ISL 10 With the Compliments of the Medical Officer of Health. Town Hall, Islington N. ISL 10 HEALTH OF ISLINGTON. Quarterly Report OF THE MEDICAL OFFICER OF HEALTH. First Quarter, 1903. LONDON: Vail & Co., Printers to the Council, 170, Farringdon Road, E.C CONTENTS. Pages. Adulteration of Food 8 Ages at Death 7 Bacteriological Diagnosis 15 Bakehouses 21 Births 5 Cancer 9 Continued Fever 12-13 Constitutional Diseases 9 Deaths—All Causes 6 „ in Sub-Registration Districts 6 „ in Wards 6 „ in Public Institutions 8 ,, Zymotic Diseases 10 Diarrhoea 12 Diphtheria 11, 13 Disinfecting Station 14 Disinfection 14 District Inspection 23 Enteric Fever 12-13 Erysipelas 13 Factories, Workshops and Laundries, Inspection of 21 Fatality 14 Food Inspection 16 Houses Let in Lodgings 23 Hospital Treatment of Infectious Diseases 13 Infantile Mortality 7 Inspection of Workshops 21 Margarine Act 20, 23 Measles 11 Meat Inspection 16 Membranous Croup 13 Mortuary and Coroner's Court 23 Notification of Infectious Disease 12 Phthisis 10 Population 5 Puerperal Fever 12-13 Prosecutions 23 Respiratory Diseases 7 Scarlet Fever 11-12 Shelter House 15 Schools, Sickness in 15 Small Pox 11-12 Typhus Fever 12-13 Whooping Cough 11 Work of Sanitary Inspectors 23 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, Bakehouses and Smoke Nuisances. 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 1 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. EBWARD JOHN DURLEY. QUARTERLY REPORT on the HEALTH and SANITARY CONDITION of the METROPOLITAN BOROUGH of ISLINGTON. First Quarter, 1903. Thirteen Weeks ending 4th April, 1903. No. 41. Public Health Department, Town Hall, 27th April, 1903. To the Worshipful the Mayor, Aldermen, and Councillors of the Borough of Islington. Gentlemen, Population.—The population of Islington on which the statistics of this report are based is 339,137. It is distributed to the sub-registration districts as follows:—Tufnell, 32,838, Upper Holloway, 34,822, Tollington, 34,765, Lower Holloway, 41,537, Highbury, 65,112, Barnsbury, 54,278, South-East Islington, 75,785. The mean population for the ten years 1893-1902, on which the decennial birth, death, and sickness rates have been calculated, is 334,783. The figures relating to the population of the borough, whether actual or estimated, are those published by the Registrar-General, and the various rates have been calculated on them. Births.—2,264 births, 1,174 being males and 1,090 females, were registered. These are 252 below the corrected average (2,516) for the preceding ten years, and are equal to an annual birth-rate of 26*70 per 1,000 of the population, as compared with a mean birth-rate of 29*68 in the preceding ten years. In London the rate was 29.1 per 1,000 inhabitants. 6 The births and birth-rates of the Sub-registration Districts were as follows:— Tufnell 193 births = 23.50 per 1,000 inhabitants. Upper Holloway 276 „ = 31.70 „ Tollington 224 „ = 25.77 „ Lower Holloway 273 „ = 26.29 „ Highbury 361 „ = 22.17 „ Barnsbury 433 „ = 31.91 „ Islington South-East 504 „ = 26.60 „ The Borough 2,264 „ = 26.70 „ Deaths.—These numbered 1,383, the lowest figure recorded in any corresponding quarter during the last eighteen years. They were 307 less than the corrected average (1,690) of the ten years (1893-1902), and were equal to an annual death-rate of 16.31 per 1,000, as compared with a mean rate in ten years for this quarter of the year of 19.93 per 1,000. The decreased mortality was mainly due to the unusually mild climatic conditions that prevailed during the quarter. The highest number of deaths occurred in the third week in January, and the lowest in the second week in March. In the County of London the death rate was 16.8, and in the Encircling Districts 16.9 per 1,000. In the Sub-registration Districts the deaths were as follows:— Tufnell 107 deaths, Upper Holloway 151, Tollington 140, Lower Holloway 181, Highbury 229, Barnsbury 249, and Islington South-East 326. These deaths represented a death-rate of 13.04 in Tufnell, 17.34 in Upper Holloway, 16.10 in Tollington, 17.43 in Lower Holloway, 14.06 in Highbury. 18.35 in Barnsbury, and 17.20 in South-East Islington. In the Wards the several returns were as follows:— Wards. Deaths. Death-rates. Wards. Deaths. Death-rates. Tufnell 107 13.04 Thornhill l6l 19.30 Upper Holloway 151 17.34 Barnsbury 88 16.83 Tollington 140 16.10 St. Mary 64 14.80 Lower Holloway 181 17.43 Canonbury 135 37.32 Highbury 132 15.14 St. Peter 140 17.11 Mildmay 84 13.51 7 Ages at Death. —Of the 1,383 deaths, 329 were under a year old, which is 4 above the average of the preceding ten years. The deaths under five years were 528, or 30 below the average of the first quarters of these years. The deaths above five years numbered 855 and were 255 above the average, Ages. Number of Deaths. Mean Deaths (10 years), 1893-02. Increase or decrease on Mean. 0–1 329 325 + 4 1—5 199 233 — 34 5—15 43 54 — 11 15—25 42 64 — 22 25—35 65 92 — 27 35—45 101 134 — 33 45—55 121 160 — 39 55—65 151 193 — 42 65—75 165 211 — 46 75—85 130 162 — 32 85 upwards 37 40 — 3 1.383 1,668 — 285 Causes of Death (Classified).—Compared with the first quarters of the preceding eight years the deaths from diseases of the following classified causes showed a decrease, viz.:-Miasmatic Diseases 35, Constitutional 32, Developmental 51, Nervous System 46, Respiratory 123, Digestive System 13. Venereal 1, Dietic 1, Urinary System 2, Reproductive System 2, Integumentary System 4, Violence 1, and from Ill-defined causes 22; whilst from the undermentioned diseases there was an increase, namely, 4 from Diarrhœa, 7 from Septic Diseases, 4 from Organs of Special Sense, 11 from Circulatory System, 1 from Parasitic Diseases, 3 from Lymphatic system, and 1 from Diseases of Bones and Joints. Infantile Mortality.—There were 329 deaths of infants under a year old, or 4 above the average (325) of the preceding ten years at this period of the year. These deaths represented an infantile mortality rate of 145 per 1,00) infants born, as compared with 135 per 1,000 in the first quarters 1893-02. In London the rate was 127 ; and in the encircling Boroughs 121. In the latter the mortality in the separate Boroughs was as follows:—St. Pancras 123, Stoke Newington 127, Hackney 115, Hornsey 100, Finsbury 136 and Shoreditch 123. In the sub-registration districts the Infantile deaths and the proportional mortality to births were as follows:— 8  Deaths under one year. Deaths per 1.000 Births. Tufnell 27 = 140 Upper Holloway 45 = 163 Tollington 32 = 143 Lower Holloway 45 = 165 Highbury 50 = 138 Barnsbury 48 = 111 Islington, South-East 82 = 163 The Borough 329 = 145 DEATHS IN PUBLIC INSTITUTIONS. Within the Borough.—385 deaths occurred in the Public Institutions of Islington, of which only 222 could be described as belonging to this borough, the remaining 163 having only come here for treatment or relief. Among the latter were 136 persons who died in the Holborn Infirmary and 14 other persons who died in the Great Northern Central Hospital. Of the 222 deaths of inhabitants, 168 occurred in the Islington Infirmary, 24 in the Islington Workhouses, and 21 in the Great Northern Central Hospital. The proportion which the 222 deaths bore to the total mortality was 16.0 per cent. Without the Borough—166 deaths of persons belonging to Islington were registered as occurring in Public Institutions in other parts of London outside the Borough. These included, amongst others, 25 in the North-Eastern Fever Hospital, 6 in University Hospital, 4 in the Eastern Fever Hospital, 10 in the Childrens' Hospital, Great Ormond Street, 13 in St. Bartholomew's Hospital, 14 in the Colney Hatch Asylum, 10 in the Royal Free Hospital, and 7 in the Hanwell Asylum. These 166 deaths represented 12.0 per cent. of all the deaths registered in the quarter. Within and Without the Borough.—These deaths numbered 551, and were equal to 39.8 per cent. of the total deaths registered during the first quarter. Fatal Accidents or Sudden Deaths outside the Borough.—Six 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. 0 1st Quarter of Years. Total Deat hs in Local Institutions. 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 Inhabiiants in all Institutions. 1895 382 220 162 189 15 126 346 1896 336 204 132 152 25 173 377 1897 348 201 147 157 23 160 361 1898 371 222 149 179 26 148 370 1899 442 281 161 225 34 111 392 1900 529 341 188 267 35 146 487 1901 377 262 115 218 28 137 399 1902 472 280 192 186 33 216 496 Average 407 251 156 197 27 152 403 1903 389 222 167 168 21 172 394 CONSTITUTIONAL DISEASES. Cancer was the registered cause of the deaths of 90 persons, of whom 38 were males, and 52 females, representing an annual death-rate of 1.06 per 1,000 inhabitants. These deaths are 2 below the corrected average (65) of the first quarters of the preceding ten years, and represent a decrease in the deathrate of 0.03 per 1,000. The ages at death were as follows:— Years: o— 5 5—15 15—25 25—35 35—45 2 deaths. 1 death. 1 „ 2 deaths. 17 ,, Years. 45—55 55—65 65—75 75—85 85 and upwards 22 deaths. 22 „ 17 .. 6 „ – ,, The deaths were distributed in the sub-districts as follows:— Tufnell 6 deaths. Upper Holloway 9 „ Tollington 10 „ Lower Holloway 7 „ Highbury 19 „ Barnsbury 16 „ Islington South-East 23 „ The Borough 90 10 Phthisis caused 108 deaths (as against an average of 153 in the first quarters of the preceding ten years) which were equal to an annual death-rate of 1.27 per 1,000. The ages at death were as follows:— Years. 0—5 5—15 15—25 25—35 35—45 11 deaths. 2 „ 6 „ 21 „ 29 ,, Years. 45—55 55—65 65—75 75—85 85 and upwards 19 deaths. 15 ,, 4 ,, 1 death. – ,, Other Tubercular Diseases—In addition to the deaths from Phthisis there were 35 other tubercular diseases, namely from Tabes Mesenterica Tubercular Meningitis Tuberculosis of the Larynx General Tuberculosis Other forms of Tuberculosis 9 deaths. 19 ,, 1 death. 5 deaths. 1 death. These bring up the total deaths from tubercular diseases to 143 which are equal to an annual death-rate of 1. per 1,000 inhabitants. The distribution of these deaths in the sub-registration districts was as follows:— Phthisis. Tabes Mesenterica. Tubercular Meningitis. Tuberculosis of Larynx. General Tuberculosis. Other forms of Tuberculosis. Totals. Tufnell 8 1 — — – — 9 Upper Holloway 11 2 1 — 1 — 15 Tollington 13 2 — — 1 — 16 Lower Holloway 15 — 3 — 1 1 20 Highbury 15 1 7 — 1 — 24 Barnsbury 15 — 4 — — — 19 Islington South-East 31 3 4 1 1 — 40 The Borough 108 9 19 1 5 1 143 DEATHS FROM THE ZYMOTIC DISEASES.—To these diseases the deaths of 170 persons were ascribed, which were equal to an annual death-rate of 2.00 per 1,000 inhabitants. These returns compare 11 satisfactorily with the corrected average of 178 and the mean death-rate of 2.13 in the first quarters of the ten years 1893-1902. The deaths are, therefore, 8 below this average, and the death-rate 0.13 below the mean. The death-rate was 1.83 per 1,000 in the County of London, while in the Encircling Boroughs the zymotic death-rate was 1.83 per 1,000, whilst in St. Pancras it was 2.07, in Stoke Newington, 1.69, in Hackney, 1.61, in Hornsey, 1.17, in Finsbury, 2.17, and in Shoreditch, 2.01 per 1,000. Locally the deaths and death-rates of the Sub-registration Districts were as follows:— Death-rates. Tufnell 14 deaths = 1.70 Upper Holloway 17 ,, = 1.95 Tollington 23 ,, = 2.64 Lower Holloway 26 „ = 2.50 Highbury 26 ,, = 1.6o Barnsbury 40 = 2.95 Islington South-East 24 = 1.27 The Borough 170 — 2.00 Small Pox.—No death was registered from Small Pox during the quarter, as against an average of 2 deaths in the first quarters of the ten years, 1893-1902. Measles was credited with 35 deaths, or 29 less than the corrected average (64) of the preceding ten first quarters of the year. Pneumonia was ascribed as a secondary cause in 26 of these deaths, Bronchitis in 5, and Empyema in 1, or altogether 32 from these affections of the respiratory organs. In the borough the death-rate was equal to 0.41 per 1,000 inhabitants per annum, in London 0.58, and in the Encircling Boroughs 0.65. Scarlet Fever.—Only 9 deaths were registered, or 3 more than the corrected average (12) of the ten preceding first quarters. The death-rate was 0.10. Diphtheria caused 20 deaths, which were equal to a death-rate of 0.24 per 1,000 inhabitants, as against a corrected average of 37, and a mean deathrate of 0.43 per 1,000. Whooping Cough showed an increased mortality, for 88 deaths were ascribed to it, whereas the average mortality has been 48, and were equal to a death-rate of 1.04 per 1,000 inhabitants. 12 Typhus Fever.—Nil return. During ten years only one death has been registered in the first quarter, namely in 1895. Enteric Fever caused 7 deaths, or one less than the average (8) for the ten preceding first quarters, and produced a death-rate of 0.08. Diarrhœal Diseases.—These led to 10 deaths, which were 4 above the corrected average (6), and the death-rate was 0.12 per 1,000. Continued Fever.—Only one death was ascribed to this disease. OTHER INFECTIOUS DISEASES.—Influenza returned only 30 deaths, compared with a corrected average of 51, the resulting death-rate being 0.35, as against a mean rate of 0.59. Puerperal Fever.—3 deaths were registered, or one above the average (2). This death-rate was in the proportion of 1.32 per 1,000 children born, as against 079 per 1,000 births in the preceding ten first quarters. Erysipelas.—Only 2 deaths were recorded, as against 4 in the corresponding quarter of last year. THE NOTIFICATION OF INFECTIOUS DISEASES. These diseases comprise Small Pox, Scarlet Fever, Diphtheria, Membranous Croup, Enteric Fever, Typhus Fever, Continued Fever, Erysipelas and Puerperal Fever. The total number of cases notified was 437, which produced an annual attack-rate of 5.15 per 1,000 inhabitants. They show a decrease of 209 on the average (646) which obtained in the first quarters of the preceding ten years. This was due to a decrease, on the average of ten years, of 109 cases of Scarlet Fever, 36 cases of Diphtheria, 22 cases of Enteric Fever, and 21 cases of Erysipelas. In London the attack-rate was 6.15 per 1,000, or 1.00 higher than in Islington, while in the Encircling Boroughs it was 6.21, or 1.06 higher than here. Small Pox.—No case was known in the borough during the quarter, as compared with 121 cases in the corresponding quarter of last year, whilst the average for the previous ten (first quarters) was 19. Scarlet Fever, of which 199 cases were notified, showed a decrease of 109 on the corrected average (308) of the first quarters 1893-1902. The attack-rate was equal to 2.35 per 1,000 inhabitants annually, which is a 13 decrease of 1.28 per 1,000 on the mean rate (3.63) of the preceding ten first quarters. Diphtheria and Membranous Croup were not so prevalent, but were, however, responsible for 146 cases of illness, or 36 below the corrected average (182) of the first quarters of the preceding ten years. The attack-rate was equal to 172 per 1,000 inhabitants annually, or 0.43 per 1,000 below the mean rate (2.15) of these quarters. In January the cases averaged 14 per week; in February they fell to 11 per week; and in March to 11 per week, The weekly average for the quarter was 11 cases. The chief incidence of the disease fell on Lower Holloway, Upper Holloway, Tollington and Tufnell Wards, where the attack-rates were respectively 4.53, 1.95, 1.84 and 1.58 per 1.000 inhabitants. In London the attack-rate was 1.95 per 1,000, and in the Encircling Boroughs 2.18. Enteric Fever was notified in 23 instances, or 22 less than the corrected average of 45 which obtained during the first quarters of 1893.2. The attackrate was 0.27 per 1,000 annually, or 0.26 per 1,000 below the mean rate (0.53) of the first quarters during the last ten years. In London the rate was 0.38 and in the Encircling Boroughs 0.43 per 1,000. Typhus Fever.—Nil return. Erysipelas.—Sixty-three cases were notified, or 21 less than the corrected average (84) of the first quarter of the preceding ten years, the attack-rate being 0.74 per 1,000, as compared with 0.96 in London, and 0.96 in the Encircling Boroughs. Puerperal Fever.—Four notifications were received, being in the proportion of 1.77 cases per 1,000 births. These figures represent a decrease of 3 on the average number of cases and of 1.32 in the proportion of attacks to births. Continued Fever.—Two cases were notified, compared with a corrected average of 1, in the first quarters of the ten years 1893-1902. HOSPITAL TREATMENT OF THE INFECTIOUS DISEASES. There were 316 cases isolated in hospital equal to 72.3 per cent. of the 437 cases which were notified during the quarter. 14 This proportion contrasts with previous first quarters as follows :— 1896 - 46.8 per cent. 1900 - 62.6 per cent. 1897 - 55.0 „ 1900 - 62.6 per cent. 1898 - 53.8 „ 1902 - 71.7 „ 1899 - 62.0 „ 1903 - 72.3 „ This percentage has not been exceeded in any previous first quarter. The particulars respecting each disease are as follows:— Scarlet Fever - 174 out of 199 notified cases, or 87^4 per cent, were isolated. Diphtheria - 115 „ 146 „ „ 78.7 Enteric Fever - 16 „ 23 „ „ 69.5 „ Erysipelas - 9 „ 63 „ „ 14.3 Puerperal Fever 1 „ 4 „ „ 25.0 „ „ Continued Fever 1 „ 2 „ „ 50'0 „ ,, FATALITY.—Of the 199 Scarlet Fever cases there died 4.5 per cent.; of the Diphtheria cases 137 per cent.; of the Enteric Fever cases 30.4 per cent.; of the Erysipelas cases 3.2 per cent.; of the Puerperal Fever cases 75 per cent.; and of the Continued Fever cases 50 per cent. The fatality among all the notified cases was 9.6 per cent.; and of all cases treated in hospital 10.1 per cent, and at home 8.2 per cent. DISINFECTION.—Houses.—474 rooms were disinfected with formaldehyde in the first quarter, as compared with 975 in the corresponding period of last year, while 35 rooms were stripped as against 872. In consequence of the prevalance of Measles, Scarlet Fever, and Diphtheria amongst the scholars, the Infants' departments of the following schools were disinfected :— 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 Caledonian Asylum Hornsey Road Board School Alexandra Orphanage Wesley an Schools, Drayton Park Bed Clothing, etc.—5,254 large articles, such as bedding or carpets, were disinfected by the Steam Disinfector, at the Council's Disinfecting Station, compared with 10,639 large articles disinfected in the first quarter of last year. Among them were 414 beds, 735 blankets, 278 15 bolsters, 266 mattresses, 286 palliasses, 708 pillows, 646 sheets, and 1,339 smaller articles which are not classified but disinfected in parcels. Shelter House.—During the first quarter no application was received for admission into the Shelter House. BACTERIOLOGICAL DIAGNOSES.—63 examinations were made of sputum, blood and membrane of patients suspected to be suffering from either Phthisis, Enteric Fever, or Diphtheria, of which 17, or 27 per cent., gave positive results. Diphtheria.—22 cases were examined, and in 5, or 22.7 per cent., the disease was identified. Enteric Fever.—14 specimens of blood were submitted for examination, of which 2, or 14.3 per cent., gave indications of the disease. Phthisis.—27 specimens of sputum were examined, and in 10, or 37 per cent., tubercle bacilli were discovered. INFECTIOUS DISEASES IN THE PUBLIC ELEMENTARY SCHOOLS. Notifiable Infectious Diseases.—Out of the total number of infectious diseases (437) notified during the quarter 196 occurred among children attending the Public Elementary Day Schools, of whom 123 were attacked with Scarlet Fever, 61 with Diphtheria, 7 with Enteric Fever, and 5 with other Fevers. Scarlet Fever was most prevalent in the following schools, viz:— Yerbury Road (7) ; Catholic School, Eden Grove (7) ; St. John's, Conewood Street (11); and Richard Street Board School (9). Diphtheria occurred in 25 out of 55 schools. The largest number of recorded cases was referred to Brecknock, Hungerford and Canonbury Road Board Schools, in each of which there were 11, 7 and 5 cases respectively. Enteric Fever. —Only 7 cases occurred among the scholars of 6 schools. In addition to the 196 cases of notifiable diseases among scholars, 122 cases occurred among children and adults who resided in houses from which children attended the schools. Non-Notifiable Diseases.—A large number of cases (1,103) have come to my knowledge during the quarter. They comprised 533 cases of Measles, 115 of Whooping Cough, 107 of Chicken Pox, and 348 of other diseases. 16 The information respecting these cases was received for the most part from the teachers of 41 schools, to whom the Public Health Department feel much indebted. INSPECTION AND EXAMINATION OF FOOD AND PLACES WHERE FOOD IS PREPARED. Food—Inspection of.—Inspector Wilkinson reports that during the quarter he has paid 655 visits to the 42 slaughter houses, in which he has ascertained that 9,598 animals were killed, namely :—668 oxen, 102 cows, 8 calves, 31 pigs, and 8,789 sheep. The total amount of unsound or diseased meat destroyed was 16 cwt., 2 quarters. 10 lbs. The diseases from which the animals suffered are set out in detail in his report. Cow Houses.—These, which number 13, were visited systematically, 38 inspections having been made. Offensive Trade Establishments.—47 visits have been paid to these places, and 13 visits to the knacker's yard. In none of these has there been cause for complaint. Mr. H. WILKINSON'S REPORT. Public Health Department, Town Hall, To A. E. Harris, Esq., Upper Street, N. Medical Officer of Health. April 21st, 1903. Dear Sir, I have pleasure in submitting my report for the quarter ending April 4th, 1903, on the inspection of slaughterhouses, butchers' raeat, etc., etc. During the quarter 655 visits have been paid to the 42 slaughterhouses within the Borough, the whole of which have been kept in satisfactory sanitary condition. The numbers of animals slaughtered therein during the period were as follows, viz. :— Oxen. Cows. Calves. Sheep. Pigs. Totals. 668 102 8 8,789 31 9,598 These, generally speaking, were of good quality, but tuberculous lesions were found in the carcase or some individual organ or organs of 35 cattle, 31 of which were cows and 4 oxen; the whole of which carcases were well nourished and in every case the affection was mild in degree or localised in extent. After the necessary stripping of diseased membranes and the rejection of affected organs or parts the carcases were passed as fit for human consumption. The carcases and organs of two calves which were unwholesome and unfit for human food were condemned, as were also the carcase and organs of a sheep which had died or been slaughtered in a moribund condition. A large number of organs (various) were condemned on account of other diseases and affections, chiefly of a parasitic nature, particulars of which will also be found in the appended table:— 17 No. Description of Carcase. Extent of Disease or Affection. Nature of Disease. How disposed of. 2 Calves Entire carcase and Organs Unwholesome Carcase & Organs destroyed 1 Sheep do. do. do. do. do. 1 Ox Portion of flank, &c. Bruised Bruised parts do. 1 Cow Right flank do. do. do. 1 do. All internal organs—heart T uberculosis Affected Organs do. 1 Ox All internal organs—heart and liver do. do. do. 4 Cows Lungs, liver and bronchial lymphatic glands do. do. do. 1 do. Lungs, tripe, spleen, &c. do. do. do. 3 do. Lungs and bronchial lymphatic glands do. do. do. 14 do. Lungs do. do. do. 3 Oxen do. do. do. do. 2 Cows Livers do. do. do. 6 do. Mediastinal and other bronchial lymphatic glands do. do. do. 6 do. Livers Abscesses do. do. 3 Oxen do. do. do. do. 3 Cows do. Distomatosis do. do. 1 Ox do. do. do. do. 1 Cow Head and tongue Actinomycosis do. do. 13 Sheep Liver and lungs Echinococus do. do. Veterinorum 22 do. Lungs do. do. do. 5 do. Livers do. do. do. 1 do. do. Distomatosis do. do. 1 do. Liver, lungs and heart Abscess do. do. 1 do. Lungs Pseudo-tuberculosis do. do. 1 do. do. Congested do. do. 1 do. Kidney and surrounding fat and tissues Dropsical do. do. The whole of the foregoing organs, etc., were found in slaughterhouses and were destroyed by owners' consent. The butchers' shops and stalls, the preserved meat factories, and various food establishments have been regularly and frequently visited, over 1,100 visits being paid to these during the quarter, and the quality of the meat, etc., as a general rule has been good. The following unsound foods were found during such visits, viz. :—20 lbs. of beef tainted, 5 ox tails tainted, 3 rabbits tainted, 78 lbs. of unsound fruit, and 450 lbs. of ox livers and spleens, which came under your notice and were condemned as unwholesome and unfit for human consumption on account of imperfect preservation in a cold air store. These were all destroyed by owners' consent, and warnings were addressed to persons where any disregard or carelessness concerning the provisions of the unsound food clauses of the Public Health Act were observed. The approximate weight of diseased and unsound food destroyed during the quarter were as under, viz. : — Cwt. Qrs. lbs. Diseased organs, meat, etc., from slaughterhouses 11 2 6 Unsound meat, organs, etc., from shops 4 1 10 Unsound fruit, from shops 0 2 22 Total 16 2 10 18 The 13 cowsheds have received 38 visits, and have been fairly well kept; the offensive trade establishments have been visited regularly, a total of 47 visits being paid to these; and also 13 visits to the knacker's yard. In none of these has any cause for complaint arisen during the quarter. I am, Sir, Yours Obediently, H. WILKINSON, Meat Inspector. Adulteration of Food.—During the first quarter 284 samples of food and drugs were purchased, or procured during transit by the Inspectors, of which, 5 were bought under the Margarine Act; 43 or 15*4 per cent, of the total samples were found upon analysis to be adulterated. The samples included, Milk, 151 ; Butter, 41; Coffee, 13; Cocoa, 8 ; Demerara Sugar, 15; Iron Pills, 6; Cream of Tartar, 2 ; Tincture of the Perchloride of Iron, 2; Whiskey, 1; Gin, 1. Of these there were adulterated :— Milk 20, or 13 per cent.; Butter 5, or 12 per cent.; Demerara Sugar 7, or 47 per cent.; Iron Pills 4, or 66 per cent. 29 summones were issued, of which 26 were successfully prosecuted. PenaltiesAltogether penalties to the amount of £56 were obtained, and of this amount £35 15s. resulted from Inspector Ward's prosecutions, and £20 5s. from the prosecutions by the other Inspectors. Milk.—The particulars of the Analysis of the Milk samples, which I have now published for several years for the purpose of showing that the official standard is too low, were as follows:— Milk procured in transit at No. of Samples. Solids not Fat. Fat. Total solids. Finsbury Park Station 30 8.70 3.71 12.41 Milks taken on Sundays 52 8.41 3.55 11.96 Milks taken on week-days 69 8.45 3-64 ., I2'00 Official Standard - 8.50 3 00 .. . 11*50 The particulars as to the genuineness or otherwise of the samples procured or purchased on Week-days, Sundays, and at Finsbury Park Railway Station were as follows :— Number taken. Genuine. Adulterated. Percentage Adulterated Samples taken Sundays 52 46 6 11.5 Samples taken on Weekdays 69 56 13 18.8 Samples taken at Finsbury Park Station 30 29 1 3.3 151 131 20 13.2 19 PUBLIC ANALYST'S REPORT. The Worshipful the Mayor, Aldermen and Councillors of the Metropolitan Borough of Islington. Gentlemen, During the Quarter ending on March 31st, I have analysed 289 samples submitted to me for that purpose under the Sale of Food and Drugs Acts. Of these samples I had to report against 46, showing 15-9 per cent, of adulterated samples. These samples came from three sources. 99 were submitted by your Special Food and Drugs Inspector, but his time has been so much occupied by other duties that he has only been able to purchase about two-thirds of his usual number. The advisability of relieving your Food and Drugs Inspector from his other duties is a matter I have commented on previously, and the figures of the present Quarter strengthen my reasons. Of the 99 samples from your Food and Drugs Inspector 25 samples (or 25-3 per cent.) were adulterated. The second source of supply was your other Inspectors, who submitted 185 samples, of which 18 samples (or 9-7 per cent.) were adulterated ; and the third source of supply was a private purchaser, who submitted 5 samples of butter, of which 3 samples (or 60 per cent.) were adulterated. Of the 284 samples purchased officially 43 samples (or i5'i per cent.) were adulterated. Previous comments of mine on the prevalence of adulteration in Islington have been the cause of placing me in a most unpleasant position, which is not encouraging to anyone endeavouring to fearlessly and honestly perform his statutory duties. My views have, however, so comparatively recently been placed before you that I trust it is unnecessary on the present occasion to repeat them. I am, Gentlemen, Your obedient servant, FRANK L. TEED, Public Analyst. 20 Showing the Samples of Food and Drugs submitted to, and examiued by, the Public Analyst {Mr. F. L. Teed, D.Sc.) during the First Quarter, 1903. Samples taken. Description. Genuine. Adulterated. 151 Milk 131 20 .. Brandy .. .. 1 Whisky .. 1 .. Rum .. .. 1 Gin .. 1 8 Cocoa 8 .. 13 Coffee 12 1 1 Black Tea 1 .. 1 Pepper, White 1 .. 2 Pepper, Black 2 .. 1 Mustard 1 .. 1 Arrowroot 1 .. 2 Linseed, Crushed 2 .. Bread .. 5 41 Butter 36 .. 1 Lard 1 .. 1 Ground Ginger 1 .. 15 Demerara Sugar 8 .. 2 Malt Vinegar 2 .. 2 Baking Powder 2 3 Yeast 2 2 Paregoric 2 2 Lime Water 2 .. Quinine Wine 1 1 Sal. Volatile .. Precipitated Sulphur .. .. Diluted Acetic Acid .. 2 Tincture of Digitalis 2 2 Camphor, Spirits of 2 .. Iodi. Tinct .. 2 Solution of Strychnine Hydrochloride 2 1 Tincture of Nux Vomica 1 1 Tincture of Iodine 1 3 Sweet Spirits of Nitre 3 2 Tincture of Gentian 2 2 Olive Oil 2 Juniper Oil .. 1 Cream of Tartar 1 1 1 Prescription .. 1 .. Sulphate of Quinine .. 6 Iron Pills 2 4 Milk Sulphur .. 2 Com. Tincture of Rhubarb 2 1 Tincture of the Perchloride of Iron .. 1 279 All Articles 236 43 = 15.4 MARGARINE ACT. Samples. Description. Samples taken in contravention of Act. 5 Margarine 0 N,B.—Five samples of butter were also submitted to Dr. Teed by private purchasers, of which two were genuine and three adulterated. 21 SANITARY WORK. FACTORY ACT—ADMINISTRATION OF. Factories, Workshops, Laundries and Bakehouses, Inspection of. —inspector West and Miss Gray made 2,106 inspections and visits to the factories, workshops and bakehouses in the district. The several inspections and visits of these inspectors were as follows:— Inspector West. Miss Gray. Total. Factories and Workshops 915 708 1623 Homeworkers — 226 226 Bakehouses 63 — 63 Restaurants - 194 — 194 Totals II72 934 2106 Bakehouses.--The Public Health Sub-Committee visited 119 Underground Bakehouses during the quarter, in company with the Medical Officer of Health and the Chief Inspector. In every instance a communication has been sent to the occupiers or owners advising them that before a certificate is granted by the Council in accordance with section 101 (2) of the " Factory and Workshop Act, 1901," certain specified alterations must be carried out in order to comply with the requirements necessary to render the premises suitable for the purpose. INSPECTOR WEST'S REPORT. Town Hall, Upper Street, Islington, N. To A. E. Harris, Esq., April 22nd, 1903. Medical Officer of Health. Sir, I have pleasure in submitting for your consideration a report of my work for the three months ending the 4th April, 1903, during which period you will observe I have visited 1,172 places of business, comprising factories, workshops, and work-rooms in the Borough, and reported upon various nuisances existing thereon; 531 inspections and 641 re-inspections were made, including visits to the following trades:—'112 tailors, 190 shoemakers, 46 pianoforte makers, 31 cycle makers, 63 bakehouses, 194 restaurants, and 536 miscellaneous. During the quarter, 90 notices have been served for the abatement of nuisances, 82 workshops have been limewhited, 7 additional w.c.'s have been provided (5 for males and 2 for females), also 108 other improvements have been carried out. Outworkers.—In accordance with Section 107 of the Factory and Workshop Act, 1901, I have sent to the Medical Officers of Health of various Metropolitan Boroughs the names and addresses of 140 outworkers who live and work at home in their districts for tradespeople in this Borough. 22 I have reported to H.M. Inspector of Factories the addresses of three workshops in the Borough where young people under the age of 18 years were employed, as required by Section 27 of the Public Health Act, 1901. Register.—At present there are 618 workshops with 909 work-rooms on the register. Thirty, five workshops containing 39 work-rooms have been added during the quarter. I am, Sir, Your Obedient Servant, GEORGE WEST, Inspector of Workshops, Src. MISS GRAY'S REPORT. The Town Hall, To A. E. Harris, Esq., Islington, N. Medical Officer of Health. APril 22nd> 1903' Sir, I have the honour of laying before you a report of my work for the first three months of the year 1903. Register.—At the end of the quarter there were on the Register 1,089 workshops, work-places and laundries, in which females were employed, containing 1,828 work-rooms. Fifty-nine workshops, etc., were added to the Register during the quarter, while 39 workshops were removed from it. The addresses of 53 workshops, not previously visited by H.M. Inspector of Factories for the district, have been forwarded to him. Inspections.—I have made 548 inspections during the quarter; 295 of these inspections were of the registered workshops, 226 were of the homes of female outworkers, and 27 were miscellaneous inspections. The premises inspected contained 713 work-rooms. I have also made 386 calls and re-inspections. Cleanliness.—I found 22 work-rooms in a dirty condition. Eighteen of these were cleansed and whitewashed, and arrangements were made for the others to be done during the Easter holidays. Overcrowding.—I found four work-rooms overcrowded; in these the overcrowding has been abated. I have distributed 77 cards, stating the cubic capacity of work-rooms and the number of persons who may be employed in each. Sanitary Defects.—Besides the defects which I have mentioned, I have discovered and reported to you 28 defects, liable to be dealt with as "nuisances" under the Public Health Act. I have served seven intimation notices, and I have personally supervised the abatement of 12 nuisances. Homeworkers.—During the quarter I have paid 286 visits to the homes of female outworkers, who were notified as living in Islington, and whom I had not previously visite'd. Sixty of these had removed or had given up work before I called on them. I inspected the homes of 226 workers. The addresses of 297 homeworkers who work for Islington employers in other districts have been forwarded to the Medical Officers of Health for those districts. I am, Sir, Your Obedient Servant, JESSY M. S. GRAY, Sanitary Inspector. 23 Housesw Let in Lodgings—Inspection of.—The houses on the register, to which 53 were added during the quarter, number 586. They received 2,146 visits, which resulted in 337 improvements being effected in 170 houses. Inspector Jordan. Inspector Ward. Totals. Houses on Register "- & - 586 Houses Inspected - - 318 - 42 - 360 Re-visits - - - 1,287 * 499 - I»786 Premises Improved - 170 - — - 170 Improvements - - 337 - — - 337 District Inspection.—During the first quarter 1,470 houses were inspected by the District Inspectors, in which 3,503 improvements were effected. The subsequent visits for the purpose of inspecting work in the course of construction or for passing it when completed numbered 16,062. Among the nuisances dealt with were the following :— Dirty houses - 155 Defective Dustbins - 135 Foul w.c.'s 196 Defective Drains 372 Improperly constructed w.c.'s 258 Unventilated Drains 154 Defective w.c.'s 154 Rain water pipes connected Insanitary yards 135 with drains *45 Gullies inside houses 106 Mortuary and Coroner's Court.—During the first quarter 168 bodies were received into the mortuary, and 110 inquests were held. PROSECUTIONS.—First Quarter, 1903. Successful. Dismissed. Withdrawn. Total. " Public Health (London) Act, 1891 " - 4 I — 5 " Sale of Food and Drugs Acts " - 26 3 — 29 " Margarine Act " .... — — — — 30 4 — 34 24 Table I. Deaths Registered in the Borough of Islington during Quarter ending 4th April, 1903. Deaths of Non-Residents in Hospitals excluded. Deaths of Residents in Public Institutions are distributed. Deaths in In-i stitutions within Boro' DISEASES. AGES. Under 5. Over 5. DISTRICTS. Males. Females. Totals. 0- 1- 5- 10 l5- 20- 25- 35- 45- 56- 65- 75- 85- Tuf. U.K. Toll. L.H. H. B. S.E. Small Pox (a) Vaccinated .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. (b)Unvaccinated .. .. .. .. .. .. .. .. .... .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. (c)No Statement .. .. .. .. .. .. .. .. .... .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Measles 7 28 .. .. .. .. .. .. .. .. .. .. 35 .. 3 1 1 2 9 12 7 23 12 35 Scarlet Fever 1 4 1 2 .. .. 1 .. .. .. .. .. .. 5 4 1 1 .. 1 2 3 1 1 8 9 Typhus Fever .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 2 Epidemic Influenza .. 1 1 .. 1 1 3 3 7 7 4 2 .. 1 29 4 4 2 1 6 5 8 16 14 30 3 Whooping Cough 43 44 1 .. .. .. .. .. .. .. .. .. .. 87 1 5 13 18 14 11 17 10 40 48 88 1 Diphtheria 1 8 8 1 .. 1 1 .. .. .. .. .. .. 9 11 1 2 2 8 1 5 1 11 9 20 Enteric Fever .. .. .. 1 1 1 .. 2 1 1 .. .. .. .. 7 .. .. .. 1 3 2 1 3 4 7 Asiatic Cholera .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 1 Diarrhoea, Dysentery 6 3 .. .. .. .. .... .. .. .. .. .. .. 9 .. 3 .. 2 .. .. 1 3 5 4 9 Epidemic Enteritis .. 1 .. .. .. .. .. .. .. .. .. .. .. 1 .. .. .. .. .. .. .. 1 1 1 Other Allied Diseases .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Hydrophobia .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Glanders .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Tetanus .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Anthrax .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Cow Pox .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 1 Syphilis 2 1 .. .. .. .. .. 1 .. .. .. .. .. 3 1 .. 2 .. 1 .. .. 1 3 1 4 Gonorrhœa .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Phagedœna .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Erysipelas 2 .. .. .. .. .. .. .. .. .. .. .. .. 2 .. 1 .. .. 1 .. .. .. 2 2 Puerperal Fever .. .. .. .. .. 1 2 .. .. .. .. .. .. .. 3 1 1 .. 1 .. .. .. .. 3 3 1 Pyaemia 1 .. .. .. .. .. .. 1 1 1 1 .. .. 1 4 .. 1 .. 2 .. 1 .. 3 5 Infective Endocarditis .. .. .. .. 1 .. 1 .. .. .. .. .. .. .. 2 .. .. 1 1 .. .. .. .. 2 2 2 Other Allied Diseases 1 1 *1 .. .. .. .. .. .. .. 1 .. .. 2 2 *2 .. .. 1 .. 1 .. 4 4 Malarial Fever .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Rheumatic Fever .. .. .. 1 .. .. .. .. .. .. 1 .. .. .. 2 .. .. .. .. 1 .. 1 2 2 Rheumatism of Heart .. .. .. .. .. 1 .. .. 1 1 .. .. .. .. 3 .. .. .. .. 2 .. 1 1 2 3 Tuberculosis of Brain 5 10 3 .. .. 1 .. .. .. .. .. .. .. l5 4 .. 1 .. 3 7 4 4 12 7 19 Tuberculosis of Larynx .. .. .. .. .. .. 1 .. .. .. .. .. .. .. 1 .. .. .. .. .. .. 1 1 1 26 Phthisis 5 6 1 1 2 4 21 29 19 l5 4 1 .. 11 97 8 11 13 l5 15 15 31 57 51 108 1 Abdominal TuberculoAbdominal Tuberculosis 4 5 .. .. .. .. .. .. .. .. .. .. .. 9 .. 1 2 2 .. 1 .. 3 4 5 9 General Tuberculosis .. 2 2 .. .. .. .. .. .. 1 .. .. .. 2 3 .. 1 1 1 1 .. 1 3 2 5 Other forms Tuberculosis .. .. 1 .. .. .. .. .. .. .. .. .. .. .. 1 .. .. .. 1 .. .. .. 1 1 Other Infective Diseases .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Thrush 1 .. .. .. .. .. .. .. .. .. .. .. .. 1 .. .. .. .. .. .. .. 1 1 1 Actinomycosis .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Hydatid Diseases .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Scurvy .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Other Diseases due to Altered Food .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Acute Alcoholism .. .. .. .. .. .. 1 .. .. .. .. .. .. .. 1 .. .. .. .. .. 1 .. 1 1 1 Chronic Alcoholism .. .. .. .. .. .. .. 1 3 3 1 .. .. .. 8 2 1 1 .. 2 .. 2 5 3 8 Chronic Industrial Poisonings .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Other Chronic Poisonings .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Osteo-arthritis .. .. .. .. .. .. .. .. 1 1 1 .. 1 .. 4 .. .. .. 1 1 1 1 1 3 4 Gout .. .. .. .. .. .. .. .. .. .. .. 1 .. .. 1 .. .. .. 1 .. .. .. .. 1 21 Cancer .. .. 2 1 .. 1 2 17 22 22 17 6 .. .. 90 6 9 10 7 19 16 23 38 52 90 Diabetes Mellitus .. .. .. .. .. .. .. .. .. 1 2 .. .. .. 3 .. 1 .. .. 1 .. 1 1 2 3 Purpura Hœmorrhagica .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Hœmophilia .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Anaemia .. .. .. .. .. .. .. .. .. 1 1 .. .. .. 2 .. 1 1 .. .. .. .. 1 1 2 Lymphadenoma .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Premature Birth 54 .. .. .. .. .. .. .. .. .. .. .. .. 54 .. 3 4 5 8 12 5 17 24 30 54 Injury at Birth .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Debility at Birth 9 .. .. .. .. .. .. .. .. .. .. .. .. 9 .. 1 1 .. 2 1 1 3 8 1 9 Atelectasis 5 .. .. .. .. .. .. .. .. .. .. .. .. 5 .. .. 2 .. .. .. 1 2 3 2 5 Congenital Defects 5 1 .. .. .. .. .. .. .. .. .. .. .. 6 .. .. .. 2 .. .. .. .. 5 6 Want of Breast Milk .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Atrophy, Debility, Marasmus 32 5 .. .. .. .. .. .. .. .. .. .. .. 37 .. 5 9 1 3 6 4 9 21 lb 37 * 1, Continued Fever. 25 Table I.—Continued. Deathsin lnstitutions within Boro' 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 6 4 .. .. .. .. .. .. .. .. .. 10 .. 1 1 4 2 1 1 .. 6 4 10 Rickets 1 3 .. .. .. .. .. .. .. .. .. 4 .. .. .. .. 1 .. .. .. .. .. 4 Old Age Senile Decay .. .. .. .. .. .. .. .. .. 8 22 12 .. 42 4 5 .. 5 .. .. .. .. 23 42 Convulsions 18 1 .. .. .. .. .. .. .. .. .. 19 .. 1 5 1 3 1 1 7 13 6 19 Meningitis .. 2 2 .. .. .. .. .. 2 .. .. 5 4 1 .. 1 1 2 .. .. .. .. 9 Encephalitis .. .. .. .. 1 .. .. .. .. .. .. .. 1 .. .. 1 .. .. .. .. .. 1 1 Apoplexy .. .. .. .. .. .. .. .. 4 2 8 5 .. .. 19 1 2 3 2 5 3 3 8 .. 19 Softening of Brain .. .. .. .. .. .. .. .. .. 1 2 .. .. 3 .. .. .. 1 2 .. .. 2 .. 3 Hemiplegia .. .. .. .. .. .. .. .. .. 1 5 3 .. .. 9 .. 2 .. 2 2 .. 3 3 6 9 General Paralysis of the Insane .. .. .. .. .. .. .. 1 2 .. .. .. .. .. .. .. .. .. .. .. .. .. 7 other forms of Insanity .. .. .. .. .. .. 1 1 1 3 1 .. .. 7 l 3 .. 1 .. .. 2 1 6 7 Chorea .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Cerebral Tumour .. 1 .. .. .. .. .. .. 1 .. .. 1 1 1 1 .. .. .. .. .. .. .. 2 Epilepsy .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 14 Laryngismus Stridulus .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 6 Locomotor Ataxy .. .. .. .. .. .. .. .. 1 1 .. .. .. 2 .. .. .. 1 1 .. .. .. .. 6 Paraplegia .. .. .. .. .. .. .. .. .. 3 5 6 .. .. 14 .. 1 .. 3 2 4 4 6 8 14 Other forms, Brain Diseases .. .. .. .. .. 1 1 1 .. 1 1 .. .. 1 5 .. .. .. 1 1 1 3 2 .. 6 Otitis 4 .. .. .. 1 .. .. 1 .. .. .. 4 2 .. .. .. 3 2 1 .. 2 4 6 Disease of Nose, Epistaxis 1 .. .. .. .. .. .. .. .. .. .. 1 .. .. .. 1 .. .. .. .. 1 .. 1 Disease of Eye 1 .. .. .. .. .. .. .. .. .. .. 1 .. .. .. .. .. .. .. .. .. .. 1 Pericarditis .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 1 Endocarditis .. .. 1 .. .. 1 1 .. .. .. .. .. 3 .. .. .. .. .. .. .. .. .. .. Hypertrophy of Heart .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 1 Angina Pectoris .. .. .. .. .. .. .. .. .. 1 .. .. .. 1 .. .. .. .. .. .. .. .. .. 4 1 Aneurism .. .. .. .. 1 .. .. .. 1 1 1 .. .. .. 4 .. .. .. .. .. .. .. .. .. 1 Senile Gangrene .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. ..6 2 Embolism, Thrombosis .. .. .. .. .. .. 1 .. 1 2 1 1 .. 6 .. 1 2 2 1 .. .. .. .. .. Phlebitis .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 1 Varicose Veins .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 36 Othc Diseases, Heart and Vessels 1 2 .. 2 4 2 4 11 17 30 28 23 7 3 128 10 12 10 15 22 33 29 51 80 131 Laryngitis .. 2 .. .. .. .. .. .. .. 1 .. .. .. 2 1 1 2 .. .. .. .. .. 3 Croup .. 1 .. .. .. .. .. .. .. .. .. .. .. 1 .. .. .. .. .. 1 .. .. 1 Other Diseases, Larynx and Trachea 1 .. .. .. .. .. .. .. .. .. .. .. .. 1 .. .. .. 1 .. .. .. 1 1 Acute Bronchitis 26 19 .. .. .. .. 1 3 1 4 12 7 1 45 29 9 10 4 9 11 11 20 36 38 74 Chronic Bronchitis .. 2 l .. .. 1 1 4 15 20 31 26 9 2 108 5 4 12 13 19 24 33 41 69 110 Lobar Pneumonia .. .. .. .. 1 .. 1 .. 1 .. .. 1 .. .. 4 .. 1 .. .. 2 1 .. 2 4 Lobular Pneumonia .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 108 Pneumonia .. 34 .. .. .. 2 4 6 2 11 8 6 5 64 44 7 13 17 13 7 21 30 58 .. 1 Emphysema, Asthma .. .. .. .. .. .. .. .. .. 1 .. .. .. .. 1 .. 1 .. .. .. .. .. .. 4 2 Pleurisy .. .. .. .. .. 1 .. .. 1 .. 2 .. .. .. .. .. .. .. .. .. .. .. 3 Other Diseases, Respiratory System .. .. l .. 1 .. .. 1 .. 1 .. 1 .. .. 5 1 1 .. 1 1 1 3 2 5 Diseases of Mouth and Annexa .. .. 2 .. .. .. .. .. .. .. .. .. .. .. 2 .. 1 .. .. 1 1 1 2 Diseases of Pharynx .. .. .. .. .. .. .. .. .. .. .. .. .. 2 .. .. 1 1 .. .. .. .. .. .. 2 Diseases of Œsophagus .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Ulcer of Stomach and Duodenum .. .. .. 1 .. 1 2 3 1 .. .. .. .. .. 8 1 1 1 1 1 3 2 6 8 Other Diseases of Stomach 6 .. .. .. .. .. .. .. .. 1 1 1 .. 6 3 .. .. 3 .. .. .. .. 9 Enteritis 14 3 .. .. 1 .. .. .. .. .. .. 1 .. 17 2 1 1 2 4 .. .. 3 .. .. 19 Appendicitis .. .. 1 1 2 1 .. .. .. .. .. .. .. .. 5 1 .. 1 1 2 4 1 5 Obstruction of Intestine 5 .. .. .. .. .. .. .. .. 1 1 .. .. .. 2 .. 2 3 1 1 .. 4 3 7 Other Diseases of Intestine .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Cirrhosis of Liver .. .. .. .. .. .. .. 1 1 1 .. .. .. .. 3 .. 1 .. 1 1 .. 1 2 3 Other Diseases of Liver .. .. .. .. .. .. 1 .. .. .. 1 .. 1 .. 3 .. 1 .. .. 1 1 .. 1 3 Peritonitis 1 .. .. .. .. .. 2 .. .. .. .. .. .. .. 2 .. 1 .. .. .. .. .. .. 3 Othc Diseases, Digestive System .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Diseases, Lymphatic System and Glands 1 .. .. .. .. .. .. .. 1 1 2 .. .. 1 4 .. .. 2 1 2 1 4 5 Acute Nephritis .. .. 2 .. .. .. 1 1 .. .. .. .. .. .. 4 1 .. 3 .. .. 4 .. 4 Bright s Disease .. .. .. .. .. .. 3 1 3 5 5 5 .. .. 22 1 3 2 6 5 3 3 14 8 22 Calculus .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Diseases of Bladder and Prostate .. .. .. .. .. .. .. .. .. 1 3 2 .. .. 6 .. 1 1 1 2 1 6 .. 6 Other Diseases, Urinary System .. 1 .. .. .. .. .. .. 1 1 1 2 .. 1 5 2 2 1 .. .. .. .. 6 Diseases of Testis and Penis .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Diseases of Ovaries .. .. .. .. .. 1 .. .. .. .. 1 .. .. .. 2 .. 1 1 .. .. .. .. 2 2 Diseases of Uterus and Appendages .. .. .. .. .. .. 1 1 .. 1 .. .. .. .. 3 .. 1 1 .. 1 .. 6 3 Diseases of Vagina and External Genitals .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Diseases of Breast .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Abortion, Miscarriage .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Puerperal Mania .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Puerperal Convulsions .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Placenta Praevia, Flooding .. .. .. .. .. .. 1 .. .. .. .. .. .. .. 1 .. .. .. 1 .. .. 1 1 26 Table I.—continued. Deaths in Institutions within Boro'. 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. Puerperal Thrombosis .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Other Diseases, Pregnancy and Childbirth .. .. .. .. .. 1 .. .. .. .. .. .. .. .. 1 1 .. .. .. .. .. .. .. 1 1 Arthritis. Ostitis, Periostitis .... .. .. .. .. .. .. .. .. 1 .. 3 .. .. .. 4 .. .. 1 1 1 .. 1 1 3 4 Other Diseases, Osseous System .. .. .. 1 .. .. .. 1 .. .. .. .. .. .. 2 .. .. .. .. 1 .. 1 .. 2 2 Ulcer, Bedsore .. .. .. .. .. .. .. .. .. .. .. 1 .. .. 1 .. 1 .. .. .. .. .. 1 .. 1 Eczema .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Pemphigus .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Other Diseases, Integumentary System 1 1 .. .. .. .. .. .. .. .. .. .. .. 2 .. .. 1 .. 1 .. .. 1 1 2 Accidents and Negligence. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. In Vehicular Traffic .. .. .. .. .. .. .. 1 .. .. .. .. .. .. 1 .. .. 1 .. .. .. .. 1 .. 1 On Railways .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. On Ships, Boats, etc. (not drowing) .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. In Building Operations .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. By Machinery .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. By Weapons and Implements .. .. .. .. 1 .. .. .. .. .. .. .. .. .. 1 .. .. .. .. 1 .. .. 1 .. 1 Burns and Scalds .. 2 .. .. 1 .. 1 2 2 .. .. 1 .. 2 7 .. 3 .. 1 2 2 1 2 7 .. 1 Poisons, Poisonous Vapours .. .. .. .. .. .. .. .. .. 1 .. .. .. .. 1 1 .. .. .. .. .. .. 1 .. 1 Surgical Narcosis .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Eftects of Electric Shock .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Corrosions by Chemicals .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Drowning .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Suffocation, Overlaid in Bed 15 .. .. .. .. .. .. .. .. .. .. .. .. 15 .. .. .. 2 1 2 6 4 9 6 15 ,, Otherwise 3 .. .. .. .. .. .. .. .. .. .. .. .. 3 .. .. .. .. .. .. .. 3 3 .. 3 4 Falls not specified .. 1 .. .. .. .. 1 2 2 1 .. 2 .. 1 8 .. 1 2 .. 1 2 3 4 5 9 Weather Agencies .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Otherwise, not stated 2 .. .. .. .. .. .. .. .. .. .. .. .. 2 .. .. .. .. 1 .. .. 1 2 .. 2 Homicide 2 .. .. .. .. .. .. .. .. .. .. .. .. 2 .. .. 1 .. .. 1 .. .. 1 1 2 Suicide. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. By Poison .. .. .. .. .. .. .. 1 3 .. .. .. .. .. 4 1 .. .. 1 .. 2 .. 1 3 4 By Asphyxia .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. By Hanging and Strangulation .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. By Drowning .. .. .. .. .. .. .. .. 1 1 .. .. .. .. 2 .. .. .. .. .. 2 .. 2 .. 2 By Shooting .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. By Cut or Stab .. .. .. .. .. .. 1 1 .. .. .. .. .. .. 2 .. 1 .. .. .. .. 1 1 1 2 By Precipitation from Elevated Places .. .. .. .. .. .. .. 1 .. .. .. .. .. .. 1 l .. .. .. .. .. .. .. 1 1 By Crushing .. .. .. .. .. .. .. 1 .. .. .. .. .. .. 1 .. .. .. .. .. .. 1 1 .. 1 By other and unspecified methods .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 1 Execution .. .. .. .. .. .. .. .. 1 .. .. .. .. .. 1 .. .. .. .. .. .. 1 .. 1 1 Sudden Death, cause not ascertained .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Ill-defined and unspecified causes .. .. .. .. .. .. .. .. .. .. 1 .. .. .. 1 .. .. .. .. 1 .. .. .. 1 1 Males 193 102 15 5 7 10 34 39 63 73 69 57 14 295 386 46 73 59 102 114 116 172 .. .. 681 Females 136 97 16 7 12 16 31 62 58 78 96 73 23 233 469 61 78 82 79 115 133 154 .. .. 702 152 TOTAL DEATHS 329 199 31 12 19 23 65 101 121 151 165 130 37 528 855 .. 151 140 181 229 249 326 681 702 1383 Table II. Showing the Births, Deaths, Infantile Mortality, the Deaths from the Zymotic Diseases, and from Influenza, CanCer, Phthisis and Puerperal Fever during the First Quarters, 1898—1903. Years. Births. Birth-rates. Deaths. Death-rate. 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-rate. Influenza. Cancer. Phthsis. Puerperal Totals. Small Pox. Measles. Scarlet Fever. Diphtheria. Whooping Cough. Typhus Fever. Enteric Fever. Simple and undefined Fevers. Diarrhoeal Diseases. Deaths. Death-rates. Deaths. Death-rates. Deaths. Death-rates. Deaths. Deaths in 1,000 births. 1893 2,492 30-48 1,597 19.53 403 161 134 .. 25 24 32 32 .. 9 .. 12 1.64 31 0.37 58 0.71 123 1.50 2 0 .80 1894 2,490 3014 1,613 19.52 313 125 231 .. 66 16 64 70 .. 8 .. 7 2.79 31 0.37 45 0.54 146 1.77 5 2.01 1895 2,618 31-35 1,936 23.18 353 134 106 .. 7 21 25 35 ..1 9 1 7 1.27 137 1.64 65 0.78 191 2.29 3 1.14 1896 2,467 2922 1,664 19.71 373 151 330 .. 170 10 56 76 .. 13 2 3 3.91 13 0.15 58 0.68 126 1.49 1 0.40 1897 2,570 30.48 1,421 16.85 296 115 122 .. 15 18 40 38 .. 7 .. 4 1.45 14 0.16 66 0.78 142 1.68 3 1.l6 1898 2,401 28.52 1,774 20.71 362 151 308 .. 183 10 41 58 .. 4 1 11 3.66 41 0.48 65 0.77 133 1.58 3 1.25 1899 2.493 29.65 1,681 19.99 308 123 131 .. 45 3 12 61 .. 9 .. 1 1.56 52 0.61 58 0.69 165 1.96 2 0.80 1900 2,475 29.47 1,819 21.66 326 132 132 .. 64 7 25 23 .. 9 .. 4 1.57 122 1.45 64 0.76 185 2.20 0 •• 1901 2.453 29.26 1,411 16.83 304 124 82 .. 7 1 17 41 .. 8 1 7 096 18 0.21 74 0.88 152 1.81 4 1.63 1902 2,378 28. 20 1,796 21.30 311 131 181 16 53 15 48 36 .. 9 1 3 214 45 0.53 92 1.09 153 1.81 2 073 Corrected Average. 2,516 29.68 1,690 19.93 339 135 178 2 64 12 37 48 .. 8 1 6 2 13 51 0.59 65 0.76 153 1.80 2 0. 79 1903 2.264 26.70 1 383 16.31 329 145 170 .. 35 9 20 88 .. 7 1 10 2 00 30 0.35 90 106 108 1.27 3 1.32 Departure from Average. — 252 —298 —307 —3 62 —10 + 10 —8 —2 —29 —3 —17 + 0 .. —1 .. + 4 —013 —21 —024 + 25 +0 30 —45 —053 +1 + 0.53 I am, Gentlemen, Your obedient servant, Medical Officer of Health.