2 3 4 5 6 7 Under 1. 1 to 5. 5 to 15. 15 to 25. 25 to 65. C>5 and upwards. Tufnell. Upper 1 . olloway Tollington. Lover Holloway Higl-bury. Barnsbury. South-East Tufnell. Upper Holloway. Tollington. Lower Holloway. Highbury. Barnsbury. South-East. Small-pox 9 1 2 5 1 3 1 .. 2 .. .. 3 3 1 .. 2 .. .. 3 Cholera .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Diphtheria 452 13 174 196 36 33 .. 43 45 47 i20 58 51 88 29 42 37 91 36 42 60 Membranous Croup 3 .. 3 .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Erysipelas 227 5 3 25 23 156 15 23 28 22 25 31 35 63 6 8 3 5 1 6 5 Scarlet Fever 865 10 228 517 78 32 .. 76 78 113 129 207 130 132 59 70 107 119 161 115 125 Typhus Fever .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Enteric Fever 130 .. 8 35 43 44 .. 9 !3 14 11 29 28 26 4 11 10 8 23 25 19 Relapsing Fever .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Continued Fever 2 .. .. 2 .. .. .. 1 .. .. .. .. .. 1 .. .. .. .. .. .. 1 Puerperal Fever 19 .. .. .. 5 14 .. 3 4 1 4 5 1 1 1 .. .. 1 .. .. .. Plague .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Totals 1707 28 417 777 190 280 15 158 169 197 292 330 246 315 102 132 157 226 221 188 213 265 1908 table k. Showing the Cases of Small Pox that occurred in the several Wards from 1891 to 1903. Year. Tufnell. * U pper Holloway. Tolling ton. Lower Holloway. Highbury. IMildmay. Thornhill. Barnsbury. St. Mary's. Canonbury. St. Peter's. Totals. 1891 .. .. .. 1 .. .. .. .. .. .. .. 1 1892 .. 12 .. 12 .. 7 .. .. 9 1 1 42 1893 .. 41 .. 28 6 3 14 6 6 5 9 118 1894 17 8 1 5 2 3 10 .. 15 2 26 90 1895 1 6 3 1 1 1 2 4 1 5 25 1896 8 3 25 1 6 5 1 1 .. .. .. 50 1897 1 1 .. .. .. .. .. .. .. 1 .. 3 1898 .. .. .. .. .. .. .. .. .. .. .. .. 1899 .. .. 2 .. .. .. .. .. .. .. 1 3 1900 .. .. .. 1 .. 1 .. .. .. .. .. 2 1901 3 .. .. 11 4 1 13 6 4 4 4 50 1902 9 34 28 32 17 13 25 33 7 16 62 276 1903 3 1 .. 2 .. .. .. .. .. 1 2 9 * The figures for 1891-2-3 are inclusive of Tufnell and Tollington Wards t The figures for 1891-2 are inclusive of Highbury Table L. Showing the Cases of Scarlet Fever that occurred in the several Wards from 1891 to 1903. Year. Tufnell. *Upper Holloway. Tollington. Lower Holloway. Highbury. IMildmay. Thornhill. Barnsbury. St. Mary's. Canonbury. St. Peter's. Totals. 1891 ... 229 ... 108 ... 99 55 59 27 46 105 728 1892 ... 435 ... 225 ... 313 148 100 94 194 200 1709 1893 ... 790 ... 368 ... 633 355 209 136 201 187 2880 1894 176 235 114 196 152 67 165 1l6 91 90 91 1493 1895 142 166 220 214 168 117 182 89 108 112 174 1692 1896 181 244 191 169 230 127 150 149 104 191 295 2031 1897 144 153 193 187 137 126 155 91 76 113 202 1577 1898 159 151 152 182 151 102 114 38 58 107 122 1336 1899 100 172 183 178 176 118 117 I02 79 98 171 1494 i900 78 85 102 133 152 90 85 66 51 107 120 1074 190 1 97 109 129 172 178 83 x37 86 61 93 141 1286 1902 140 147 160 187 121 88 187 67 45 94 136 1372 1903 76 78 113 129 130 70 88 42 28 36 75 865 * The figures for 1891-2-3 are inclusive of Tufnell and Tollington Wards f The figures for 1891-2-3 are inclusive of Highbury. s 266 1903] Table M. Shewing the Cases of Diphtheria th.it occurred in the several Wards from 1891 to 1903. Year. Tufnell. Upper Holloway. Tollington Lower Holloway. Highbury. Mildina y Thornhill. Barnsbury. St. Mary's. Canonbury. St. Peter's. Totals. 1891 .. 305 .. 43 .. 112 37 44 44 54 73 712 1892 .. 299 .. 43 .. 95 49 43 54 37 75 695 1893 .. 283 .. 57 .. 140 94 46 55 62 117 855 1994 86 91 177 131 93 40 81 37 45 25 97 843 1895 64 77 50 67 80 21 46 28 21 34 76 564 1896 129 177 84 89 87 46 200 95 29 49 82 1067 1897 71 77 118 66 43 60 81 43 30 52 59 700 1898 44 52 50 36 41 64 54 30 26 92 42 531 1899 148 99 88 56 62 28 28 29 39 52 59 688 1900 61 64 46 62 49 74 47 43 55 38 85 624 1901 83 69 61 104 87 55 96 67 61 60 159 902 1902 128 100 62 165 106 38 73 31 29 55 84 871 1903 43 45 47 120 37 17 34 17 21 36 35 452 Table N. Showing the Cases of Membranous Croup that occurred in the several Wards from 1891 to 1903. Year. Tufhell. Upper Holloway. /Tollington, Lower Holloway. Highbury. Mildmay. Thornhill, Barnsbury. St. Mary's. Canonbury. St. Peter's. Totals. 1891 .. 20 .. 2 .. 5 3 1 1 2 10 44 1892 .. 10 .. 3 .. 10 3 1 2 8 6 43 1893 .. 10 .. 5 .. 3 3 3 1 .. 5 30 1894 2 2 .. 5 .. 2 6 1 .. 5 1 24 1895 1 3 .. 3 3 1 1 .. 1 1 4 18 1896 3 3 .. 4 4 1 3 1 1 1 3 24 1897 2 4 2 5 .. .. 1 .. 3 3 3 29 1898 2 4 .. 1 1 .. 4 .. 1 .. .. 13 1899 2 1 1 2 1 1 3 2 1 .. 3 17 1900 2 .. .. 1 1 .. 1 2 .. 1 1 9 1901 1 .. 1 1 2 1 2 .. 1 .. 9 1902 .. 1 .. 3 1 .. 1 1 .. .. .. 7 1903 .. .. .. 1 .. 1 •• .. .. 1 3 267 [1903 Table O. Showing the Cases of Typhoid Fever that occurred in the several Wards from 1891 to 1903. Year. Tufnell. Upper Holloway. Tollington. Lower Holloway. Highbury. Mildmay. Thornhill. Barnsbury. St.Mary's. Canonbury. | St. Peter's. Totals. 1891 .. 61 .. 25 .. 33 31 15 8 5 11 189 1892 .. 78 .. 19 .. 49 25 16 7 12 13 219 1893 .. 88 .. 19 .. 56 17 17 9 24 21 251 1894 24 23 18 32 25 23 19 21 9 21 30 245 1895 21 16 12 25 26 22 10 9 9 14 20 184 1896 17 22 19 35 30 15 40 10 9 12 20 229 1897 25 25 43 34 25 27 20 18 10 11 l8 256 1898 22 34 24 30 26 21 18 16 10 15 21 237 1899 39 40 94 24 49 17 31 17 15 16 11 353 1900 14 37 42 25 23 27 34 15 9 13 20 259 1901 32 42 19 39 22 28 15 14 14 27 29 281 1902 29 22 18 32 23 12 37 25 11 20 28 257 1903 9 13 14 11 13 13 21 7 4 13 12 130 Table P. Showing Cases of Typhus Fever that occurred in the several Wards from 1891 to 1903. Year. Tufnell. Upper Holloway. Tollington. Lower Holloway. Highbury. Mildmay. Thornhill. Barnsbury. St. Mary's. Canonbury. St. Peter's. Totals. 1891 .. .. .. .. .. .. .. 1 .. .. 1 2 1892 .. .. .. .. .. .. .. .. .. .. .. .. 1893 .. 1 .. .. .. .. .. .. .. .. .. 1 1894 .. .. .. 1 .. .. .. .. .. .. .. 1 1895 3 .. .. .. .. .. .. 2 .. .. .. 5 1896 .. .. .. .. .. .. .. .. .. .. .. .. 1897 .. .. .. .. .. .. .. .. .. .. .. .. 1898 .. .. 1 .. .. .. .. .. .. 1 .. 2 1899 .. .. .. .. .. .. .. .. .. .. .. .. 1900 .. .. .. .. 1 .. .. .. .. .. .. 1 1901 .. .. .. .. .. .. 1 1 .. .. .. 2 1902 .. .. .. .. .. .. .. .. .. .. .. .. 1903 .. .. .. .. .. .. .. .. .. .. .. .. S2 268 1903 Table q. Showing the Cases of Erysipelas that occurred in the several Wards from 1891 to 1903. Year. Tufnell. Upper Holloway. Tollington. Lower Holloway. Highbury. Alildmay. Thornhill. Barnsbury St. Mary's. Canonbury. St. Peter's. Totals. 1891 .. 139 .. 23 .. 42 30 28 13 23 45 343 1892 .. 194 .. 46 .. 80 35 39 44 39 73 550 1893 .. 244 .. 70 .. 75 63 51 49 41 79 672 1894 34 85 23 59 29 19 43 19 20 26 38 395 1895 49 62 23 38 36 24 26 21 16 12 33 319 1896 54 65 20 51 15 30 22 29 18 22 19 385 1897 24 66 21 38 25 26 19 15 16 19 43 312 1898 23 60 20 31 22 16 15 17 13 22 40 279 1899 15 70 36 47 25 12 39 23 22 19 42 350 1900 31 45 25 30 24 13 29 16 15 20 37 285 1901 24 52 30 16 18 14 37 10 15 25 44 285 1902 33 47 34 41 30 is 33 19 13 51 38 357 1903 23 28 22 25 16 10 25 10 12 31 25 227 Table R. Showing the Cases of Puerperal Fever that occurred in the several Wards from 1891 to 1903. Year. Tufnell. Upper Holloway. Tollington. Lower Holloway. Highbury. Mildmay. Thornhill. Barnsbury. St. Mary's. Canonbury. St. Peter's. Totals. 1891 10 9 7 2 i i 3 33 1892 28 5 7 5 2 2 2 5* 1893 3 5 4 7 5 3 3 3 2 3 38 1894 1 3 6 4 3 2 2 i i 23 1895 .. 1 2 I 2 6 2 3 i I 3 22 1896 3 2 3 5 2 1 5 2 I 3 3 30 1897 •• 5 6 2 4 3 1 4 I 1 27 1898 2 2 2 3 2 I 4 3 19 1899 1 7 4 9 1 1 4 3 1 2 33 1900 4 2 1 3 3 2 1 16 1901 2 3 4 5 5 2 3 4 3 3 34 1903 .. 2 1 2 1 4 5 3 1 19 1903 .. 3 4 1 4 4 1 1 1 19 269 1908 Table S. Showing the Cases of Continued Fever that occurred in the several Wards from 1891 to 1903. Year. Tufnell. Upper Holloway. Tollington. Lower Holloway. Highbury. Mildmay. Thornhill. Barnsbury. St. Mary's. Canonbury. St. Peter's. Totals. 1891 .. 1 .. 2 .. .. 3 .. .. .. .. 6 1892 .. 2 .. .. .. 3 .. .. .. 1 .. 6 1893 1 .. .. .. 1 .. 1 .. 1 1 2 7 1894 .. .. 2 1 3 .. .. .. .. 1 .. 7 1895 .. 4 1 .. 1 3 .. .. .. .. .. 9 1896 1 2 .. .. .. 1 1 1 .. .. .. 6 1897 .. .. .. .. .. .. .. .. .. .. 1 1 1898 .. .. .. .. .. .. .. .. .. 1 .. 1 1899 .. .. .. .. .. .. 1 .. .. .. 1 2 1900 .. .. .. 3 .. 2 .. .. .. 1 .. 6 1901 .. .. .. 1 .. .. 1 .. .. .. 1 3 1902 .. .. .. .. .. .. 5 .. .. .. .. 5 1903 1 .. .. .. .. .. .. .. .. l .. 2 Table T. Showing the Cases of Relapsing Fever thai occurred in the several Wards from 1891 to 1903. Year. Tufnell. Upper Holloway. Tollington. Lower Holloway. Highbury. Mildmay. Thornhill. Barnsbury. St. Mary's. Canonbury. St. Peter's. Totals. 1891 .. 1 .. .. .. .. .. .. .. .. .. 1 1892 .. .. .. .. .. .. .. .. .. .. .. . 1893 .. .. .. .. .. .. .. .. .. .. .. . 1894 .. .. .. .. .. .. .. .. .. .. .. . 1895 .. .. .. .. .. .. .. .. .. .. .. . 1896 .. .. .. .. .. .. .. .. .. .. .. .. 1897 .. .. .. .. .. .. .. .. .. .. .. .. 1898 .. .. .. .. .. .. .. .. .. .. .. .. 1899 .. .. .. .. .. .. .. .. .. .. .. .. 1900 .. .. .. .. .. .. .. .. .. .. .. .. 1901 .. .. .. .. .. .. .. .. .. .. .. .. 1902 .. .. .. .. .. .. .. .. .. .. .. .. 1903 .. .. .. .. .. .. .. .. .. .. .. .. 270 1003] Table U. Showing the Cases of Cholera that occurred in the several Wards from 1891 to 1903. Year. Tufnell. Upper Holloway. Tollington. Lower Holloway. Highbury. Mildmay. Thornhill. Barnsbury. St. Mary's. Canonbury. St. Peter's. Totals 1891 .. .. .. .. .. .. .. .. .. .. .. .. 1892 .. .. .. .. .. .. .. .. .. .. •3 3 1893 .. .. .. .. .. .. 1 .. .. .. .. .. 1894 .. .. .. .. .. .. .. .. .. .. .. .. 1895 .. .. .. .. .. .. .. .. .. .. .. .. 189(5 .. .. .. .. .. .. .. .. .. .. .. .. 1897 .. .. .. .. .. .. 1 .. .. .. .. 1 1898 .. .. .. .. .. .. .. .. .. .. .. .. 1899 .. 2 1 .. .. .. .. .. .. .. .. .. 1900 .. .. .. .. .. .. .. .. .. .. .. 3 1901 .. .. .. .. .. .. .. .. .. .. .. .. 1902 .. .. .. .. .. .. .. .. .. .. .. .. 1903 .. .. .. .. .. .. .. .. .. .. .. .. •Asiatic Cholera. 271 1903 Table V. Showing the Analyses (made monthly) of the New River Company's Water Supply recorded during the Year. Analyses of Samples tahen from the Works of the Company. 1903. Total Solid Matter. Chlorine. Equal to Chloride of Sodium. Nitrogen as Nitrates. Nitrogen as Ammonia. Oxygen required to oxidise Organic Matter. Degree of Hardness. Degree after boiling J of an hour. Organic Carbon. Organic Nitrogen. January 24.60 1.368 2 242 0 261 0.000 o.o19 17.58 4.40 • • .. February 25.40 1.440 2-360 0 229 ,, 0.027 17.58 4.40 • • .. March 25.20 1.440 2*360 0208 ,, 0.o49 16.10 4.80 .. .. April 21.00 1.440 2360 0156 ,, 0.019 15.05 3.89 .. .. May 23.60 1. 368 2*242 0146 ,, 0.023 15.26 3.99 .. .. June 23.60 1.512 2478 0156 ,, 0.011 14.42 3.70 .. .. July 23.80 1. 440 2*360 0125 ,, 0.054 14.42 3.99 .. .. August 23.80 1.296 2124 0156 ,, 0.026 16.10 3.80 .. .. September 22.70 1.296 2-124 0156 ,, 0.043 17.16 4.99 .. .. October 23.80 1. 296 2124 0167 ,, 0.027 16.10 3.89 .. .. November 24.00 1. 296 2124 0177 ,, 0.068 19.05 4.69 .. .. December 25.20 1.440 2360 0 292 ,, 0.031 17.79 4.20 .. .. Average 23.90 1.386 2.272 0.186 0.000 0.033 16.38 4.23 .. .. Analyses of Samples taken from the Mains of the Company. 1903. Total Solid Matter. Chlorine. Equal to Chloride of Sodium. Nitrogen as Nitrates. Nitrogen as Ammonia. Oxygen required to oxidise Organic Matter. Degree of Hardness. Decree after boiling J of an hour. Organic Carbon. Organic Nitrogen. January .. 1.440 2.360 0.240 0.000 0.022 17.51 .. 0.077 0.011 February .. 1.458 2.389 0.208 ,, 0.016 16.89 .. 0.064 0.009 March .. 1.404 2.301 0.203 ,, 0.032 16.15 .. 0.096 0.011 April .. 1.416 2.321 0.170 ,, 0.017 15.05 .. 0.055 0.005 May .. 1.404 2.301 0.148 ,, 0.026 14.73 .. 0.093 0.009 June .. 1.422 2.330 0.125 ,, 0. 031 14.58 .. 0.093 0.008 July .. 1.332 2.158 O.159 ,, 0.020 15.78 .. 0.063 0.009 August .. 1.296 2.124 0.125 ,, 0.027 15.61 .. 0.077 o.o1o September .. 1.350 2.212 0.156 ,, 0.031 17.26 .. 0.099 o.o12 October .. 1.332 2.183 0.172 ,, 0.055 16 .73 .. 0.159 0.018 November .. 1.368 2.242 0.201 ,, 0.046 18.28 .. 0.130 0.013 December .. 1.416 2.321 0.240 ,, 0.035 17.93 .. 0.133 0.015 Average .. 1-387 2.270 0.179 0.000 0.031 16.37 .. 0.095 0.011 272 1903] Table W. BATHS AND WASHHOUSES. Table showing the Number of Persons using the Swimming Baths, Private Baths, and Washhouses during 1903. Swimming Baths. Bathers. Caledonian Road. Hornsey Road. Essex Road. Total. Public. 1st class Males 12,665 44,991 14,060 71,716 (Females 248 9,183 1,609 11,040 2nd class Males 31.738 35,960 24,670 92,368 Females 2,058 4,655 3,362 10,075 Schools. 1st class Boys 27 6,993 45 7,065 Girls ... 1,673 14 1,687 2nd class Boys 38,698 34,264 34,249 107,211 Girls 18,868 12,804 13,190 44,862 Totals 104,302 150,523 91,199 346,024 Private (Slipper Baths.) 1st class Males 18,449 32,948 16,580 67,977 Females 1,542 3,787 2,398 7,727 2nd class Males 54-902 50,028 50,561 155,491 Females 15,720 18,500 19,537 53,757 Totals 90,613 105,263 89,076 284,952 Washhouses. Washers 34,064 24,051 63,757 121,872 Total Persons using all Establishments. Total persons using each establishment in 1903 228,979 279,837 244,032 752,848 273 [1908 LONDON COUNTY COUNCIL RETURNS. INSPECTIONS OF FACTORIES, WORKSHOPS, AND WORKPLACES. CLASS OF WORKS. Number of Places.* Number of Inspections. 1903. Number of Notices. 1903. Numbei of Prosecutions. 1903. On Register at end of 1902. Added in 1903 Removed in 1903. On Register at end of 1903. Premises. Rooms. Factories— ... ... ... ... ... ... ... ... Factory Laundries ... ... ... ... ... ... ... ... Factory Bakehouses ... ... ... ... ... ... ... ... Other Factories ... ... ... ... ... ... ... ... Workshops— Workshop Laundries 193 8 10 191 3180 300 ... ... Workshop Bakehouses 218 4 247 729 332 ... Other Workshops 1241 469 162 1548 2282 ... 1 Workplaces— Outworkers' Premises 600 500 ... 1100 1100 511 ... ... Places where Food is prepared for Sale 326 ... ... 326 326 673 78 ... Workplaces other than the above ... ... ... ... ... ... ... ... Total 2578 977 176 3412 4606 4495 410 1 *A Register is required by s. 131 in the case of Workshops only. 274 1903 WORKSHOPS AND WORKPLACES. MATTERS DEALT WITH. PARTICULARS. Number of Defects. Notices Issued. Prosecutions. Found. Notified by Home Office. Remedied Notified to Home Office. Matters under the Public Health (London) Act, 1891. Want of Cleanliness 4121 11 423 9 ... ... Want of Ventilation 13 1 14 1 ... ... Want of Air Space : Overcrowding 13 ... 13 ... ... ... Sanitary Accommodation (s. 38). Insufficient 30 ... 30 ... ... ... Unsuitable 6 ... 6 ... ... 1 Not Separate for Sexes 5 ... 5 ... ... ... Want of Drainage of Floors ... ... ... ... ... ... Other Nuisances 547 2 549 2 410 ... Contraventions of Factory and Workshop Act, 1901. Occupying Underground Bakehouse without Certificate ... ... ... ... ... ... Breach of Special Sanitary Requirements for Bakehouses (ss. 97 to 100) ... ... ... ... ... ... Failure as regards Lists of Outworkers (s. 107) None2 ... ... ... ... ... Giving out work to be donej in premises which are Unwholesome (s. 108) ... ... ... ... ... ... Infected (s. no) ... ... ... ... ... ... Allowing Wearing Apparel to be made in Premises infected by Scarlet Fever or Small Pox (s. 109) ... ... ... ... ... ... Other Contraventions ... ... ... ... ... ... Total 1026 14 1040 12 410 1 1. In addition 18 were cleansed voluntarily. 2 All sent in lists but 104 only after notice was sent them. 275 1903 Cases reported Abstract not affixed 140 to As to action taken in cases notified by H.M. Inspector 12 H.M. Inspector Other cases — Number of underground bakehouses in use at the end of 1903 112 Certificates granted (s. 101) 94 Number of workshop rooms measured 645 LIST OF OUTWORKERS (S. 107). Class of Homework. 1903. Number of Lists Received. Number of Addresses of Outworkers Up to Feb. 1st. Up to Aug. 1st. Forwarded to Other Authorities Received from Other Authorities. Wearing Apparel*. No of Lists. No. of Outworkers No of Lists No. of Outworkers. 841 919 68 770 70 787 Lace ... ... ... ... ... ... Cabinet making ... ... ... ... ... ... Fur pulling ... ... ... ... ... ... Other ... ... ... ... ... ... Total 68 770 70 787 841 919 Number of Notices prohibiting homework in unwholesome premises (s. 108) None Number of Orders prohibiting homework in infected premises (s. no) None 276 1903] LONDON COUNTY COUNCIL RETURN. PROCEEDINGS DURING 1903. PREMISES. Number of Places— Number of inspections, 1903. Number of Notices. 1903. Number of Prosecutions 1903. On Register at end of 1902. Added in 1903. Removed in 1903. On Register at end of 1903. Milk premises 661 13 ... 674 573 47 2 Cowsheds 13 None 1 12 152 None ... Slaughter-houses 42 ,, 2 40 2414 1 4 Other offensive trade premises 7 ,, ... 7 220 None ... Ice cream premises 183 ,, ... 183 29 17 ... Registered houses let in lodgings 533 122 ... 655 8407 (a)*80 (a)* ... (b)†978 (b)†11 * (a) For overcrowding. f (b) For other conditions. Overcrowding, 1903— Number of dwelling rooms overcrowded 117 Number remedied 117 Number of notices issued 104 Number of prosecutions — Underground rooms — Number closed during year 40 Insanitary houses— Number closed under the Public Health (London) Act, 1891 Shelters provided under sec. 60 (4) of the Public Health (London) Act, 1891— Number of persons accommodated during the year 20 Customs and Inland Revenue Acts—- Number of houses for which applications were received during year 14 Number of dwellings comprised therein 113 Number of certificates granted 4 277 1908 Number of prosecutions under By-laws under Public Health Act, 1891. (a) For prevention of nuisance arising from snow, ice, salt, filth, etc 4 (b) For prevention of nuisance arising from offensive matter running out of any manufactory, etc. — (c) For the prevention of keeping of animals in such a manner as to be injurious to health — (d) As to paving of yards, etc., of dwelling houses — (e) In connection with the removal of offensive matter, etc. 4 (f) As to cesspools and privies, removal and disposal of refuse, etc — (g) For securing the cleanliness of tanks, cisterns, etc. — (h) With respect to water closets, earth closets, etc. 4 (;i) With respect to sufficiency of water supply to water closets —• (j) With respect to drainage, etc (Metropolis Management Act, Section 202) (k) With respect to deposit of plans as to drainage, etc. (Metropolis Management Act, Section 202) — Mortuaries— Total number of bodies removed 681 Total number of infectious bodies removed 1 APPENDIX II. REPORT ON THE DUTIES OF THE BOROUGH SANITARY INSPECTORS BY The Medical Officer of Health. 280 1908 DUTIES OF SANITARY INSPECTORS. To the Chairman and Members of the Public Health Committee. Gentlemen, During the last twelve years, or since the Public Health (London) Act, 1891, came into force, there has been an increasing number of Sanitary Inspectors appointed by the different Metropolitan Sanitary Authorities to enable them to carry into effect the duties which have been imposed on them by that Act. Thus in 1893 the total number of Sanitary Inspectors in London was only 188, whereas in 1903 it was 301, or an increase of 60 per cent. This increase has been particularly noticeable during the last two years, during which period Paddington has added 6 to its staff, Hammersmith 1, Marylebone 1, Hampstead 2, St. Pancras 2, Stoke Newington 1, Finsbury 2, City 3, Stepney 1, Bermondsey 2, Battersea 2, Camberwell 2, Deptford 2, Greenwich 2, Lewisham 2, Woolwich 1. In other districts there has been no occasion to add to their staffs, because when the Boroughs were recently formed it was found that the duties could be adequately performed by the Inspectors of the combined districts, or that even, as in three Boroughs a reduction could be made. This, however, involved only 4 Inspectors. A most noticeable feature in the character of the work allotted to the Inspectors is that, whereas formerly their duties were of a similar character generally, they now differ greatly, as special men are generally being appointed for special work; thus it has become customary, as in the great Boroughs of the country, to appoint men to look after Food, Factories and Workshops; Houses let in Lodgings, the administration of Food and Drugs Acts, House to House Inspection, Infectious Diseases, Dairies, Cowsheds and Milkshops, Ice Creams, and other matters. Islington was one of the first districts in London to recognise the necessity for the sub-division of work in this manner, for as the duties increased it became very evident that the ordinary district Inspector had his time fully occupied in gaining information as to infectious diseases, in attending to complaints from householders and others, in inspecting houses and in supervising drainage work. Indeed it is not too much to say that it almost impossible for him to map out his duty twelve hours in advance, because his day's work must largely depend on the complaints that are received each 281 [1903 morning, or the appointments that are fixed for him by builders and plumbers, and on the convenience of householders, apart altogether from the direction his work may be compelled to take by the receipt of certificates notifying infectious diseases, which it is hardly necessary to say, vary very much from day to day. Consequently work which is of such importance that it should be systematically performed should not be placed on the shoulders of District Inspectors. It was for this reason that the late Vestry appointed Inspectors to inspect Houses let in Lodgings, Meat, Factories and Workshops, Laundries and places where women are employed, and to obtain samples under the Sale of Food and Drugs Acts. New duties have been gradually added, and it will be in your recollection that when the Metropolitan Boroughs came into existence, the London County Council transferred to them the control of the Slaughterhouses, Cowhouses, and the Dairies and Milkshops. The Factory, and Workshop Act, 1901, in no uncertain manner, has placed on the shoulders of the Sanitary Authority the duty of examining into the sanitary conditions under which work is performed in workshops,workplaces, and in the homes of outworkers, and it has enacted that the Medical Officer of Health shall report to the Home Secretary how this work is executed. Among the places included in the definition of "Workplace" are the kitchens of restaurants, and as there are fully four hundred of them, it will be seen that in this item alone a very heavy duty is entailed. Indeed it is evident that as these places should be visited at least every two months to ensure there being kept in a sanitary state, this work alone will require 2,400 visits, apart altogether from any return calls that may be necessary for the supervision of any work that may have been demanded in sanitary notices. There are also 60c milkshops on the register, which should be visited at least every three months, and would therefore entail 2,400 visits. It is very apparent, judging from these two sets of duties alone, that the work of inspection is heavy. It might be well here to set out in more detail the work which at present devolves on your staff, as compared with London as a whole. There is One Inspector in Islington to every— 1,930 inhabited houses as against 1,900 in London. 3,956 tenements „ „ 3.387 2,790 tenements under 5 rooms as against 2,233 504 overcrowded tenements as against 415 16,750 persons as against 15.072 9,821 persons in tenements under five rooms as against 8,139 2,847 overcrowded tenements as against ... 2,412 „ 1903] 282 This statement shows clearly that, compared with the rest of London, Islington is undermanned, particularly when it is recollected that this Borough is far more a residential district, whose houses are mainly let in lodgings, than a manufacturing centre, and that the tendency is for it to grow more and more into a place of tenement houses or houses let in lodgings, which is proved by the fact that the number of tenements increased from 72,652 in 1891 to 79,129 in 1901. The heavy duties devolving on the staff may be gathered from the particulars which are set out in Table I., which is arranged in Sanitary Inspectors' districts. It is not, however, meant thereby that each district Inspector performs all the work put down to his district, but it does show to a large extent the work which each Inspector would have to perform if certain duties, which the special Inspectors now carry out, were to be undertaken by him. There is no Borough in the Metropolis where so much work has to be performed, as is shown by Table II., in proportion to the number of Inspectors employed. When we examine the report on " Sanitary Officers" recently prepared by the Medical Officer of Health of the London County Council, it is apparent to every one that Islington does not now stand in anything like the position it once occupied with respect to its work, but, in the light which that report throws on the subject, has fallen to a low position. This statement is proved by the following facts:— The proportion of Inspectors to Inhabited Houses is greater in the following 14 Boroughs than in Islington:—Bermondsey, Bethnal Green, Finsbury, Hammersmith, Hampstead, Holborn, Kensington, Paddington, Marylebone, St. Pancras, Southwark, Stepney, Westminster, and the City. The proportion of Inspectors to Tenements is greater in the following 21 Boroughs than in Islington:—Battersea, Bermondsey, Bethnal Green, Deptford, Finsbury, Greenwich, Hackney, Hammersmith, Hampstead, Holborn, Kensington, Lewisham, Paddington, Marylebone, St. Pancras, Southwark, Stepney, Stoke Newington, Westminster, Woolwich, and the City. The proportion of Inspectors to Tenements under 5 Rooms is greater in the following 21 Boroughs than in Islington:—Battersea, Bermondsey, Bethnal Green, Camberwell, Deptford, Finsbury, Greenwich, Hackney, Hammersmith, Hampstead, Holborn, Kensington, Lewisham, Paddington, Southwark, Stepney, Stoke Newington, Wandsworth, Westminster, Woolwich, and the City. 283 [1203 The proportion of Inspectors to Overcrowded Tenements is greater in the following 19 Boroughs than in Islington:—Battersea, Bermondsey, Camberwell, Chelsea, Deptford, Fulham, Greenwich, Hackney, Hammersmith, Hampstead, Kensington, Lewisham, Paddington, Southwark, Stoke Newington, Wandsworth, Westminster, Woolwich, and the City. The proportion of Inspectors to Total Population is greater in the following '20 Boroughs than in Islington:—Battersea, Bermondsey, Bethnal Green, Deptford, Finsbury, Greenwich, Hackney, Hammersmith, Hampstead, Holborn, Kensington, Lewisham, Paddington, Marylebone, St. Pancras, Southwark, Stepney, Westminster, Woolwich, and the City. The proportion of Inspectors to Population Residing in Tenements under 5 Rooms is greater in the following 22 Boroughs than in Islington:—Battersea, Bermondsey, Camberwell, Chelsea, Deptford, Finsbury, Greenwich, Hackney, Hammersmith, Hampstead, Holborn, Kensington, Lewisham, Paddington, Marylebone, St. Pancras, Southwark, Stoke Newington, Wandsworth, Westminster, Woolwich, and the City. From these facts it is apparent that the statement so often made that your Borough is overstaffed with Inspectors is most misleading, for they show that out of the 29 Metropolitan Boroughs Islington only ranks— 15th in proportion to Inhabited Houses. 22nd in proportion to All tenements. 22nd in proportion to Tenements of under 5 rooms. 20th in proportion to Overcrowded tenements. 21st in proportion to Population. 23rd in proportion to Population (in tenements under 5 rooms). 20th in proportion to Population (in overcrowded tenements). These are important matters for consideration when inquiring into the numerical strength of the sanitary staff. It is true that the actual number of Inspectors in Islington is greater than in any London district, but it must be remembered that Islington possesses not only the largest population but also the largest number of houses and tenements, and,' therefore, must, other considerations apart, require a larger number of Sanitary Officers. At one period Islington stood nearly at the top of the list of London Sanitary areas in the number of its inspectorial staff, but that cannot be said of it now, for although new duties have devolved on it, the staff has not been increased to meet its new obligations. At the present time it is contemplated to— (a) Largely increase the number of samples of food and drugs taken under the Adulteration Acts; 1903] 284 (b) To inspect the kitchens of restaurants; (c) To more rigorously inspect bakehouses, and (d) To considerably increase the number of houses let in lodgings on the Register. Under these circumstances it is well to consider the duties of your present staff. Duties of the District Inspectors.—These Inspectors are 14 in number, each having charge of a district containing an average of 25,000 inhabitants, in which his duties are— (a) The inspection of premises including house to house inspection, when time permits, and the abatement of nuisances; (b) The investigation of complaints respecting nuisances, and the service of notices requiring their abatement; (c) Making inquiries respecting infectious diseases; (d) Obtaining particulars respecting the schools attended by the sick or by those living in the same house; (e) The supervision of the disinfection of houses; (/) The taking (in rotation) of samples of milk on Sundays, and at the Railway Stations once a quarter after midnight; (g) The abatement of smoke nuisances; (h) The enforcement of the Dairies, Cowsheds and Milkshops Order of 1885 and 1886 respecting milkshops; (i) The inspection of places in which Ice Creams are made; (j) The inspection on Saturday nights of market thoroughfares, and the shops where food is exposed for sale, in their respective districts. In addition to these duties they are expected to undertake any special occasional work that may arise, such as recently the search for military blankets. Special Inspection. Duties of Inspector of Meat.—He inspects the whole of the slaughter-houses, butchers' shops, and cowsheds as to their sanitary state. He also examines all carcases of animals slaughtered at the slaughter-houses in the Borough (Cattle Market excepted). He also inspects all food, whether animal (meat or fish) or vegetable exposed or in preparation for sale. This work is sometimes undertaken in the early morning—sometimes late at night, the time greatly depending on the hours at which the butchers slaughter. 285 [1908 Duties of Male Inspector of Factories and Workshops.—Inspects factories, workshops, workplaces, laundries where males are employed, the homes of male outworkers, bakehouses (230), and kitchens of restaurants (400), and deals with all matters relating to these places. This Inspector's work is the heaviest of all the Inspectors. Duties of Female Inspector of Factories and Workshops.—Inspects factories, workshops, workplaces and laundries in which women are employed, also the homes of female outworkers, and deals with all matters relating to these places. She also makes inquiries respecting special matters in which women alone are concerned. Duties of Inspectors of Houses let in Lodgings.—The Inspector attached to the Southern District inspects all registered houses let in lodgings which are in the south part of the Borough, in addition to which he undertakes all urgent work of any character which may arise late at night or on Sundays. The Inspector attached to the Northern District performs similar work with regard to houses let in lodgings, and also undertakes the chief work in connection with the administration of the Adulteration Acts, in consequence of which the inspection of houses let in lodgings suffers. Duties of the Inspector under the Sale of Food and Drugs Acts. This is the same Inspector who was last mentioned. His work under this heading is considerable, and requires care and forethought. It is done at varying times of the morning, day and night. It is now proposed to greatly increase the number of samples taken for analysis. If this be done then it is clearly evident that he cannot perform the dual duties, which even at present he complains are too heavy. There is no doubt that the detection of persons dealing in adulterated articles of food is becoming annually more difficult, because the vendors are becoming more careful, and rarely palm off an adulterated food on the first visit. Consequently it is necessary to become known at the shop as a customer before procuring samples, for generally speaking it is not till then that the sophisticated article is sold. Even when the prosecution is determined on there remains much to be done in the way of procuring evidence and preparing the case. In view of the heavy work of the present staff, and of the fact that work of a character which requires daily and systematic attention is about to be increased, and of the fact that Sanitary Authorities everywhere are appointing Inspectors for special work, I have no hesitation in making the following recommendations:— 1903] 286 First.—That the Inspector at present engaged in the inspection of Houses let in Lodgings in the Northern District and the administration of the Sale of Food and Drugs Acts (so far as the procuring of samples) shall in the future devote the whole of his time to the latter duty. Such an arrangement to take place when the Council has settled the question of fees with the Public Analyst. Second.—That an additional Inspector be appointed for the inspection of Houses let in Lodgings situated in the Northern District. Let me point out that the imposition of the duty of inspecting houses let in lodgings on the District Inspectors would be very unevenly distributed, because whereas one of them would have to inspect 162 houses, probably those too requiring the most supervision, another would only be required to look after 3 houses. Any other step than that I have proposed would in my opinion be a retrogade one, for reasons already stated. An examination of the report of the London County Council, herewith enclosed, shows that in nearly every Borough Inspectors are being selected for special work, those with a special aptitude being chosen. My proposal comes to this: that the work of the staff generally remains as heretofore, that Inspector Ward be relieved of the Houses let in Lodgings, and that an Inspector be appointed in his place to the Northern District. I think that these proposals, in view of the largely increased duties of your staff, must be considered most moderate by every person who has studied the sanitary administration of this and other boroughs. I am, Your obedient Servant, A. E. HARRIS, Medical Officer of Health. Town Hall, Islington, 10th June, 1903. 287 [1903 Table I. Showing the Work that would devolve on each Inspector if the Duties now devolving on the Special Inspectors were to be assigned to them. No of Inspector's District. Notifiable Infectious Diseases, (cases). Measles, Whooping Cough, &c. No. of Dairies, Milkshops. No. of Houses Let in Lodgings. No. of Bakehouses. No. of Restaurants, Kitchens. Samples of Food, taken for Analysis. I 207 141 43 59 16 21 68 2 287 124 62 17 29 41 68 3 104 88 18 3 7 17 68 4 240 295 71 126 25 47 68 5 149 36 24 5 10 14 68 6 207 81 43 52 16 25 68 7 177 131 32 7 14 23 68 8 133 57 19 2 6 10 68 9 251 139 59 162 25 18 68 10 20I 105 45 2 16 22 68 11 270 85 68 90 19 29 68 12 208 99 77 47 19 51 68 13 149 27 43 13 12 40 68 14 193 81 57 3 17 4 68 Totals 2,776 1,489 661 588 231 398 952 Note.—In addition to the above there would be the workshops, workplaces, and homes of outworkers. 1903] 288 Table II. Showing the Number of Persons, Houses, etc., per Sanitary Inspector in the Metropolitan Boroughs. Sanitary Areas. Houses Tenements. Tenements under 5 rooms. Over-crowded tenements. Persons. Persons in tenements under 5 rooms. Population in overcrowded tenements. Battersea 2,133 3,544 2,190 276 15,355 8,091 1,671 Bermondsey 1,757 3,230 2,452 479 14,529 9,573 2,858 Bethnal Green 1,556 3,134 2,637 709 14,409 10,984 4,268 Camberwell 2,619 4,070 2,280 291 18,524 8,403 1,787 Chelsea 2,160 4,367 3,020 478 18,460 9,431 2,665 Deptford 2,260 3,516 1,994 238 15,771 7,409 1,428 Finsbury 1,031 2,677 2,279 708 11,274 8,705 3,969 Fulham 3,089 5,356 3,613 390 22,881 13,561 2,482 Greenwich 2,034 2,815 1,554 171 13,681 5,894 1,135 Hackney 2,188 3,485 2,078 263 15,662 7,491 1,595 Hammersmith 1,689 2,868 1,723 243 12,471 6,140 1,466 Hampstead 1,613 2,428 1,025 123 11,706 3,459 745 Holborn 941 2,758 2,154 557 11,881 7,145 2,975 ISLINGTON 1,932 3,956 2,790 504 16,754 9,821 2,847 Kensington 1,702 2,950 1,624 354 13,587 5,648 2,016 Lambeth 3,193 5,453 3,423 504 23,223 11,783 2,839 Lewisham 2,844 3,463 1,070 67 15,937 3,616 427 Paddington 1.474 2,805 1,818 284 11,998 6,103 1,628 Poplar 2,827 4,473 3,277 552 21,103 13,187 3,462 St. Marylebone 1,692 3,953 2,868 647 16,663 9,269 3,518 St. Pancras 1,482 3,565 2,814 635 14,707 9,737 3,526 Shoreditch 2,124 4,505 3,823 1,045 19,773 14,930 5,921 Southwark 1,228 2,812 2,330 478 12,128 8,701 2,710 Stepney 1,748 3,395 2,732 919 16,589 11,622 5,510 Stoke Newington 2,572 3,941 1,938 166 17,082 6,204 945 Wandsworth 3,433 4,523 1,914 139 21,094 6,939 940 Westminster 1,670 3,749 2,424 395 16,637 7,602 2,169 Woolwich 2,010 2,732 1,557 138 13,020 5,665 859 City of London 227 314 195 30 1,584 625 172 County of London 1,900 3,387 2,233 415 15,072 8,139 2,412